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What is Asthma and who is affected?
- A hypersensitivity disorder characterised by the following which lead to breathing insufficiency.: Spasm of the bronchi.
- Swelling of the bronchial mucosa.
- Excessive excretion of a viscous mucus.
- Prevalence ~8% in the UK
- Most common in children younger than 10.
- 2:1 male-to-female ratio in children, which equalises by age 30.
- Extrinsic or atopic asthma: Immunologically mediated IgE mediated
- Intrinsic: Generally not antigen-antibody stimulated, but as a response to chemicals, cold air, exercise, infection and emotional upset
- HOWEVER phenotyping by atopic status is not particularly useful as lung tissue of atopic vs. non-atopics presents in similar way and it does not predict response to corticosteroid treatment.
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S&S?
- Clinical diagnosis on presence of symptoms which include:
- Chest tightness and shortness of breath.
- Wheezing when breathing out (Expiratory wheeze).
- Rapid, shallow breathing that is easier when sitting up.
- Difficulty breathing.
- Neck muscles tighten.
- Coughing, especially at night, occasionally with thick, clear or yellow sputum.
- Lung function testing such as spirometry can help inform diagnosis but not in children under 5.
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Causes and risk factors:
- Asthmatics have an imbalance in AA metabolism meaning COX is downregulated in favour of LOX, leading to an increase in leukotrienes which are potent stimulators of bronchial constriction.
- Weaning before 6 months
- Formulas in place of breastfeeding
- Food additives (colourings, preservatives esp. benzoates and sulphites)
- Salt increases bronchial reactivity and mortality from asthma.
- Food allergy (leaky gut = increased antigen load = increased bronchoconstrictive compounds into circulation)
- Candida Albicans (overgrowth of yeast in GI tract)
- Inherited dysbiosis
- Obesity
- Viral infection + bacterial co-infections
- Hygiene Hypothesis (minimising exposure to infectious agents favours Th2 dominance).
- Chemical air pollutants
- Increase antibiotic use
- Whooping Cough Vaccine
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Diagnosis and Conventional Treatment for Asthma?
- Mild intermittent asthma symptomatic treatment with inhaled beta-agonists (bronchodilators).
- Mild persistent asthma daily inhalation of a corticosteroid, along with symptomatic treatment with short-acting beta-agonist.
- Moderate persistent asthma daily inhaled corticosteroid and/or long-acting beta agonist or leukotriene antagonist
- Severe asthma requires high-dose inhaled corticosteroids or oral corticosteroids, along with other controller medicines.
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Nutritional therapy for asthma:
- Grand elimination diet and food diary – to identify food allergies
- Antioxidants – inhibit leukotriene formation and histamine release, increases integrity of epithelial lining of respiratory tract, protect lungs against free radicals
- Diet rich in fruit and vegetables - decreased phlegm and better pulmonary function.
- Red wine – antioxidant
- Onions & garlic – inhibit LOX and COX enzymes which generate inflammatory mediators
- Omega 3 from fish – reduces availability of AA in cell membrane which leads to shift in leukotriene synthesis from inflammatory 4-series to less inflammatory 5-series.
- Decrease AA – meat, dairy, omega 6, refined CHO
- Vegan diet – with vegan omega 3
- Supplements:
- Omega 3 EPA dominant
- B6 - to aid metabolism of tryptophan
- Vit C
- Vit E
- Mg – natural bronchodilator
- Quercetin
- Probiotics
- Liquorice root
- Buteyko breathing
- Salt pipe
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