[Present physiopathological concepts of asthma in adults].
Curiously enough, a kind of curse combined with therapeutic fatalism still hovers over bronchial asthma and a sense of hopelessness may be encountered when faced with this illness. This pessimism is totally unfounded. However, our therapeutic possibilities depend partly on a better understanding of the asthma syndrome. In the past, this condition may not have been recognised for what it is, that is to say a multi factorial syndrome resulting from the innate and the acquired, from specific (allergic) and/or non-specific factors. Undoubtedly, too much responsibility has been placed on the allergic factor in asthma. Although important, it has made us overlook the fact that, allergic or not, asthma is an inflammatory illness of the bronchi provoked by the liberation of mediators. The role of histamine has been well known for a long time and we now realise the importance of the actions of the metabolites of arachidonic acid (prostaglandins and thromboxanes on the one hand, leukotrienes on the other). The characteristics bronchial hyperreactivity observed in asthma may certainly be congenital but this factor may also be acquired as in professional and post-viral asthma. If bronchial asthma remains under-diagnosed and under-treated in France and in Europe it is due to the fact that the artificial distinction between paroxysmal (bronchitis called "asthmatic"), and persistent (that is to say a so-called asthmatic illness), is is often maintained. There is no real ground for maintaining this distinction. Every child with wheezy dyspnea must therefore be the object of a thorough, initial medical examination, including in particular a respiratory function exploration followed by the institution of a long-term, coherent therapeutic strategy.
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Michel
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Godard
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Bousquet
D000328:Adult; D001249:Asthma / Q000209:etiology / Q000235:genetics / Q000503:physiopathology*; D001980:Bronchi / Q000503:physiopathology*; D001982:Bronchial Diseases / Q000503:physiopathology; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology; D013577:Syndrome
Actualités physiopathologiques de l'asthme de l'adulte.