Cough, shortness of breath… In 90% of cases, asthma is allergic because it is linked to an allergen. Typical symptoms, treatments, causes and advice in the event of a crisis at night with Dr. Olivier Michel, specialist in pneumo-allergology.
[Mise à jour le 9 mars 2023 à 10h26] Asthma is a inflammatory disease of the airways, which will result in narrowing of the bronchi. She is in the majority of “allergic” cases i.e. caused by a allergen which can be pollenof the mold… Discovery of theallergic asthma with Dr Olivier Michel, pulmonologist-allergist.
Definition: what is allergic asthma?
“This bronchial inflammation reaction is in 90% of cases caused by a respiratory allergy to an allergen“says Dr. Olivier Michel from the outset. 10% of cases are linked to a different process such as an immune deficiency or a professional component (exposure to toxic substances such as toxic fumes, cleaning products, etc.). The main allergens are:
- THE mites,
- THE pets,
- THE mold,
- THE pollen (seasonal asthma depending on their presence on the territory).
What are the symptoms of allergic asthma?
Allergic asthma causes the following 4 symptoms:
- A shortness of breath
- a oppressionfeeling of chest tightness
- a dry cough sometimes with the production of small viscous sputum (often chronic)
- A hissing breathing, breath sounds
What to do against allergic cough?
“Cough medicines and medications do not work to relieve cough associated with allergic asthma. Only bronchodilators and anti-inflammatories are very effective, hence the importance of making the right diagnosis” supports our interlocutor.
What causes allergic asthma?
The allergenic principles are the mites, pets (cats, dogs, rabbits etc.), mold, pollen (seasonal asthma depending on their presence on the territory). “A genetic factor is concomitant with the allergy : anyone allergic to an allergen will not necessarily develop asthma. The genetic risk factor must be associated. About half of people sensitized to an allergen will develop asthma“ recalls our expert.
“Asthma attacks are more frequent at night due to the rhythm of lung function”
Why do asthma attacks happen at night?
“Asthma attacks are more common at night due to the lung function rhythm. The natural physiological rhythm of breathing is 10% lower if observed at 5 a.m. compared to 5 p.m. (we therefore breathe less well, editor’s note). In allergic asthmatics, the difference is amplified, it is more than 20%” develops Dr. Olivier Michel. Moreover, it is at night that exposure to dust mites is highest (bedding, mattresses).
You must already know if you are asthmatic. “The diagnosis begins with the description of theat least one of the symptoms asthma and is confirmed by the result ofan abnormal breath test” indicates the pneumo-allergist. “To measure lung function, the patient takes a breathing test consisting of blowing into devices and if the bronchi have narrowed, it will be abnormal. In case of doubt, the doctor may prescribe a challenge test (induce mild asthma in someone) via a stress test For example” continues Dr. Michel. Once the diagnosis of asthma has been made, skin and/or blood tests are performed to determine if the patient has an allergy. “THE skin test consists of put an allergen extract in contact with the skin and if a reaction occurs within 15 minutes, the patient is allergic. The blood test is based on a molecular approach, it is more precise because it allows find out which allergen protein the patient is allergic to. This information helps predict the level of response to desensitization“adds our interlocutor.
What treatment to treat allergic asthma?
The first treatment for allergic asthma is removal of the cause. “If the patient is allergic to rabbits and it is his pet, he must be removed. For dust mites, there are avoidance measures such as bedding sanitation“says Dr. Olivier Michel. In addition, the treatments developed since the 1960s are based on two major main approaches:
- THE bronchodilators : drugs that relax the muscles of the bronchi to open them. They quickly relieve the crisis in case of acute asthma.
- THE anti-inflammatories : there cortisone administered in micrograms by inhalation (no side effects unlike oral administration).
► The desensitization decreases sensitivity to allergens (allergic reaction). “This fairly natural therapy consists of administering extracts of the allergen, previously modified in the laboratory, so that the immune system recognizes it differently.. The treatment is spread over a period of 2 to 3 years and is administered either by subcutaneous injection whose frequency is one injection every 4-6 weeks or orally. The patient deposits daily drops containing the allergenic extract under the tongue and keep the product for two minutes before ingesting it“.
► Among these patients, there are still around 5% of problematic asthmatics, i.e. “THE severe or very severe asthma, resistant to corticosteroids and bronchodilators. We then turn to a biological treatment (biotherapy) based on the use of monoclonal antibodies. This treatment has been developing since around 2010, but it is extremely expensive (between 10,000 and 25,000 euros per year and per patient)” emphasizes Dr. Olivier Michel.
What natural remedies for allergic asthma?
Lemon eucalyptus or ribwort plantain can relieve asthma-related breathing problems. “But be careful, you have to be careful with essential oils and take care of ventilate the House” warns our interlocutor. Moreover, natural treatments do not replace, without medical advice, an allopathic treatment. Seek advice from a doctor.
Thanks to Dr Olivier Michel, specialist in pneumo-allergology and Professor at the Free University of Brussels (ULB).