Asthma, a chronic health condition affecting the lungs can exacerbate during illness, particularly respiratory infections. This is why asthma-related symptoms become worse when you catch a cold. This can be attributed to various interconnected factors, such as the immune system, respiratory function, and the specific characteristics of asthma. To shed light on the same we spoke to Dr E Ravindra Reddy, Senior Pulmonologist, Kamineni Hospitals, LB Nagar, Hyderabad, who explained the reasons behind asthma exacerbations and how to manage it.
According to the Journal of Allergy and Clinical Immunology, instances of worsened asthma significantly contribute to the morbidity of the disease, escalating healthcare expenses, and, in certain individuals, lead to a more pronounced and progressive decline in lung function. The Global Burden of Disease Report for 2019 shows that India faces the highest burden of asthma, including disabilities and deaths, compared to any other country in the world.
Immunological Response
Inflammation
When the body is infected with a virus or bacteria, the immune system launches an inflammatory response to combat the invaders. “In individuals with asthma, the airways are already inflamed, and the additional inflammation triggered by the infection can exacerbate this pre-existing condition”, highlighted Dr Reddy. This increased inflammation contributes to increased airway resistance and narrowing, making it difficult for air to flow freely.
Cytokines Release
Dr Reddy added, “In response to an infection, the immune system releases various signalling molecules called cytokines. Some of these cytokines can promote inflammation and airway hyperreactivity, both of which are key components of asthma exacerbations.” The release of these signalling molecules can create a pro-inflammatory environment in the airways, intensifying asthma symptoms.
Also Read: Asthma In Children: Expert Lists Symptoms And How To Deal With It
Airway Hyperresponsiveness
Viral Triggers
Respiratory infections, especially those caused by viruses, can act as potent triggers for airway hyper-responsiveness in individuals with asthma. “The infected airways become more sensitive to stimuli, leading to exaggerated bronchoconstriction and increased difficulty in breathing”, said Dr Reddy. This heightened responsiveness can persist even after the infection has been resolved, prolonging asthma symptoms.
Mucus Production
The body produces mucus as a protective response to trap and eliminate pathogens. However, excessive mucus production during an infection can clog the airways, further obstructing airflow. Dr Reddy said, “For individuals with asthma, this increased mucus can compound the effects of inflammation and airway constriction, making it harder to breathe.”
Viral Impact on the Airways
“Certain respiratory viruses can directly affect the cells lining the airways, causing damage and exacerbating inflammation. This direct impact on airway cells can contribute to a more severe and prolonged exacerbation in individuals with asthma”,added Dr Reddy. The specific characteristics of the infecting virus can influence the degree of airway involvement and the severity of asthma symptoms.
Also Read: Night-Time Asthma Attack: Expert Lists Tips To Prevent It
Medication Adjustments
Illness often necessitates adjustments in asthma medication. Failure to adapt the medication regimen appropriately can lead to inadequate control of asthma symptoms. Dr Reddy listed some of the medication adjustments as follows:
- Bronchodilators, which help to open the airways, may need to be used more frequently to relieve symptoms.
- Inhaled corticosteroids, which reduce inflammation, may also be adjusted to manage increased airway inflammation during illness.
Environmental Factors
During illness, individuals may be exposed to environmental triggers that can worsen asthma symptoms. Indoor irritants like dust, mould, or pet dander, coupled with the effects of the respiratory infection, can create a challenging environment for individuals with asthma. Avoiding known triggers becomes crucial during these periods to minimise the risk of exacerbations.
Weakened Respiratory Function
Respiratory infections can result in temporary reductions in lung function. “In individuals with asthma, whose airways are already compromised, this decline in lung function can have a more pronounced impact, informed Dr Reddy. The combination of infection-induced lung impairment and pre-existing asthma-related limitations can lead to more severe respiratory distress.
Psychological Stress
Dealing with illness can be emotionally stressful, and psychological stress has been linked to worsen asthma symptoms. Dr Reddy added, “Stress hormones released during times of illness can contribute to increased airway inflammation and bronchoconstriction”. Managing stress through relaxation techniques and emotional support can play a role in mitigating the impact on asthma.
[Disclaimer: This article contains information provided by a registered healthcare professional and is for informational purposes only. Hence, do not substitute this information with medical treatment and consult your expert if you experience any complications.]
