What is stress-induced asthma

Asthma, chaos and stress

Asthma attacks are also induced psychologically

Asthma is a widespread disease; around 100 million people worldwide suffer from this chronic shortness of breath. In Western Europe, one patient dies from this disease every hour. According to experts, 90 percent of these deaths would be avoidable if better informed and treated. New scientific findings show how an asthma attack works - and how stress intensifies the symptoms.

Around 30 million people in Europe are asthmatics, but so far there is a lack of reliable knowledge about this disease and there is not enough information about this disease. "Many patients are too little informed about their illness and are often not informed enough by their doctors," criticized the managing director of the German Allergy and Asthma Association (DAAB), Andrea Wallrafen, on the occasion of World Asthma Day 2005. I have asthma Bad image and is still taboo in public, criticizes the association.

Of those affected in Europe, 1.5 million suffer from severe asthma with at least one dramatic attack per week. In Germany, a third of the severe asthmatics in a survey by leading lung specialists and the DAAB stated that their illness was destroying their social life, meeting friends, going to the cinema or the theater were not possible. A quarter perceive asthma as life-threatening and a fifth is so limited by this chronic disease that they had to give up their professional activity.

At the end of August, the German Medical Association adopted the National Asthma Care Guideline. This guideline program is understood as a content basis for structured medical care and for updating practicable recommendations for action according to the best available state of medical knowledge.

chaos

In the spring, researchers at Harvard Medical School carried out a computer simulation of the processes in the lungs during an asthma attack and published the results in the science journal Nature (Self-organized patchiness in asthma as a prelude to catastrophic shifts).

First, the regional distribution of blood flow and ventilation was measured in selected patients. To do this, the scientists injected nitrogen 13N in saline solution into the arm vein of the test subjects. The blood carried the nitrogen into the lungs, where it diffused into the breathing gases and is exhaled. With the help of positron emission tomography (PET) it was then possible to map the change in the nitrogen concentration over time. This will reveal blood flow and ventilation.

Using this data, the computer then creates corresponding models of the airway tree, which make it clear what exactly happens in the lungs during an asthma attack. The inhaled air hardly reaches whole areas of the lungs. The complex interactions are simulated in the computer and it was shown that the lungs function according to chaos theory. One of the main authors, Tilo Winkler, explained on the occasion of a visit to his old university, the TU Dresden:

The principle of self-organization behind it occurs in many complex systems that are related to chaos theory. I think the results can be used to derive important new approaches that are important to doctors and patients with asthma.

For example, we have shown in the simulation that the size of the areas with impaired ventilation does not increase continuously, but rather changes suddenly, and that the tidal volume, i.e. how deep you inhale and exhale, has an influence. For example, if a patient's tidal volume decreases during an asthma attack, the areas of deteriorated ventilation increase. In the worst case, this can reduce the tidal volume even further and enlarge the poorly ventilated areas even further.

This becomes clear in the computer simulations of the anatomy of an asthma attack, which were put online as videos for the article in Nature (supplementary information).

The findings are not only important for a fundamentally better understanding of asthma, but also for the effectiveness of drugs to be inhaled. If the herbs cannot reach large areas of the lungs at all, their effects remain severely limited. This explains why some of the patients do not respond very well to this treatment.

stress

But asthma affects the whole body, even if the focus of attention is on the airways, because that is where the symptoms appear. A brand new study by researchers led by Melissa Rosenkranz from the University of Wisconsin-Madison, which appeared on September 2 in the journal Proceedings of the National Academy of Sciences (PNAS), shows that structures in the brain play an important role in asthma diseases ( Neural circuitry underlying the interaction between emotion and asthma symptom exacerbation). Stress exacerbates asthma attacks - that is the clear finding of the studies. Even mentioning a word like “wheezing” activates two areas in the brain that are responsible for processing emotions and causes increased shortness of breath.

Six test persons suffering from mild forms of asthma underwent magnetic resonance imaging after inhaling substances that trigger allergies (and thus their asthma). Then words related to the shortness of breath such as “gasp”, completely neutral words such as “curtain” or negative words that were not related to the illness such as “loneliness” were put into the room. The magnetic resonance scans revealed that two regions of the brain (the anterior cingulate cortex and the insula) responded that otherwise activated responses to feelings or pain when the category of asthma-related words came into play. The symptoms of the asthma attack intensified immediately after the brain cells lit up. There was no reaction to the other - even the negative - words.

It has long been known that stress factors can literally take the breath away from asthmatics. But what the triggering functions and processes are was previously unclear.

The experimental group was too small to make definitive statements, but further investigations should follow in order to open up possible new approaches for therapies and drugs. (Andrea Naica-Loebell)

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