Causes·Symptoms Various severe asthma… Why is it difficult to treat?

Asthma is a disease caused by an allergic inflammatory reaction of the bronchi in the lungs. The exact cause has not been clearly identified. It is an allergic disease caused by a combination of genetic and environmental factors. There are countless types of substances (antigens) that cause asthma allergies, such as house dust mites, pollen, food, and drugs, as well as stress, air pollution, and fine dust.

Asthma is also a field in which treatment technology has developed most rapidly in recent years. In particular, with the development of inhaled steroid anti-inflammatory drugs and long-acting beta-stimulating inhalers, 90% of asthma patients can effectively manage their symptoms.

The remaining 10% of asthma patients are classified as severe asthma as intractable. Because the causes and symptoms of severe asthma are so diverse, the medical definition and classification have not yet been fully established. There is no clear cure for severe asthma.

Professor Cho Yoo-sook of the Department of Allergy at Seoul Asan Medical Center points out that “clinically, the definition of severe asthma is very simple, but the diversity of symptoms must be taken into consideration when dealing with and treating severe asthma.”

Basically, if the symptoms are not controlled despite the appropriate prescription of asthma medication, it can be classified as severe asthma. This is because most of them progress beyond chronic inflammation or airway constriction in the airway to symptoms of airway obstruction, and show resistance to existing core treatments.

However, the fact that the causes of such drug resistance are so diverse is also a reason why treatment is difficult. If each shows a different clinical response, it means that the symptoms are caused by different factors.

Representatively, △cases where tolerance has developed due to continuous use of systemic steroid therapy to control asthma symptoms △cases that are resistant to steroid therapy △cases accompanied by drug hypersensitivity reactions △severe asthma with a history of smoking △neutrophilic asthma △eosinophilic asthma However, when the response is low to steroid treatment, △ allergic severe asthma, etc. Neutrophils and eosinophils are types of white blood cells that are involved in immune function, respectively.

Vitamin D is a nutrient known to be good for controlling severe asthma symptoms. However, as a result of a recent review of related studies, the conclusion was overturned that there was no effect other than direct administration of the calcidol form. Recently, a research team led by Professor Hae-Shim Park of the Department of Allergy at Ajou University Hospital announced the results of a study showing that an enteric bacterium called ‘Micrococcus luteus’ suppressed airway inflammation in patients with severe neutrophilic asthma.