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Justyn Henson

Professor Hellmers

ENG 1201

11 July 2021

Literature Review

Around the world, many suffer from a lower respiratory disease called Asthma. This

disease is widely known for its untreatability, constriction of the airways, and the difficulty of

life it provides. This disease is widely researched and evaluated and many people wonder, what

is everything we know about asthma?

The concept of Asthma has been around since ancient times. Before the collective mind

of medicine, the symptoms of asthma were not categorized into one. It was not until these

concepts were put together did an understanding of Asthma arise. “While scriptures from China

as far back as 2,600 B.C.E. and ancient Egypt mention symptoms of breathlessness and

respiratory distress, asthma did not have its name or unique characteristics until Hippocrates

described it over 2,000 years later in Greece”(Felman). Hippocrates was the first to see the onset

of symptoms caused by asthma. The continued research of this disease continued throughout

history as many continued to try and understand Asthma. “In 1892, Sir William Osler, one of the

co-founders of the John Hopkins Medical School, set out his own definition of asthma. Bronchial

spasms featured high on his list, and he noted the similarities between asthma and allergic

conditions, such as hay fever, as well as asthma’s tendency to run in families and start in

childhood. He also identified specific triggers of asthma, such as climate, extreme emotion, and

diet.”(Felman). Osler’s research on the constriction of airways was the first to make the leap into
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medication. Since then, the advancement in research of this disease has skyrocketed. Adam

Felman and his research on the history of Asthma lays out the different research tactics and

developments that led to the increased knowledge of the disease.

The years spent researching this disease have prepared a strong base for understanding

what Asthma is, its causes, triggers that cause an attack, the symptoms, and the treatments. The

World Health Organization, a leading research organization, aims to educate the general public

about Asthma. “ The air passages in the lungs become narrow due to inflammation and

tightening of the muscles around the small airways”(World Health Organization). During an

asthma attack, the lungs become stricken and close up, leaving poor airflow. Just like many other

diseases, different versions of Asthma exist. The most common type of Asthma occurs in

children and young adolescents. “Childhood asthma - Asthma is the most common chronic

condition in children. It can develop at any age, but it is slightly more common in children than

in adults.”(Brazier, 2020). Childhood asthma is often to have been from birth and carried through

the child's life. Although most Asthma patients are born with this disease, Asthma still has the

possibility of forming in adulthood. “Asthma can develop at any age, including during

adulthood. According to one 2013 study, adults are more likely than children to have persistent

symptoms.”(Brazier, 2020). Adult-onset asthma that forms later in life is often considered worse.

Symptoms are often worse, mainly because of the way the disease was brought on.

The causes and originality of Asthma are unknown. Many speculate both genetics and

environmental factors influence the disease. “Health professionals do not know exactly what

causes asthma, but genetic and environmental factors both seem to play significant roles. Some

factors, such as sensitization to an allergen, may both be causes and triggers.”(Brazier, 2020).

The genetics linked to Asthma often come from a family member, particularly immediate
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members like parents or siblings. Another way Asthma can be caused is from your daily life.

“Exposure to a range of environmental allergens and irritants are also thought to increase the risk

of asthma, including indoor and outdoor air pollution, house dust mites, molds, and occupational

exposure to chemicals, fumes, or dust.”(World Health Organization). Increased exposure to

allergens can create the possibility of forming the disease. This is often how Adult-onset asthma

is formed. Conditions ranging from allergies to smoking can rapidly increase your chances.

The triggers of the disease come in a variety of ways. The biggest triggers of asthma are

allergies, irritants, and exercise. “Common allergens that cause allergic asthma include Dust

mites, Cockroach, Pollen, Molds, Pet dander, Rodents.”(aafa). Allergens that would normally

cause sneezing and the sniffles for most, would lead to tightening airways for asthmatics.

However, not all things that trigger asthma are allergens. “Irritants in the environment can also

bring on an asthma episode. Although people are not allergic to these items, they can bother

inflamed, sensitive airways.”(aafa). Irritants can all include smoke, fumes, and chemicals in the

air. The last major trigger and perhaps the most common is exercise. “Asthma that is triggered by

physical activity. It is also known as exercise-induced asthma.”(aafa). Asthma induced from

physical activity can happen very rapidly with little warning. There is no benchmark for the

amount of activity before an attack. Symptoms from these attacks can often be more fatal. The

Asthma and Allergy Foundation of America accurately describes the different symptoms and

triggers of Asthma. They provide awareness of this disease and provide details you need to know

to have a good understanding of it.

The symptoms of an asthma attack are often not well defined and can vary from each

attack. “The symptoms of asthma can be nonspecific and varied, making the diagnosis difficult.

Patients often present with wheezing, shortness of breath, and cough that occur more frequently
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during the night and early morning.”(So et. al). The diagnosis of asthma is often difficult. The

symptoms of this disease are not constant and have little to no pattern. Symptoms are constantly

evolving and changing as new diagnoses are being produced. “A person with asthma may

experience:tightness in the chest, wheezing, breathlessness, coughing, increased mucus

production”(Brazier,2020). The symptoms of Asthma present themselves in many ways, with

many overlaps into other diseases. Some symptoms are severe, while others are more

manageable. Attacks can begin suddenly and range from mild to life-threatening. “In some

cases, swelling in the airways can prevent oxygen from reaching the lungs. This means that

oxygen cannot enter the bloodstream or reach vital organs. Therefore, people who experience

severe symptoms need urgent medical attention”(Brazier). Asthma attacks often require medical

attention as attacks can range from mild to severe without warning.

According to So et. al(2018), over 230 million people are diagnosed with Asthma around

the world. They also tell us there were more than 383,000 asthma-related deaths in the year

2015. Asthma is the most common respiratory disease diagnosed around the world. As said by

AsthmaMD, “Each year, asthma accounts for more than 10 million outpatient visits and 500,000

hospitalizations.” With increased hospitalizations and mortality rates, treatment for Asthma is

needed more than ever. Although there is no cure for Asthma, there are treatments available to

reduce the pain and incomfort that comes with having it. “The goal of asthma treatment is

symptom control and prevention of future exacerbations.” Asthma treatments are only available

to make having this disease more comfortable and to prevent future asthma attacks. The most

common treatment includes rescue inhalers, steroids, and nebulizers. According to WebMD,

“Short-acting beta-agonists are the first choice for quick relief of asthma symptoms. They

include albuterol (ProAir HFA, Proventil HFA, Ventolin HFA), epinephrine (Asthmanefrin,
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Primatene Mist), and levalbuterol (Xopenex HFA)”(2010). The purpose of rescue inhalers is to

calm the inflammation and swelling in the midst of an attack. Oftentimes, if a rescue inhaler is

failing to reduce inflammation, another medication will be prescribed. Corticosteroids,

particularly prednisone, are often the choice for preventative maintenance. “ If no other medicine

can get your asthma attacks under control, your doctor might have you take these medications for

a couple of weeks. They come in pills or liquids.”(WebMD,2020). Corticosteroids often come in

pill form and have the ability to stay in your system for several weeks. These medications often

come with their own set of symptoms. “weight gain, gastritis, osteoporosis, hypertension, adrenal

suppression, and psychosis.”(So et. al, 2018). Corticosteroids and their symptoms are frequently

looked down upon because of the unknown factor of their effects on the body. Another

treatment, without symptoms, is a nebulizer. “ This machine changes asthma medications from a

liquid to a mist so it’s easier to get the medicine into your lungs.”(WebMD,2020). A nebulizer

produces a mist that provides a simple path to the inflamed lungs. Oftentimes, especially in

young children, different asthma medicines struggle to reach the lungs. Nebulizers take out that

struggle and the mist can effectively do its job.

A common misconception with Asthma is its close relative, COPD. Although they both

are respiratory diseases, they have their differences. “COPD is the general name given to a group

of lung diseases. The main lung diseases involved in COPD are emphysema and chronic

bronchitis, both of which are considered different forms of COPD by many researchers and

doctors.”(Post Acute Medical). COPD is not one disease. It is several that combine into one and

present similar symptoms to those of Asthma. Both COPD and Asthma present similar

symptoms, but in different ways. “asthma can get better and its symptoms may come and go,

whereas COPD comes with constant symptoms that may worsen over time.”(Post Acute
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Medical). Symptoms of these diseases are different for many reasons. Asthma symptoms are

often periodic, only showing signs during an attack. COPD symptoms occur throughout the day,

never-ending. A big difference between COPD and asthma is the way they form. Asthma is often

from birth, revolving around genetics and allergies while COPD forms later in life. “COPD

symptoms typically develop in people over the age of 40.”(Post Acute Medical). This is often

from triggers, common to the ones for Asthma. These triggers are often from tobacco use in

smoking. According to Post Acute Medical, smoking is the lead cause in COPD, as well as

pollution and chemicals. These outside factors are the reason why COPD forms late in life.

COPD, similar to Asthma, is incurable, with only treatments available to reduce symptoms. “

Stopping smoking is the best way to prevent further damage to the lungs. While smoking is the

primary trigger for COPD, other irritants should be avoided as well, such as air pollution,

chemicals, and dust.”(Post Acute Medical). Treatments for COPD are more scarce than Asthma.

Besides stopping the exposure to triggers, only one form of treatment is available.

“Bronchodilators are medicines typically delivered via inhalers to relax the muscles around the

airways to make breathing easier. Because bronchodilators may be short- or long-acting, they

can be used as needed or daily.”(Post Acute Medical). COPD and Asthma have many

similarities, but they should not be confused with each other. This article from Post Acute

Medical is intended to determine the differences in COPD and Asthma to prevent the common

misinterpretation of both diseases.

The idea and symptoms of asthma are ancient. The ever-evolving knowledge surrounding

the disease continues to grow as research continues. As of now, the biggest mysteries of the

disease are its originality and its curability. Currently, there is no definitive proof of why Asthma

appears or how to get rid of it. The increased research over the years has led to major
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breakthroughs in understanding this disease. We understand what it does to the body, what

triggers cause it, and the symptoms that follow. The research behind Asthma will continue to

grow and what we know will keep expanding.

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Works Cited

“AAFA.” Asthma and Allergy Foundation of America, 2019, www.aafa.org/asthma-triggers-

causes/

“Asthma Statistics.” AsthmaMD, www.asthmamd.org/asthma-statistics/.

“Asthma vs. COPD: What's the Difference?” Asthma vs. COPD: What's the Difference? | PAM,

https://postacutemedical.com/company/company-updates/asthma-vs-copd-whats-the-

difference

“Asthma.” World Health Organization, World Health Organization, 3 May 2021,

www.who.int/news-room/fact-sheets/detail/asthma.

Brazier, Yvette. “Asthma: Types, Causes, and Diagnosis.” Medical News Today, MediLexicon

International, 28 Jan. 2020, www.medicalnewstoday.com/articles/323523#what-is-

asthma.

Felman, Adam. “The History of Asthma: Development, Understanding, and Treatments.”

Medical News Today, MediLexicon International, 2 Nov. 2018,

www.medicalnewstoday.com/articles/323526#asthma-is-ancient.

Pichardo, Gabriela. “Asthma Treatments: Inhalers, Nebulizers, and Medications.” WebMD,

WebMD, 2020, www.webmd.com/asthma/asthma-treatments.

So, Jennifer, et al. “Asthma: Diagnosis and Treatment.” European Medical Journal, 17 Dec.

2018, www.emjreviews.com/respiratory/article/asthma-diagnosis-and-treatment/.
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