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Asthma is a chronic inflammatory disorder of the airways that
causes recurrent episodes of wheezing, breathlessness, chest
tightness and coughing 1. It is usually mediated by immunoglobulin E
(IgE) and triggered by allergens. IgE is formed in response to
exposure to allergens such as pollen or animal dander 1.
Sensitisation occurs at first exposure, which produces allergen-
specific IgE antibodies that attach to the surface of mast cells. Upon
subsequent exposure, the allergen binds to the allergen-specific IgE
antibodies present on the surface of mast cells, causing the release
of inflammatory mediators such as leukotrienes, histamine and
prostaglandins. These inflammatory mediators cause bronchospasm,
triggering an asthma attack 1. Chronic inflammation causes an
increase in airway hyperresponsiveness that leads to recurrent
episodes of wheezing, breathlessness, chest tightness and coughing,
particularly at night or in the early morning 1.
There is no single cause for asthma, and a range of environmental
and genetic factors are known to influence its development. These
include premature birth and low birth weight and exposure to
tobacco smoke (especially if the mother smokes in pregnancy) 1. It is
more common in prepubertal boys, but girls are more likely to
remain asthmatic in adolescence 1. A diagnosis of asthma in both
children and adults is based on assessment of symptoms. The
classic signs of asthma are wheezing (especially expiratory
wheezing), breathlessness, coughing (typically in the early morning
or at night time) and chest tightness 1. Children and adults with a
high probability of asthma on assessment usually start a treatment
trial with a corticosteroid such as beclometasone. Children and
adults with an intermediate probability of asthma are assessed with
lung function tests such as spirometry, peak flow and airway
responsiveness to confirm the diagnosis 1.
1
: The Pharmaceutical Journal
Source(s)
1. Asthma: pathophysiology, causes and diagnosis - The Pharmaceutical Journal
2. Pathophysiology of asthma - Wikipedia
3. Asthma - Symptoms and causes - Mayo Clinic