Atopy and Asthma

Anne B Yates, University of Mississippi Medical Center, Jackson, Mississippi, USA
Richard D de Shazo, University of Mississippi Medical Center, Jackson, Mississippi, USA

Published online: September 2010

DOI: 10.1002/9780470015902.a0002161.pub3

Atopy is the genetic propensity to develop an immunoglobulin E antibody response to common allergens. The most common clinical manifestations of atopy are allergic rhinitis, asthma and atopic dermatitis. Asthma is a complex disorder of the airways, involving airway hyperresponsiveness, airflow obstruction that is at least partially reversible, and inflammation of the airways. Although atopy has been identified as the strongest predisposing factor for the development of asthma, not all asthma is allergic in nature. The overall prevalence of asthma has been increasing worldwide for the past few decades, and continues to increase globally. Guidelines for the evaluation and treatment of asthma were developed in the early 1990s, and are revised periodically as research into effectiveness of available medications emerges, and development of new therapies arise.

Key Concepts:

  • Asthma is a common but complex disorder of the airways, involving variable and recurrent symptoms, airway obstruction, inflammation and bronchial hyperresponsiveness.
  • Symptoms of asthma include coughing, wheezing, shortness of breath and feelings of chest tightness or pain with breathing.
  • Onset of asthma usually begins early in life, although adult-onset of asthma may occur.
  • Genetic predisposition, as well as environmental factors, play a role in the development of asthma.
  • Treatment of asthma centres around control of chronic inflammation, avoidance of triggering factors and treatment of acute bronchospasm when needed.
  • Individuals over 65 may have a decreased perception of breathlessness and air hunger. Therefore, the use of clinical symptoms to diagnose and treat seniors may underestimate the severity of airways obstruction.

Keywords: allergy; airway hyperresponsiveness; inflammation; bronchospasm

Figure 1. Mechanisms of allergic reaction. IL, interleukin; GM-CSF, granulocyte–macrophage colony-stimulating factor; IgE, immunoglobulin E; TNF, tumour necrosis factor ; LTC4, leucotriene C4; PGD2, prostaglandin D2; HETEs, hydroxyeicosatetraenoic acids; PAF, platelet-activating factor.
Figure 2. A step-care approach to managing asthma in adults and children. Preferred treatments are in bold type. Note: Patients at any level of severity can have mild, moderate or severe exacerbations. Some patients with intermittent asthma may experience severe and life-threatening exacerbations separated by long periods of normal lung function and no symptoms. Adapted from National Asthma Education and Prevention Program (2007).
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    Von Mutius E (2009) Gene environment interactions in asthma. Journal of Allergy and Clinical Immunology 123: 3–11.

Related Sub-Topics:

Diagnostics, Therapeutics and Methods | Allergy and Hypersensitivity
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Article Title: Atopy and Asthma
 
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Yates, Anne B, and de Shazo, Richard D(Sep 2010) Atopy and Asthma. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0002161.pub3]