Asthma (cont.)

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The scope of the problem

Asthma is now the most common chronic illness in children, affecting one in every 10. In North America, 8% of adults are also afflicted. In all, there are about 3 million Canadians and 25 million Americans who suffer from this disease.

While the number of people with asthma has continued to increase, rates of asthma-related hospitalizations and deaths have declined since the mid 1980s and 1999.

Seventy to 80% of children and 50% of adults with asthma also have allergies.

There are about 3,400 deaths annually from asthma in the U.S. and about 250 deaths per year in Canada.

Normal bronchial tubes

Before we can appreciate how asthma affects the bronchial airways, we should first take a quick look at the structure and function of normal bronchial tubes.

Lung Picture - Asthma
Lung Picture - Asthma

The air we breathe in through our nose is processed to prepare it for presentation to our lower respiratory tract. This air is moistened, heated, and cleansed prior to passage through the vocal cords (larynx) and into the windpipe (trachea). Dry or cold air presented to our trachea can cause coughing and wheezing as a normal response to this type of irritation. The air then enters the lungs by way of two large air passages (bronchi), one for each lung. The bronchi divide within each lung into smaller and smaller air tubes (bronchioles), just like branches of an inverted tree. Inhaled air is brought through these airways to the millions of tiny air sacs (alveoli) that are contained in the lungs. Oxygen (O2) passes from the air sacs into the bloodstream through numerous tiny blood vessels called capillaries. Similarly, the body's waste product, carbon dioxide (CO2), is returned to the air sacs and then eliminated upon each exhalation.

Normal bronchial tubes allow rapid passage of air in and out of the lungs to ensure that the levels of O2 and CO2 remain constant in the bloodstream. The outer walls of the bronchial tubes are surrounded by smooth muscles that contract and relax automatically with each breath. This allows the required amount of air to enter and exit the lungs to achieve this normal exchange of O2 and CO2. The contraction and relaxation of the bronchial smooth muscles are controlled by two different nervous systems that work in harmony to keep the airways open.

The inner lining of the bronchial tubes, called the bronchial mucosa, contains: (1) mucus glands that produce just enough mucus to properly lubricate the airways; and (2) a variety of so-called inflammatory cells, such as eosinophils, lymphocytes, and mast cells. These cells are designed to protect the bronchial mucosa from the microorganisms, allergens, and irritants we inhale, and which can cause the bronchial tissue to swell. Remember, however, that these inflammatory cells are also important players in the allergic reaction. Therefore, the presence of these cells in the bronchial tubes causes them to be a prime target for allergic inflammation.

Medically Reviewed by a Doctor on 12/6/2013

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