INTRODUCTION e.g., Asthma mortality rate is 1.1%

INTRODUCTIONAsthma is a condition that affects around 1 in 12 people, about 8% of the population. Currently, in the United Kingdom, 5.4 million people have this disease with an average of 3 people who lose their lives to it 1. In 2012 1,246 people died from asthma 358 were males and 888 were females. Deaths from asthma attacks are less frequent due to medication however although the mortality rates are low in asthma compared to other lung diseases, given the manageability of asthma it should be closer to zero, e.

g., Asthma mortality rate is 1.1% in 2012 whereas COPD was 26.1% 2. Although asthma prevalence is 8%, it varies widely among different ethnicities. The severity of asthma is higher in specific ethnic groups, especially those in poverty-stricken areas because of environmental exposure, care received and stress 3. Asthma becomes more prevalent and worsens in women especially those who have an early onset of menstruation which suggests that there is a correlation between sex hormones and asthma. Although it is more common for women to suffer from asthma in adulthood, childhood asthma is more frequent in boys than girls 4.

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Asthma is a chronic inflammatory lung disease with three factors, an increase in the responsiveness of the conducting airways resulting in AHR (Airway Hyper-responsiveness), reversible airway obstruction as well as airway inflammation 5. AHR causes the airway smooth muscle to constrict quickly due to a wide range of stimuli which leads to immune cells generating inflammation in the bronchi, narrowing the airways leading to breathlessness 168. A healthy lung function occurs when oxygen is inhaled through the mouth or nose and is taken down through the trachea which branches off into bronchi’s. Bronchi’s branch off into further bronchioles and at the end of each bronchiole are alveoli sacs where gas exchange occurs, taking oxygen to cells and tissues around the body as well as getting rid of waste products such as carbon dioxide. The most common type of asthma is allergic asthma which accounts for over 60% of asthma cases 7.

Although all cases of asthma are not extrinsic (allergic), most allergic examples are seen in younger patients that show an immediate hypersensitivity to environmental allergens 5.Types of Asthma There are two types of asthma, Atopic asthma which is extrinsic and non-atopic asthma which is intrinsic. Atopic asthma is due to an allergy to antigens resulting in a heightened immune response to either food or inhaled common allergens 9. Usually, the allergens are airborne in the form of dust, smoke, animal dander and pollen. Intrinsic asthma is caused by recurrent infections of the bronchi due to bacteria or viruses which lead to an infection. Airway cooling can also lead to an attack which is due to exercise and change in temperatures (e.

g. cold weather) or emotional stress, non-specific irritants cause these attacks. Another type of asthma classed as ‘mixed’ is when a patient has a combination of atopic and non-atopic asthma factors. Atopic asthma is more common and has a childhood onset due to a hypersensitivity reaction to the immune response.

The symptoms that arise with an asthma attack is a wheezing type of respiration, pale skin, bluish colour to the lips or skin(cyanosis) along with a production of thick sputum as the attack progresses 10. The start of asthma depends highly on the dendritic cells (DC) and epithelial cells (EC) lining the airways. In asthma, the epithelial cell junctions are defective as it enables penetration of inhaled allergens. The activation of epithelial cells results in the release of chemokines such as CCL20, CCL19 etc. which attracts immature dendritic cells that can differentiate as well as activate inflammation and adaptive immunity 5.-        Current medication and treatments-       Inflammation-       Future drug therapies    Method WHERE? SEARCH BAR RESULTS Inclusion area Exclusion area Pubmed Allergic asthma 34,341 Full text, within 5 years, humans Anything over 10 years Pubmed Allergic asthma inflammation adults 311 Clinical trial phase 3, review, full text, within 5 years, humans Anything over 10 years Pubmed IgE in allergic asthma atopic 263 Clinical trial phase 3, review, full text, within 5 years, humans Anything over 10 years Pubmed allergic asthma, TH2, IgE 57 Clinical study, 2014-2017, full text, Anything over 5 years+, on animals, Google scholar Difference between extrinsic and intrinsic asthma inflammation 18,800 Since 2017 10 years+, anything on animals, anything to do with cancer or rhinitis PUBMED what is atopic asthma inflammation th2 children 72 2014+, CLINICAL TRIALS 10 years+ , anything on animals, anything to do with atopic eczema Pubmed Asthma and ethnic minorities: socioeconomic status 59 Clinical trials 10 years+ Pubmed Asthma and ethnic minorities: socioeconomic status 30(ref29) Clinical trials, 2009-2017   10 years+, anything to do with cancer   I carried out my research on PubMed, narrowing down my results with more specific terminologies which reduced the amount of results which can be seen in the table above. My inclusion and exclusion stayed the same. Inclusions included papers on clinical studies within a 10-year space, clinical trials only on human subjects as well as being in phase 3 of the clinical trial to ensure that the data collected was sufficient.

To further advance my search the exclusions consisted of papers no longer than 10 years as the research into asthma and the current treatments are still developing, certain areas in the information needed was narrowed down further to less than 5 years also excluding any research papers that included atopic eczema, cancer and rhinitis.            Reference 1.     asthma?, W. (2016). What is asthma? | Asthma UK.

online Asthma UK. Available at: https://www.asthma.org.uk/advice/understanding-asthma/what-is-asthma/?gclid=Cj0KCQiA4bzSBRDOARIsAHJ1UO5WTlcloBpTlM00NObKvr4j2kFRti9xNn-5yxfJcDtfu8vcp5Le6q4aAiY1EALw_wcB Accessed 10 Nov.

2017.2.     Statistics.blf.org.uk.

(2018). Asthma statistics | British Lung Foundation. online Available at: https://statistics.blf.org.uk/asthma Accessed 11 Dec. 2017.3.

     Forno, E., & Celedón, J. C. (2009). Asthma and Ethnic Minorities: Socioeconomic Status and Beyond. Current Opinion in Allergy and Clinical Immunology, 9(2), 154–1604.     Asthma UK.

(2018). Women | Asthma UK. online Available at: https://www.asthma.org.uk/advice/manage-your-asthma/women/ Accessed 9 Jan.

2018. 5.     Chapel, H., Haeney, M. and Misbah, S. (2014). Essentials of Clinical Immunology.

6th ed. John wiley & sons, pp.94-97.6.     Murdoch, J. and Lloyd, C. (2010). Chronic inflammation and asthma.

 Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 690(1-2), pp.24-39.7.     Aafa-md.org. (2018).

 Asthma Basics :: Asthma & Allergy Foundation of America of Maryland – Greater Washington DC. online Available at: http://www.aafa-md.org/asthma_basics.

htm Accessed 14 Nov. 2017.8.     Bihouée, T., Bouchaud, G., Chesné, J., Lair, D., Rolland-Debord, C.

, Braza, F., Cheminant, M., Aubert, P.

, Mahay, G., Sagan, C., Neunlist, M., Brouard, S.

, Bodinier, M. and Magnan, A. (2018). Food allergy enhances allergic asthma in mice.9.     https://www.

aaaai.org/conditions-and-treatments/conditions-dictionary/atopy10.  https://medical-dictionary.thefreedictionary.com/atopic+asthma

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