Category: Defeating Asthma Series

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Understanding and Managing Severe Asthma: Types, Symptoms, and Treatment

Severe asthma is a type of asthma that is difficult to control and can have a significant impact on a person’s daily life. Symptoms of severe asthma can include frequent exacerbations (attacks), high levels of asthma symptoms, and a need for high doses of medication to manage symptoms. Causes of severe asthma can include allergies, exposure to environmental triggers, and genetics. Treatment for severe asthma typically includes a combination of long-term control medications, such as inhaled corticosteroids and bronchodilators, as well as quick-relief medications to be taken during exacerbations. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.

Types of severe Asthma

There are several subtypes of severe asthma that can be characterized based on specific symptoms and causes. These include:

It’s important to note that some people may have characteristics of more than one subtype of severe asthma. It’s important to work with a healthcare professional to identify your specific subtype of asthma and develop a treatment plan that works for you.

Allergic Asthma

Allergic asthma is a subtype of severe asthma that is caused by an allergic reaction to a specific trigger, such as dust mites, mold, animal dander, pollen, or certain foods. The allergens cause the immune system to overreact and release chemicals, such as histamine, which can lead to inflammation and narrowing of the airways.

  1. Allergic asthma: characterized by an allergic reaction to a specific trigger, such as dust mites, mold, or pet dander.
  2. Non-allergic asthma: characterized by symptoms that are not caused by an allergic reaction, but rather by triggers such as viral infections, cold air, or exercise.
  3. Aspirin-exacerbated respiratory disease (AERD): characterized by severe asthma symptoms that are triggered by the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs)
  4. Obesity-related asthma: characterized by asthma symptoms that are made worse by being overweight or obese.
  5. Occupational asthma: characterized by symptoms caused by exposure to specific triggers in the workplace, such as chemicals or dusts.
  6. Bronchial thermoplasty: characterized by symptoms caused by structural changes in the airways, such as thickening of the muscle layers that can make it harder to breathe.
  7. Eosinophilic asthma: characterized by a high number of white blood cells called eosinophils in the airways.

Symptoms of allergic asthma can include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing, especially at night or early in the morning
  • Difficulty breathing, especially during physical activity
  • Rapid breathing

Allergic asthma is diagnosed through a combination of medical history, physical examination, and laboratory tests such as skin prick test or blood test (specific IgE) to determine the specific allergens to which an individual is sensitive.

Treatment for allergic asthma typically includes:

  • Avoiding exposure to allergens as much as possible
  • Long-term control medications, such as inhaled corticosteroids and bronchodilators
  • Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
  • Allergen-specific immunotherapy (allergy shots) to help reduce sensitivity to specific allergens over time.

It’s important to note that many people with allergic asthma also have other allergic conditions, such as hay fever, eczema, or hives. They may have benefit from a comprehensive allergy management plan, including allergy testing and immunotherapy.

Non allergic asthma

Non-allergic asthma is a subtype of severe asthma that is not caused by an allergic reaction, but rather by other triggers such as viral infections, cold air, exercise, stress, or exposure to certain chemicals or pollutants. The exact cause of non-allergic asthma is not known, but it is thought to be related to changes in the airways that make them more sensitive to certain triggers.

Symptoms of non-allergic asthma can include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing, especially at night or early in the morning
  • Difficulty breathing, especially during physical activity
  • Rapid breathing

Non-allergic asthma is diagnosed through a combination of medical history, physical examination, and laboratory tests such as pulmonary function test, to rule out other causes of asthma like infections or structural changes.

Treatment for non-allergic asthma typically includes:

  • Identifying and avoiding triggers as much as possible
  • Long-term control medications, such as inhaled corticosteroids and bronchodilators
  • Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
  • Monitoring of symptoms and lung function regularly

It’s important to note that non-allergic asthma and allergic asthma can have similar symptoms and the distinction between the two subtypes can be difficult. A healthcare professional will work with you to identify the specific triggers of your asthma and create an individualized treatment plan.

Mucus Plugs and Asthma

Mucus plugs, also known as bronchial plugs, can be a complication of asthma. Mucus plugs are clumps of thick, sticky mucus that can block the airways and make it harder to breathe. They can form in the airways of people with asthma as a result of inflammation and increased mucus production in the lungs.

Symptoms of mucus plugs in asthma can include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing, especially at night or early in the morning
  • Difficulty breathing, especially during physical activity
  • Rapid breathing
  • Wet or gurgling sounds when breathing
  • Increased mucus production and difficulty clearing mucus from the lungs

Mucus plugs can be caused by a number of factors, including exposure to triggers such as allergens, viral infections, or pollutants, as well as by changes in the airways that make them more sensitive to certain triggers.

Treatment for mucus plugs in asthma typically includes:

If you have asthma and are experiencing symptoms of mucus plugs, it’s important to speak with your healthcare professional to develop an individualized treatment plan. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.

Wheezing and Severe Asthma

Wheezing is a common symptom of severe asthma, as well as other types of asthma. It is a whistling or whistling sound that can be heard when breathing, especially during exhalation. Wheezing is caused by narrowed or obstructed airways, which can make it harder to breathe.

In severe asthma, wheezing can be a sign of increased inflammation and narrowing of the airways, which can lead to difficulty breathing and increased risk of exacerbations. The increased airflow resistance leads to increased air movement velocity, generating the wheezing sound.

Symptoms of severe asthma can include:

  • Frequent exacerbations (attacks)
  • High levels of asthma symptoms, such as shortness of breath, chest tightness, and coughing
  • A need for high doses of medication to manage symptoms
  • Increased risk of hospitalization
  • Difficulty with daily activities and impairment of quality of life

Treatment for severe asthma typically includes a combination of long-term control medications, such as inhaled corticosteroids and bronchodilators, as well as quick-relief medications to be taken during exacerbations. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.

It’s important to work closely with a healthcare professional to develop an individualized treatment plan for severe asthma. This may include regular monitoring of symptoms and lung function, as well as a plan to manage exacerbations and prevent future attacks.

  • Identifying and avoiding triggers as much as possible
  • Long-term control medications, such as inhaled corticosteroids and bronchodilators
  • Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
  • Chest physical therapy, such as chest clapping and vibration, to help remove mucus from the lungs
  • Monitoring of symptoms and lung function regularly
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The World Asthma Foundation Announces Speakers for Microbiome First Summit

On this World Asthma Day, May 3, 2002, The Microbiome First – Pathway to Sustainable Healthcare Summit organization committee invites healthcare professionals, non-communicable disease community leaders, and stakeholders to participate in the inaugural Microbiome First Summit, a virtual event taking place online at MicrobiomeFirst.org this May, 17-19, 2022. FREE to participants.

For detailed information and to register, visit: https://microbiomefirst.org/

The event, Microbiome First – Pathway to Sustainable Healthcare Summit, kicks off the inaugural event underwritten and moderated by the
World Asthma Foundation (WAF), which is pleased to announce the
following speakers:

Event Keynote
RODNEY DIETERT, PHD
Cornell University Professor Emeritus
Ithaca, NY, USA
Author of The Human Superorganism.
Keynote: “Big Picture View of Our Tiny Microbes”

Researcher Sessions
MARIE-CLAIRE ARRIETA, PHD
Associate Professor, departments of Physiology, Pharmacology, and Pediatrics, University of Calgary
Calgary AB, CANADA
Session: “The early-life mycobiome in immune and metabolic development”

JAEYUN SUNG, PHD
Assistant Professor, Microbiome Program, Center for Individualized Medicine, Mayo Clinic.
Rochester, MN, USA
Session: “A predictive index for health status using species-level gut microbiome profiling”

KATRINE L. WHITESON, PHD
Assistant Professor, Molecular Biology and Biochemistry School of Biological Sciences
Associate Director, UCI Microbiome Initiative
Irvine, CA, USA
Session: “High-Fiber, Whole-Food Dietary Intervention Alters the Human Gut Microbiome but Not Fecal Short-Chain Fatty Acids”

LISA AZIZ-ZADEH, PHD
Cognitive neuroscientist; Expert in brain imaging, autism, body cognition
Associate Professor in the USC Chan Division of Occupational Science and Occupational Therapy
Los Angeles, CA, USA
Session: “Brain-Gut-Microbiome System: Pathways and Implications for Autism Spectrum Disorder”

MARTIN KRIEGEL, MD, PHD
Chief of Rheumatology and Clinical Immunology at University Hospital of Münster
GERMANY
Associate Professor Adjunct of Immunobiology at Yale School of Medicine.
Session: “Dietary Resistant Starch Effects on Gut Pathobiont Translocation and Systemic Autoimmunity”

ERICA & JUSTIN SONNENBURG, PHD
Senior research scientist and Associate Professor in the Department of Microbiology and Immunology at the Stanford University School of Medicine.
Palo Alto, CA, USA
Session: “Gut-microbiota-targeted diets modulate human immune status”

EMMA HAMILTON-WILLIAMS, PHD
Associate Professor
Principal Research Fellow
The University of Queensland Diamantina Institute
Faculty of Medicine
The University of Queensland
Translational Research Institute
Woolloongabba, QLD, AUSTRALIA
Session: “Metabolite-based Dietary Supplementation in Human Type 1 Diabetes is associated with Microbiota and Immune modulation”

ANDRES CUBILLOS-RUIZ, PHD
Scientist, Wyss Institute of Harvard University and Institute of Medical Engineering and Science at Massachusetts Institute of Technology
Cambridge, MA, USA
Session: “Protecting the Gut Microbiota from Antibiotics with Engineered Live Biotherapeutics”

EMERAN A MAYER, MD
Gastroenterologist, Neuroscientist, Distinguished Research Professor
Department of Medicine, UCLA David Geffen School of Medicine
Executive Director, G. Oppenheimer Center for Neurobiology of Stress and Resilience at UCLA
Founding Director, UCLA Brain Gut Microbiome Center.
Los Angeles, CA, USA
Session: “The Gut–Brain Axis and the Microbiome: Mechanisms and Clinical Implications”

BENOIT CHASSAING, PHD
Principal Investigator, Chassaing Lab
Associate professor, French National Institute of Health and Medical Research.
Paris, FRANCE
Session: “Ubiquitous food additive and microbiota and intestinal environment”

SEI WON LEE, MD, PHD
Associate Professor
College of Medicine, University of Ulsan
Department of Pulmonary and Critical Care, Asan Medical Center
Seoul, KOREA
Session: “The Therapeutic Application of Gut-Lung Axis in Chronic Respiratory Disease”

PATRICIA MACCHIAVERNI, PHD
Clinical and translational researcher
Research Fellow, The University of Western Australia
Perth, WA, AUSTRALIA
Honorary Research Associate, Telethon Kids Institute.
Session: “House Dust Mite Shedding in Human Milk: a Neglected Cause of Allergy Susceptibility?”

LIEKE VAN DEN ELSEN, PHD
Research Fellow, The University of Western Australia, Australia
Honorary Research Associate, Telethon Kids Institute.
Perth, WA, AUSTRALIA
Session: “Gut Microbiota by Breastfeeding: The Gateway to Allergy Prevention”

PAUL TURNER, PHD
Rachel Carson Professor of Ecology and Evolutionary Biology, Yale University
Microbiology faculty member, Yale School of Medicine.
New Haven, CT, USA
Session: “New Yale Center to Advance Phage Research, Understanding, Treatments, Training, Education”

ANDRES CUBILLOS- RUIZ, PHD
Scientist, Wyss Institute of Harvard University and Institute of Medical Engineering and Science of Massachusetts Institute of Technology MIT
Boston, MA, USA
Session: “Protecting the Gut Microbiota from Antibiotics with Engineered Live Biotherapeutics”

CLAUDIA S. MILLER, MD, MS
Emeritus Professor, Allergy/Immunology and Environmental Health University of Texas San Antonio, TX, USA
Session: “Toxicant-Induced Lost of Tolerance for Chemicals, Foods and Drugs: a Global Phenomenon”

Media Supporter Content
TONI HARTMAN
PRINCIPAL
Microbiome Courses
London, England UK
Session “Educating Parents About ‘Seeding And Feeding’ A Baby’s Microbiome”

Summit Details:

The goal of the Microbiome First – Sustainable Healthcare Summit is to
improve quality of life at reduced cost by addressing the microbiome
first, as recent research shows that all of these non-communicable diseases have a relationship to the microbiome.

For additional information visit https://microbiomefirst.org/ or on Twitter at @MicrobiomeFirst https://twitter.com/MicrobiomeFirst

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Asthma Rates and Mask – Good or Bad?

65% drop in serious asthma cases due to mask-wearing Israeli hospital reports

The Times of Israel reports that the Sheba Medical, an Israeli hospital reports 65% drop in serious asthma cases due to mask-wearing.

Here’s the 411 according to published reports:

• A study conducted by Sheba Medical Center found that the past year saw a 65 percent drop in serious asthma cases that required hospitalization.

• The drop was credited to widespread mask-wearing during the COVID-19 pandemic, which also helped decrease the spread of viruses such as the flu in the past year.

• By wearing masks, people are also less likely to suffer from seasonal allergies, as face coverings prevent pollen from flowers, trees, and grass coming into contact with the nose and mouth.

• The report follows Israel’s decision to drop the requirement to wear masks outdoors.

Israeli hospital reports 65% drop in serious asthma cases due to mask-wearing Jerusalemites wearing face masks walk in Jerusalem on February 04, 2021.

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Asthma and Bacteria: Nose to the Toes

Staphylococcus aureus enterotoxins (intestinal toxins) have a demonstrated effect on airway disease including Asthma in early life according to multiple studies. These bacteria are in the gut and on the skin.

To further the WAF misson to improve our understanding of what drives Severe Asthma, the World Asthma Foundation reached out to Rodney Dietert, PhD, for his thoughts on the topic of Asthma and Staphylococcus aureus.

Rodney Dietert, PhD is a Cornell University Professor Emeritus, Health Scientist Head of Translational Science + Education for SEED, and the Author of the Human Super-Organism How the Microbiome is Revolutionizing the Pursuit of a Healthy Life.

This is the third in the series of interviews on the topic of Asthma and Staphylococcus aureus with Rodney Dietert, Phd.

Today We Learn About

* Staphylococcus aureus beyond the nose including the skin and the gut

Video Interview

Bacteria – Staph A and Asthma

World Asthma Foundation: Dr. Dietert, can we talk about Staphylococcus aureus and Asthma beyond the nose? 

Rodney Dietert, PhD: There are skin and gut microbiome effects on the Staph A asthma connection as well. It’s not just the nose but the nose is a good starting point.

Staph A, diet consumption, the bacteria that are in place, particularly in the nose, but also to some extent in the gut and even the skin, can determine what’s going to happen later in the risk for conditions like asthma. I think the thing to realize is that that bacteria and early on, that’s when you’re still recruiting cells. Lung maturation is one of the late-maturing systems. The lung and brain are late compared to a lot of other physiological systems. You don’t really fully mature the lung until something like 18 or 20.

Those effects on recruiting and getting balance in your immune cells in the lung are really important. When you’ve got a bacterium there that is producing allergens, it is stimulating a population we didn’t use to know about, called T helper 9. These cells produce a cytokine called Interleukin-9. The important thing to know is that these cells interact exquisitely with mast cells. They actually have T helper 9 cells.

Immune cells have histamine receptors so they’re co-stimulating between these cells and mast cells. Imagine (the outcomes) when an infant is skewed toward producing that kind of immune cells in these tissues, like the lung, and them having that kind of interactions with mast cells.

See also Dr. Dietert’s interview about the Gut and Lung connection.

Staph A bacteria - Dr. Dietert.

For full story and video follow the link below

Asthma and Bacteria: Nose to the Toes

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Asthma and Bacteria in Early Life

Staphylococcus aureus enterotoxins (intestinal toxins) have been demonstrated to affect airway disease including Asthma in early life according to multiple studies. The study of Asthma and Bacteria in early life is very interesting.

To further the WAF misson to improve our understanding of what drives Severe Asthma, the World Asthma Foundation reached out to Rodney Dietert, PhD, for his thoughts on the topic of Asthma and Staphylococcus aureus.

Rodney Dietert, PhD is a Cornell University Professor Emeritus, Health Scientist Head of Translational Science + Education for SEED and the Author of the Human Super-Organism How the Microbiome is Revolutionizing the Pursuit of a Healthy Life.

Asthma and Bacteria in Early Life: Staphylococcus Aureus

This is the second interview of three on the topic of Asthma and Staphylococcus aureus with Rodney Dietert, PhD. Today we learn about:

  • Relationship between Asthma and Staphylococcus aureus
  • Multinational studies on the topic of Asthma and Staphylococcus aureus
  • Importance of diet

 

Asthma and Bacteria in Early Life: Staphylococcus Aureus

World Asthma Foundation: Can you talk about the relationship between Staph A and Asthma as a biomarker in early life?

Rodney Dietert, PhD: Yes. There’s a multi-nation study that was done to look at the nasal microbiome in early life. They were measuring that two, four, six, nine months up through to two years and then looked, among their cohorts, at asthma between ages 6 and 18.

Nasal Microbiota Findings

What they found was really striking. They found four major categories of progression of the nasal microbiota as the infant aged. There was one of those groups where Staph A was the most prevalent bacterium or Staphylococcus, and particularly Staph A, that was present. The two-month major (bacterium). It was the main bacterium.

That group that started that way, at two months, had, I think it ranged from age 6 to 18, they were measuring asthma and that microbiome beginning (2 months). That contributed to 45 to 60% of the asthma among all of those children they were evaluating. Just from that one (microbiota) type. That was really an impressive predictor of asthma in later childhood. That suggests you don’t want to see Staph A like that, in a two-month-year-old baby. If you do, you better do something about it.

Staph A

Now, again, that is still an association but we understand what Staph A does to the immune system, because of what it does in terms of producing toxins that actually are allergens or can be allergens, what it does to IgE production. You know if that is really the prevalent nasal bacteria at that age and that is not what you usually see, that’s a problem. Right there, there is a biomarker in my opinion that should be a red flag. We should be looking to do something about that.

Sweet Consumption

There are also studies in early life that show consumption of sweets is a contributing factor to the risk when you’ve got Staph A in there. Some of the children actually seem to have a receptor detection of sweet issue. There’s a cohort that actually can’t tell that they’ve really had what would be considered an overabundance of sweets. They’re a little resistant to detecting it, so they eat more and that actually will propel them to severe asthma later on. That combination of Staph A, and diet even, is very important.

Asthma and Bacteria in Early Life: Staph A
Asthma and Bacteria in Early Life: Staph A, Rodney Dietert PhD

For additional information on Asthma and Staphylococcus aureus and the WAF defeating Asthma Project, visit:

Defeating Asthma Project