Asthma News and Treatment

/ February 26th, 2011/ Posted in Asthma / No Comments »

The Wheezing Game: What Really Triggers Asthma?

According to the Mayo Clinic, asthma is a condition where the airways (the tubes that bring air into-and-out of) the lungs are obstructed. During an attack, the airways narrow and swell, producing extra mucus, and exhaling becomes difficult. The most common signs of asthma include coughing, wheezing, chest tightness and shortness of breath. Asthma attacks vary. For some, they may be constant while others may have an attack only once a year. Asthma symptoms can be triggered by different variables including stress, dust, pet hair, dander, changes in weather, mold, pollen, exercise and even aspirin.

TREATMENT: Asthma can’t be cured but symptoms can be controlled and improve overtime. The ultimate goal of treatment is avoiding asthma triggers and monitoring symptoms. Doctors may take a series of blood tests, chest x-rays and lung function tests to first diagnose asthma and then determine the most appropriate treatment. Two medicines are prescribed for the treatment of asthma – medicine to prevent attacks and medicine to provide quick relief during an attack. (SOURCE: National Asthma Education and Prevention Program)

MANAGEMENT: With proper self-management and medical treatment, most people diagnosed with asthma can live normal lives. Those who have infrequent attacks may use quick relief medication as needed. Those with frequent episodes need to take medications on a regular basis to prevent symptoms. Complications from asthma can be severe: at the extreme level it can lead to death, severe chest pain, and changes in lung functionality. Persistent cough and drowsiness is also possible. (SOURCE: National Heart, Lung, and Blood Institute)

PREVENTATIVE TIPS: Keeping yourself far, far away from a flare-up is a key tenet of living with asthma. Just how to go about doing that isn’t always easy. The tips below should help.

– Avoiding triggers and substances that irritate the airways are possible.

– Cover bedding with “allergy proof” casings to reduce exposure to dust mites.

– Remove carpets from bedrooms and vacuum regularly around the house.

– Use unscented detergents and cleaning materials.

– Avoid smoking and/or homes/areas where tobacco use is common

Steroids to treat asthmatic children

A new University of Montreal study is evaluating the impact of steroid use on the immune system of kids.

The study has suggested that kids experiencing an asthma attack who are treated with a short burst of oral steroids may have a transient depression of immune response.

These findings have implications for asthmatic children who have flare-ups and who may be exposed to new contagious diseases.

“There is no question that the administration of corticosteroids reduces the risk and duration of hospital admission in children with acute asthma remain the most effective treatment for moderate and severe asthma exacerbations,” said first author Francine M. Ducharme of the University of Montreal.

“However, the safety profile of these medications continues to raise concerns among parents and physicians. New concerns over their possible impact on the immune system stem from rare reports linking or severe chickenpox infections linked with corticosteroid administration,” said Ducharme.

Ducharme and colleagues evaluated the immune response of children aged 3 to 17 years, who had arrived at the emergency department (ED) with an asthma attack.

“Several corticosteroid-treated children had a significantly lower immune response, as measured by the amount of antibody produced, than non-treated kids,” said Ducharme.

Children enrolled in the study were revaccinated with the antigen five weeks following their initial ED visit. Comparable immune responses were measured in children exposed to oral corticosteroids and not exposed to corticosteroids.

“These findings indicate there is a transient, not sustained, immune suppression in some children exposed to a new antigen at the same time as a corticosteroid administration.

In summary, our finding suggest a transient immune suppression occurs in some children who are concomitantly exposed to a new antigen and corticosteroids during an asthma attack, with a recovery within six weeks,” said Ducharme.

“Given the high frequency of use of these drugs over the past 20 years, the very rare occurrence of severe infectious disease is reassuring and would suggest that the window of risk is very small and only applies to exposure to a new antigen. However, before prescribing oral corticosteroids, it would appear prudent to systematically enquire about recent exposure to chickenpox in children who did not have chickenpox or the vaccine,” added Ducharme.

Mild asthma might not need to be treated daily

Mild asthma might not need to be treated every day, say US researchers.

A “preventer” inhaler containing corticosteroid is part of many asthma sufferers’ daily routine, but it can result in reduced growth and children often forget to take it.

This study, published in The Lancet, shows that it is possible to manage the symptoms without a daily dose.

Asthma UK said daily treatment was still the most effective, and concerned patients should speak to their doctor.

The disease causes inflammation of the tubes which carry air to and from the lungs. If they become irritated, then the airways narrow, sticky mucus is produced and breathing becomes difficult.

More than 5 million people in the UK are being treated for the illness and Asthma UK estimates 1.1 million have asthma which is mild and under control.
Missing doses

Researchers at the University of Arizona believe there is a problem with the way the disease is managed.

Two types of inhalers are used: “relievers” which are used when breathing is difficult and “preventers” which are taken every morning and evening.

However, the researchers said that many children stop taking the daily medication if their symptoms disappear.
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Professor Fernando Martinez, from the University of Arizona, told the BBC: “If you have a daily drug and a very significant number are not taking it, then that tells you it’s a losing strategy.”

“We want to find something which is more child- and parent-friendly as well as avoid the growth effect.”

In all, 288 children and teenagers with mild and persistent asthma took part in the 44-week trial.

The study showed that taking corticosteroids twice a day was still the most effective treatment, However, those taking the medication grew by 1.1cm (0.5in) less than children not taking the drug during the trial.
Potent combination

Importantly, asthma was also managed without daily treatment if the corticosteroids were combined with the “reliever” inhaler.

This eliminated the effect on growth and the researchers say it would be an easier form of treatment for children.

Further clinical trials will be needed to verify the results.

Professor Martinez said: “I’m continuing to recommend daily corticosteroid to my patients, but I know some of them will not take it.”

Asthma UK said the study confirmed that daily inhaled corticosteroids were the most effective treatment.

Dr Samantha Walker, executive director of research and policy at Asthma UK, said: “We know that long-term adherence to medicine treatment plans can be difficult, particularly when a child’s asthma seems to be under control.

“The use of combined ‘preventer’ and ‘reliever’ medicines as rescue therapy appears to be superior to ‘reliever’ inhalers alone and offers a new ‘step-down’ approach to the management of mild, well-controlled asthma in children and young people who find it difficult to adhere to long-term daily treatment with inhaled steroids.

“Many parents have concerns about their child’s steroid intake. However, research shows that children on low daily doses of ‘preventer’ medicines show no difference in growth. At higher doses, the picture is less clear. For all children, treatment plans should be reviewed at least every six months.

“If you have any concerns about your asthma treatment, Asthma UK recommends you speak to your doctor or asthma nurse.”

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