Allergic Asthma:

What is allergic asthma?

Allergic asthma is asthma caused by an allergic reaction. It is a condition where your airways tighten when you breathe in an allergen, also called as triggers, because they set off asthma. This can be something in the air — often pollen, dander or mold spores.

Allergens cause an allergic reaction because your immune system thinks they are harmful. Your immune system responds by releasing a substance called immunoglobulin E (or IgE). This substance is meant to fight back and protect your body. However, too much IgE can trigger inflammation (swelling) of the airways in your lungs. This can make it harder for you to breathe and can cause an asthma attack. These trigger a series of reactions that can cause swelling, runny nose, and sneezing.

Asthma is a disease of the lungs that causes your airways to:

• Become swollen or irritated (called inflammation) specifically in the airway linings.
• Produce large amounts of mucus that is thicker than normal.
• Narrow because the muscles around the airways tighten.

It is the most common type of asthma.

What are the causes of allergic asthma?

Allergens can be found all around you. These can be in your indoor and outdoor environments. When you have allergic asthma, inhaling these allergens can set off (trigger) your symptoms. It’s important to know what can trigger your asthma so that you can control your condition.

Possible allergens that can trigger allergic asthma can include:

• Dander: This is skin flakes and it’s usually from pets. Hair is often grouped with dander as a common allergen.
• Pollen: A powdery substance, pollen comes from plants. The most common types of pollen that trigger allergic asthma are grass and weeds.
• Mold: Typically found in places that hold moisture (basements), mold produces spores that get into the air and can trigger your asthma.
• Dust mites: Very small and shaped like spiders, dust mites live in the soft surfaces of your home (carpets, soft furniture coverings and clothes). They eat skin flakes that you naturally shed all of the time. Both the mites themselves and their feces are allergens.
• Cockroaches: These pests can be found in many homes and other buildings. Your asthma can be triggered by the feces, saliva and other body parts of the cockroaches.
• Tobacco smoke, air pollution, cold air, strong odors – including scented lotions and perfumes, chemical fumes.

Some people suffer from seasonal allergies. These are allergies that flare up at a certain time of year. This is often connected to spring because of the blooming of many plants. During this time of year, there is more pollen in the air than other seasons (fall or winter).

Less common allergens that can cause an asthmatic reaction include: Milk, fish, shellfish, eggs, peanuts, wheat, tree nuts.

What are the symptoms of allergic asthma?

Allergic asthma and regular asthma have the same symptoms. They include:

• Feeling short of breath.
• Coughing frequently, especially at night.
• Wheezing (a whistling noise during breathing).
• Experiencing chest tightness (feels like something is pressing or squeezing your chest).
• Rapid breathing

If you have hay fever or skin allergies, you might also experience:

• Itchy skin
• Rash
• Flaky skin
• Runny nose
• Itchy eyes
• Watery eyes
• Congestion

If you swallowed the allergen, these symptoms might be present as well:

• Hives
• Swollen face or tongue
• Tingly mouth
• Swollen mouth, throat, or lips
• Anaphylaxis (severe allergic reaction)

How is allergic asthma diagnosed?

A skin prick test is the common way to check for allergies. Your doctor will poke your skin with a needle containing a small amount of an allergen. After 20 minutes, your doctor will check your skin for red bumps. These bumps are a sign of an allergic reaction.

Additional tests that can check whether you have asthma along with your allergies include:

• Spirometry: measures the amount of air you inhale and exhale, and looks for narrowing in the bronchial tubes of your lungs
• Exhaled nitric oxide test (FeNO test): In this test, your provider will measure the amount of nitric oxide in your breath when you exhale. This may be used in more mild cases of allergic asthma where you might not feel extreme symptoms. In those cases, the test will still detect the nitric oxide.
• Bronchoprovocation test: This test is similar to the allergy tests that may be run on your skin in that your provider will introduce possible allergens to see what causes you to have a reaction. This is done in a controlled environment and your provider will use small samples to avoid a serious reaction. You’ll breathe in possible allergens to see what’s triggering your asthma.
• Peak flow:a simple test of lung function, this measures air pressure as you breathe out
• Lung function: checks whether your breathing improves after you use an asthma medication called a bronchodilator (if this medication improves your breathing, you probably have asthma)

What are the treatments for allergic asthma?

Treating allergic asthma can involve treating the allergy, the asthma, or both.

Asthma

To treat your asthma, your doctor may prescribe inhaled anti-inflammatory medication or oral medications that help block the allergic response. A fast-acting relief inhaler, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA) is best used to treat asthma symptoms when they occur and may be the only medication needed if you have intermittent symptoms. If you have mild persistent asthma symptoms, inhalers may be prescribed for daily usage. Examples of these include Pulmicort, Asmanex, and Serevent.

If your asthma symptoms are more severe, an oral medication like Singulair or Accolate is often taken in addition to the inhalers.

Bronchodilators, which relax the muscles around the airways, allow you to breathe easier. These drugs are often used to stop asthma symptoms after they’ve started. Sometimes, you use them daily to help control your asthma.

Allergies

Allergy treatment depends on the severity of your symptoms. You may need an anithistamine to deal with classic allergy symptoms such as itching. You might also need allergy shots if your symptoms are more severe.

How can I prevent allergic asthma?

While asthma itself can’t be prevented, you can reduce your risk of an allergic asthma attack by knowing your triggers and controlling your environment.

Immunology

Immunology is the branch of biomedical science that deals with the response of an organism to antigenic challenge and its recognition of what is self and what is not. It deals with the defence mechanisms including all physical, chemical and biological properties of the organism that help it to combat its susceptibility to foreign organisms, material, etc.

In general, the immune system of higher organisms can be broken down into two primary response systems that work together to create immunity. The two primary response systems are innate and adaptive immune responses, with the latter further divided into cell-mediated and antibody-mediated responses. The cell-mediated response is produced when a subset of sensitized white blood cells or lymphocytes directly attack material (e.g., usually a cell or a virus) that has been determined to be foreign to the body. The antibody-mediated response involves the transformation of a subset of lymphocytes into cells that produce and secrete specific antibodies against the foreign material. These two immune responses are triggered when foreign material is introduced into the host.

What is immunology?

Immunology deals with physiological functioning of the immune system in states of both health and disease as well as malfunctions of the immune system in immunological disorders like allergies, hypersensitivities, immune deficiency, transplant rejection and autoimmune disorders.

Immunology deals with physical, chemical and physiological characteristics of the components of the immune system in vitro, in situ, and in vivo. Immunology has a vast array of uses in several disciplines of science and medical science.

Key lymphoid organs of the immune system

The key primary lymphoid organs of the immune system are thymus and bone marrow, and secondary lymphatic tissues such as spleen, tonsils, lymph vessels, lymph nodes, adenoids, and skin.

In good health thymus, spleen, portions of bone marrow, lymph nodes and secondary lymphatic tissues can be surgically removed without much harm to humans.

The actual components of the immune system are cellular in nature and not associated with any specific organ. They are widely present in circulation throughout the body.

Anesthesia

Anesthesia is a treatment using drugs called anesthetics. These drugs keep you from feeling pain during medical procedures. Anesthesiologists are medical doctors who administer anesthesia and manage pain. Some anesthesia numbs a small area of the body. General anesthesia makes you unconscious (asleep) during invasive surgical procedures.

What is anesthesia?

Anesthesia is the use of medicines to prevent pain during surgery and other procedures. These medications used to block pain are called anesthetics. They may be given by injection, inhalation, topical lotion, spray, eye drops, or skin patch. Different types of anesthesia work in different ways. Some anesthetic medications numb certain parts of the body, while other medications numb the brain, to induce sleep through more invasive surgical procedures, like those within the head, chest, or abdomen.

What is anesthesia used for?

Anesthesia may be used in minor procedures, such as filling a tooth. It could be used during childbirth or procedures such as colonoscopies. And it is used during minor and major surgeries.

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

How does anesthesia work?

Anesthesia temporarily blocks sensory/pain signals from nerves to the centers in the brain. Your peripheral nerves connect the spinal cord to the rest of your body.

What are the types of anesthesia?

There are several different types of anesthesia:

• Local anesthesia numbs a small part of the body. It might be used on a tooth that needs to be pulled or on a small area around a wound that needs stitches. You are awake and alert during local anesthesia.
• Regional anesthesia is used for larger areas of the body such as an arm, a leg, or everything below the waist. You may be awake during the procedure, or you may be given sedation. Regional anesthesia may be used during childbirth, a Cesarean Section(C-section), or minor surgeries.
• General anesthesia affects the whole body. It makes you unconscious and unable to move. It is used during major surgeries, such as heart surgery, brain surgery, back surgery, and organ transplants.

What are the risks of anesthesia?

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

• Heart rhythm or breathing problems
• An allergic reaction to the anesthesia
• Delirium after general anesthesia. Delirium makes people confused. They may be unclear about what is happening to them. Some people over the age of 60 have delirium for several days after surgery. It can also happen to children when they first wake up from anesthesia.
• Awareness when someone is under general anesthesia. This usually means that the person hears sounds. But sometimes they can feel pain. This is rare.

Intensivist

An intensivist is a physician who specializes in the care of critically ill patients, most often in the intensive care unit (ICU). Intensivists can be internists or internal medicine sub-specialists (most often pulmonologists), anesthesiologists, emergency medicine physicians, pediatricians (including neonatologists), or surgeons who have completed a fellowship in critical case medicine. The intensivist must be competent not only in a broad spectrum of conditions common among critically ill patients but also with the technical procedures and devices (i.e. mechanical ventilators) used in the intensive care setting.

What is an intensive care physician?

An intensive care physician (or intensivist) is a doctor who specialises in caring for critically ill patients. Intensive care physicians work within intensive care units, which generally operate in major hospitals with access to all types of bedside, laboratory, radiology and other investigative departments.

Intensivists are often the leaders of multi-disciplinary teams of care providers to help coordinate, collaborate and facilitate providing evidenced-based outcomes. The team members consist of physicians, advanced practice providers such as physician assistants or nurse practitioners, nurses, respiratory therapists, pharmacists, dietitians and other disease specific experts.

What do intensive care physicians treat?

An intensive care physician treats patients who have any medical or surgical illness or operation that requires critical care support – generally life threatening major illnesses or operations where high level life support is required.

• Surgical intensive care
• Medical intensive care
• Paediatric intensive care
• Research

Treatments and procedures

Treatment generally involves a multidisciplinary team. The intensive care specialist will direct patient management and ensure the patient is medically controlled as well as possible while other specialty teams intervene as appropriate.

Some common procedures include:

• Intubation
• Ventilation
• Dialysis
• Percutaneous tracheostomy
• Central venous access
• Arterial cannulation

Pulmonoligist

Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often involves managing patients who need life support and mechanical ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections.

What is a pulmonologist?

These specialists diagnose and treat conditions that affect the respiratory system in men and women, as well as children. Pulmonologists have expertise in the following types of respiratory disorders:

• infectious
• structural
• inflammatory
• neoplastic, which means having to do with a tumor
• autoimmune

In some instances, this extends to the cardiovascular system. Certain conditions, such as pulmonary vascular disease, can first affect the respiratory system but go on to affect other organs in the body.

A pulmonologist may work in their own office or as part of a multidisciplinary practice. They can also work in hospital settings, particularly in intensive care units.

What conditions do pulmonologists treat?

Conditions pulmonologists commonly treat include:

• asthma
• bronchiectasis, a condition that involves inflammation and excess mucus
• bronchitis, which happens when you have inflamed lower airways
• Chronic obstructive pulmonary disease (COPD), which causes an airflow blockage
• emphysema, which happens when the alveoli in your lungs are damaged
• Interstitial lung diseases, which affect the space and tissue within the lung
• occupational lung diseases, which can occur due to the inhalation of dusts, chemicals, or proteins
• Obstructive sleep apnea, which causes your breathing to slow or stop entirely when you’re sleeping.

What procedures do pulmonologists use?

Pulmonologists can use and interpret exams and tests to help determine a lung-related diagnosis. These may include the following:

• CT Scan to get detailed images of the bones, muscles, fat organs, and blood vessels in your chest
• chest fluoroscopy, an X-ray test to see how well your lungs are functioning
• chest ultrasound to examine the organs and other chest structures
• pleural biopsy to remove a small tissue sample from the pleura, which is the membrane that surrounds your lungs
• Pulmonary function test, a breathing test to see how well your lungs are working
• Pulse oximetry test to determine the oxygen saturation level in your blood
• Thoracentesis to remove and sample fluid from around your lungs
• chest tube to remove air or fluid from around your lungs
• Bronchoscopy to examine your airway and determine if you have any issues in your trachea, lower airways, throat, or larynx
• sleep study to help diagnose sleep disorders, such as sleep apnea

In the case of more serious lung diseases and conditions, a pulmonologist may refer you to a chest surgeon for procedures, such as a lobectomy to remove a portion of a diseased lung or a lung transplant.