ASTHMA
 A SERIOUS MEDICAL CONDITION REQUIRING
DIRECT SUPERVISION BY A PHYSICIAN.
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This page is intended for educational purposes only and should not
be used as a substitute for consulting with a doctor
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Most of the contributors are not health care professionals; this page
in part is a collection of personal experiences, suggestions, and practical information.
Please remember when reading this that every asthmatic responds differently;
what is true for some asthmatics may or may not be true for you.
Although every effort is made to keep this information accurate, this
should not be used as an authoritative reference.
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* DRUG ALERT *
DOCTORS WARNED ABOUT  ASTHMA DRUG::Singulair
Washington( AP) Asthma patients who take the drug Singulair should be
watched carefully by their Doctors for signs of a rare but serious
complication called Churg-Strauss syndrome, drug-maker Merck & Co. advises.
Churg-Strauss syndrome is a tissue disorder that sometimes strikes adult
asthma patients and if untreated, can destroy organs.
Merck said Thursday, December 3, 1998, it has received fewer than 20 reports out of 600,000 people worldwide who have tried the drug.
Merck has written to 165,000 doctors and pharmacists to alert them to 
signs of the condition,:: including flu-like symptoms, rash, tingling, or numbness of the arms and legs, or severe sinusitis.  Some asthmatics experience worsening lung symptoms as pulmonary blood vessels 
become inflamed.
Merck also revised Labeling to include the caution and to tell patients to
alert their doctors to such symptoms
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Ephedra is back in the spotlight after reports indicated that the dietary supplement is indeed associated with serious side effects and that labels on some ephedra products are not accurate.
http://onhealth.com/ch1/MT.asp?t=/ch1/briefs/item$88771.asp&s=1
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FAQ
1.  WHAT  IS  ASTHMA ?

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Asthma is best described by its technical name: Reversible Obstructive Airway 
Disease (ROAD).
In other words, asthma is a condition in which the airways of the lungs become
either narrowed or completely blocked, impeding normal breathing. However, in asthma, this obstruction of the lungs is reversible, either spontaneously or with medication.  Quickly reviewing the structure of the lung: air reaches the lung by passing through the windpipe (trachea), which divides into two large tubes 
(bronchi), one for each lung. Each bronchi further divides into many little tubes (bronchioles), which eventually lead to tiny air sacs (alveoli), in which oxygen
from the air is transferred to the bloodstream, and carbon dioxide from the bloodstream is transferred to the air. Asthma involves only the airways (bronchi
and bronchioles), and not the air sacs. The airways are cleaned by trapping 
stray particles in a thin layer of mucus which covers the surface of the airways.
This mucus is produced by glands inside the lung, and is constantly being renewed. The mucus is then either coughed up or swept up to the windpipe (trachea) by cilia, tiny hairs on the lining of the airways.
Once the mucus reaches throat, it can again be coughed up. Do not reswallow. 
Although everyone's airways have the potential for constricting in response to allergens or irritants, the asthmatic's airways are oversensitive, or hyperreactive.
In response to stimuli, the airways may become obstructed by one of the following:
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1.  constriction of the muscles surrounding the airway;
2.  inflammation and swelling of the airway; or
3.  increased mucus production which clogs the airway.
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Once the airways have become obstructed, it takes more effort to force air through them, so that breathing becomes laboured. This forcing of air through constricted airways can make a whistling or rattling sound, called wheezing.  Irritation of the airways by excessive mucus may also provoke coughing.  Because exhaling through the obstructed airways is difficult, too much stale air remains in the lungs after each breath.  This decreases the amount of fresh air which can be taken in with each new breath, so not only is there less oxygen available for the whole body, but more importantly, the high concentration of carbon dioxide in the lungs causes the blood supply to become acidic. This acidity in the blood may rise to toxic levels if the
asthma remains untreated.
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2.  WHAT  IS  AN  ASTHMA  ATTACK ?
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An asthma attack, also known as an asthma episode or flare, is any shortness of breath which interrupts theasthmatic's well-being and requires either medication
or some other form of intervention for the asthmatic to breathe normally again.
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3.  WHAT  IS  WHEEZING ?

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Wheezing is the whistling or rattling sound that occurs when air flows through obstructed airways.  At the start of an asthma attack, wheezing usually only occurs while exhaling, or breathing out, but as the attack progresses, wheezing may then
be heard both while inhaling and exhaling.  If after the attack progresses further, 
the asthmatic then stops wheezing, this may indicate that many bronchioles (small airways) have become completely blocked, which is a very serious condition.
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4. DO  ALL  ASTHMATICS  WHEEZE ?

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No, not all asthmatics wheeze. Although wheezing is extremely common in 
asthmatics, in All About Asthma, Dr. Paul says, "It is important to note that not all asthmatic symptoms need be present for one to experience an asthma attack.  For instance, not all asthmatics wheeze.  And sometimes wheezing is so slight, it can 
only be heard with a stethoscope.  With some asthmatics, coughing is the only symptom present." Similarly, in Children with Asthma,  Dr. Plaut states that 
children with chronic coughs "may have asthma even though no wheezing is 
present." He diagnoses such children with asthma if their peak flow improves
when given an inhaled bronchodilator.
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5. WHAT  IS  "COUGHING  ASTHMA" ?

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In Children with Asthma, Dr. Plaut defines "coughing asthma" as "a form of asthma
in which coughing is the only symptom and there is no abnormality in any lung 
function test." This condition is also known as "cough variant asthma." Coughing asthma often improves when standard asthma medications are taken.
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6. IS  ASTHMA  HEREDITARY ?

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No, asthma itself is not hereditary, but there does seem to be a hereditary 
component to the tendency to develop asthma. In All About Asthma, Dr. Paul states that if neither parent has asthma, the chances of each of their children having
asthma are less than 10%. When one parent has asthma, the chances rise
to 25%, and when both parents have asthma, the chances climb to 50%. (Actually, there is considerable disagreement among my sources as to the exact numbers,
but all agree that the chances climb dramatically if one or both parents have asthma.)  Similarly, if one or both parents have allergies, the chances of each of their children having allergies are 35% and 65%, respectively, compared to a less than 10% 
chance if neither parent has allergies.  However, Dr. Paul cautions that "children 
don't inherit asthma itself, but the tendency to develop it."
Whether or not an individual develops asthma is also  influenced by their exposure
to various other factors such as infections, irritants, and allergens.
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7. WHAT  IS  CHRONIC  ASTHMATIC  BRONCHITIS ?

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If Chronic asthmatic bronchitis is the condition in which the airways in the lungs
are obstructed due to both persistent asthma and chronic bronchitis (see
sections 1.0 and 1.0.6).  People with this disease generally also have a persistent cough which brings up mucus.  Chronic asthmatic bronchitis which also involves
emphysema is usually classified under the more general category of COPD.
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 8. WHAT  IS  STATUS  ASTHMATICUS ?

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Status asthmaticus is defined as a severe asthma attack that fails to respond to routine treatment, such as inhaled bronchodilators, injected epinephrine (adrenalin),
or intravenous theophylline.
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9. WHAT  IS  ANAPHYLACTIC  SHOCK ?

Anaphylactic shock is defined as a severe and potentially life-threatening allergic reaction throughout the entire body.  It occurs when an allergen, instead of 
provoking a localized reaction, enters the bloodstream and circulates through the entire body, causing a systemic reaction. (There may also be an intrinsic trigger,
as some cases of exercise-induced anaphylaxis have been reported.)  The symptoms of anaphylactic shock begin with a rapid heartrate, flushing, swelling of the throat, nausea, coughing, and chest tightness. Severe wheezing (asthma), cramping,
and a rapid drop in blood pressure follow, which may lead to cardiac arrest.
Hives and vomiting are also common features. The treatment for anaphylaxis is intravenous epinephrine (adrenalin),
with antihistamines and steroids also being used in selected cases. Aminophylline
may also be given for pronounced asthmatic reactions that do not respond to epinephrine.
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10. WHAT  IS  COPD ?

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COPD is chronic obstructive pulmonary disease, also known as either COAD, for chronic obstructive pulmonary disease, or COLD, for chronic obstructive lung 
disease. COPD is a disease in which the airways are obstructed due to a combination of asthma, emphysema, and chronic bronchitis.  The 1987 Merck Manual notes that "the term COPD was introduced because these conditions often coexist, and it may
be difficult in an individual case to decide which is the major one producing the obstruction."
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11. WHAT  IS  EMPHYSEMA ?

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Emphysema is the disease in which the air sacs themselves, rather than the airways, are either damaged or destroyed.  This is an irreversible condition, leading to poor exchange of oxygen and carbon dioxide between the air in the lungs and the bloodstream.
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12. WHAT  IS  BRONCHITIS ?

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Bronchitis is an inflammation of the bronchi, the large airways inside the lungs. (Bronchiolitis is the inflammation of the bronchioles, the small airways.) This inflammation often leads to increased mucus production in the airways.  Bronchitis is generally caused either by a virus or by exposure to irritants such as dust, fumes, or cigarette smoke. If caused by a virus, the bronchitis will likely be only temporary. In the case of prolonged exposure to irritants, particularly cigarette smoking, if there
is permanent damage to the bronchi, bronchitis may become chronic.
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13.  WHAT  IS  PNEUMONIA ?

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Pneumonia is an infection of the lung tissue. In adults, it is generally caused by bacterial infections, though viruses, fungi, and protozoa may also be culprits. The latter microorganisms have become very common as causes of pneumonia in immunosuppressed persons, such as those with HIV infection. However, for those
with chronic illnesses, especially cardiac orrespiratory diseases, or those at 
increased risk for pneumonia, there is a pneumococcal pneumonia
vaccination available as a preventive measure for the most common of these
bacterial infections, streptococcus pneumoniae. In children, pneumonia is most commonly caused by viruses.
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14.  WHAT  IS  CYSTIC FIBROSIS ?

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Cystic fibrosis is a disease in which excessive amounts of unusually thick mucus
are produced throughout the body.  Because this mucus production also occurs 
in the lungs, people with cystic fibrosis are extraordinarily prone to bacterial
infections which result in progressive lung damage. 
Cystic fibrosis can be diagnosed by a "sweat test" as people with cystic fibrosis
have elevated chloride levels in their perspiration. This condition often resembles asthma in children.
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15.  WHAT  IS  INTRINSIC/EXTRINSIC  ASTHMA ?   (sometimes called irreversible asthma)

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Intrinsic and extrinsic asthma are outdated terms which have now been replaced by terms related to the asthma trigger, since the inflammatory response of the airways
is the same independent of the cause of the asthma. What was known as extrinsic asthma is now called allergic asthma, while asthma triggered by allergic asthma, 
while asthma triggered by non allergic factors, formerly called intrinsic asthma, is 
separated into such categories  as exercise-induced asthma and occupational (chemical- induced) asthma.
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16.   WHAT  IS  OCCUPATIONAL  ASTHMA ?

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Occupational Asthma is asthma that is caused by sensitization from exposures in
the work place.  Asthmatics whose asthma is exacerbated by exposures in the workplace would not be classified as having occupational asthma.  There are over
200 substances that have been documented as causing occupational asthma, but there are probably more that have not been recognized. The substances that
are known to cause occupational asthma can be divided into two main categories.  High molecular weight proteins of animal or plant origins are common causes. 
Things like animal dander, flour proteins, and animal scales are frequently causes
of occupational asthma. These same things are also common causes of non-occupational asthma. These are usually IgE-mediated responses. 
Low molecular weight chemicals that have the ability to bind with proteins or act
as haptans are causes of occupational asthma. There may be other mechanisms
involved besides the classic IgE-mediated responses as not all those that are
sensitized have specific antibody production.  Reactions may have reflex, inflammatory, pharmacological, or immunologic pathways or a combination of several.
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Often occupational asthma is difficult to diagnosis. There are may be immediate, 
late, or biphasic reactions.  In late reactions the symptoms may not occur until 
away from the work place. Frequently the asthma worsens as the work week progresses and improves over the weekend.
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Treatment for occupational asthma is basically the same as any other asthma
with a few very important exceptions. For those that have chemically induced 
asthma from sensitization to that chemical; avoidance of the trigger is essential. 
While steroids and other medications are helpful in treating the symptoms,
they do not prevent the underlying sensitivity from increasing.
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Once sensitized to a substance, some react to minute amounts. Levels below 
current TLV levels still trigger reactions. For a sensitized individual any exposure
can cause symptoms.
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Continued exposure to the triggering chemical can cause permanent lung damage, chronic asthmatic conditions, and even death. Medication should never be used to allow the worker to continue to work in an environment where there is exposure
to the triggering substance. Early recognition and removal from exposure is
essential in preventing long term disability from asthma.
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Chemically induced asthma can occur both in the workplace and outside of the workplace. There are many exposures outside of the workplace that there are exposures to chemicals that can induce asthma. Most physicians are not familiar
with this type of asthma. For anyone that has chemically induced asthma, 
avoidance of the trigger is essential.
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Perfumes.

I have respiratory sensitivity to common fragrance chemicals.  When trying
to pinpoint the specific chemical I was sensitized to I became very
interested in the effect fragrances have on health.  This is a definite
problem in substantial numbers of people. Unfortunately, people feel they have a 'perfect right' to use excessive perfume and to spray perfumes, particularly in shared workspace. Please support Betty Bridges in her effort
to collect information which helps people who are made ill by inconsiderate use of fragrances. Her website is informative.
This site is so very informative about hazzards and sensetivities of perfumes and chemicals.
We all need to read to understand exactly how bad the problem really is.
It also goes by the name of MCS which is (Multiple Chemical Sensetivities)

Allergy to Perfume in the Air
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Click also on my MCS Web SITE
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ASTHMA SITES OF INTEREST
  Asthma -- General Information
  Real Cause of Asthma
 Asthma Control
ACAAI Asthma Life Quality Test
 Yahoo! - Health:Diseases and Conditions:Asthma
 Dave's Asthma and Exercise
 Disability on the Net - Asthma
Asthma
 UK & Ireland - Health:Diseases /Conditions:Asthma
 Allergy Shots help Asthma Patients
 Breathe Well Magazine
 AMA Physician Select Reference Library: Asthma
Diagnosis and Management of Asthma
 aaspc home
 Allergy Asthma Technology, Ltd.
 Pedipress Asthma Publications
 Asthma Tutorial for Children and Parents
 Asthma: Destroying the Myths
 FAQ - Allergy and Asthma
Nuvance Helps Moderate Asthmatics Breathe Easier
 Teaching  About Asthma: A Clinician's Guide
 National Asthma Education Programme 
Clubhouse Kids Learn about Asthma
Health Care Information Resources -- Asthma Links
Doctor's Guide to the Internet - Asthma
Atlantic Asthma Network (AAN)
 Allergens in the home
 Prevention of Nosocomial Pneumonia
 Change in Metered Dose Inhalers
CFC-free asthma drugs
 Respiratory Products and Information
Could Asthma Be a Viral Affair
Better control for asthmatics' and Allergy Sufferers
Reduce risk of serious asthma exacerbations
  First and Only Medication That treats cause of Asthma
Allergy Allert Zone Map
Trouble breathing? Find out if you've got asthma
 Going With the Gut May Prevent Allergy, Asthma
 
Nationwide Asthma Screenings
   
 
 

 
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Gas stoves linked to childhood asthma
NEW YORK, Sep 22 (Reuters) -- Exposure to gas stoves in the home may lead to respiratory problems in children, especially those with asthma, researchers report. Research reveals "a significant adverse effect
of gas stove exposure on respiratory health in children," write a team of researchers led by Dr. Maria
Garrett of Monash University in Churchill, Australia. Their report appears in the current issue of the
American Journal of Respiratory and Critical Care Medicine. Based on the results of previous studies,
the researchers say they suspected that nitrogen dioxide, a byproduct of gas stoves and heaters, might
trigger or exacerbate asthma symptoms. They studied the 1-year respiratory health of 148 children, 53
of whom were asthmatic. The authors say air samples obtained from homes with gas stoves revealed
overall nitrogen dioxide levels to be "low." Nevertheless, they found that exposure to gas stoves
was still a significant risk factor for respiratory distress and asthma in children, more than doubling 
their risk for respiratory symptoms. "These results suggest that alternative methods of cooking should
be used by families with young children, particularly children with asthma," the investigators say. They
add that the "appropriate ventilation of all indoor combustible appliances, including gas stoves,
is strongly recommended."
SOURCE: American Journal of Respiratory and Critical Care Medicine
1998;158:891-895.
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Can Antireflux Therapy Improve Asthma?  As if wheezing and coughing weren't enough, many people with 
asthma also suffer from the heartburn and other symptoms of gastroesophageal reflux disease (GERD), 
caused by backflow or "reflux" of stomach content into the esophagus. While the exact cause-and-effect
mechanism is unclear.   GERD has been known to affect a disproportionate number of asthmatics
four to five times more than other people. Asthmatics with heartburn may take heart, however: A report
in the July issue of Chest confirms that antireflux therapy not only can soothe the burn, it often reduces
asthma symptoms too.  Canadian doctors analyzed 12 studies (a technique called meta-analysis)
published between 1966 and 1996 on the use of antireflux medication in asthmatics with GERD, 
involving a total of 326 subjects. They found that 69 percent of the treated patients showed improvement
in asthma symptoms and 62 percent needed less asthma medication. Surprisingly, the studies also
showed that antireflux therapy had no effect on lung function per se an apparent paradox that the 
researchers thought worthy of further investigation.  Meanwhile, asthmatics who have GERD should
be sure to treat their reflux symptoms, says HealthNews associate editor Dr. Arthur Feinberg, M.D.
In milder cases, lifestyle changes losing weight; eating smaller, more frequent meals; and avoiding
triggers such as caffeine, alcohol, cigarettes and fatty foods often do the trick.
      If GERD symptoms are more advanced, however, antireflux medication such as an H2 blocker, may
be in order. And since some 25 percent of asthmatics are thought to have asymptomatic GERD,
people with severe, poorly controlled asthma even in the absence of digestive reflux symptoms
may want to ask their doctor about a two-week trial of an H2 blocker such as cimetidine (Tagamet) or
ranitidine (Zantac), to see if asthma symptoms improve. This strategy may also be worth trying for chronic
cough and other respiratory diseases.
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Many people are diagnosed with asthma who are not asthmatics and that the attacks go away completely 
once reflux is controlled.  Left untreated, reflux can destroy healthy lungs.  From personal experience
I can also tell you that acid reflux can damage or destroy the valve that opens and closes as you swallow
to allow food to leave the esophagus and enter the stomach.  People with COPD are at higher risk of having 
reflux because of the bronchodilators we take to keep our airways open.  Theophylline is the worst culprit but
is also necessary for some of us as it enables us to breathe easier.
Stay on top of the reflux.  If you're having lots of asthma attacks, try to make a connection between
the attacks and food you've eaten.  Most reflux occurs in 1-2 hours after eating.  Water-brash reflux can
be during or immediately after eating.  Lying down or bending over after a meal can also trigger reflux.
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BRONCHITIS is an upper respiratory disease in which the mucous membrane in the lungs' upper
bronchial passages becomes inflamed. As the irritated membrane swells and grows thicker, it narrows
or shuts off the tiny airways in the lungs, resulting in coughing spells accompanied by thick phlegm and 
breathlessness. The disease comes in two forms: acute and chronic. In addition, people with asthma
also experience an inflammation of the lining of the bronchial tubes called asthmatic bronchitis.

THE BRONCHIAL TUBES
Acute bronchitis is responsible for the hacking cough and phlegm production that sometimes accompany
an upper respiratory infection; in most cases the infection is viral in origin, but sometimes it is caused by
bacteria. If you are otherwise in good health, the mucous membrane will return to normal after you've 
recovered from the initial lung infection, which usually lasts for several days. Chronic bronchitis, like the
lung disease emphysema, is a serious long-term disorder that requires regular medical treatment. People
who have chronic bronchitis tend to be obese and lead sedentary lives, and most are heavy smokers; they
typically have emphysema as well, which accounts for some of the overlapping symptoms. If you are a
smoker and come down with acute bronchitis, it will be much harder for you to recover. Even one puff on a 
cigarette is enough to cause temporary paralysis of the tiny  hairlike cells in your lungs that are responsible
for brushing out debris, irritants and excess mucus.
If you continue smoking, you may do sufficient damage to these cells, known as cilia, to prevent them from
functioning properly, thus increasing your chances of developing chronic bronchitis. In some heavy 
smokers, the membrane stays inflamed and the cilia eventually stop functioning altogether. Clogged 
with mucus, the lungs are then vulnerable to viral and bacterial infections, which over time distort and 
permanently damage the lungs' airways.  Acute bronchitis is very common among both children and
adults. The disorder often can be treated effectively without professional medical assistance. However,
if you have severe or persistent symptoms or if you cough up blood, you should see your doctor. If 
you suffer from chronic bronchitis, you are at risk for developing cardiovascular problems as well as
more serious lung diseases and infections, so you should be monitored by a doctor.

SYMPTOMS
Acute bronchitis:
Hacking cough.
Yellow, white, or green phlegm, usually appearing 24 to 48 hours after a
cough.
Fever, chills.
Sore....ess and tightness in chest.
Some pain below breastbone during deep breathing. Some shortness of
breath.
Chronic Bronchitis:
Persistent cough producing yellow, white or green phlegm 
(for at least three months of the year, and for more than two consecutive years).
Wheezing, some breathlessness
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Researchers find molecule that may trigger asthma reactions - December 18, 1998

WASHINGTON (AP) -- In a discovery that may lead to new drugs, researchers have identified a molecule
that has a crucial role in causing asthma, a breathing disorder that affects 15 million Americans.

Two teams of scientists experimenting independently with laboratory mice have found that a reaction 
triggered by a molecule called interleukin-13, or IL13, is a primary element in causing the inflammation,
restricted air flow and breathing problems of asthma.

The studies appear Friday in the journal Science.

At Johns Hopkins University, researchers treated asthma-prone mice with a drug that blocks the
action of IL13.

When the mice were exposed to an allergen, a substance that normally caused asthma attacks, the animals     developed no breathing problems. Mice not treated with the IL13 blocker, however, had the inflammation
and restricted airways typical of asthma.

In another study, researchers at the University of California, San Francisco applied IL13 blocker to the
nasal passages of mice and then exposed the animals to an asthma-causing protein.

Animals treated with the IL13 blocker had few asthma symptoms, the scientists report.

The University of California team also found that another molecule  interleukin-4, or IL4, also played a role
in asthma.  But, said David Corry of the university, "IL13 may be more poten."  If the mouse experiments 
can be duplicated in humans, they could give new targets for drugs that treat asthma at the cellular level. 
Such drugs, in effect would stop an asthma reaction at its source instead of treating just the symptoms of
the disorder.
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last edited on 02-23-2003