Asthma Pathophysiology

Pathophysiology is the study of what is abnormal, or what causes normal physiological processes to be disturbed.  Asthma is a chronic inflammatory problem of the lungs and bronchioles which is characterized by reversible bronchospasm that often result from an exaggerated response to a variety of stimuli.  This is the pathophysiological response which the lungs take when assaulted by an allergen.

What does all this mean?  Well in the first place it means that asthma is not all in the mind and that it cannot be outgrown.  It also means that it is a serious disease but is that you cannot catch it from someone else who has it.  The pathophysiological changes resulted inflammation and symptoms such as coughing, wheezing and shortness of breath.

There are actually two types of asthma-extrinsic and intrinsic.  An asthmatic who suffers from extrinsic asthma will have difficulty with allergic and immune responses.  These individuals are often classified as being atopic, meaning that they have difficulty with IgE responses.  Individuals who have asthmatic attacks from intrinsic factors means that they do not have an immune response but rather an allergic response to either aspirin or specific types of infections.

The more common of the two are those individuals who suffer from extrinsic asthma, or that which is immune mediated.  In these cases the lungs of the individual becomes inflamed and the bronchial tubes become hyper responsive to allergens.  The inflammation in the airway is an important part of the pathology and the underlying process which derives and maintains the inflammatory process.

The inflammation will activate the release of mast cells, eosinophils and macrophages in the airway.  These substances increase the amount of mucus secretion present in the airways.

Therefore an individual with asthma struggles with two individual responses in the bronchi and bronchioles which results in decreased air exchange in the lungs, coughing, wheezing and shortness of breath.  In the first instance the lungs become inflamed or swollen from the allergic response to an inhaled substance.  The inflammation alone is enough to cause difficulty breathing, wheezing and shortness of breath.

Combined with the inflammation is the increased mucus production caused by the body\’s response to the allergen inside the lungs.  This increased mucus production also causes shortness of breath and wheezing but it also induces coughing to clear the mucus.

This complex interaction between inflammatory cells, mediators and tissues in the airway cause injury to the epithelium and prolonged contraction of the smooth muscle.  The lungs continue to secrete mucus, swell and change the involuntary control of breathing.  These inflamed airways become more narrow and obstructed which causes hyper-responsiveness and results in narrowing when the stimulus is introduced.

Individuals who suffer from extrinsic asthma can be triggered by a viral respiratory infections, pollen or mold, tobacco smoke, cold air or even exercise.  Most individuals must determine their particular triggers in order to avoid them and thus prevent an asthmatic attack.

This airway obstruction can develop suddenly or gradually and will cause very real physical symptoms that can range from mild to life-threatening.  Although stress has been known to increase the severity of the symptoms, asthma is not a condition which is psychologically based.  But, like all other physical conditions, stress will increase the severity of the body\’s reaction to the disease.