Comparative Pathophysiology of Chronic and Acute Asthma

Pathophysiology of Asthma

Asthma is a common respiratory disease believed to be influenced or determined by genetic and environmental factors, such as allergens and respiratory viruses (Chung & Adcock, 2001). Asthma can be acute, chronic or fatal. It is acute when it is severe and sudden (Hadjlladis, 2014), chronic when it develops for a long period of time, and fatal, when it leads to death. An acute first asthmatic attack can lead to chronic asthma if it is not treated (Hadjilladis).

Mechanisms

During an attack, changes occur in the airways, consisting in chronic inflammation and altered matrix proteins, which account for the narrowing of the airway and increased responsiveness of the bronchial tubes (Chung & Adcock, 2001). Many inflammatory mediators, like histamine and cysteinyl-lekotrienes, are released by inflammatory mediators. These trigger the tightening of the brochial tubes, production of mucus and plasma exudation and brochial hyp0er-responsiveness. T-helper 2-derived cytokines like interleukin-4 become overactive. These responses are not yet fully understood but are considered connected to the development of an allergen-specific immunological memory that deviates from the T-helper 2 (Chung & Adcock).

The Genetic Factor

Genetic factors are believed to assert strong influence over the development or triggering of an allergy (Barnes, 2003). Moreover, several genes linked to asthma. Most of these are, however, associated with all allergic diseases. On the other hand, environmental factors are considered by some experts of greater importance in inclining a person to develop asthma. But more experts view genetic factors as more influential in influencing the severity of the disease and the strength of the inflammatory response (Barnes).

Both acute and chronic inflammatory responses create many and different effects on the big cells of the respiratory tract (Barnes, 2003; Chung & Adcock, 2001). These produce the typical pathophysiological changes seen in asthma. Scientific advances have drawn experts closer to a better understanding of these changes but how they produce clinical symptoms remains unclear. Interest is mostly focused on the structural changes that occur in the airways of asthmatics, which are referred to as "remodeling." Most experts assume that these changes explain the irreversible changes in airway function experienced by some asthmatics. But because many of them go through life with normal life function, the opinion on the greater influence of genetic factors in determining these structural airway changes remains stronger (Barnes).

2. Diagnoses and Treatments