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1、Asthma:CurrentstatusandfuturedirectionsAsthmaexacerbations:Origin,effect,andpreventiona,b,c,da,b,c,da,b,c,dDavidJ.Jackson,MRCP,AnnemarieSykes,MRCP,PhD,PatrickMallia,MRCP,PhD,anda,b,c,dSebastianL.Johnston,MRCP,MD,PhDLondon,UnitedKingdomAsthmaisthemostcommonchro
2、nicrespiratorydisease,affectingupto10%ofadultsand30%ofchildrenintheAbbreviationsusedWesternworld.Despiteadvancesinasthmamanagement,acuteACQ:AsthmaControlQuestionnaireexacerbationscontinuetooccurandimposeconsiderableBEC:Bronchialepithelialcellmorbidityonpatient
3、sandconstituteamajorburdenonhealthICS:InhaledcorticosteroidLABA:Long-actingb-agonistcareresources.RespiratorytractviruseshaveemergedastheNO2:NitrogendioxidemostfrequenttriggersforexacerbationsinbothchildrenandPEF:Peakexpiratoryflowadults;however,themechanismsun
4、derlyingtheseremainRSV:Respiratorysyncytialviruspoorlyunderstood.Morerecently,ithasbecomeincreasinglyTLR:Toll-likereceptorclearthatinteractionsmightexistbetweenvirusesandothertriggers,increasingthelikelihoodofanexacerbation.Inthisarticlewebeginwithanoverviewof
5、thehealth,economic,andsocialburdenthatexacerbationsofasthmacarrywiththem.exacerbationscontinuetooccurandimposeconsiderablemor-Thisisfollowedbyareviewofthepathogenesisofasthmabidityonpatientsandconstituteamajorburdenonhealthcareexacerbations,highlightingthevari
6、oustriggersresponsibleandresources.Thefrequencywithwhichacuteexacerbationsoccurmultipleinteractionsthatexistbetweenthem.Thefinalsectioninasthmaticpatientsvariesdependingonthedefinitionusedforfirstaddresseswhatpreventativemeasuresarecurrentlytheexacerbation,thesev
7、erityanddegreeofcontroloftheavailableforasthmaexacerbationsandsubsequentlyexaminesunderlyingdisease,andthesourceofthedata.Themostwhichofthenewtreatmentsindevelopmentmightlessenthecomprehensivedataonexacerbationincidencecomesfromburdenofexacerbationsinthefuture
8、.(JAllergyClinImmunoltherapeuticclinicaltrialsinasthmaticpatients.IntheOPTIMA2011;128:1165-74.)trialinpatientswithmildasthma,exacerbationrateswere0.92perpatientperyearinthosereceiv
