Can asthma be cured?

Asthma is a chronic inflammatory disease of the airway. When you have asthma, your bronchial tubes tend to be inflamed, so they are narrower than they should be. This prevents air from circulating well through them. Since bronchial tubes are to air what pipes are to water, people with asthma have a harder time breathing. The causes of asthma are not clear. There seems to be a genetic susceptibility. This does not mean that there is a specific gene involved but that in some people there is a certain genetic weakness and certain stimuli, such as allergies or virus infections, that trigger a series of signals that cause the body itself to generate a chronic inflammation of the bronchi.

In order to control the inflation, inhalers are commonly used, which are based on drugs called corticosteroids. These drugs act on the lung and barely pass into the systemic route (the rest of the organism), and act to lower the inflammation. When the inflammation subsides, breathing returns to normal. It is also true that not all patients respond in all cases. Sometimes higher doses of inhaled corticosteroids are required and in other cases, biologic drugs may be needed.

Biologic drugs are injected and act on specific cells that cause inflammation, such as eosinophils or their receptors in the lung membrane. What these achieve is that the eosinophils practically disappear or are greatly reduced in number, leading to the disappearance of the inflammation. This treatment has been introduced during the last 15 years.

It is most common for asthma in children to begin with an allergic type of disease. There are cases of children who suffer from asthma in childhood and yet in adulthood it may disappear. We do not know why. This is not the case when asthma appears in adults. Cases of the disease first affecting people in adulthood tend to be more frequent in women. It is also more common for patients living in polluted environments, such as cities, to suffer from the disease.

Uncontrolled asthma can cause a choking sensation, making it more difficult for the person to breathe and unable to exert him/herself. If it happens suddenly, because sometimes crises occur and the bronchial tubes close abruptly, that person may have to go to the emergency room to receive corticosteroid injections to try to reduce the inflammation.

Years ago, when current treatments did not exist, a person could die from an asthma attack. Now it is much rarer because there are effective treatments that patients respond to. But it is also true that asthmatic patients who smoke can suffer more serious crises and may have to be admitted to an ICU.

Belén Gómez is a pulmonologist at the Hospital Virgen de la Victoria in Málaga and a researcher at the Institute of Biomedical Research. This article is part of an initiative sponsored by the Dr. Antoni Esteve Foundation and the L’Oréal-Unesco ‘For Women in Science’ program to answer readers’ questions about science and technology. This question was sent in by Ada Veiga.

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