Asthma inflammation is primarily due to eosinophil activity. The incidence of asthma in adults and the elderly is approximately equal.
Asthma develops in a person with a genetic predisposition to asthma who is exposed to an environmental trigger.
Asthma inflammation is associated with narrowing of the airway lumen and loss of airway epithelial lining cells.
The elderly may have a poor response to therapy because of persistent airway narrowing resulting from years of poorly controlled asthma.
Symptoms:
- cough, wheeze, breathlessness, chest tightness
Presentation pattern:
- nighttime symptoms
- seasonal worsening
Co-morbid conditions:
- rhinitis or eczema
- Sensitivity to non-specific irritants
Risk factors:
- Family history of asthma or atopic disease
Objective testing:
- Spirometry to confirm
Supplemental testing:
- Fraction of exhaled Nitric Oxide (FeNO) (>20 ppb)
- Sputum eosinophils (>2%)
Asthma Triggers:
- cold air
- exercise
- emotional stress
- viral respiratory infections
- allergens (indoor, outdoor)
- respiratory irritants: air pollution (ozone, sulphur dioxide)
- occupational chemicals
- drugs (ASA, NSAIDs), gastric reflux, rhinitis
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Resource Person: Lobna Adi