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Asthma is a chronic respiratory disease characterized by blockages in the airways that cause difficulties breathing. It is relatively common, particularly in childhood. There are two main types of asthma, intrinsic and extrinsic. They each have different causes and physiological mechanisms. Intrinsic asthma is also referred to as non-atopic or non-allergic asthma because the condition is not caused by allergic reactions to environmental stimuli. Environmental stimuli ranging from smoke to air quality might trigger an asthma attack in persons with intrinsic asthma independently of the immune system (Ulrick, et al., 1995). Triggers of intrinsic asthma include anxiety or overexertion. Extrinsic asthma is by definition caused by allergic reactions to things like dust. As Ulrick, et al. (1995) note, "the pathogenic mechanisms underlying intrinsic and extrinsic asthma in children may differ," (p. 547). Sibbald & Turner-Warwick (1979) found that relatives of children suffering from extrinsic asthma are more likely to have relatives with other autoimmune responses like hay fever. Even the immunopathology of extrinsic and intrinsic asthma may be similar in that "there might be local IgE production directed against unknown antigens, possibly of viral origin or even autoantigens, in this important clinically distinct variant of the disease," (Humbert, et al., 2000,...
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In spite of the different mechanisms by which these two types of asthma work, symptomology remains the same with coughing, wheezing, and shortness of breath the defining features. These manifest symptoms are caused by the primary feature of both intrinsic and extrinsic asthma, which is an inflammatory response. In both intrinsic and extrinsic asthma, inflammation of the bronchi is caused by the different triggers: either intrinsic or extrinsic. Often the same trigger is implicated for both, such as cigarette smoke. There may be a genetic component to both intrinsic and extrinsic asthma (Sibbald & Turner-Warwick, 1979).
Both intrinsic and extrinsic asthma types can be treated with same types of medications like glucocorticoids. Medications may be orally administered or inhaled, and can even be used over the long-term as asthma is chronic and there is no cure. Reducing the triggers is an important part of the treatment regimen for both intrinsic and extrinsic asthma. However, the triggers of intrinsic asthma are less concrete and more difficult to manage. Relaxation exercises may be indicated for both types of asthma and can be particularly effective for sufferers of intrinsic asthma. Reducing exposure to environmental toxins is important for both types of asthma.
References
Humbert, et al. (2000). The immunopathology of extrinsic (atopic) and intrinsic (non-atopic) asthma. Immunology Today 20(11).
Sibbald, B. & Turner-Warwick, M. (1979). Factors influencing the prevalence of asthma among first degree relatives of extrinsic and intrinsic asthmatics. Thorax 34.
Ulrik, et al. (1995). Extrinsic and intrinsic asthma from childhood to adult age: a 10-yr follow-up. Respiratory Medicine 89(8).
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