CHEST CLINICAL COPD & ASTHMA IMMERSION PROGRAM - AUGUST 14, 2024-Maselli - Asthma Definition, Epidemiology, Risk Factors, and Pathophysiology

Maselli - Asthma Definition, Epidemiology, Risk Factors, and Pathophysiology

Pdf Summary

The provided document outlines a comprehensive curriculum on asthma, focusing on its definition, epidemiology, risk factors, and pathophysiology. Authored by Dr. Diego J. Maselli, it is designed for internal use by the CHEST pulmonology faculty and should not be duplicated or distributed for external promotional purposes.<br /><br />Asthma is characterized as a heterogeneous disease with chronic airway inflammation, having symptoms like wheezing, cough, chest tightness, and shortness of breath that vary in intensity over time, leading to variable airflow limitation. The disease can range from mild to severe, and control levels also vary among individuals.<br /><br />Asthma's epidemiology reveals it as a prevalent chronic respiratory condition in the United States. Various biomarkers are critical in managing the disease, including blood eosinophils and FeNO levels. These biomarkers help in determining the endotype of asthma, predicting exacerbation risks, and tailoring personalized treatment strategies.<br /><br />Risk factors for asthma include genetic predispositions, early-life exposure to allergens (e.g., cockroach, house dust mites, molds), air pollution, diet, obesity, and psychosocial stressors. Factors such as microbial diversity through vaginal birth and breastfeeding are protective, while antibiotic use and respiratory infections like RSV and RV promote asthma development.<br /><br />Understanding asthma's pathophysiology involves complex gene-environment interactions and type 2 inflammation mechanisms, which include cytokines like IL-4, IL-5, and IL-13 and chemokines that drive inflammatory processes. Endotypes, based on specific biological mechanisms, and phenotypes, based on observable traits, provide a pathway to precise and personalized therapy.<br /><br />Control of asthma is determined by the frequency of daytime symptoms, night waking due to asthma, SABA use, and activity limitations. Nonadherence to therapy, exposure to triggers, comorbidities, and improper inhaler techniques are common causes of uncontrolled asthma.<br /><br />The curriculum emphasizes the necessity of personalized medicine and the role of biomarkers in refining treatment approaches, ultimately aiming to improve patient outcomes in asthma management.

Keywords

asthma

epidemiology

risk factors

pathophysiology

biomarkers

personalized treatment

chronic airway inflammation

gene-environment interactions

type 2 inflammation

asthma control