Bronchial asthma is an allergic form. allergic asthma. Factors that provoke bronchial asthma

Bronchial asthma is a very common disease that occurs in about 6% of people. It is characterized chronic course with periodic exacerbations, during which there is a pronounced narrowing of the lumen of the bronchi and the corresponding clinical picture develops.

Allergic bronchial asthma is the most common form of this disease, which accounts for the vast majority clinical cases. Many children and adults are allergic to any substances that can cause the development of the disease. Especially dangerous is the fact that mild forms of asthma are often not detected in a timely manner and long time are out of the view of experts.

The severity of the disease

Depending on the severity of the symptoms, doctors distinguish 4 degrees of severity of the course of the disease, on the basis of which the treatment is planned.

Intermittent asthma (stage 1) - daytime attacks of the disease are extremely rare (no more than 1 time per week), and at night the disease bothers the patient no more than 2 times a month. Exacerbations pass very quickly and practically do not affect the physical activity of the patient.
Mild persistent asthma (stage 2) - the disease comes on more than once a week, but less than once a day, and nocturnal attacks occur at least 2 times a month. During an exacerbation, the patient may be disturbed by sleep, activity may be limited.
Persistent asthma moderate(stage 3) - the disease worsens almost daily, and night attacks occur more than once a week. At the same time, the patient's sleep and physical activity are severely disturbed.
Severe persistent asthma (Stage 4) - both daytime and nighttime asthma attacks are very common. The physical activity of a person is sharply reduced.

What happens in the body with allergic asthma?

The pathogenesis of bronchial asthma has not yet been fully studied. It has been established that many cells, structures and substances are involved in the development of a pathological response from the bronchi.

When an allergen enters the body, individual blood cells are activated, which release biologically active substances responsible for inflammatory reactions organism.
Muscle cells in the bronchial walls of asthma patients are initially predisposed to contraction, and their receptors are more sensitive to any effect of active substances.
As a result of all, a spasm of the smooth muscles of the bronchi occurs and the lumen of the respiratory tract is significantly reduced. The patient cannot breathe fully and develops shortness of breath, which in the severe case may lead to death.

All reactions are fast enough to sharp deterioration human health status. The patient may feel an approaching attack within a few minutes after contact with the allergen.

Reasons for the development of the disease

allergic asthma may develop for various reasons.

Burdened heredity - often in patients, close relatives also have any allergies or suffer from asthma. It has been proven that if one of the parents has asthma, then the probability of developing it in a child is about 20-30%. If the disease is diagnosed in both the father and the mother, then the child will encounter asthma with a 70% probability. It is important to understand that the disease itself is not inherited, and the child only gets a tendency to develop it.
Frequent infectious diseases respiratory tract can provoke hypersensitivity of the bronchial wall.
Unfavorable environmental conditions and occupational hazards.
Smoking, including passive smoking. This suggests that smoking parents significantly increase the likelihood of developing allergic bronchial asthma in your child.
Eating a large amount of preservatives, dyes and other additives with food.

Directly an asthma attack develops when the sensitive bronchi come into contact with an allergen, which may be different for each patient. The most common triggers for asthma attacks are:

plant pollen;
animal hair;
mold spores;
house dust;
food products - rare cause, which nevertheless cannot be overlooked;
substances with pungent odors (perfumes, household chemicals, etc.);
smoke, cold air also act as irritants.

Clinical manifestations of the disease

The symptoms of allergic asthma are not particularly specific and practically do not differ from the manifestation of asthma of non-allergic origin.

Difficulty breathing - the patient feels that it is difficult for him to inhale and exhale (and exhalation is given with great difficulty). Most often, shortness of breath occurs literally a few minutes after the patient has come into contact with the allergen and during physical activity.
Wheezing wheezing that occurs as a result of the passage of air through a severely narrowed airway. They can be so strong that they can be heard at a considerable distance from the patient.
The characteristic posture of a sick person during an asthma attack. Since it is not possible to satisfy all the needs of the body for air due to the respiratory muscles, the patient is forced to involve in the act of breathing additional groups muscles. To do this, he rests his hands on the windowsill, table, wall and any other convenient surface.
Paroxysmal cough that does not bring relief. There is such a variant of the course of the disease, in which the patient has only a cough. Often people do not pay attention to this symptom and think that the cough comes from another cause. It is important to know that the usual reflex cough disappears after a few minutes, because during this time everything mechanical stimuli manage to leave the airway.
Selection a small amount clear and viscous (glassy) sputum.
status asthmaticus - severe exacerbation a disease characterized by a prolonged attack of suffocation during which the patient does not respond to traditional treatment. If timely assistance is not provided, then against the background of a lack of oxygen, a person may gradually lose consciousness and fall into a coma. In the most severe case, a lethal outcome develops.

Because the we are talking about allergic asthma, then all of the above symptoms appear after the patient encounters an allergen. Depending on which allergen the patient develops an asthma attack in response to, there is a different frequency and duration of exacerbation. An example is an allergy to plant pollen: the patient can hardly avoid contact with the allergen, which at this time is everywhere. The result is a characteristic seasonality of exacerbations.

Diagnosis of allergic bronchial asthma

To begin with, the doctor interviews the patient in detail, records all his complaints and collects an anamnesis. If the patient is seen during an attack, the doctor may hear wheezing and notice shortness of breath. Later used specialized methods providing information about the respiratory system.

Spirometry is a method of examination during which a special device characterizes in numbers the main parameters of lung activity. Forced expiratory volume is very important for doctors, since it is the most difficult to exhale for a patient with asthma.
The study of sputum secreted during coughing. In patients with bronchial asthma, eosinophils, Cushman's spirals and Charcot-Leiden's spirals, particles specific to this disease, can be found there.
Since we are talking about allergic bronchial asthma, it is always necessary to find out which substance is the exacerbation provocateur. For this, a special allergic test- small scratches are applied to the skin, and then a small amount of a solution with the alleged allergen is dripped onto them. The body reacts to the allergen with reddening of the skin and the development of a small inflammation.

Treatment of the disease

Allergic asthma can be treated with the same substances that are used to prevent and eliminate other forms of pathology. Of course, the allergic nature of the disease leaves its mark on the process of therapy.

If the patient knows that he has an allergy, then it is very useful to take antihistamines in a timely manner, which today are presented in a large assortment in pharmacies. The substance blocks receptors, which are usually affected by histamine, and the effect of its release into the blood is not observed or is less pronounced. If it is clear that contact with the allergen cannot be avoided, then it is advisable to take the medicine in advance and reduce the likelihood of exacerbation.
There is also a technique according to which the allergen, under the supervision of a doctor, is introduced into the body in gradually increasing quantities. As a result, the susceptibility to this allergen is reduced, and it is less likely to provoke attacks of the disease.
Inhaled glucocorticoids and β2-adrenergic blockers long-acting- the most commonly used drugs basic therapy that allow you to control the disease for a long time.
Antibodies, which are an antagonist of immunoglobulin E, allow for a long time to eliminate hypersensitivity bronchi and prevent exacerbations.
Cromones are a group of drugs that are actively used in the treatment of children, since they do not give the desired result in adults.
Methylxanthines.
With an exacerbation of the disease, fast-acting adrenergic blockers, adrenaline, oral glucocorticoids are used.

Preference is always given to inhaled drugs, which, with the help of a special device, fall directly into Airways patient and provide their therapeutic effect almost instantly. This allows you to get rid of side effects that can develop when drugs are taken orally.

Patients with allergic asthma should understand that their priority is to prevent an exacerbation, that is, avoid contact with the allergen. It is enough to follow the following recommendations:

regularly carry out wet cleaning in the living room;
if you are allergic to wool - refuse to keep pets;
avoid using perfumes with strong odors;
change jobs to one where you do not have to inhale a lot of dust and other harmful substances.

Work immune system primarily aimed at protecting the human body from various kinds pathogens. But sometimes it fails, it begins to perceive even harmless factors. environment how . Then there is pathological condition– allergy.

Allergic asthma is one of the most serious illnesses associated with immune responses in the body. According to statistics, 6% of the world's population suffer from bronchial asthma, and 80% of all cases have an allergic genesis.

Manifestation of the disease, severity

Allergic (or atopic) bronchial asthma is a chronic disease of the upper respiratory tract that occurs due to the action of allergens, which, in turn, cause inflammation. The mechanism of development of this pathology is associated with the hyperreactivity of the organism in relation to any environmental agent. These agents, in fact, are called "allergens": they cause the production of immunoglobulins (antibodies), which leads to the release of histamine and other inflammatory mediators from mast cells.

Determination of the degree of the disease is based on symptoms, as well as the results of a study of respiratory function, namely, peak expiratory flow (PEF). To do this, conduct a study called peak flowmetry. Depending on the above data, there are 4 main degrees of severity:

Mild form (intermittent atopic asthma). Manifestations of the disease are recorded no more than 1 time in 7 days, night attacks - no more than 2 times a month. PSV over 80-85% of normal(PSV norm depends on age). Fluctuations in the morning and evening PSV are not more than 20-25%. The general condition of the patient is usually not disturbed.
Mild persistent atopic form. Symptoms of the disease appear 1 time in 2-6 days, night attacks - more than 2 times a month. PSV is more than 80%, fluctuations in PSV during the day do not exceed 25-30%. If the attacks are prolonged, they can disrupt physical activity, sleep.
Moderate form. Manifestations of the pathological condition are noted daily, night attacks - 1 time per week and more often. PSV is within 65-80% of the norm, fluctuations in the indicator exceed 30%. Significant disturbances in the daily activity of a person are often noted, the quality of sleep becomes many times worse.
Severe disease. At this stage, the disease worsens 3-5 times a day, night attacks occur 3 or more times a week. PSV is below 60-65%, daily fluctuations are more than 30-35%. A person is unable to do daily activities, especially those related to physical activity, are also observed neurotic disorders and violations by other organs and systems.

Consequence severe forms if left untreated, it can become asthmatic status- threatening condition lethal outcome and requiring immediate medical care. Status asthmaticus is characterized by a persistent, severe and prolonged asthma attack that is not relieved by pocket inhalers. To avoid given state, you need to contact a medical institution when the first symptoms appear.

Associated pathologies

Often enough allergic rhinitis registered as concomitant pathology. This is due primarily to the characteristics of the immune system, which are inherited. It has been proven that if one of the parents suffers from allergic ailments, then the likelihood of hypersensitivity in a child is about 50%.

If the allergic history is burdened by both the mother and the father, then the likelihood of hyperreactivity reactions increases up to 80%.

But you need to understand that it is not a specific disease that is genetically programmed, but only an excessive reactivity of the immune system. That is why not only cases of bronchial asthma are taken into account, but also other allergic diseases of family members (for example, hay fever, atopic dermatitis).

To date, it has been proven that there is a connection between 3 diseases: atopic dermatitis (often recorded at 1 year of age), allergic rhinitis and bronchial asthma. It is in this sequence that these diseases often occur - doctors call this condition " atopic march". Therefore, if atopic dermatitis or allergic rhinitis is detected, everything must be done necessary measures to avoid the manifestation of the disease.

Symptoms of the disease

Often this pathological condition does not manifest itself in any way outside an attack, and it is the first paroxysm of the disease that makes a person turn to a specialist. Patients with this disease most often present the following complaints:

dry, barking, unproductive cough(sputum is released only at the end of the attack, it is transparent and very viscous, but it is not enough);
severe expiratory shortness of breath (a person cannot exhale);
wheezing and whistling sounds during the act of breathing;
sensations of chest compression, sometimes pain;
increase in the frequency of respiratory movements.

Also, for an attack of this disease, it is characteristic forced position the patient - orthopnea (a person sits, leaning his hands on the edge of the bed or chair). It is in this position that it is easier for a person to inhale - the shoulder girdle rises, the chest expands.

What allergens most often provoke an attack in adults and children?

As mentioned above, a predisposition to this pathology may be due to aggravated heredity, but a specific allergen provokes an attack. Scientists have identified several thousand agents that exacerbate this disease. The most common causes of an attack in adults are such allergens:

Biological agents(pollen of plants, fluff and feathers of birds, wool and biological fluids animals, dust mites, fungal spores).
Physical agents(cold or hot air).
Chemical agents(components of cosmetics, perfumes and household chemicals, traffic fumes cars, tobacco smoke drugs, food allergens).

AT childhood Allergic disease can be provoked not only by these allergens, but also by food. Especially often, manifestations of allergies occur with improper introduction of complementary foods. But, according to statistics, allergic type asthma is recorded in adolescence, young and adulthood, and it is caused by the allergens described above.

Typically, these agents enter the body in one of 3 ways: through the skin, through the upper respiratory tract, and also through the mucous membranes. gastrointestinal tract. The first 2 routes of entry are considered the most dangerous, since in these cases the allergen quickly enters the bloodstream and causes symptoms of the disease.

Diagnosis of the disease

Bronchial asthma is a dangerous condition, so in no case should you take any medication on your own without consulting a specialist. Immunologists, allergists, internists and pulmonologists are involved in making a diagnosis and prescribing treatment - only by joint efforts. qualified specialists you can achieve a good result and maximally alleviate the course of the disease.

During the initial visit to a medical institution, the doctor conducts a survey of the patient, which includes the collection of complaints, anamnesis of the disease and life, as well as family and allergic anamnesis. After that, the specialist conducts an inspection of the systems, Special attention gives to the respiratory organs. On the this stage you can talk about staging preliminary diagnosis, however, this is not enough to prescribe therapy - it is also necessary to conduct other studies that will confirm the doctor's assumptions and help determine the stage of the pathological process.

in instrumental and laboratory research includes:

A general blood test (the content of eosinophils is increased, which indicates an allergic reaction).
Biochemical blood test (increased concentration of seromucoids, sialic acid and gamma globulins).
Sputum analysis (the content of eosinophils is increased, Charcot-Leiden crystals are found, Curshman spirals may also be present).
ELISA ( linked immunosorbent assay) for the content of class E immunoglobulins (increased several times).
Scarification tests, prick test. During these studies, possible allergens that provoked an attack are applied to the skin (with positive sample redness, swelling).
Chest X-ray (usually normal, but necessary to rule out other lung diseases).
Spirometry (decrease vital capacity lungs, increase in functional residual capacity, and also decrease expiratory reserve volume and mean volume velocity).
Peakfluometry (decrease in PSV, increase in the difference between morning and evening PSV).
ECG (increased heart rate, performed to exclude heart pathologies that cause shortness of breath).

A number of these studies allows you to accurately determine not only the presence of the disease, but also the severity of the disease.

Remember that treatment should be prescribed only after.

The process of treatment: pharmacological drugs used in the disease

To date, many drugs have been developed that can stop the attack of this disease. There are also a number of drugs used as additional therapy(during the absence of seizures):

M-anticholinergics. Used to relieve seizures pocket inhalers with M-anticholinergics (Atrovent, Spiriva) - they are safe and can be used by the patient on their own. In severe paroxysms of the disease, use injectables from this group: atropine sulfate and ammonium. However, they have large quantity side effects, so they are used only in emergency cases.
Cromons. Drugs from this group reduce the production of mast cells, which helps to reduce the frequency and intensity of seizures. The advantage of cromones is that they can be used to treat allergic diseases in childhood. The most commonly used drugs are Nedocromil, Intal, Kromglikat, Cromolyn.
Antileukotriene agents. Reduce the production of leukotrienes, which are formed during an allergic reaction. Preparations of this group, mainly tablets, are prescribed without exacerbation of the disease. Apply Formoterol, Montelukast, Salmeterol.
Glucocorticoids systemic use . They are prescribed only in case of a severe course of the disease, as well as in the relief of asthmatic status. Anti-inflammatory and antihistamine action of these drugs is very pronounced, they are extremely effective, because. significantly reduce the body's reactivity to various allergens. AT clinical practice most commonly used Metipred, Prednisolone, Hydrocortisone, Dexamethasone, as well as inhalation drugs: Aldecin, Pulmicort.
β 2 -agonists. The mechanism of action of drugs from this pharmacological group based on an increase in the sensitivity of receptors to adrenaline. This leads to vasoconstriction, a decrease in edema and mucus secretion, as well as an expansion of the bronchial lumen. They are produced mainly in the form of inhalations, most often they use drugs such as Ventolin, Salbutamol, Seretide.
Methylxanthines. These drugs, by successive chemical reactions inhibit the interaction between actin and myosins - proteins muscle tissue, which leads to relaxation of the smooth muscles of the bronchi, also dramatically reduce the destruction of mast cells, which leads to less release of inflammatory mediators. Used for severe attacks and status asthmaticus. Preparations from the group of methylxanthines: Eufillin, Theophylline, Teotard.
Expectorants. During an attack in the bronchi accumulates a large number of viscous mucus that clogs the airway, aggravating general state patient. In order for sputum to come out better, the following drugs are prescribed: Lazolvan, ACC, Bromhexine, Solvil.
Antihistamines. They attach to cell receptors, making them less sensitive to histamine, the main mediator of an allergic reaction. As a result, they decrease clinical manifestations illness. These drugs are used systematically, especially if contact with the allergen cannot be avoided. To date, Zodak, Tsetrin, Edem, Loratadin are most often used.

Remember, in order for the treatment to be effective, it must be, first of all, complex, and it must be prescribed by a highly qualified specialist.

Do I need to follow a diet?

Since any factor can be an allergen, then food product may exacerbate the disease. Therefore, doctors recommend that patients with this pathology limit highly allergenic foods. These include:

nuts;
seafood;
chocolate;
citrus;
mushrooms;
raspberries and strawberries.

It is also necessary to give up alcohol, spices, coffee, fatty and fried foods. In addition to all of the above, it is better to limit salt intake - nutritionists recommend adding no more than 6 g of salt per day to food.

Lifestyle with illness

Like all other allergic diseases, this type of asthma can become more severe with the wrong way life. In order to, doctors recommend adjusting sleep and wakefulness, engaging in regular physical activity (for example, doing breathing exercises and specialized exercises from the exercise therapy complex).

It is also necessary to ensure that contact with the allergen is as limited as possible, while it is recommended to be outdoors more often, regularly undergo examinations with a doctor, and also refuse bad habits. Will benefit sanitary-resort treatment, hardening.

In addition, it is necessary to eliminate or minimize stressful situations in Everyday life, because it is this factor that most often provokes exacerbations. If you follow these recommendations in combination with the prescribed treatment, you can achieve excellent results and transfer the disease into remission.

Possible complications of the disease

Prolonged course of bronchial asthma allergic component can lead to complications such as status asthmaticus, pulmonary emphysema, cardiac and respiratory failure, closed pneumothorax, atelectasis, pneumomediastinum.

Most of these conditions can become a threat to human life and health, some of them lead to disability of the patient. That is why experts insist on timely handling population to medical institutions.

Folk methods of treatment

There are several folk remedies that are effective for treatment:

It is necessary to take 800 g of chopped garlic, put it in a jar and pour water, leave for 1 month in a dark place. Take 1 tsp. 20-30 minutes before meals, for 6-8 months.
Dry ginger (400-500g) must be ground with a coffee grinder, pour 1 liter of alcohol, leave for 7-10 days. Then the resulting tincture is recommended to strain and drink 1 tsp. 2-3 times a day. The course of treatment is 90 days.
Mix propolis and alcohol in a ratio of 1:5, insist for 5-7 days. You need to drink this remedy with milk, 25 drops 2-3 times a day (before meals).

Despite the fact that there are many methods of herbal treatment, doctors argue that herbal medicine is contraindicated for patients, as it can aggravate a person's condition.

Remember that none folk remedy should not be used without consulting a physician.

Conclusion

The disease is considered a chronic, severe pathology not only respiratory system but of the whole organism. However, this diagnosis is not a sentence! All the forces of the doctor and the patient should be directed to achieve maximum effect in the treatment of the disease. If you turn to a specialist in time, he will conduct necessary examinations and appoint effective treatment, which will make the attacks of the disease less frequent and intense.

The disease is characterized by rapid chronicity, due to which exacerbation occurs periodically (usually May-June), which is manifested by a pronounced narrowing of the bronchial lumen with an increase in characteristic clinical signs.

It is known that the disease proceeds according to the type immediate response sensitization:

immunological stage . When the antigen first enters the body, the production of class E immunoglobulins begins. At this stage, there are no symptoms yet. However, over time, after repeated contact with allergens, the formation of specific antigen-antibody immune complexes occurs, which are fixed on mast cells, on the shell of basophils;
pathochemical stage . Previously formed immune complexes damage the walls of mast cells and activate their enzymes. Further, the formation and production of allergic mediators, including histamine, MRSA, serotonin, and others;
at the pathophysiological stage target cells located in the muscle tissue of the bronchi begin to be affected by allergic mediators, products of incomplete cell decay and the immune complex. This is the cause of spasm of bronchial muscle tissue, swelling of the mucous layer of the walls, active production of viscous discharge from the bronchi, which greatly disrupts the ventilation activity of the lungs and manifests itself characteristic features suffocation.

These stages replace each other quite quickly, so there is a rapid deterioration in the general well-being of the patient. As a rule, the patient feels an increase in signs of an approaching attack within 5-10 minutes after contact with allergens.

Etiology

The allergic form of bronchial asthma develops when:

genetic predisposition, that is, the closest relatives of the patient are also sick with asthma or suffer from manifestations of allergic reactions;
frequent lesions of the respiratory system of an infectious nature, which provokes the appearance of hypersensitivity of the bronchial mucosa in relation to allergic factors;
adverse environmental conditions;
prolonged contact with an aggressive allergic environment (dust, mold, dry air);
if professional activity associated with harmful substances affecting the respiratory system;
passive and active smoking;
abuse of certain drugs;
abuse of products containing preservatives, dyes, flavors, that is, those substances that can provoke the rapid development of sensitization in the form of asthmatic attacks.

The cause of an asthma attack in each patient with asthma may be different. However, most often such allergens are mold spores, pollen of plants and trees, wool, house dust, and any substances that have a sharp aroma.

Symptoms

Allergic asthma has no specificity and no characteristic symptoms, which would allow to differentiate this form from others of a non-allergic nature. The clinical picture includes:

reversible obstruction, that is, narrowing of the lumen of the bronchi, which is the most characteristic symptom;
shortness of breath, that is, it is difficult for the patient to take a full breath and exhale. Such shortness of breath appears within 10-15 minutes after contact with the allergen, as well as during strong physical exertion;
whistling wheezing is heard, appearing when air passes through abnormally narrowed airways;
the features of the position of the patient's body during the development of an asthma attack are noted. Since the patient cannot take a full breath using only the respiratory muscles, he has to involve other muscle groups. To do this, he rests his hands on any hard surface;
obsessive paroxysmal cough, which does not bring relief to the patient;
discharge of viscous transparent sputum of a small volume;
the development of asthmatic status, that is, an exacerbation of the disease, which is characterized by a prolonged attack of suffocation, which is not stopped by standard drugs.

Such symptoms gradually increase after the patient comes into contact with allergens. The frequency and duration of exacerbation depends on the type of allergen and how often the patient is forced to contact them.

Types and forms of allergic asthma

There are several classifications of the disease, which is determined by the causes of the development of the disease, the forms of severity of the manifestation of symptoms.

By origin, they distinguish:

exogenous form, the attacks of which are provoked by allergens that enter the body by inhalation or with food;
endogenous form provokes external negative impact in the form of inhalation of cold air, stress, physical activity;
mixed form arising under the influence external factors and inhalation of the allergen.

According to the form of severity, allergic bronchial asthma "passes" 4 stages:

intermittent: attacks occur once in 7-10 days, nighttime ones disturb a maximum of twice a month, exacerbations pass quickly without the use of specific drugs and practically do not affect the general well-being of the patient;
mild persistent: attacks occur more often than once a week, night attacks - 2-3 times a month, with an exacerbation, the patient notes sleep disturbance, his activity is slightly limited;
medium persistent: attacks occur almost daily, nightly - at least 1 time within 7-10 days;
severe persistent: Seizures occur almost daily.

The allergist determines the severity of allergic bronchial asthma only after conducting an appropriate examination. In the treatment of each form and degree of the disease, separate sets of methods and drugs are used.

Diagnostic measures

If symptoms of bronchial asthma appear, you should contact an allergist, who will first collect an anamnesis. With the development of an attack, the doctor will be able to listen to characteristic wheezing, note shortness of breath.

The doctor will also prescribe an analysis of sputum that comes out when you cough. In patients, Charcot-Leiden spirals, eosinophils, Cushman spirals are found in the biomaterial, which are specific feature diseases.

If an allergic nature of bronchial asthma is suspected, an allergotest is recommended. This study will help identify the allergen that leads to seizures.

Treatment

Treatment of an allergic form of bronchial asthma simultaneously includes 2 directions - basic and symptomatic.

Basic treatment drugs prevent asthmatic attacks.

Symptomatic treatment aimed at eliminating the symptoms of the disease. Drugs of this orientation eliminate seizures, affecting smooth muscle bronchial tree.

In addition, the patient is recommended to take antihistamines (Aleron, Cetrilev, Erius).

Some allergists practice the following technique: an allergen is gradually introduced into the patient's body under the supervision of the attending physician. This method called allergen-specific immunotherapy. This significantly reduces the body's susceptibility to this substance.

The components of the basic treatment are inhaled forms of glucocorticoids (Beclomethasone, Fluticasone) and β2-adrenergic blockers (Salbutamol, Ventolin) prolonged exposure. It is these drugs that allow you to control the disease for a long time.

In addition, drugs containing antibodies to IgE are prescribed. The direction of their action is to eliminate the hypersensitivity of the bronchi to the effects of allergens and the timely prevention of exacerbation of the condition.

Preference is always given to inhaled forms. Thanks to a special device, the components of the product enter directly into the respiratory tract, as a result of which almost instant effect.

Patients should understand that it is better to prevent the development of an attack than to eliminate its consequences. To do this, you must follow these recommendations:

carry out daily wet cleaning in the apartment;
in case of sensitization to wool, it is necessary to abandon the keeping of any pets;
you can not use perfumes that have a sharp aroma.

The World Organization for Asthma Research, or GINA, indicates the need for periodic review of treatment tactics for each individual patient every 3 months.

This will allow you to timely adjust the dosage of drugs, replace drugs with more effective ones, which will positively affect the patient's health.

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! An accurate diagnosis can only be made by a doctor.

Allergic bronchial asthma is one of the most common manifestations of the asthmatic syndrome, which is characterized by hypersensitivity of the respiratory system to certain allergic agents.

When an allergen enters the respiratory system through the air, the body receives a signal about the pathogen, triggering an immune system response that is accompanied by bronchial spasm.

In the muscles of the respiratory system, an inflammatory process begins, provoking the formation of thick and viscous sputum.

Despite the fact that the disease has vivid symptoms, a clear definition and great diagnostic opportunities, allergic asthma is often confused with various types bronchitis, leading to ineffective and inadequate treatment with antibiotics and antitussives.

Reasons for the development of allergic bronchial asthma

The principle of the development of bronchial asthma allergic nature is an immediate pathogenic hypersensitivity, which is characterized by the instant manifestation of symptoms after the allergic factor enters the respiratory system.

Depending on the etiology of the disease, two types of allergic asthma are distinguished: atopic and infectious-allergic, which differ in symptoms in the initial stages.

Atopic bronchial asthma develops as a result of inhalation contact with irritants that enter the body when air is inhaled.

Activated cells of the immune system can react to plant pollen, animal hair, house and medicinal dust, perfumes, household chemicals, metals, tobacco smoke or food preservatives and additives

Reaction to irritant component promotes the formation of histamine, resulting in inflammation of the bronchi.

In addition, the atopic form of bronchial asthma can develop as a result of prolonged contact with aggressive allergens, for example, in the case of a long stay in a building whose walls are infected with mold fungus.

Smoking can cause illness not only in smokers, but also in people who are forced to inhale tobacco smoke. For this reason, atopic asthma often occurs in children of smoking parents.

Also, the development of the disease can contribute to factors such as:

unfavorable ecology;
work in hazardous production;
systematic inhalation of industrial impurities, solvent fumes, air fresheners, exhaust gases,
long-term medication;
abuse of preservatives, food colorings and additives.

The infectious-allergic form of asthma often develops in adult patients, and the cause of its occurrence is the presence of foci chronic infection respiratory tract.

The infectious effect is accompanied by a thickening of the muscular layer of the bronchi and the germination of the walls connective tissue, after which the bronchial lumen narrows and the process of air penetration into the lungs becomes more difficult.

Atopic and infectious forms of bronchial asthma can be provoked by aggravated heredity.

That is, the risk of a person whose relatives suffer from allergies or asthma increases by 20-30%. If parents are diagnosed with allergic asthma, the probability of the child's illness reaches 70%.

At the same time, it is not the pathology itself that is inherited, but the tendency to develop an allergic reaction.

Symptoms of the disease

The course of allergic asthma may be accompanied by various symptoms, which can appear immediately after the penetration of the allergen into the body.

The main signs of the disease:

shortness of breath, shortness of breath, suffocation;
wheezing and whistling during breathing, due to narrowing of the lumen in the bronchi;
rapid shallow breathing;
paroxysmal form of cough, accompanied by the separation of small clots of mucus at the end of the attack. In some cases, a dry cough may be a single manifestation of an asthmatic syndrome;
pain in the chest region.

The middle and severe stages of the disease are characterized by the appearance of shortness of breath as a result of physical effort.

With an exacerbation of the disease, there is an increase in shortness of breath, as well as other symptoms that may not even manifest themselves during periods of remission.

Exacerbation of asthma can cause the following factors:

long stay in a dusty room;
cleaning;
contact with animals or plants;
intense physical effort.

main feature infectious form Asthma is considered a long course of diseases of the respiratory system, often accompanied by exacerbations.

The exacerbation of the disease is characterized by active inflammatory process, which leads to the fact that the patient reacts even to non-specific pathogens: a pungent odor, temperature fluctuations, the smell of smoke.

The course of the disease may also depend on the type of specific allergen and on the frequency of contact of the patient with this irritant.

For example, an allergic reaction to pollen aggravates only in a certain season - in spring and summer, while the patient cannot avoid contact with the allergen.

One of the main characteristic symptoms of allergic asthma is the onset of relief after taking antihistamines and inhalation with bronchodilator drugs.

The atopic form of asthma can manifest itself at different intervals depending on the stage and form of the course of the disease:

Mild intermittent course of the disease. In this case, the disease can remind of itself no more than twice a month.
Mild persistent course. Episodes of pathology occur several times a week, and no more than once a day, while nocturnal relapses can occur more than twice a month.
Medium severity. Attacks occur almost daily, including during sleep.
Severe stage of asthma severity. Pathology manifests itself constantly, episodes occur more than three times a day, while once every two days the patient is disturbed by night attacks.

by the most severe manifestation disease is status asthmaticus, in which the patient has prolonged attacks of suffocation with the inability to exhale.

In this case, the traditional drug therapy does not bring results, and if you do not provide timely help, the patient loses consciousness and may plunge into a coma, also in this case, the risk of death is high.

The development of the disease in children

The allergic form of asthma in children can develop at any age, but mainly after a year of life, while allergic etiology has the most big risk occurrence than other forms of asthmatic syndrome.

The course of atopic asthma in children has its own difficulties, since its symptoms can be hidden under the signs of bronchial obstruction.

If bronchial obstruction in a child worsens more than 4 times during the year, this most likely indicates the development of atopic bronchial asthma.

Treatment of allergic asthma in children begins with the identification of the allergic agent that triggered the reaction. The basis of therapy, as a rule, is inhalation, which not only eliminates the effect of the allergen, but also increases protective function immune system.

After five years, allergen-specific treatment can be prescribed, which at this age brings good result and often helps to get rid of the disease.

Diagnosis of the disease

In the allergic form of bronchial asthma, a thorough pulmonological and allergological examination should be carried out, the task of which is to identify the causes of the disease, establish the mechanism of its development and determine possible comorbidities.

Diagnosis of the disease begins with an examination and questioning of the patient, fixing all his complaints and forming an anamnesis, after which comprehensive examination to help define a clear clinical picture allergic asthma:

A study using a spirometer allows you to characterize the performance of the lungs. One of the important parameters is a forced sharp exhalation, since it is the most difficult for asthmatics;
Analysis of sputum released during coughing shows the content of eosinophils and particles characteristic of bronchial asthma - the Cushman and Charcot-Leiden spiral;
An allergy test identifies an allergic agent that provokes an exacerbation. During this manipulation, a small scratch is applied to the skin, onto which a little solution with an allergen is dripped. In case of an allergic response, redness and slight inflammation appear on the skin.

How should the disease be treated?

Treatment of allergic asthma should be structured in such a way that the course of the disease is taken into account and individual characteristics organism, therefore it is carried out exclusively under medical supervision.

Self-treatment can not only not lead to positive dynamics, but also aggravate the course of the disease with serious complications.

Antihistamines, taken in a timely manner, reduce symptoms and relieve severe course illness.

The effectiveness of antihistamines is due to the blocking of receptors and stopping the formation and release of histamine into the blood.

If the patient cannot avoid contact with the allergen, antihistamine must be taken in advance, which reduces the risk of an acute reaction of the body.

In addition, there is effective method combating allergic reactions with microdoses of the allergen, which consists in introducing the allergen into the blood, while the dosage is gradually increased to the maximum tolerated.

As a result of these activities, the body develops susceptibility to the pathogen, and the risk of an allergic reaction is reduced.

Stopping an attack of allergic asthma requires a whole range of measures that are aimed at prompt elimination symptoms of the disease.

First of all, the patient needs to relax and calm down, as anxiety and excitement only aggravate his well-being.

To do this, immediately provide an influx of fresh air, free the chest from tight-fitting clothing, take a horizontal position and make moderate respiratory movements.

A patient diagnosed with allergic asthma should always carry an inhaler with him. drug, which quickly stops an asthma attack and restores the functioning of the smooth muscles of the respiratory system after a spasm.

The treatment of each case of the disease has its own characteristics, but common ground are the following means:

Glucocorticoids and beta-adrenergic blockers prolonged action, which for a long time control the course of the disease.
Antitelac immunoglobulin E, eliminating the increased excitability of the bronchi and preventing the risk of exacerbation for a long time.
Cromones, influencing inflammatory cells who participate in allergic inflammation. This remedy is used in the treatment of allergic asthma in children; in the treatment of adults, it does not give the desired effect.
Methylxanthines, used in atopic asthma, have the ability to quickly block adrenoreceptors.
Inhalations that have virtually no side effects and act immediately due to direct penetration medicinal product into the respiratory system.
Expectorant drugs that help cleanse the bronchi of sputum.
Immunostimulating drugs.

In order for the treatment to bring positive dynamics, during the entire period of the disease, the patient must follow the following recommendations:

Minimize your stay outside during the flowering period of plants, if possible, keep the windows closed;
wash clothes in very hot water;
put hypoallergenic covers on mattresses and pillows:
get rid of carpets and soft toys that create favorable conditions for the appearance of dust mites;
control air humidity. If the humidity index exceeds 40%, there is a risk of mold and dust mites, in this case it is recommended to use air drying;
limit contact with animals;
maintain dryness in the bathroom and in the kitchen, install hoods that will reduce humidity;
install an air filter that will eliminate smoke, pollen, small particles that can serve as irritants;
perform any work on the plot in a special mask that prevents the ingress of allergens;
avoid the use of perfumes with a pungent odor;
change work if it is associated with the systematic inhalation of harmful components or dust;
do sports or breathing exercises.

Adequate treatment of allergic asthma gives a fairly favorable prognosis.

Emphysema and cardiopulmonary failure can develop as complications.

To date, there are no universal preventive methods, which can completely eliminate the risk of developing allergic bronchial asthma.

The problem is solved already when the disease appears, and therapy in this case is aimed at stabilizing the course of asthma and reducing the likelihood of possible complications.