PATHOPHYSIOLOGY OF ASTHMA

Asthma is a common pulmonary condition defined by chronic inflammation of

respiratory tubes, tightening of respiratory smooth muscle, and episodes of
bronchoconstriction. According to the World Health Organization (WHO), asthma affects
235 million people worldwide. There are two major categories of asthma which are allergic
and non-allergic. The airways of the lungs are surrounded by muscles and contain mucus
glands. These muscles are normally relaxed but a person having asthma will be often
sensitive and inflamed. The pathophysiology of asthma is complex and involves airway
inflammation, intermittent airflow obstruction, and bronchial hyper-responsiveness. Diagram
1 shows the differences between a normal airway and asthmatic airway.

Diagram 1

Airway inflammation

Airflow limitation is induced by airway inflammation such as bronchoconstriction,

airway hyper-responsiveness and air edema. Bronchoconstriction happened when bronchial
smooth muscle contraction that quickly narrows the airways in response to exposure to a
variety of stimuli. Airway hyper-responsiveness is an exaggerated bronchoconstrictor
response to stimuli. While airway edema present as the disease becomes more persistent and
inflammation become more progressive, edema, mucus hyper secretion, and formation of
inspissated mucus plugs further limit airflow.
Bronchoconstriction

During an asthma episode, inflamed airways react to environmental triggers such as

smoke, dust, or pollen. The airways narrow and produce excess mucus which making it
difficult to breathe. In essence, asthma is the result of an immune response in the bronchial
airways. The airways of asthma patients are hypersensitive to certain triggers, also known as
stimuli. In response to exposure to these triggers, the bronchi contract into spasm.
Inflammation soon follows, leading to a further narrowing of the airways and excessive
mucus production, which leads to coughing and other breathing difficulties.

Types of asthma

Asthma can occur in many different ways and for many different reasons, but the
triggers are often the same. Asthma is divided into five types which are:

1) Childhood asthma
2) Adult-onset asthma
3) Occupational asthma
4) Seasonal asthma