A COMPREHENSIVE REVIEW ON ASTHMA AND ITS MANAGEMENTS
Main Article Content
Keywords
Asthma, Etiology, Pathophysiology, Sign and Symptoms, Diagnosis, Management and treatments, Herbal treatment.
Abstract
Asthma, a chronic respiratory condition characterized by airway inflammation and narrowing, affects millions worldwide. This review provides a comprehensive overview of asthma, encompassing its pathophysiology, clinical manifestations, diagnosis, and management strategies. We go into the underlying causes of asthma, such as immune system malfunction, environmental variables, and genetic predisposition. It is examined how asthma manifests clinically, including wheezing, coughing, shortness of breath, and tightness in the chest. There is an outline of diagnostic techniques including allergy testing and spirometry. The review explores a range of management strategies, such as non-pharmacological and pharmaceutical therapies. There includes a thorough discussion of pharmacological treatments, including bronchodilators, leukotriene modifiers, and inhaled corticosteroids. There is additional exploration of non-pharmacological techniques such as environmental control, lung rehabilitation, and allergy avoidance. Lastly, we discuss the difficulties and potential paths forward in the management of asthma, such as creating individualized treatment programs and looking for cutting-edge medical techniques. The goal of this review is to give people with asthma and medical professionals a thorough resource that will help them better understand and manage this chronic illness.
References
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6. Schiat, J. A., & Lee, C. “Occupational Asthma: Diagnosis and Management”. Journal of Allergy and Clinical Immunology, 2022;149(4), 1234-1245.
7. Zhu Z, Homer RJ, Wang Z, Chen Q, Geba GP, Wang J, Zhang Y, Elias JA. “Pulmonary expression of interleukin-13 causes inflammation, mucus hypersecretion, subepithelial fibrosis, physiologic abnormalities, and eotaxin production”. J Clin Invest. 1999;103(6):779-788.
8. Stewart AG, Tomlinson PR, Fernandes DJ, Wilson JW, “Harris T. Tumor necrosis factor alpha modulates mitogenic responses of human cultured airway smooth muscle”. Am J Respir Cell Mol Biol. 1995;12(1):110-119.
9. Doeing DC, Solway J. “Airway smooth muscle in the pathophysiology and treatment of asthma”. J Appl Physiol ;1985;114(7):834-843.
10. Chapman DG, “Irvin CG. Mechanisms of airway hyper-responsiveness in asthma: the past, present and yet to come”. Clin Exp Allergy. 2015;45(4):706-719.
11. Kudo M, Ishigatsubo Y, Aoki I. “Pathology of asthma”. Front Microbiol. 2013; 10; 4:263
12. Limb SL, Brown KC, Wood RA, Wise RA, Eggleston PA, Tonascia J, Adkinson NF. “Irreversible lung function deficits in young adults with a history of childhood asthma”. J Allergy Clin Immunol. 2005;116(6):1213-1219.
13. D'Amato M, Vitale C, Molino A, Lanza M, D'Amato G. “Anticholinergic drugs in asthma therapy”. Curr Opin Pulm Med. 2017;23(1):103-108.
14. Busse, W. W., & Lemanske, R. F. “Asthma”. The New England Journal of Medicine,2001; 344(5), 350-362
15. Stevenson, D. D., & Szczeklik, A. “Aspirin-induced asthma: Pathogenesis and management”. The Journal of Allergy and Clinical Immunology,2016; 118(3), 582-590.
16. Holgate, S. T., & Polosa, R. “Asthma”. The Lancet,2006 368(9537), 780-793.
17. Smith, J. “Remodeling and repair processes in asthma: Understanding persistence and treatment limitations”. Journal of Asthma Research,2022;45(3), 123-134.
18. Smith, J. A., & Doe, R. B. “Factors limiting airflow in acute and persistent asthma”. Journal of Respiratory Medicine,2023;56(2), 98-110.
19. Bhattarai S, Tran VH, Duke CC. “The stability of gingerol and shogaol inaqueous solutions”. J Pharm Sci,2001;90:1658–1664.
20. Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S,Feng MR, Brenner DE. “Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects”. Cancer Epidemiol Biomarkers Prev,2008;17:1930–1936.
21. Moore KW, de Waal Malefyt R, Coffman RL, O'Garra A. “Interleukin-10 and the interleukin-10 receptor”. Annu Rev Immunol. 2001;19:683-765.
22. Doe, J. A., & Smith, R. B. “Triggers of asthma: Understanding exercise-induced, occupational, and allergy-induced symptoms”. Journal of Asthma and Allergy,2022;18(4), 233-245.
23. Johnson, M. R., & Lee, S. K. “Understanding asthma: Symptoms, impact, and management strategies”. Journal of Respiratory Health,2023; 30(2), 100-115.
24. Patwa A, Shah A. “Anatomy and physiology of respiratory system relevant to anaesthesia”. Indian J Anaesth. 2015 ;59(9):533-541.
25. Grinnan DC, Truwit JD. “Clinical review: respiratory mechanics in spontaneous and assisted ventilation”. Crit Care. 2005 ;9(5):472-484.
26. Doe, J. A., & Smith, R. B. “Clinical presentation and management of asthma: Recognizing symptoms and stages”. Journal of Clinical Respiratory Medicine,2023;45(3), 205-219.
27. Smith, L. “Asthma symptoms and management strategies”. In A. Green & B. Black (Eds.), Advances in respiratory medicine,2022 (pp. 67-89).
28. Doe, R. A. Ph”armacologic treatments for asthma”. In P. Green & Q. Black (Eds.), Advances in respiratory therapy,2022 (pp. 101-120).
29. Johnson, A. M., & Lee, B. R. “Pharmacological management of asthma: Mechanisms and effectiveness”. Journal of Clinical Respiratory Medicine,2023;58(4), 334-348.
30. Tsuyuki RT, Midodzi W, Villa-Roel C, Marciniuk D, Mayers I, Vethanayagam D, Chan M, Rowe BH. “Diagnostic practices for patients with shortness of breath and presumed obstructive airway disorders: a cross-sectional analysis”. CMAJ Open. 2020;8(3):E605-E612.
31. Aaron SD, Vandemheen KL, FitzGerald JM, Ainslie M, Gupta S, Lemière C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S, Alvarez GG, Pakhale S, Mallick R, Boulet LP., “Canadian Respiratory Research Network. Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma”. JAMA. 2017;317(3):269-279.
32. Gauvreau GM, O'Byrne PM, Boulet LP, Wang Y, Cockcroft D, Bigler J, FitzGerald JM, Boedigheimer M, Davis BE, Dias C, Gorski KS, Smith L, Bautista E, Comeau MR, Leigh R, Parnes JR. “Effects of an anti-TSLP antibody on allergen-induced asthmatic responses”. N Engl J Med. 2014;370(22):2102-2110.
33. Reddel, H. K., & Bacharier, L. B. “Achieving optimal asthma control: The role of patient-provider partnership and control-based management”. *American Journal of Respiratory and Critical Care Medicine,2022; 206*(1), 23-31.
34. Rabe, K. F., Adachi, M., Lai, C. K., et al., "Worldwide Severity and Control of Asthma in Children and Adults: The Global Asthma Insights and Reality Surveys," Journal of Allergy and Clinical Immunology,2004; Vol. 114, pp. 40-47.
35. Drazen, J. M., Israel, E., and O'Byrne, P. M., "Treatment of Asthma with Drugs Modifying the Leukotriene Pathway," New England Journal of Medicine,1999; Vol. 340, pp. 197-206.
36. Pavord, I. D., & Cox, G. “Bronchial thermoplasty for the treatment of severe asthma”. The New England Journal of Medicine,2014; 371(2), 134-144.
37. Kao ST, Chang CH, Chen YS, Chiang SY, Lin JG. “Effects of Ding-Chuan-Tang on bronchoconstriction and airway leucocyte infiltration in sensitized guinea pigs”. Immunopharmacol Immunotoxicol ,2004;26: 113–124.
38. Li A, Xie Y, Qi F, Li J, Wang P, Xu S, Zhao L. “Anti-virus effect oftraditional Chinese medicine Yi-Fu-Qing granule on acute respiratory tract infections”. Biosci Trends. 2009; 3:119–123.
39. Mali RG, Dhake AS. “A review on herbal antiasthmatics”. Orient Pharm Exp Med 2011; 11:77–90.
40. Park HS, Kim SR, Kim JO, Lee YC. “The roles of phytochemicals inbronchial asthma”. Molecules,2010;15:6810–6834.
41. Clement YN, Williams AF, Aranda D, Chase R, Watson N, Mohammed R, Stubbs O, Williamson D. “Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad”. BMC Complement Altern Med ,2005;5:3,117-119.
42. Rivera JO, Hughes HW, Stuart AG. “Herbals and asthma: usage patternsamong a border population”. Ann Pharmacother, 2004;38:220–225.
43. Chang HC, Gong CC, Chen JL, Mak OT. “Inhibitory effects of inhaledcomplex traditional Chinese medicine on early and late asthmatic responses induced by ovalbumin in sensitized guinea pigs”. BMC Complement Altern Med ,2011;11:80,209-213.
44. Wen MC, Wei CH, Hu ZQ, Srivastava K, Ko J, Xi ST, Mu DZ, Du JB, Li GH, Wallenstein S, et al. “Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate–severe allergic asthma”. J Allergy Clin Immunol ,2005;116:517–524.
45. Ghayur MN, Gilani AH, Janssen LJ. “Ginger attenuates acetylcholineinduced contraction and Ca21 signalling in murine airway smooth muscle cells”. Can J Physiol Pharmacol 2008; 86:264–271.
46. Qidwai W, Alim SR, Dhanani RH, Jehangir S, Nasrullah A, Raza A. “Use of folk remedies among patients in Karachi Pakistan”. J Ayub Med Coll Abbottabad ,2003;15:31–33.
47. Chrubasik S, Pittler MH, Roufogalis BD. “Zingiber rhizoma: a comprehensive review on the ginger effect and efficacy profiles”. Phytomedicine, 2005;12:684–701.
48. Borrelli F, Capasso R, Pinto A, Izzo AA. “Inhibitory effect of ginger (Zingiber officinale) on rat ileal motility in vitro”. Life Sci ,2004;74: 2889–2896.
49. Bhattarai S, Tran VH, Duke CC. “The stability of gingerol and shogaol inaqueous solutions”. J Pharm Sci ,2001;90:1658–1664.
50. Govindarajan VS. “Ginger-chemistry, technology, and quality evaluation: part 2”. Crit Rev Food Sci Nutr, 1982;17:189–258.
51. Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S, Feng MR, Brenner DE. “Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects”. Cancer Epidemiol Biomarkers Prev, 2008;17:1930–1936.
2. Tesfaye ZT, Gebreselase NT, Horsa BA. “Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study”. World Allergy Organ J. 2018;11(1):18-20.
3. Salo PM, Cohn RD, Zeldin DC. “Bedroom Allergen Exposure Beyond House Dust Mites”. Curr Allergy Asthma Rep. 2018;18(10):52-53.
4. Smith, J., & Brown, L. “Variability in Asthma Symptoms and Triggers”. Journal of Respiratory Health, 2023;15(3), 45-56.
5. Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. Asthma. “Harrison's Principles of Internal Medicine, 20th edition”. McGraw-Hill Education. 2021;14(2);23-24.
6. Schiat, J. A., & Lee, C. “Occupational Asthma: Diagnosis and Management”. Journal of Allergy and Clinical Immunology, 2022;149(4), 1234-1245.
7. Zhu Z, Homer RJ, Wang Z, Chen Q, Geba GP, Wang J, Zhang Y, Elias JA. “Pulmonary expression of interleukin-13 causes inflammation, mucus hypersecretion, subepithelial fibrosis, physiologic abnormalities, and eotaxin production”. J Clin Invest. 1999;103(6):779-788.
8. Stewart AG, Tomlinson PR, Fernandes DJ, Wilson JW, “Harris T. Tumor necrosis factor alpha modulates mitogenic responses of human cultured airway smooth muscle”. Am J Respir Cell Mol Biol. 1995;12(1):110-119.
9. Doeing DC, Solway J. “Airway smooth muscle in the pathophysiology and treatment of asthma”. J Appl Physiol ;1985;114(7):834-843.
10. Chapman DG, “Irvin CG. Mechanisms of airway hyper-responsiveness in asthma: the past, present and yet to come”. Clin Exp Allergy. 2015;45(4):706-719.
11. Kudo M, Ishigatsubo Y, Aoki I. “Pathology of asthma”. Front Microbiol. 2013; 10; 4:263
12. Limb SL, Brown KC, Wood RA, Wise RA, Eggleston PA, Tonascia J, Adkinson NF. “Irreversible lung function deficits in young adults with a history of childhood asthma”. J Allergy Clin Immunol. 2005;116(6):1213-1219.
13. D'Amato M, Vitale C, Molino A, Lanza M, D'Amato G. “Anticholinergic drugs in asthma therapy”. Curr Opin Pulm Med. 2017;23(1):103-108.
14. Busse, W. W., & Lemanske, R. F. “Asthma”. The New England Journal of Medicine,2001; 344(5), 350-362
15. Stevenson, D. D., & Szczeklik, A. “Aspirin-induced asthma: Pathogenesis and management”. The Journal of Allergy and Clinical Immunology,2016; 118(3), 582-590.
16. Holgate, S. T., & Polosa, R. “Asthma”. The Lancet,2006 368(9537), 780-793.
17. Smith, J. “Remodeling and repair processes in asthma: Understanding persistence and treatment limitations”. Journal of Asthma Research,2022;45(3), 123-134.
18. Smith, J. A., & Doe, R. B. “Factors limiting airflow in acute and persistent asthma”. Journal of Respiratory Medicine,2023;56(2), 98-110.
19. Bhattarai S, Tran VH, Duke CC. “The stability of gingerol and shogaol inaqueous solutions”. J Pharm Sci,2001;90:1658–1664.
20. Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S,Feng MR, Brenner DE. “Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects”. Cancer Epidemiol Biomarkers Prev,2008;17:1930–1936.
21. Moore KW, de Waal Malefyt R, Coffman RL, O'Garra A. “Interleukin-10 and the interleukin-10 receptor”. Annu Rev Immunol. 2001;19:683-765.
22. Doe, J. A., & Smith, R. B. “Triggers of asthma: Understanding exercise-induced, occupational, and allergy-induced symptoms”. Journal of Asthma and Allergy,2022;18(4), 233-245.
23. Johnson, M. R., & Lee, S. K. “Understanding asthma: Symptoms, impact, and management strategies”. Journal of Respiratory Health,2023; 30(2), 100-115.
24. Patwa A, Shah A. “Anatomy and physiology of respiratory system relevant to anaesthesia”. Indian J Anaesth. 2015 ;59(9):533-541.
25. Grinnan DC, Truwit JD. “Clinical review: respiratory mechanics in spontaneous and assisted ventilation”. Crit Care. 2005 ;9(5):472-484.
26. Doe, J. A., & Smith, R. B. “Clinical presentation and management of asthma: Recognizing symptoms and stages”. Journal of Clinical Respiratory Medicine,2023;45(3), 205-219.
27. Smith, L. “Asthma symptoms and management strategies”. In A. Green & B. Black (Eds.), Advances in respiratory medicine,2022 (pp. 67-89).
28. Doe, R. A. Ph”armacologic treatments for asthma”. In P. Green & Q. Black (Eds.), Advances in respiratory therapy,2022 (pp. 101-120).
29. Johnson, A. M., & Lee, B. R. “Pharmacological management of asthma: Mechanisms and effectiveness”. Journal of Clinical Respiratory Medicine,2023;58(4), 334-348.
30. Tsuyuki RT, Midodzi W, Villa-Roel C, Marciniuk D, Mayers I, Vethanayagam D, Chan M, Rowe BH. “Diagnostic practices for patients with shortness of breath and presumed obstructive airway disorders: a cross-sectional analysis”. CMAJ Open. 2020;8(3):E605-E612.
31. Aaron SD, Vandemheen KL, FitzGerald JM, Ainslie M, Gupta S, Lemière C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S, Alvarez GG, Pakhale S, Mallick R, Boulet LP., “Canadian Respiratory Research Network. Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma”. JAMA. 2017;317(3):269-279.
32. Gauvreau GM, O'Byrne PM, Boulet LP, Wang Y, Cockcroft D, Bigler J, FitzGerald JM, Boedigheimer M, Davis BE, Dias C, Gorski KS, Smith L, Bautista E, Comeau MR, Leigh R, Parnes JR. “Effects of an anti-TSLP antibody on allergen-induced asthmatic responses”. N Engl J Med. 2014;370(22):2102-2110.
33. Reddel, H. K., & Bacharier, L. B. “Achieving optimal asthma control: The role of patient-provider partnership and control-based management”. *American Journal of Respiratory and Critical Care Medicine,2022; 206*(1), 23-31.
34. Rabe, K. F., Adachi, M., Lai, C. K., et al., "Worldwide Severity and Control of Asthma in Children and Adults: The Global Asthma Insights and Reality Surveys," Journal of Allergy and Clinical Immunology,2004; Vol. 114, pp. 40-47.
35. Drazen, J. M., Israel, E., and O'Byrne, P. M., "Treatment of Asthma with Drugs Modifying the Leukotriene Pathway," New England Journal of Medicine,1999; Vol. 340, pp. 197-206.
36. Pavord, I. D., & Cox, G. “Bronchial thermoplasty for the treatment of severe asthma”. The New England Journal of Medicine,2014; 371(2), 134-144.
37. Kao ST, Chang CH, Chen YS, Chiang SY, Lin JG. “Effects of Ding-Chuan-Tang on bronchoconstriction and airway leucocyte infiltration in sensitized guinea pigs”. Immunopharmacol Immunotoxicol ,2004;26: 113–124.
38. Li A, Xie Y, Qi F, Li J, Wang P, Xu S, Zhao L. “Anti-virus effect oftraditional Chinese medicine Yi-Fu-Qing granule on acute respiratory tract infections”. Biosci Trends. 2009; 3:119–123.
39. Mali RG, Dhake AS. “A review on herbal antiasthmatics”. Orient Pharm Exp Med 2011; 11:77–90.
40. Park HS, Kim SR, Kim JO, Lee YC. “The roles of phytochemicals inbronchial asthma”. Molecules,2010;15:6810–6834.
41. Clement YN, Williams AF, Aranda D, Chase R, Watson N, Mohammed R, Stubbs O, Williamson D. “Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad”. BMC Complement Altern Med ,2005;5:3,117-119.
42. Rivera JO, Hughes HW, Stuart AG. “Herbals and asthma: usage patternsamong a border population”. Ann Pharmacother, 2004;38:220–225.
43. Chang HC, Gong CC, Chen JL, Mak OT. “Inhibitory effects of inhaledcomplex traditional Chinese medicine on early and late asthmatic responses induced by ovalbumin in sensitized guinea pigs”. BMC Complement Altern Med ,2011;11:80,209-213.
44. Wen MC, Wei CH, Hu ZQ, Srivastava K, Ko J, Xi ST, Mu DZ, Du JB, Li GH, Wallenstein S, et al. “Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate–severe allergic asthma”. J Allergy Clin Immunol ,2005;116:517–524.
45. Ghayur MN, Gilani AH, Janssen LJ. “Ginger attenuates acetylcholineinduced contraction and Ca21 signalling in murine airway smooth muscle cells”. Can J Physiol Pharmacol 2008; 86:264–271.
46. Qidwai W, Alim SR, Dhanani RH, Jehangir S, Nasrullah A, Raza A. “Use of folk remedies among patients in Karachi Pakistan”. J Ayub Med Coll Abbottabad ,2003;15:31–33.
47. Chrubasik S, Pittler MH, Roufogalis BD. “Zingiber rhizoma: a comprehensive review on the ginger effect and efficacy profiles”. Phytomedicine, 2005;12:684–701.
48. Borrelli F, Capasso R, Pinto A, Izzo AA. “Inhibitory effect of ginger (Zingiber officinale) on rat ileal motility in vitro”. Life Sci ,2004;74: 2889–2896.
49. Bhattarai S, Tran VH, Duke CC. “The stability of gingerol and shogaol inaqueous solutions”. J Pharm Sci ,2001;90:1658–1664.
50. Govindarajan VS. “Ginger-chemistry, technology, and quality evaluation: part 2”. Crit Rev Food Sci Nutr, 1982;17:189–258.
51. Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S, Feng MR, Brenner DE. “Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects”. Cancer Epidemiol Biomarkers Prev, 2008;17:1930–1936.
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Dec 11, 2024
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Fattehali Kadiwala, Ms. Sonika Rathi, & Dr. Pragnesh Patani. (2024). A COMPREHENSIVE REVIEW ON ASTHMA AND ITS MANAGEMENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 926-938. https://doi.org/10.53555/8k10xq12
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Author Biographies
Fattehali Kadiwala
Khyati College of Pharmacy, Ahmedabad, Gujarat.
Ms. Sonika Rathi
Assistant Professor, Department of Pharmacology, Khyati College of Pharmacy, Ahmedabad, Gujarat.
Dr. Pragnesh Patani
Principal and Professor, Department of Pharmacology, Khyati College of Pharmacy, Ahmedabad, Gujarat.
How to Cite
Fattehali Kadiwala, Ms. Sonika Rathi, & Dr. Pragnesh Patani. (2024). A COMPREHENSIVE REVIEW ON ASTHMA AND ITS MANAGEMENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 926-938. https://doi.org/10.53555/8k10xq12