World Asthma Day!
What exactly is asthma and how is it treated in Russia? ASI asked Andrey Belevsky, Doctor of Medical Sciences, Chief Pulmonologist of the Moscow City Health Department, Professor at the N.I. Pirogov Russian National Research Medical University's Department of Pulmonology, President of the Russian Respiratory Society, Chairman of the Moscow Branch of the Russian Respiratory Society, and President of the Association of Russian-Speaking Specialists in Respiratory Medicine.
What is bronchial asthma?
Bronchial asthma (BA) is a condition in which the bronchi narrow, causing an attack. The spasm is not caused by microbes but results from contact with allergens, irritants, or other factors. Inflammation causes substances to be released that lead to swelling of the bronchi and mucus build-up, resulting in difficulty breathing, chest tightness, wheezing, coughing, and sometimes even suffocation.
Today, it's known that at least 348 million people worldwide have bronchial asthma. According to the Russian Ministry of Health, over 1.5 million people in Russia live with BA as of 2022. This means every medical district has patients with bronchial asthma.
Which types of allergens affect the bronchi?
Allergens such as pollen, pets, house dust mites, and molds commonly trigger asthma. Food allergies are not usually related to asthma.
The disease mechanism involves sensitization after initial exposure to an allergen, followed by antibody production. Subsequent exposures cause exacerbations of bronchial asthma. Allergic (atopic) asthma is associated with allergic rhinitis in almost 65% of cases. If a child already suffers from allergic rhinitis due to cat dander and continues living with the animal, there's a high risk of developing bronchial asthma alongside their existing condition.
Is it contagious?
You cannot catch asthma. Children whose parents suffer from asthma or allergies are more likely to develop the condition. However, it's been proven that what gets passed down isn't asthma itself, but rather a predisposition to allergies, which often underlie the disease.
Less frequently, occupational factors can contribute to the development of bronchial asthma. For example, working in chemical or mining industries, where there’s exposure to various substances and vapors, increases the risk of asthma development.
What medications should you take for asthma?
Asthma medications fall into two categories. The first group includes bronchodilators used to relieve attacks, also called rescue inhalers. The second group consists of anti-inflammatory drugs that suppress inflammation in the bronchial walls and prevent symptoms from developing. These belong to the basic therapy for bronchial asthma.
The expert emphasizes that you mustn't stop treatment or change your dosage on your own, as visible improvements don't necessarily mean the disease is under control. Prematurely ending treatment renders it ineffective.
The quality of treatment is determined not by how quickly symptoms disappear, but by how long they remain absent. The longer the remission lasts, the better the prognosis.
When should you seek medical help?
Consult a doctor if you experience any symptoms resembling asthma. For those who've had asthma for some time, it's crucial not to miss signs of worsening.
An asthma flare-up is a serious situation that shouldn't be underestimated. If quick-relief bronchodilators become ineffective and the intervals between doses shorten, seek immediate medical attention or call an ambulance. Delaying could result in severe complications.
Can asthma be cured?
As bronchial asthma is a chronic lung disease, complete recovery isn’t possible; the illness persists throughout life.
However, during puberty—a stage of physiological development—asthma symptoms may change: decrease until disappearing entirely, stay the same, or intensify. Even when symptoms vanish, this only indicates a prolonged remission of the chronic condition.
It’s important to constantly monitor your condition, prevent flares, and engage in preventive measures. These include regular physical exercise, quitting smoking completely, and avoiding known allergens.
How do you live with bronchial asthma?
A diagnosis of “bronchial asthma” is not a dogma or a death sentence, but rather a guideline requiring certain lifestyle changes. The main adjustment is taking medication regularly. Modern treatments can fully manage the disease, allowing individuals to lead normal lives.
Imagine someone having an asthma attack in a shopping centre. How would you help them?
Attacks can indeed happen suddenly. It’s essential for bystanders to remain calm and act swiftly to support the person with asthma and ease their distress. First, try to stay composed. Panicking will only make things worse. Speak slowly and confidently, helping the individual focus on their breathing.
The most critical action is to immediately dial 112 for emergency services and explain that you’re witnessing an asthma attack. Afterwards, assist the person in loosening their clothing and, if possible, ensure access to fresh air.
Sometimes, a person experiencing an attack might ask for specific assistance: to sit down or retrieve their inhaler. Typically, asthmatics know what to do themselves. Just follow their instructions.
But if the person doesn’t understand what's happening, it’s best to rely on medical professionals.
While waiting for the specialists, continue monitoring the person's condition, noting signs like blue lips or nails, labored breathing, or loss of consciousness. These indicate a serious deterioration.
What does the Russian Respiratory Society do?
The RRS is not a hospital or clinic where patients can go; it’s a community of doctors. Through its activities, Russian pulmonology advances, improving respiratory disease diagnostics and treatment nationwide.
Education is a key part of the RRS’ work. This year, the society supported the creation of the informational resource called Breathe Easy, developed by PSK Pharma.
Additionally, the Russian Respiratory Society significantly contributes to training medical professionals. Each year, it organizes online and offline events for knowledge sharing, including the National Congress on Diseases of the Respiratory System for leading experts from Russia and abroad.
Special emphasis is placed on nurturing young talent—the society operates a Council of Young Scientists where students and residents learn under mentors' guidance and participate in real-life case analyses.
Another significant aspect of the society’s work is drafting normative documents, including clinical guidelines addressing various respiratory diseases.
Clinical recommendations are periodically updated documents aimed at practicing physicians, providing clarifications on prevention, diagnosis, and treatment of different illnesses.