Asthma is a respiratory disease characterized by narrowing and excessive reactivity of the lungs. It is a chronic disease as complex as it is common, especially during childhood, in which several factors, both genetic and environmental, come into play.
In most cases asthma can be kept under control with current treatments, although some individuals may suffer from more severe forms. Asthma symptoms can worsen either gradually or suddenly in a so-called asthma attack, a sudden exacerbation that can require hospitalization and, in some cases, be life-threatening.
People with untreated (or undertreated) asthma may suffer from sleep disturbances, fatigue, and poor concentration, a condition that also results in increased difficulty in school and work, with a financial impact on the family and the community at large.
Where does medicine stand in the treatment of this disease?
A disease that in the eyes of many might seem “under control” is nonetheless being watched with interest by the scientific community to continually improve our understanding, treatment options and prospects for achieving a lasting cure.
The efforts of the scientific community are focusing on finding long-term solutions. WHO has included the disease in the Global Plan of Action for the Prevention and Control of Noncommunicable Diseases and the United Nations 2030 Agenda for Sustainable Development to help improve asthma management in primary health care in low-resource settings.
The latest news on asthma treatment
Current treatments, including steroids, provide short-term relief of asthma symptoms by relaxing the airways or reducing inflammation. However, no current drugs address the structural changes that the disease brings to the airways and lungs in a way that would provide longer-lasting treatment.
Some research is focusing on stem cells, specifically the cell known as the “pericyte.” When asthmatics have an inflammatory reaction, pericytes move to the airways. Once there, they develop into cells that make the walls thicker and less flexible. The researchers found that blocking this movement of pericytes resulted in a reduction in symptoms. Although the results are promising, it will be several years before the treatment can be tested in people.
Another study is focusing on receptor for advanced glycation end products (RAGE), which are implicated in lung development and the pathogenesis of chronic respiratory diseases. From early results, it appears that inhibition of RAGE signaling reduces airway inflammation in some cases of asthma.
The current situation with asthma
There are currently several treatments available for asthma. The most common are inhalers, small devices that allow people to inhale medication, acting directly on the affected area. The main types are:
- Bronchodilators, which open the airways and relieve symptoms.
- Steroids, which reduce airway inflammation, improving asthma symptoms and reducing the risk of severe asthma attacks and death.
With current treatments, it is possible to control the disease and enable people with asthma to lead normal, active lives, provided it is properly diagnosed. According to WHO, there are about 262 million people with asthma, and asthma-related deaths each year are around 455,000, concentrated especially in low- and middle-income areas of the world where the disease is poorly diagnosed.
A great deal of work can be done on raising awareness of the issue and raising the number of diagnoses before major attacks can occur. In any case, it is a condition that requires ongoing and sustained treatment, with a not inconsiderable cost to the poorer segments of the population.