Abstract
Several symptoms are common to different processes that affect the respiratory system and their precise assessment is key to a correct diagnosis. Amongst those symptoms, mostly dyspnoea oriented toward the possible diagnosis of asthma. Nevertheless, the concept of asthma has changed in recent times, as inflammation of the bronchial tree is valued as the pathogenic base of the process, although it can not be ignored that the bronchial hyperresponsiveness is still the basis of dyspnoea crisis. In the last years, several variants have been established, being defined as phenotypes and endotypes that can identify diverse asthmatic or pseudo-asthmatic processes, and there for it is questioned if asthma is not the only process, but a syndrome. In any case, it cannot be ignored that dyspnoea episodes can be based on bronchial hyperresponsiveness of genetic origin or due to inflammation because of unfavourable environmental conditions, as well as physical exercise or the ingestion of aspirin, processes in which other mechanisms are involved.References
Carney IK, Gibson PG, Murree-Allen K, Saltos N, et al. A systematic evaluation of mechanisms in chronic cough. Am J Respir Crit Care Mes 1997;158:211-216.
McCool FD. Global physiology and pathophysiology of cough. Chest 2006;129:48-53.
Pratter MR. Chronic upper airway cough syndrome secondary to rhinosinus diseases (Previously referred as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest 2006;129:63-71.
Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics. Chest 2006;129:260-283.
Muñoz López F. Alergia respiratoria en la infancia y adolescencia. Cap. 9: Fisiología del asma. Broncomotricidad. 2ª ed. Barcelona: Springer-Verlag-Ibérica, 1999.
Bellanti JA. Immunology IV. Clinical application in health and disease. Cap. 18: Allergic disease and asthma. Maryland: I Care Press, 2012;661-683.
Elphick HE, Sherlock P, Foxall G, Simpson EJ, et al. Survey of respiratory sounds in infants. Arch Dis Child 2001;84:35-39.
Martínez FD, Godfrey S. Wheezing disorders in the preschool child. London, New York: Martin Dunitz, 2003.
Muñoz López F. Asma y patología respiratoria en la edad preescolar. Cap. 3: Patogenia de los síntomas comunes a las broncopatías obstructivas. Barcelona: Ed. Mayo, 2010.
Makino S, Sagara H. Evolution of asthma concept and effect of current asthma management guidelines. Allergy Asthma Immunol Res 2010;2:172-175.
Cottini M, Asero R. Asthma phenotypes today. Eur Ann Allergy Clin Immunol 2013;45:17-24.
Weinmayr G, Keller F, Kleiner A, du Prel JB, et al. Asthma phenotypes identified by latent class analysis in the ISAAC II Spain study. Clin Exp Allergy 2012;43:223-232.
Spycher BD, Silverman M, Kuehni CE. Phenotypes of childhood asthma: are they real? Clin Exp Allergy 2010;40:1130-1141.
Lötvall J, Akdis RF, Bacharier LB, Bjermer L, et al. Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol 2011;127:355-360.
Agache I, Akdis C, Jutel M, Virchow JC. Untangling asthma phenotypes and endotypes. Allergy 2012;67:835-846.
Karmaus W, Ziyad AH, Eversn T, Holloway JW. Epigenetic mechanisms and models in the origins of asthma. Curr Opin Allergy Clin Immunol 2013;13:63-69.
Drazen JM. Asthma: the paradox of heterogeneity. J Allergy Clin Immunol 2012;129:1200-1201.
Borish L, Culp JA. Asthma: a syndrome composed of heterogeneous diseases. Ann Allergy Asthma Immunol 2008;101:1-9.
Pavord ID, Wardlaw AJ. The A to E of airway disease. Clin Experimental Allergy 2010;40:62-67.
Holloway JW, Yang IA, Holgate ST. Genetics of allergic diseases. J Allergy Clin Immunol 2010;125:81-94.
Muñoz-López F. Bronchial hyperresponsiveness and asthma in pediatric population. Allergol Immunophatol 2014;42:230-234.
Global Strategy for Asthma Management and Prevention (GINA). National Institute of Health. Revised 2002, 2014.
O’Byrne PM. Airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest 2010;138:1-3.
Brannan JD, Logheed MD. Airway hyperresponsiveness in asthma: mechanisms, clinical significance and treatment. Frontiers in Physiology 2012;3.
Busse WW. The relationship of airway hyperresponsiveness and airway inflammation. Chest 2010;138:4-10.
Galli SJ, Tsai M, Piliponsky AM. The development of allergic inflammation. Nature 2008;454:445-454.
Cockcroft DW, Davis BE. Mechanisms of airway hyperresponsiveness. J Allergy Clin Immunol 2006;118:551-559.
Thomson NC, Chaudhuri R. Why is eosinophilic bronchitis not asthma? Am J Respir Crit Care Med 2004;170:4-5.
Robinson DS. The role of the mast cell in asthma: induction of airway hyperresponsiveness by interaction with smooth muscle? J Allergy Clin Immunol 2004;114:58-65.
Maestrelli P, Boyce PB, Fabbri LM, Mapp CE. Mechanisms of occupational asthma. J Allergy Clin Immunol 2009;123:531-542.
Postma DJ, Kerkhof M, Boezen M, Koppelman GH. Asthma and chronic obstructive pulmonary disease. Common genes, common environments? Am J Respir Crit Care Med 2011;183:1588-1594.
WAO Position Paper. Allergen immunotherapy therapeuticvaccines for allergic diseases. Allergy 1988;53:4-42.
Alvaro M, Sancha J, Larramona H, Lucas JM, et al, Immunotherapy Working Group, Sociedad Española de Inmunología Clínica y Alergia Pediátrica. Allergen-specific immunotherapy: update on immunological mechanisms. Allergol Immunopathol 2013;41:265-272.
Calderón MA, Demoly P, Van Wijk RG, Bousquet J, et al. EAACI: a European Declaration on Immunotherapy. Designing the future of allergen specific immunotherapy. Clin Transl Allergy 2012;2:1-8.
Chang JE, Chil W, Simon R. Aspirin-sensitive asthma and upper airway diseases. Am J Rhinol Allergy 2012;26:27-30.
Szczeklik A, Nizankowska E, Duplaga M. Natural history of aspirin-induced asthma. Eur Repir J 2000;16:432-436.
Neighbour H. Mechanisms of aspirin-intolerant asthma: identifying inflammatory pathway in the pathogenesis of asthma. Int Arch Immunol 2014;163:1-2.
Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczynska M, et al. EAACI/GA2LEN guideline; aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy 2007;62;1111-1118.
Weiler JM, Bonini S, Coifman R, Craig T, et al. American Academy of Allergy, Asthma & Immunology Work Group Report: Exercise-induced asthma. J Allergy Clin Immunol 2007;119:1349-1358.
Pongdee T, Li JT. Exercise-induced bronchoconstriction. Ann Allergy Asthma Immunol 2013;110:311-315.
Martín-Muñoz MF. Asma inducida por ejercicio: aclarando conceptos. Allergol Immunopathol 2011;39:42-46.
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