Hospital therapy. Etiology of bronchial asthma (BA) (most important)

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Hospital therapy. Etiology of bronchial asthma (BA) (most important)

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21. Etiology of bronchial asthma (BA)

An exhaustive definition of asthma does not exist to date, however, the most complete definition of this disease was given by G. B. Fedoseev in 1982. Bronchial asthma (BA) is an independent, chronic, recurrent disease with a primary lesion of the respiratory tract, the main and obligatory pathogenetic mechanism of which is altered bronchial reactivity due to specific (immunological) and (or) non-specific, congenital or acquired mechanisms, and the main (mandatory) clinical sign is an asthma attack and (or) asthmatic condition (asthmatic status) due to spasm of bronchial smooth muscles, hypersecretion, dyscrinia and swelling of the bronchial mucosa.

Etiology. A combination of several factors plays an important role in the occurrence of asthma. In this regard, there are 2 forms of asthma - atopic (from the Latin athopia - “hereditary predisposition”) and infectious-allergic. Hereditary predisposition is due to the connection of certain histocompatibility antigens (HCA) with the severity of asthma, and an increase in the severity of the disease is especially often observed in carriers of antigens B35 and B40.

Internal factors in the development of the disease are biological defects in the immune, endocrine systems, autonomic nervous system, bronchial sensitivity and reactivity, mucociliary clearance, pulmonary vascular endothelium, rapid response system (mast cells, etc.), metabolism of arachidonic acid, etc.

External factors include:

1) infectious allergens (viruses, bacteria, fungi, yeast, etc.);

2) non-infectious allergens (pollen, dust, industrial, medicinal, food; allergens of ticks, insects and animals);

3) mechanical and chemical irritants (metal, wood, silicate, cotton dust; vapors of acids, alkalis; fumes, etc.);

4) meteorological and physico-chemical factors (changes in air temperature and humidity, fluctuations in barometric pressure, the Earth's magnetic field, physical effort, etc.);

5) stressful, neuropsychic effects and physical activity.

Infectious agents can have not only an allergenic effect, but also reduce the body's sensitivity threshold to non-infectious (atopic) allergens, increase the permeability of the respiratory mucosa for them; to form a change in the reactivity of target cells (mast cells, basophils, monocytes, etc.) and effector systems.

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