Causes, symptoms, research… Where are we on asthma today?

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Asthma is a particularly common multifactorial respiratory disease. The world day dedicated to it on May 2 is an opportunity to discuss the latest advances in research around this disease.

Asthma: what we know about this respiratory disease

A chronic pathology affecting all ages, asthma affects approximately 4 million French people and causes more than 60,000 hospitalizations each year. It has therefore become a real public health issue.

Asthma, a disease of the bronchi which is expressed in the form of attacks

Defined by the inflammation or permanent irritation of the bronchial tubes, asthma appears in the form of attacks that can last from a few minutes to several hours . These are due to the thickening of the bronchial mucosa, due to its irritation. The bronchi then become particularly sensitive and likely to react in the presence of predisposing factors. During an asthma attack, the passage of air in the bronchi thus becomes more difficult, and all the more so as the muscles around them contract and the bronchial mucosa secretes more mucus.

Asthma attacks are characterized by difficulty breathing most often in the form of shortness of breath, but also by wheezing, a dry cough or a feeling of tightness in the chest. When an attack occurs, it is because the asthma is not sufficiently controlled: the treatment must then be modified or readjusted.

What are the causes of asthma?

Several factors can explain asthma, in particular a genetic predisposition (family history or allergic ground). Associated, environmental factors are also involved:

To a lesser extent, cold air is also likely to trigger an asthma attack, as well as a strong emotion . Finally, certain anti-inflammatory drugs may be involved.

The work environment is also important: so-called “occupational” asthma represents 10% of cases in France. Bakers and pastry chefs exposed to flour, health trades, hairdressers, painters and cleaning workers exposed to certain products, as well as woodworking trades are particularly at risk.

Finally, certain medical histories occurring from birth and during early childhood can also promote asthma: The occurrence of allergic rhinitis during childhood, which triples the risk of becoming asthmatic.

Asthma: what treatments?

To treat your asthma, and therefore control it, two forms of treatment are necessary:

Basic treatments that reduce or even eliminate the symptoms. This treatment varies from patient to patient, depending on the severity of the disease. The main family of drugs prescribed? Corticosteroids. It is possible to combine them with long-acting bronchodilators or antileukotrienes. In the most severe cases of allergic asthma, biomedicines may be prescribed.

Crisis treatments , which are intended to quickly relieve symptoms if they appear, by immediately dilating the bronchi. Inhaler (which must always be at hand), inhaled corticosteroids and long-acting bronchodilator are the main components.

Specificity of asthma of mild to moderate allergic origin: it is possible to have you desensitized to the allergenic agent responsible for your asthma (provided you have clearly identified the agent concerned beforehand). Especially if it is an allergy to pollens, dust mites, certain animals or molds. The main form of desensitization consists of subcutaneous injections over several weeks. Other more recent treatment? A liquid allergenic extract to be kept under the tongue for 2 minutes before swallowing.

Asthma: where is the research?

About 5% of asthmatics suffer from severe forms that are difficult to control. This is one of the major research challenges today: to better understand these forms, in order to find new management approaches, in particular through targeted treatments. And the work is already well underway, with promising results.

One of the avenues explored by researchers is immunotherapy . The latter consists of administering substances to stimulate the body’s immune defenses that are lacking in the event of a declared pathology. In the case of asthma, in particular allergic, this immunotherapy would more or less take the form of desensitization. On this same theme, the development of a vaccine against allergic asthma is already well advanced, since the scientific teams dedicated to it are about to launch clinical trials.

Another promising treatment in development: thermoplasty , which consists of burning the smooth muscles of the bronchi by radiofrequency, in several sessions and several weeks apart.

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