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Allergic Asthma Information
Allergic Asthma affects 60% of asthma
sufferers. Below, Henry Milgrom, MD, FAAAAI, explains allergic asthma
and its treatments. Dr. Milgrom is a Professor of Pediatrics at the
National Jewish Medical and Research Center in Denver, and is Chair of
the Health Care Quality and Delivery Interest Section of the American
Academy of Allergy, Asthma and Immunology.
Understanding Allergic Asthma
By Henry Milgrom, MD, FAAAAI
Q. What is allergic asthma?
A. Allergic asthma is a chronic inflammatory disorder of the airways.
Its symptoms are made worse by exposure to an allergen (e.g., dust,
mold, pollen, animal dander) to which the patient has been sensitized.
Q. What are the symptoms of allergic asthma?
A. The symptoms of allergic and non-allergic asthma are the same. They
include coughing, wheezing, shortness of breath or rapid breathing, and
chest tightness. These symptoms are often provoked by an identifiable
trigger.
Q. What factors can cause or trigger allergic asthma?
A. A family history of allergies is the most important predictor of
whether a person will develop asthma. Environmental substances
(allergens) can trigger an exacerbation – or attack – in patients with
allergic asthma. The allergens include tree, grass, and weed pollen,
plus molds, animal dander, dust mites and cockroach droppings. Asthma
attacks can also be triggered by viral infections, exercise, cold air
and non-specific irritants.
Q. How many people suffer from allergic asthma?
A. Allergic asthma is the most common form of asthma. According to the
National Institute of Environmental Health Sciences, of the 20 million
asthma sufferers in the United States, 10 million have allergic asthma.
Three million are children and 7 million are adults.
Q. What is the relationship between allergies and allergic asthma?
A. Most people with asthma also suffer from other allergic disorders. In
fact, research from the World
Health Organization (WHO) shows that at least 70% of asthmatics
also suffer from allergic
rhinitis or “hay fever.” Nasal allergies and allergic asthma are both
triggered by exposure to
allergens, initiating a series of events that result in tightening of
the airways, swelling of the lining of
the airways, nose and eyes, and mucus production.
Q. What is IgE and why is it important in allergic asthma?
A. IgE (Immunoglobulin E) is an antibody in the human immune system that
plays a critical role in the allergic process. When an individual is
sensitized to an allergen, he or she produces an IgE antibody directed
against that allergen. The IgE antibody attaches to mast cells. When the
individual is exposed to that same allergen again, the allergen binds to
the IgE on the mast cell causing it to release substances such as
histamine, prostaglandins and leukotrienes, which cause symptoms such as
chest tightness, coughing and wheezing.
Q. What treatments are available for people suffering from allergic
asthma?
A. It is important for people with asthma to seek treatment. First,
patients are evaluated to identify their
specific allergic triggers and a program of allergen avoidance is
recommended. Asthma is treated
with medications including anti-inflammatory agents, such as
corticosteroids and anti-leukotrienes
that decrease inflammation in the lungs, and bronchodilators used for
relief of symptoms. Allergen immunotherapy, also known as allergy shots,
is a program of injections that reduces allergic sensitization.
A new anti-IgE drug was recently approved by the Food and Drug Administration
(FDA). It concentrates on short-circuiting the allergic
reaction in the body before it even begins. Anti-IgE therapy stops the
allergic reaction before it starts, allowing the patient to avoid
allergy symptoms that often trigger an asthma attack or lead to the
development of asthma attacks.
Researchers are looking for targets for new forms of treatment. Future
therapies may focus on cytokines, substances that maintain the chronic
inflammation responsible for asthma. Other research may also lead to the
development of new anti-inflammatory drugs, which may retain the
anti-inflammatory effects of corticosteroids but cause fewer systemic
side effects.
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