Bronchial asthma (from Greek, “breath” and often simplistic just asthma), and is a chronic, inflammatory disease of the airways with lasting history of hypersensitivity. In vulnerable individuals, the inflammation leads to paroxysmal dyspnea caused by a narrowing of the airways – a so-called bronchial obstruction (definition of the international consensus report). This airway narrowing is caused by increased secretion of mucus, spasm of the bronchial and formation of edema of the bronchial mucosa, it is reversible by treatment regress) (. A variety of stimuli cause the increase of the sensitivity of the airways (bronchial hyperreactivity or hyperresponsiveness) and the associated inflammation. Five percent of adults and seven to ten percent of children suffering from bronchial asthma.
Asthma is a 16th-century since the German detectable borrowing from Greek, asthma, which in turn, even morphologically obscure Indo-European from a root word hma with the meaning “breathe” seems to be derived.
causes (etiology) of various shapes
They do not distinguish the allergic (extrinsic) asthma from allergic (intrinsic) asthma. In its pure form, but these occur only in about ten percent of the patients in the majority of hybrids are observed. While more common in children allergic asthma occurs between the ages piled on non-allergic form. Cigarette smoke in the parental home favors asthma. There is also evidence that cultural and civilizational factors, such as certain drugs also promote applications in early childhood asthma.
Exogenous allergic asthma is triggered when the appropriate genetic predisposition to atopy by external stimuli (allergenic substances in the environment, called allergens). These immunoglobulins are formed of type E (IgE), the effect will interact with specific allergens, the allergy-causing secretion of neurotransmitters such as histamine, leukotrienes and bradykinin from mast cells. These substances will then trigger the airway constriction. In addition to this immediate response of type I after inhalation of the allergen can occur after 6 to 12 hours for a delayed reaction, which is triggered by the type of immunoglobulin G (IgG). Often, both reactions occur.
For a polygenic inheritance system speaks the observation that children of parents who both suffer from allergic asthma, a disease risk of 60-80%. On the island of Tristan da Cunha half the population suffers from asthma due to family inheritance. Hay fever (), seasonal allergic rhinitis, which like asthma is an inflammatory condition due to allergy to the mucosa of the nasopharyngeal area is, can the lower respiratory tract and then spread to asthma (run “Exchange Floor”). Almost one quarter of these patients developed this after more than 10 years, a pollen asthma. In addition, at the beginning usually a specific allergen at the center, over the years, however, it is often used to extend the range trigger so that the allergen avoidance for patients and more difficult or even impossible.
There are indications that rural life to protect unborn children against asthma: children of women who had contact with animals during pregnancy, grain and hay to get in later life, rare allergic respiratory and skin diseases. For some protection against these complaints is an ongoing contact with livestock or grain needed.
The endogenous non-allergic asthma, however, can be caused by other stimuli, infections, mostly respiratory intolerances, medications – so-called analgesics-asthma (a pseudo-reaction to pain medication, mostly nonsteroidal anti-inflammatory drugs such as aspirin), exposure to poisonous (toxic) or irritating substances (solvents, plasticizers, cold air, food additives, and others), special physical effort and the reflux disease (reflux) are possible causes of stomach acid that form. Some links and other causes have not yet been clarified.
According to a study room sprays and cleaning products for spraying the risk of respiratory symptoms and asthma can increase significantly.
For disease development (pathogenesis) three pathophysiologic processes are characteristic:
inflammation of the bronchi
Allergens or other stimuli trigger an inflammatory response of the bronchial mucosa. This has a central role in asthma. In addition to mast cells and their distributed messenger substances (inflammatory mediators, see above) play eosinophils and T lymphocytes have an important role.
For most asthmatics can demonstrate nonspecific bronchial hyperreactivity (general respiratory hypersensitivity to stimuli). The hyper-reactivity can often be objectified by the inhalation of irritating substances, such as ) when Methacholintest, histamine test or stress, such as Rennie (through the effort and the cooling of the bronchial tubes in the race, especially in children, or by cold provocation.
Lack of bronchial Cleaning (clearance)
The obstruction is the relocation of the lumen of the airways (reducing the available cross-section) as a result (of mucosal edema fluid in the mucous membrane), or impaired by increased mucus secretion (Hyperkrinie or Dyskrinie) and bronchospasm (constriction of the smooth muscle of the bronchi) . This is the self of the lung to a halt: The secretions can not drain and strengthens his injury to full relocation.