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Asthma is a common pulmonary condition defined by chronic inflammation of respiratory tubes, tightening of respiratory smooth muscle, and episodes of bronchoconstriction. [1] The Centers for Disease Control and Prevention estimate that 1 in 11 children and 1 in 12 adults have asthma in the United States of America. [1]
Airway remodelling is a multifaceted process involving multiple airway tissues. These include goblet cell hyperplasia, leading to increased mucus production, and airway smooth muscle hypertrophy (or smooth muscle cell hyperplasia), leading to the release of pro-inflammatory and pro-fibrotic messengers contributing to subepithelial fibrosis.
The respiratory bronchioles deliver air to the exchange surfaces of the lungs. [5] They are interrupted by alveoli which are thin walled evaginations. Alveolar ducts are side branches of the respiratory bronchioles. The respiratory bronchioles are lined by ciliated cuboidal epithelium along with some non-ciliated cells called club cells. [6]
Asthma phenotyping and endotyping has emerged as a novel approach to asthma classification inspired by precision medicine which separates the clinical presentations of asthma, or asthma phenotypes, from their underlying causes, or asthma endotypes. The best-supported endotypic distinction is the type 2-high/type 2-low distinction.
A bronchus (/ ˈ b r ɒ ŋ k ə s / BRONG-kəs; pl.: bronchi, / ˈ b r ɒ ŋ k aɪ / BRONG-ky) is a passage or airway in the lower respiratory tract that conducts air into the lungs.The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus.
The cells in the respiratory epithelium are of five main types: a) ciliated cells, b) goblet cells, c) brush cells, d) airway basal cells, and e) small granule cells (NDES) [6] Goblet cells become increasingly fewer further down the respiratory tree until they are absent in the terminal bronchioles; club cells take over their role to some extent here. [7]
[2] The carina occurs at the lower end of the trachea - usually at the level of the 4th to 5th thoracic vertebra . [ 3 ] [ 4 ] This is in line with the sternal angle , but the carina may raise or descend up to two vertebrae higher or lower with breathing .
[citation needed] These medications decrease immune system activity which in turn will decrease swelling of the airways, decrease airway resistance, and increase delivery of air to the alveoli during respiration. Unlike the SABAs, these medications do not provide relief of acute symptoms or asthmatic attacks, and their benefits are typically ...