Asthma

Question 1

Phentype

Answer 1

Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, resulting in symptoms such as wheezing, coughing, shortness of breath, and chest tightness. The severity and frequency of these symptoms can vary among individuals with asthma. The phenotypes, or subtypes, of asthma refer to different patterns of clinical and biological characteristics that can help classify and understand the disease. Here are some commonly recognized phenotypes of asthma:

1. Allergic asthma: This phenotype is associated with an immune response triggered by exposure to allergens such as dust mites, pollen, animal dander, or certain foods. Individuals with allergic asthma often have elevated levels of allergy-related antibodies (IgE) and may experience symptoms when exposed to specific allergens.
2. Non-allergic asthma: In contrast to allergic asthma, non-allergic asthma is not triggered by allergens. It may result from factors such as respiratory infections, exercise, cold air, stress, or exposure to irritants like smoke or strong odors.
3. Exercise-induced bronchoconstriction (EIB): Some individuals experience asthma symptoms primarily during or after exercise. Physical activity can cause the airways to narrow, leading to coughing, wheezing, and shortness of breath. EIB can occur in both allergic and non-allergic asthmatics.
4. Occupational asthma: This phenotype is characterized by asthma symptoms that are specifically triggered by exposure to substances present in the workplace. These substances may include chemicals, dust, fumes, or other occupational allergens.
5. Late-onset asthma: While asthma often begins in childhood, some individuals develop asthma symptoms later in life, typically after the age of 40. Late-onset asthma may have different underlying mechanisms and is often associated with more severe symptoms and poorer outcomes.
6. Severe asthma: Severe asthma refers to a subset of individuals with asthma who experience persistent symptoms despite high-intensity treatment. It is characterized by frequent asthma exacerbations, increased airway inflammation, and reduced lung function. Severe asthma requires specialized management and may involve the use of biologic therapies.

It’s important to note that these phenotypes are not mutually exclusive, and an individual with asthma may exhibit characteristics of more than one phenotype. Asthma is a complex condition, and further research is ongoing to better understand its underlying mechanisms and refine the classification of its phenotypes.

Question 2

Diagnosis of asthma

Answer 2

• Does the patient or his/her family have a history of asthma or other atopic condi-tions, such as eczema or allergic rhinitis?
• Does the patient have recurrent attacks of wheezing?
• Does the patient have a troublesome cough at night?
• Does the patient wheeze or cough after exercise?
• Does the patient experience wheezing, chest tightness, or cough after exposure to pollens, dust, feathered or furry animals, exercise, viral infection, or environmental smoke (cigarettes, burning incense “Bukhoor” or wood)?
• Does the patient experience worsening symptoms after taking aspirin/nonsteroidal anti-inflammatory medication or use of B-blockers?
• Does the patient’s colds “go to the chest” or take more than 10 days to clear up?
• Are symptoms improved by appropriate asthma treatment?
• Are there any features suggestive of occupational asthma?