Childhood Asthma: Developing New Therapies Essay

To better understand the impact of asthma, a brief overview of the causes (aetiology) and disease progression (pathophysiology) must be shown. As common as asthma is, not much is known about its aetiology, according to findings presented by Subbaroa, Mandhane and Sears (2009, pg. 181-187) in a review from the Canadian

Asthma is a chronic inflammatory disorder of the bronchial mucosa and hyperreactive bronchial tubes. Its etiology has been linked to both genetic and environmental factors. Several genes, including those that influence the production of proteins and cells involved in the immune response (such as interleukins, eosinophils, mast cells) have been linked with asthma. A decreased number of T-regulatory cells is also associated with asthma. Environmental factors linked with asthma include exposure to allergens, urban residence, and smoking (or exposure to secondary smoke). Recurrent respiratory tract viral infections may also contribute to the development of asthma. Decreased exposure to certain infectious organisms during early childhood, and the consequent underdevelopment of the immune response, can also lead to the development of asthma--this is known as the hygiene hypothesis (McCance & Huether, 2014, p. 1263-4).

Asthma is a respiratory disease that many people deal with every single day. “According to World Health Organization, approximately 180,000 people die from asthma each year.” (Jardins and Burton 187) Most people never think of asthma as a life threatening disease, but it can be crucial. As the number of people with asthma increases, the more likely you are to come in contact with someone who has been diagnosed with this disease. Asthma is a severe breathing problem that has many complications that is dealt with daily like shortness of breath, chronic cough, tightness of the chest and shortness of breath, my main focus is childhood asthma, allergic asthma, and medication to treat asthma.

Avoiding and controlling asthma triggers is important in every phase of the intervention process in order to manage the disease. However, many times because of lack of awareness and education, asthma

Chronic inflammation leads to structural changes, narrowing of the small airways, and destruction of lung tissue, which diminishes the ability of the airways to remain open during expiration

According to the National Heart, Lung, and Blood Institute, Asthma is a chronic lung disease that affects the airways, which is comprised of tubes that carry air in and out of the lungs. People who experience difficulties breathing have inflamed airways. The inflammation causes the tubes to swell and become sensitive, especially when inhaling strong substances. As a result, the airways tighten and the muscles around the tubes become swollen and narrower. In addition, cells in the airways might produce more mucus. This sticky and thick mucus makes it even more difficult for air to pass into the lungs.

The bronchi and bronchiole tubes are loosely wrapped with muscle. During regular breathing, the muscles around these airways are relaxed (5). This allows air to flow freely through these passageways to the alveoli. However, during an asthma attack, air has trouble reaching the alveoli, which prevents the body from receiving oxygen. This is because the airways become smaller. Firstly, the muscles around the airways spasm and contract. This then causes inflammation of the bronchioles and bronchi themselves, which causes a mucus to be produced.

In addition, asthma affects the smooth muscle walls and glands of the bronchioles, due to narrowing of the bronchial passageway, this results in a build-up of mucus in the bronchial tubes leading to difficulty breathing (Rizzo 2016, p.423). Airflow in the alveoli becomes limited due to inflammation causing bronchoconstriction, as the inflammatory process begins mast cells degranulate and release inflammatory mediators (Kaufman 2012, pp.589-590). ‘The inflammatory process results in vascular congestion, production of thick mucus, bronchial muscle spasm and thickening of the airway walls’ resulting in Jessica becoming short of breath and coughing (Kaufman 2012, pp.589-590). Typically, this reaction occurs 30 to 60 minutes after being exposed to the triggering allergen or irritant (Kaufman 2012, pp.589-590). Asthma can be triggered by a range of different factors including exercise, infection, exposure to allergens or airborne substances such as dust, fumes or pollen (Rizzo 2016, p.843). However, some asthma attacks may be worse than others, this is because a severe asthma attack can completely narrow and close the airway (Lew 2011, pp.43-45). This can result in oxygen not getting to vital organs such as the heart or brain and can result in

When the respiratory tissue damaged, the body’s inflammatory responses cause the lining of the airways to become swollen and thickened as a result of constant irritation that leads to an excessive mucus secretion in effort to protect the lungs from inhaled irritants such as cigarette smoking, air pollution, passive smoking, occupational dusts and chemicals (Currie 2009).

Known also as “Bronchial asthma”, asthma is a long term inflammatory illness. It is specific breathing problem which is caused due to decreasing the space of the airways. The respiratory system takes oxygen into the lung and discards carbon dioxide. The airways play an important role in breathing, when we breathe, the air passes in the body through nose or mouth, and goes down to the lungs. The airways conduct to the chest, where it diverge into two (bronchioles), and then every bronchiole divides into small tubes till they reach the nodes in the lungs. When these

Necrosis of the cells in the small, lower airways occurs, and mucous secretions are increased (Conquest, Cremonesini, & Neill, 2013). Because of the ciliary damage in the infants’ lungs, it is almost impossible for the secretions to be cleared. Bronchiolar level obstruction is caused by these mucosusal secretions, as is desquamation of the dead skin cells and edema (Conquest, Cremonesini, & Neill, 2013). Plugs of soughed, necrotic epithelium and fibrin in the airways will cause partial or total obstruction to airflow, making it very difficult for he infant to exhale which will consequently result in air becoming trapped and will reduce gaseous exchange (Conquest, Cremonesini, & Neill, 2013).

The pathophysiology of Asthma includes inflammation of the airway. The way in which this works is from an irritant which can include dust, pollen, cedar, or cat hair. When a reaction occurs, the airways become inflamed and narrow. The narrowing occurs because once the inflammatory response is triggered by an irritant, histamines, immunoglobulin E antibodies, and leukotrienes are released. Because of this, mucous production occurs. Since the bronchioles are inflamed and narrow, breathing becomes difficult. Wheezing sounds can be heard due to the lack of air being able to easily move in and out of the narrowed bronchioles.

Twenty percent of children living in the South Bronx have been diagnosed with Asthma. Bronx children (boys and girls) living in the vicinity of Melrose, Mott Haven, and Port Morris ages 5-12 years old have a higher percentage of hospitalization than children that reside within other inner-cities in the US. Children suffering from asthma encounter a recurrent cough, wheezing, shortness of breath and decrease response to their medication. These children often are unable to participate in physical activities, have increased absenteeism from school, are withdrawn and have decreased self- confidence. It is important that families are educated on the appropriate preventions and treatments for asthma in order to prevent mortality.

Childhood asthma impacts scores of youngsters and their families. In fact, the bulk of kids develop respiratory illness before the age of

Asthma is a chronic airway disease that can be difficult to manage, resulting in poor outcomes and high costs (Kuhn et al., 2015). It is characterized by episodes of expiratory airflow obstruction, which occurs in response to multiple stimuli or triggers. Asthma is a lifelong disease, and symptoms include wheezing, breathlessness, chest tightness, and coughing. Attacks can be mild, moderate, severe, or even life threatening and limit a person’s way of life (Centers for Disease Control and Prevention (CDC), 2011). There is no known cure for asthma, but symptoms can be controlled by avoiding the triggers and taking prescribed medicines that prevent or minimize symptoms.