Asthma Pathophysiology and Treatment

Asthma pathophysiology: what changes occur in the lungs with asthma?

Close up of older Hispanic woman using asthma inhaler
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The key to understanding why your doctor prescribes certain medications or asks you to do certain things related to asthma is to understand a little about asthma pathophysiology. Asthma pathophysiology can be thought of as the study of the changes like inflammation and bronchoconstriction that occur in the lungs related to asthma. The term pathophysiology comes from the Greek stems:

  • Pathos- meaning "suffering or disease"
  • Physiologia- combining physis meaning "nature" plus logos meaning "study".

Thus, asthma pathophysiology is the study the processes that lead to asthma and its complications. Drug developers and then your doctor target specific components that make your asthma symptoms worse. This includes all of the things that may contribute to asthma and consequently can be intervened upon as part of your asthma treatment. All of the following topics can be considered part of asthma pathophysiology:

Asthma Pathophysiology: What Happens When the Lungs Don't Work Right

As your asthma worsens, three primary asthma pathophysiology changes take place in your lungs:

  • Increased Mucus: As your airways become irritated and inflamed, the cells produce more mucus. The thick mucus may clog the airways of your lung.
  • Inflammation and Swelling: Just as your ankle swells from the irritation caused by a twisted ankle, the airways of your lungs swell in response to whatever is causing your asthma attack.
  • Muscle Tightening: As the smooth muscles in your airways tighten in response to your asthma attack, the airways become smaller.

The narrowing of the airways may occur and bring on symptoms quickly, or it may occur over a longer period of time. The symptoms of the attack itself may range from very mild to very severe.

These symptoms include:

With appropriate treatment, progression of asthma pathophysiology may be prevented. Over time if asthma is poorly controlled, remodeling can occur and lead to permanent damage to the lungs. Poor control may result from not being prescribed enough medication, not having a large enough dose of medication, or not taking your medication as prescribed.

Preventing the Consequences of the Progression of Asthma Pathophysiology

Preventing asthma from worsening is hard because your risk depends on a number of factors both under and not under your control. For example, you can't do anything about your family history, but you can control your exposure to smoke.

On the other hand, once you have been diagnosed other topics may be more important:

These will all help you gain control of your asthma. Understanding the pathophysiology of asthma will help you understand how your asthma works -- what makes it worse, what makes it better, and what you need to do to keep your asthma under control.

Asthma Pathophysiology Guides Treatment

The physiology of asthma is important to understand in relation to your treatment. When you develop acute symptoms, rapid relief of bronchoconstriction is needed. Rescue inhalers function to quickly relieve narrowed arrows to improve symptoms. Controller medications, on the other hand, seek to limit the processes that lead to symptoms in the first place. As a result, controller medications decrease inflammation in the long term and need to be taken daily to have an effect. If you have allergy symptoms that make your asthma worse your doctor may prescribe something like Singulair to limit those symptoms and your subsequent asthma symptoms.

If you have severe asthma that is due to allergy, Xolair can decrease IgE levels that lead to chronic inflammation. As you can see your asthma treatments can target specific parts of the pathophysiology of asthma that are impacting you.


Asthma and Allergy Foundation of America (AAFA). Consumer Information. IgE's Role in Allergic Asthma

National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

Merck Medicus. Asthma Pathophysiology. Function and Structure of the Respiratory System.

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