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Respirology (Carlton, Vic.) Mar 2018Severe asthma is defined by the high treatment requirements to partly or fully control the clinical manifestations of disease. It remains a problem worldwide with a... (Review)
Review
Severe asthma is defined by the high treatment requirements to partly or fully control the clinical manifestations of disease. It remains a problem worldwide with a large burden for individuals and health services. The key to improving targeted treatments, reducing disease burden and improving patient outcomes is a better understanding of the pathophysiology and mechanisms of severe disease. The heterogeneity, complexity and difficulties in undertaking clinical studies in severe asthma remain challenges to achieving better understanding and better outcomes. In this review, we focus on the structural, mechanical and inflammatory abnormalities that are relevant in severe asthma.
Topics: Airway Remodeling; Asthma; Bronchoconstriction; Forced Expiratory Flow Rates; Humans; Severity of Illness Index
PubMed: 29316003
DOI: 10.1111/resp.13251 -
Journal of Engineering and Science in... Feb 2019Asthma is characterized by chronic airway inflammation, airway remodeling, and excessive constriction of the airway. Detailed investigation exploring inflammation and... (Review)
Review
Asthma is characterized by chronic airway inflammation, airway remodeling, and excessive constriction of the airway. Detailed investigation exploring inflammation and the role of immune cells has revealed a variety of possible mechanisms by which chronic inflammation drives asthma development. However, the underlying mechanisms of asthma pathogenesis still remain poorly understood. New evidence now suggests that mechanical stimuli that arise during bronchoconstriction may play a critical role in asthma development. In this article, we review the mechanical effect of bronchoconstriction and how these mechanical stresses contribute to airway remodeling independent of inflammation.
PubMed: 32328569
DOI: 10.1115/1.4042318 -
Frontiers in Medicine 2021Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5-15 min after physical activity. The pathophysiology of EIB is related to the... (Review)
Review
Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5-15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children.
PubMed: 35047536
DOI: 10.3389/fmed.2021.814976 -
Journal of Visualized Surgery 2017Asthma is an incurable chronic disease affecting approximately 24 million people in the United States. The hallmark features of asthma are reversible airflow... (Review)
Review
Asthma is an incurable chronic disease affecting approximately 24 million people in the United States. The hallmark features of asthma are reversible airflow obstruction, airway hyperresponsiveness, airway inflammation, bronchoconstriction, and excessive mucus secretion. Clinical symptoms include episodic or persistent breathlessness, wheezing, cough, or chest tightness/pressure. Forty-five percent of asthmatics continue to have yearly exacerbations and the disease is responsible for approximately 3,600 annual deaths. Pharmacologic advancements have continued to grow as the individual phenotypes of asthma are better delineated but there continues to be small population of asthmatics that are less responsive to pharmacologic therapy. Bronchial thermoplasty (BT) is an innovative procedure targeted primarily at decreasing airway smooth muscle (ASM) which is considered by some to be a vestigial organ. Decreasing the ASM bulk decreases hyperresponsiveness and bronchoconstriction leading to decreased exacerbations, decreased cost on the healthcare system, and improvement in patient quality of life.
PubMed: 29078687
DOI: 10.21037/jovs.2017.08.07 -
European Annals of Allergy and Clinical... Mar 2016Athletes often complain about breathing problems. This is a crucial issue due to potential implications not only on their general health, but also on their competing... (Review)
Review
Athletes often complain about breathing problems. This is a crucial issue due to potential implications not only on their general health, but also on their competing performance. Asthma and exercise-induced bronchoconstriction are prevalent conditions in elite athletes, which leads doctors to rely most of the times on asthma medication to treat athletes feeling "out of breath". However, there are several other conditions that may mimic asthma and cause dyspnea in athletes. Effective treatment of dyspnea requires appropriate identification and treatment of all disorders. Proper knowledge and accurate diagnosis of such entities is mandatory, since asthma medication is not effective in those conditions. Herein we review the most common differential diagnosis of dyspnea in athletes, and describe the diagnostic strategies in order to increase awareness and to improve doctor's confidence on dealing with these patients.
Topics: Anti-Asthmatic Agents; Asthma, Exercise-Induced; Athletic Performance; Bronchial Provocation Tests; Bronchoconstriction; Diagnosis, Differential; Dyspnea; Exercise Test; Humans; Lung; Predictive Value of Tests; Prognosis
PubMed: 26934737
DOI: No ID Found