Of Antonella Sparvoli

Inflammatory disease of the respiratory tract is too often overlooked and adherence to treatment is very low, thus increasing the chances of worsening

Today there is no shortage of tools to reduce symptoms and to keep your asthma under controlpity that this inflammatory disease of the respiratory tract is too often overlooked and adherence to treatment is very low, thus increasing the chances of worsening. It is estimated that only about half of asthmatics follow the therapies correctly – points out the professor George Walter Canonica, head of the Center for Personalized Medicine, Asthma and Allergology at the Humanitas Clinical Institute and professor at Humanitas University —. So a dramatic situation, which highlights the need for more information and education.

Heterogeneous disease

Asthma is a disease that recognizes different causes. The most typical is allergy but there are also other factors that must be properly investigated, such as physical exertion, exposure to irritants (starting from smog) or viral infections. Asthma can take on very different contours and forms, but always characterized by a variable degree of constriction of the bronchi it’s yes an increased sensitivity of the respiratory tract to various stimuli, with consequent breathing difficulties – explains Canonica -. In asthma, phases of relative or complete well-being usually alternate with moments with even very serious breathing problems, so-called asthma attacks. During attacks, which can be sudden or gradual, symptoms and respiratory function worsen.

The alarm bells and tests to recognize it

Wheezing, air hunger and difficulty breathing (the so-called dyspnoea), cough and sometimes chest tightness are the typical disturbances that characterize the asthma attack. But asthma doesn’t always manifest itself in a striking way. Sometimes, for example, the only indicator of the disease a persistent coughperhaps accentuated by exercise. From a functional point of view we have the closure of the bronchus and a hypersecretion of mucus, which further reduces the caliber of the airways, increasing the hunger for air, points out the expert. Contrary to what many still think, asthma doesn’t just affect children or adolescents. In fact, it can also occur in adults and the elderly. If the disease is suspected, several tools for diagnosis are now available, including pulmonary function tests with spirometry associated with bronchial stimulation tests (reversibility test and methacholine test), thorough allergy investigation and today too the FeNO dosagei.e. the analysis of exhaled gas (nitric oxide) which, depending on the value found, indicates or does not indicate bronchial inflammation.

The importance of personalized therapy

l’asma not curable, but well treatable thanks to a series of drugs, often used in combination, which include corticosteroids, bronchodilators and leukotriene modifiers (another class of inflammatory). In allergic asthma they can be very useful too allergy vaccines, or the so-called immunotherapy, which consists in the administration of allergens for a prolonged time in order to determine a tolerance. What matters most always identify the specific characteristics of asthmapersonalize treatment and teach patients to take the drugs continuously and correctly, generally released directly into the respiratory tract with special tools such as sprays – Canonica points out -. Just regular therapyaccompanied by a periodic assessment of the state of constriction of the bronchi, may allow for good asthma control. This objective is still a long way off for many patients today, due to very low adherence to treatment.

Biological drugs for severe asthma

A lot of progress has been made in recent years treatment of the most severe forms of asthma. Today they can be used in the most insidious forms monoclonal antibodies (also called biological drugs), which affect different immunological mechanisms that can induce disease. The use of biologics requires very accurate diagnostics, which can be carried out in asthma centres, and which allows access to therapy or precision medicine and induce in a good proportion of patients the clinical remission concludes Professor Canonica.

April 21, 2023 (change April 21, 2023 | 07:56)

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