Allergies and Asthma

Asthma is a condition in which the airways are narrowed due to a hyper-reaction occurring within the body to certain stimuli. This produces inflammation and can result in a narrowing of the airways which is often reversible.

What happens during an Asthma Attack?

In a person with asthma, the airways narrow in response to stimuli that usually does not affect the airways in normal lungs. This narrowing is triggered by many stimuli which can include pollens, dust mites, animal dander, smoke, cold air and exercise. During an asthma attack the smooth muscles of the bronchi go into spasm. The tissues lining the airways swell due to inflammation and secrete mucus into the airways. These processes cause a narrowing in the diameter of the airways called bronchoconstriction.  It is this narrowing of the airways that requires the person to exert more effort to move air in and out of the lungs.

Mast cells which are found in the airway are thought to be responsible for initiating the airway and causing it to narrow in diameter. These cells which exist throughout the bronchi release substances such as histamine and leukotrienes.

Histamine and Leukotriene Secretions can result in:

• The contraction of smooth muscles contract
• Increased mucus secretions
• Instructing white blood cells to migrate to the area.

What triggers mast cells to release these substances is a response to something they recognize as foreign. The foreign particle or trigger is known as an allergen. Allergens are things such as pollen, house dust mites or animal dander to which certain people are allergic.

Can one display Asthma symptoms when not diagnosed with Asthma?

Asthma is however also common in people without defined allergies. When someone with asthma exercises or breathes cold air, a similar reaction occurs.

Stress and anxiety can also trigger mast cells to release histamine and leukotrienes. Eosinophills, another type of cell found in the airways of people with asthma, release additional substances including leukotrienes and other materials contributing to airway narrowing.

What triggers an Asthma Attack?

Determining what triggers a person’s asthma attack is often difficult.  Allergy skin testing can help identify allergens that may trigger asthma symptoms. An allergic response to a skin test however does not necessarily mean that the allergen being tested is causing the asthma. The affected individual will still has to note whether attacks occur after exposure to the identified allergen. If a specific allergen is suspected, a blood test that measures the level of antibody produced in response to the allergen can be performed to determine the degree of sensitivity.

The progression of an Asthma Attack

Asthma attacks vary in frequency and severity. Some people with asthma are symptom-free for the majority of time. There may be an occasional, brief, mild episode of shortness of breath.

Others may cough and wheeze most of the time and have severe attacks after viral infections, exercise, or exposure to allergens or irritants. Symptoms may also be brought on by crying or hearty laughter.

An asthma attack may begin suddenly with wheezing, coughing and shortness of breath. Wheezing is more prominent when a person breathes out or exhales. Sometimes an attack may come on slowly with gradually worsening symptoms. An attack may be over in minutes or last for hours or days.

In very severe asthma attacks, a person will be able to say only a few words without stopping for breath. Wheezing may diminish because hardly any air is moving in and out of the lungs. Confusion, lethargy and blue skin color (cyanosis) are signs that a person’s oxygen supply is limited and as a result it is vitally important that emergency treatment be administered.

Treatment for and Asthma Attack

Epinephrine is the first-line therapy used in the treatment of an allergic reaction. When used during an allergic reaction, epinephrine reverses the symptoms of the body’s reaction to the allergen. It does this:

• Constricting blood vessels thereby increasing blood pressure.
• It relaxes smooth muscles in the lungs to help reduce wheezing to improve breathing.
• It stimulates the heart (increasing heart rate), and works to reduce hives as well as swelling that may occur around the face and lips. An epinephrine injection is therefore used in an allergic emergency.

Signs of an allergic emergency may include:

• Closing of your breathing airways making it very difficult for you to inhale
• A wheezing sound on exhalation
• Constant and non-stop sneezing
• Hoarseness and a loss of voice
• Red bumps on skin or red patches
• Itching may be localized or all over the body
• Swelling of the lips and even tongue
• Numbness or tingling of the lips or tongue
• A rapid or erratic heartbeat. In some cases a feeble or light pulse may be experienced.
• Anxiety or panic
• Disorientation
• Pain in the stomach
• Involuntary urine or bowel movements (incontinence)
• A feeling of faintness or "passing out" (unconsciousness)
  
  

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