Can Asthma be cured? What are the latest treatments for Asthma?
Asthma is an eminently controllable illness. Indeed, for most the sufferers, control is so effective that it amounts to a virtual cure. But asthma may not curable in a different way as, say, bacterial pneumonia; it never entirely goes away. Also, no one cure would ever suffice. It is becoming increasingly clear that their many types of asthma & they differ greatly in their presentation & Genesis. For example, asthma which presents as a chronic cough, the “cough variant of asthma,” appears to be very different from the life-threatening variety, which results in extreme respiratory failure & sometimes death.
Nevertheless, the sine qua non of asthma as we know it today is the increased sensitivity of the airways to many different agents. All of these agents include the respiratory viruses (cold common virus), pollutants (cigarette smoke & ozone), airborne allergens (pollens, animal dander, & molds) & exercise, especially in a cold & dry environment. These agents called triggers, induce an inflammatory reaction in the airways that, in turn, results in the common symptoms of cough, wheezing, increased mucus production & shortness of breath. Successful control of asthma entails controlling the inflammation in the airways & reversing the symptoms before they get out of hand.
The greatest advances to controlling the asthma level may be the change in physicians’ attitudes toward using preventive medications, as well as attempts to make home rescue plans more aggressive & self-sufficient. The availability of selective & potent medications has made such changes possible. By avoiding all known triggers in the environment, such as dust mites, cigarette smoke, roach antigens & dander from warm-blooded pets like cats & dogs, patients can help minimize airway inflammation. Also, tighter, newer, & more energy-efficient homes, forced-air heating & wall-to-wall carpeting all contribute to higher levels of indoor triggers.
Another effective strategy for preventing inflammation is the use of certain medications either daily during a season (for most individuals with asthma, it is the fall season), during multiple seasons or year-round. One class of these medications stabilize the mast cell, (large cells filled with potent inflammation-inducing chemicals called leukotrienes), which line the respiratory tract & play a central role in allergy-induced asthma. These mast cell-stabilizing inhalants include Cromolyn & Nedocromil. Cromolyn is of the particular interest as it is derived from the plant to Ammi Visnaga, long used by American Indians as an herbal remedy for colic.
An exciting new class of oral medications called leukotriene modifiers, neutralize the actions of leukotrienes. This class of medication is the first new class to become available for asthma management in the past 20 years & holds great promise. It includes Zafirlukast, Pranlukast & Zileuton. The most effective preventive medications for asthma belong to the family of corticosteroids. Their widespread use is the single most important reason for the improved control of asthma in recent decades. Because these medications are applied directly to the surface of the airways through inhalation & so do not affect other parts of the body as they might if taken orally their side effects are minimized.
Many other attitudinal advances in managing asthma have been the early & aggressive use of the symptom relief the medications, including Beta-2 receptor stimulants & short courses of oral steroids, as a part of the home rescue therapy. This form of therapy has the additional advantage of making patients & caregivers self-sufficient & confident in handling an acute episode of asthma. This type of self-sufficiency is essential in the successful control of any chronic illness. & the good news on this front is that the second class of Beta-2 medications (essentially more selective optical isomers of their parent medications) has just become available.
The past few years have also seen a concerted effort by the National Institutes of Health, especially the National Heart, Lung, & Blood Institute, & other agencies to educate physicians in the best ways to manage asthma. Community education programs, support groups & the Internet have played a major role in providing useful information to parents of asthmatic children & patients alike.
In summary, the therapeutic & attitudinal advances in managing asthma have been substantial in all past 15 – 20 years, resulting in more effective & safer ways of controlling it. Although the cure is not on the horizon, nearly complete control is well within reach.