Asthma

Published on 12/22/2013. Last updated 1/17/2014.

Asthma is an obstructive lung disease caused by over reaction of the airways to various stimuli. It is classified as an autoimmune disease. In asthmatics, the air passages in the lungs become inflamed, affecting the sensitivity of the nerve endings there so they become easily irritated. During an attack, the lining of the passages swells and produces extra mucus, causing the airways to narrow and reducing the flow of air into and out of the lungs. Asthma is characterized by shortness of breath and wheezing, varying in intensity from person to person. It can occur at any age but generally starts in childhood. A severe attack can be life-threatening.

 

MAST CELLS
Remember the earlier discussion of mast cells and and my unpleasant experience when they were wildly over proliferating? Mast cells play an important role in asthma and allergies. The mechanism of many asthma (as well as allergy) triggers is an overreaction by the immune system to apparently harmless stimuli such as pollen or cat dander. When one of these stimuli is encountered, IgE-mast cells get dispatched forthwith to attack the antigen, exploding (degranulating) and releasing powerful toxins, such as histamine, to accomplish their job.
In asthma, this precipitates a secondary reaction (late phase reaction) in which the immune system mobilizes an array of cells and substances—including cytokines and (autocoids) eicosanoids such as leukotrienes—to keep up the attack on the “invader”. The result is that healthy tissues are damaged and the characteristic inflammation of asthma tends to become self perpetuating – and eventually, chronic. (Hepler, 2001)
PREVALENCE

 

CHILDREN: Asthma is one of the most common chronic disorders in childhood, affecting an estimated 7.1 million children under 18 years in the US. 4.1 million American children suffered from an asthma attack or episode in 2011. it is the third leading cause of hospitalization among children under 15. In 2011, asthma prevalence in children under 18 ranged from a low of 5.5% in Tennessee to a high of 18.0% in the District of Columbia.(American Lung Association, 2012)

ADULTS: A World Health Organization survey asked 178,215 people from 70 countries about their asthma and related symptoms in the past year. Respondents were 18 to 45 year.  4.3% had been diagnosed with asthma by a physician. 4.5% had been treated for asthma symptoms. 8.5% reported wheezing. Prevalence varied as much as 21-fold among the 70 countries.  Australia reported the highest rate of doctor diagnosed, clinical/treated asthma, and wheezing (21.0%, 21.5%, and 27.4%). Among those with clinical/treated asthma, almost 24% were current smokers, half reported wheezing, and 20% had never been treated for asthma. The highest prevalence occurred in resource-rich countries – like the US. (To, 2012)

 

ASTHMA AND ALLERGIES START IN THE GUT
When the natural mix of friendly bacteria and fungi in our guts (probiotics) becomes out of balance (into dysbiosis), asthma and allergies may develop.
See the KEFIR page for information on two probiotics, lactobacilli and bifidobacteria, that have been found to be helpful in the management of allergies and asthma.
Asthma and allergies rates have been steadily increasing over the last 40 years. The rise correlates with increasing antibiotics usage that destroys our good gut bacteria right along with the targeted bad bacteria, as well as with the increase in consumption of genetically modified foods.
The Hygiene Hypothesis also contributes to this rise. Modern sanitation practices, in which ALL bacteria are mistakenly viewed as harmful and in need of killing, deprive us of immune defenses we need to keep our gut microbiomes healthy and able to prevent asthma, allergies and other health problems.
The Hygiene Hypothesis is an important concept. It posits that exposure to infectious agents (eg, viruses, bacteria and parasites) along with symbiotic microorganisms (eg, good gut flora called probiotics)  helps us build up a natural immunity to the harmful ones. The result of providing too sanitary an environment for our children is that they aren’t able to build up a natural resistance to pathogens, making them more susceptible to developing allergies, asthma, skin conditions and a wide variety of other illnesses and diseases – including all the autoimmune conditions, heart disease and depression. Specifically, lack of exposure to pathogens is believed to lead to defects in the establishment of immune tolerance.
Many schools in the US now require children to carry and use bottles of hand sanitizers. And, at least in the US, there are Purell dispensers all over hospitals, offices, airports, grocery stores, bathrooms – and in people’s purses and pockets.
The widespread use of hand sanitizers and antibacterial soaps is seen by many as an unwelcome epidemic harming individuals’ health and contributing to the rise of drug resistant bacteria, often referred to as the super bugs.
The US Food and Drug Administration (FDA) reports evidence that triclosan, an ingredient in many hand sanitizers,  may disrupt the body’s endocrine system, altering hormone regulation. (Olberding, 2013)
The premise of the Hygiene Hypothesis was tested on lab mice. When mice drank water laced with antibiotics for five days to disrupt the balance in their gut microflora, they developed increasing numbers of fungal inhabitants – specifically they had increased amount of the yeast Candida albicans. Candida, like many other yeasts, secretes molecules that affect the immune system’s response to allergens.
These mice were then exposed to inhaled allergens: in one test the exposure was to ovalbumin (a common allergen derived from egg whites); in a separate test the exposure was to mold spores. In both tests the mice immediately showed signs of allergic airway disease similar to asthma. Another group of mice, who hadn’t been given the antibiotic laced water, were far less reactive to the allergens.
The researchers also found that the genetic makeup of the two groups didn’t matter at all nor did it matter what kind of allergen they were exposed to – pollens, danders, dust mites, and cockroach feces were also tested. The mice fed antibiotics to impair their gut immunity had an unhealthy reaction when exposed to any allergen. (Science Daily, 2005)
Upset the microflora in the gut and you upset the immune system’s ability to cope with exposure to allergens without having a severe reaction to them. We cause serious microflora unbalance in our guts with high agricultural and pharmaceutical use of antibiotics and steady consumption of the Standard American Diet (SAD) consisting of sugary, high fat, low fiber and genetically modified foods.

 

EMOTIONAL ASPECTS OF ASTHMA – AND OTHER DISEASES

 

Stress and emotions are known to play a role in triggering and then exacerbating asthma attacks. The basic mechanism is this: Psychological and other stresses have physiological effects on the body.  Stress from any source activates the adrenals to secrete corticosteroids and catecholamines, preparing the body to either fight the danger or quickly flee it.
The fight or flight response is an intense physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. In fight or flight, the body is in a hyper-aroused state. The word perceived is important here since we’re mostly not being threatened by tigers anymore but instead often react to things in our lives as if we were. When there’s no fight or fleeing, we don’t discharge that energy and our adrenals just keep us in that hyper-aroused state. 

So – learning to calm ourselves – to self soothe, to re-center ourselves – is crucial both for not getting into that hyper-aroused state in the first place (unless we truly are under attack) and then for recovering from it when we have experienced a fight or flight response.

 

Then there’s Dr John Sarno’s interesting work on the whole range of mind-body disorders. Sarno, who is Professor of Rehabilitation Medicine at New York University School of Medicine and attending physician at Rusk Institute of Rehabilitation Medicine, has written extensively on illness and pain.
Sarno, along with many others – myself included,  believes that pain and much illness is, at least in part, an unconscious distraction serving to keep deeply unconscious emotional issues repressed. He works with patients to think about what may be upsetting them in their unconscious so they can defeat their minds’ strategy to repress these powerful emotions.
His belief is that when the symptoms are seen for what they are, they will serve no purpose and will go away. His second book, Healing Back Pain: The Mind-Body Connection, has sold over 150,000 copies. His most recent book, The Divided Mind: The Epidemic of Mindbody Disorders, features chapters by six other physicians and addresses the entire spectrum of  mind-body disorders and the history of psycho-somatic medicine.
It should be noted that psycho-somatic refers to the expression of emotions via bodily symptoms. It does not mean there’s something imaginary that’s all in your head.

 

REFERENCES

American Lung Association. (2012). Asthma & Children Fact Sheet. See http://www.lung.org/lung-disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html

Hepler, J. (2001). Developing a Holistic Treatment Program for Asthmatics. Practical Asthma Review. See http://www.practicalasthma.net/pages/science/holistic_asthma.htm

Olberding, M. (2013). Dangers of Waterless Hand Soap. Livestrong.com. See http://www.livestrong.com/article/276277-dangers-of-waterless-hand-soap/

Sarno, J E. (1982). Mind Over Back Pain.

Sarno, J E. (1991). Healing Back Pain: The Mind-Body Connection.

Sarno, J E. (1998). The Mindbody Prescription: Healing the Body, Healing the Pain.

Sarno, J E. (2006). The Divided Mind: The Epidemic of Mindbody Disorders.

Science Daily. (2005). Healthy Mix Of GI Tract Microbes Are Key To Preventing Allergies And Asthma. See http://www.sciencedaily.com/releases/2005/01/050111174539.htm

To, T. et al. (2012). Global asthma prevalence in adults: findings from the cross-sectional world health survey. BioMedCentral Public Health 2012, 12:204.

 

© Copyright 2013-2014 Joan Rothchild Hardin. All Rights Reserved.

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