Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.

Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma. Regardless of the type, asthma symptoms typically include wheezing, shortness of breath, chest tightness, and sleep disturbances due to difficulty in breathing.

The development of allergic asthma, or its pathogenesis, involves an immune response in individuals genetically predisposed to this condition. This process begins with the sensitization phase, where the initial exposure to an allergen triggers the immune system to produce specific antibodies called Immunoglobulin E (IgE). These antibodies bind to mast cells in the airway mucosa, priming them for subsequent allergen encounters.

When re-exposed to the allergen, the primed mast cells release inflammatory mediators like histamine, leukotrienes, and prostaglandins. These substances contribute to the inflammatory response in the body. These substances cause the bronchial muscles to contract, leading to the narrowing of the airways or bronchoconstriction. They also stimulate the secretion of mucus and increase the permeability of blood vessels, causing vascular leakage.

Following this immediate reaction, a late-phase response occurs several hours later. It involves the influx of eosinophils and lymphocytes into the airways, releasing inflammatory proteins called interleukins. This response sustains the bronchoconstriction, inflammation, and mucus production, contributing to the chronic nature of asthma.

In non-allergic asthma, the pathogenesis differs as it is not driven by allergens or an IgE-mediated immune response. Instead, it involves airway hyper-responsiveness to non-immune triggers, such as cold air, exercise, air pollutants, respiratory infections, or strong emotions. These triggers lead to direct activation of bronchial smooth muscles and epithelial cells, causing the release of inflammatory mediators like histamine and leukotrienes. This inflammatory response contributes to bronchoconstriction, airway inflammation, and mucus production, similar to allergic asthma. Neural dysregulation, including heightened vagal tone, can also play a role by exacerbating bronchial smooth muscle contraction.

Asthma management primarily relies on two types of medications: sympathomimetics and corticosteroids. Sympathomimetics, such as albuterol and salmeterol (Serevent), act as bronchodilators, relaxing the bronchial muscles and opening the airways. Corticosteroids, such as fluticasone (Flonase) and budesonide (Pulmicort), are powerful anti-inflammatory agents, reducing swelling and mucus production in the airways. With the appropriate use of these medications, asthmatic individuals can manage their symptoms and lead active lives.