Asthma Has No Cure: Classification Of Asthma-Like Disorders

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Asthma disease: A hyperactive airway disease that has no cure
Introduction
Asthma constitutes a chronic respiratory disorder presented by incidents of acute bronchoconstriction resulting in shortness of breath, tightening of the chest, cough, wheezing, and fast respirations, that are instigated by an array of genetic factors, developmental, and environmental elements, affecting about 300 million individuals globally The burden of asthma is perceived regarding healthcare costs, and reduced productivity and engagement in family life (Vemula, Turapati, Ponugoti & Garepally 1). On the other hand, reactive airways dysfunction syndrome (RADs), an amorphous term initially coined by Brooks and Lockers in the year 1981, is fundamentally an acute occurrence of asthma-like indicators following hyperactivity of airways after exposure to elevated levels of irritants including corrosive gas, fumes or vapor. While RADs elicit symptoms similar to those of asthma, they are often insensitive to asthma management interventions (Varney, Evans & Bansal, 87).
This paper, argues in support of the fact that, asthma is a hyperactive airway disease that has no cure.
Arguments
Classification of Asthma and asthma-like disorders
King and Moores (568), describe asthma as a heterogeneous condition (not a single disorder) presenting various clinical phenotypes. Such phenotypes are categorized into clinical or physiological, trigger-based, as well as inflammatory based phenotypes. Interventions founded on inflammatory phenotyping alleviates clinical conditions of asthma morbidity. It is the understanding of such specific asthma phenotypes based on their immunologic and pathologic presentations that improve diagnosis and management. Owing to the non-specific presentation of its symptoms, other conditions are commonly misdiagnosed as asthma (King & Moore 568). Hence, any treatment given on the basis of misdiagnosis fails to work especially when the symptoms are generic or remains unresponsive to therapy.
A number of classification models have been demonstrated, however, asthma characterization still remains poor, especially with minimal knowledge of the underlying pathophysiology. There has been no consensus regarding the standard model of asthma phenotype classification. Nonetheless, much interest has moved to the categorization on the basis of immunopathology, especially the cellular inflammatory response mechanism. Clinical symptom alleviation has been realized with management approaches focusing on inflammation and not symptoms and peak flow (King and Moore 568). Hence, poor characterization has hampered development of any effective therapy.
According to the National Asthma Education and Prevention Program’s Expert Panel Report of 2007, asthma is a general chronic syndrome of the airways that is multifaceted and presented by various and recurring features of airflow hindrance, bronchial hyper-responsiveness, and a basal inflammation (King & Moore 568). This description clearly instigates that asthma constitutes amongst several disorders presented by hyperactive airway disorder. They appreciate that ‘phenotype’ involves physical manifestations, morphological, or biochemical level of a patient based on the genetic make-up and environment. Hence, asthma stems from a complex interplay between environmental and genetic elements which are difficult to cure.
To understand whether asthma is curable or not, it is fundamental that we understand its dynamic nature including its causative elements. To begin with, clinically or physiologically perceived phenotypes include, severity-based classification is most widely employed clinically. With this, asthma can be grouped as “intermittent, mild persistent, moderate persistent, or severe persistent in prior evaluation and treatment. The other clinical based classification is exacerbation-prone subgroup which is a high risk group as it entails frequent or severe exacerbation. Most of patients in this category are atopic, meaning they are genetically predisposed to the disorder based on levels of eosinophilic inflammation with environmental allergens being risk factors (King & Moore 570). This genetic predisposition may follow gender or race. It is apparent that such patients may live with the condition for the rest of their lives, but can only manage it by keeping of risk factors and taking medical interventions at the slightest onset of the symptoms.
The other clinically based group is asthma presenting chronic airflow obstruction. This is a disorder defined by reversible airflow obstruction; nevertheless, irreversible obstruction has been observed in some patients as highlighted by King and Moore, (570). Even with clinical reduction in basal pulmonary activity, such patients may still experience reasonable symptomatology of fixed obstruction, hence not curable but manageable. A study by King and Moore reported fixed obstruction as associated with greater age and chronic disease (570). This underpins why asthma remains a non-curable disease.
Moreover, treatment-resistant asthma has been categorized as a clinical-based group. Whereas the use of inhaled corticosteroids has been effective in the control of airway infl...