LAT­EST IN ASTHMA RE­SEARCH

Check what’s new in asthma treat­ments

Great Health Guide - - CONTENTS - Dr David McIn­tosh

Asthma is a very im­por­tant med­i­cal con­di­tion. In some peo­ple it can be life threat­en­ing, so it needs to be taken se­ri­ously. In the quest for try­ing to work out why some peo­ple get asthma, the lat­est in asthma re­search is start­ing to pro­vide the an­swers we need. This ar­ti­cle is a brief over­view of the lat­est in asthma re­search, with a spe­cific em­pha­sis on the role of ENT spe­cial­ists in asthma man­age­ment.

ASTHMA & SNOR­ING IN CHIL­DREN.

Chil­dren of­ten have asthma and co-ex­ist­ing prob­lems with snor­ing or sleep ap­noea. When their ton­sils and ade­noids are re­moved to un­block their up­per air­way, it can have a re­mark­able ef­fect on im­prov­ing their asthma with up to 40% of chil­dren hav­ing an im­prove­ment in their asthma. This is a sig­nif­i­cant out­come. What is in­ter­est­ing is that hav­ing asthma in­creases the chances of hav­ing prob­lems with the ton­sils and ade­noids. The con­se­quence of this is, that there is a higher rate of snor­ing in chil­dren with asthma com­pared to those chil­dren who do not have asthma. So, the lat­est in asthma re­search sug­gests that all chil­dren with asthma should have their ton­sils and ade­noids checked to see if re­mov­ing them may be ben­e­fi­cial to their health.

ASTHMA & AL­LER­GIES.

An­other im­por­tant area to look at is al­ler­gies and in par­tic­u­lar, hay fever. In fact, the Aus­tralian and In­ter­na­tional guide­lines on asthma man­age­ment high­light the im­por­tance of treat­ing hay fever se­ri­ously when it comes to those with asthma. Once again, peo­ple with asthma are more likely to have hay fever and the re­search shows that by treat­ing the hay fever with ap­pro­pri­ate med­i­ca­tions such as nasal steroid sprays, the con­trol of asthma also im­proves.

ASTHMA & IN­FLAM­MA­TION OF ‘THE UNITED AIR­WAYS’.

‘The united air­way the­ory’, de­scribes the sit­u­a­tion where the up­per and lower res­pi­ra­tory tracts are con­tin­u­ous and most im­por­tantly, they share the pas­sage of air into the lungs. Thus, ‘the united air­ways’ are sus­cep­ti­ble to the same allergens since the per­son’s im­mune sys­tem deals with all the allergens con­tained within the air that is in­haled. By set­tling down the in­flam­ma­tion in the nose caused by allergens, the gen­eral im­mune sys­tem re­ac­tiv­ity seems to de­crease and as a re­sult, the asthma at­tacks are re­duced.

ASTHMA & SI­NUS IN­FEC­TION.

The si­nuses are closely as­so­ci­ated with the nose and can be­come chron­i­cally in­fected. The lat­est in asthma re­search is show­ing pos­i­tive ben­e­fits in con­trol of asthma symp­toms when si­nus dis­ease is man­aged, par­tic­u­larly when it comes to surgery to re­move things such as polyps. Polyps in the nose and si­nuses are of­ten the re­sult of chronic si­nus dis­ease. They are as­so­ci­ated with in­flam­ma­tion. Asthma re­search sug­gests that by re­mov­ing the polyps, the si­nuses have im­proved func­tion that seems to help the lungs with re­duced asthma at­tacks.

ASTHMA & GUT BAC­TE­RIA.

The re­la­tion­ship of gut bac­te­ria to gen­eral health is a rapidly ad­vanc­ing field of re­search. There are fas­ci­nat­ing dis­cov­er­ies lead­ing to a bet­ter un­der­stand­ing of how the di­ges­tive sys­tem and the bac­te­ria that live within it, can af­fect our health. Some of the re­search on asthma and hay fever has found that us­ing cer­tain pro­bi­otics can im­prove the ef­fec­tive­ness of treat­ments of hay fever. Other re­search shows that changes in the types of gut bac­te­ria that re­side there, may re­late to al­ter­ations in the im­mune sys­tem lead­ing to changes in air­way in­flam­ma­tion and asthma. What is very in­ter­est­ing is that changes in the gut bac­te­ria in the first few months of life may lead to prob­lems later on. This is lead­ing to a great fo­cus on the im­por­tance of breast feed­ing and the pro­tec­tive ben­e­fits that it may con­fer later on in life.

Dr David McIn­tosh is a Pae­di­atric ENT Spe­cial­ist with a par­tic­u­lar in­ter­est in air­way ob­struc­tion, fa­cial and den­tal de­vel­op­ment and its re­la­tion­ship to ENT air­way prob­lems and mid­dle ear dis­ease. He also spe­cialises in si­nus dis­ease and pro­vides opin­ions on the ben­e­fit of re­vi­sion of pre­vi­ous si­nus op­er­a­tions. Dr McIn­tosh can be con­tacted via web­site.

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