Asthmas

Asthmas is a chronic inflammatory disease of the airways that causes recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, particularly at night or in the early morning. The airway obstruction is variable and usually reversible with bronchodilators or anti-inflammatory treatment. The underlying inflammation involves immune cells such as eosinophils and T-helper 2 cells, leading to airway hyperresponsiveness and, over time, possible structural changes in the airways. Triggers include allergens (dust mites, pollen, animal dander), irritants (tobacco smoke, air pollution), exercise, cold air, infections, and weather changes.

Diagnosis relies on clinical history and lung function testing. A key objective finding is reversible airway obstruction shown by spirometry, with an increase in FEV1 of at least 12% and 200 mL after bronchodilator use. When baseline tests are normal, bronchoprovocation testing can assess airway hyperresponsiveness. Peak expiratory flow monitoring and symptom tracking help assess control over time.

Asthma is commonly classified by level of control and by severity: intermittent, mild persistent, moderate persistent, and severe persistent. Exacerbations can occur and may require urgent care.

Management aims to reduce symptoms, prevent exacerbations, and maintain normal activity. Core treatment is long-term control with inhaled corticosteroids, with options including leukotriene receptor antagonists or alternative controllers as needed. Inhaled corticosteroids combined with a long-acting beta-agonist are used for some patients. Short-acting beta-agonists provide quick relief. For severe allergic or eosinophilic asthma, biologic therapies such as omalizumab, mepolizumab, or benralizumab may be considered. Regular follow-up, correct inhaler technique, trigger avoidance, vaccinations, and management of comorbidities are important. With appropriate therapy, many individuals achieve good control; however, poor control increases the risk of severe attacks and hospitalizations.