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There is growing interest in the pronounced variability in the incidence and severity of chronic respiratory diseases such as Asthma, observed to occur in any particular patient over a given period of time. It is now known that acute exacerbations are multi-factorial in origin, with pollution, allergens and viruses all implicated, and effective treatment requires a similarly complex approach that addresses each of the component causes. In this new volume, leading authorities review what is known of these causative factors and the mechanisms by which they exacerbate the symptoms of pulmonary disease both singly and in combination. The authors evaluate the individual efficacy of current treatments in the light of this knowledge and present new recommendations for formulating effective therapeutic regimens.
Table of Contents
EPIDEMIOLOGY. Acute exacerbations are major unmet needs in asthma therapy. Socio-economic costs of acute asthma exacerbations. Seasonal patterns of asthma exacerbations. Aetiology of asthma exacerbations in children. Aetiology of asthma exacerbations in adults. Differentiating asthma exacerbations from poor asthma control. Do frequent exacerbations lead to accelerated long term decline in lung function in asthma? PATHOPHYSIOLOGY. Inflammatory mechanisms of asthma exacerbations. Virus induction of neurogenic inflammation and airway responsiveness. Antiviral immunity and protection against asthma exacerbations. Lessons from RSV bronchiolitis and acute wheezing episodes in infants. Virus induction of steroid resistance. IN-VITRO EXPERIMENTAL MODELS OF ASTHMA EXACERBATIONS. In vitro models of bronchial epithelial cell infection. In vitro models of macrophage infection. IN-VIVO EXPERIMENTAL MODELS OF ASTHMA EXACERBATIONS. Murine models of allergen exposure and virus infection. A murine model of rhinovirus infection. A human experimental model of asthma exacerbation induced by rhinovirus infection. Lessons from human experimental rhinovirus infection in combination with allergen exposure. TREATMENT & PREVENTION OF ASTHMA EXACERBATIONS. Role of established asthma therapies in treating acute asthma exacerbations (adults and children). Role of leukotriene antagonists in the treating acute asthma exacerbations. How good are inhaled steroids alone at preventing asthma exacerbations? (prophylactic and doubling dose). How good are inhaled steroids/LABA in combination at preventing asthma exacerbations? New targets for treatment/prevention of asthma exacerbations. DELIVERY OF CARE Role of self-management in preventing asthma exacerbations. Psychosocial factors in severe asthma
"With contributions from 38 renowned asthma experts, the editors provide a global view of asthma and its impact on morbidity and mortality. [...] I would recommend its purchase. [...] a well-referenced book that deals with a broad list of asthma topics. Overall the writing is clear, thorough, and well-organized. The content is timely and accurate."
Dennis R. Wissing, Respiratory Care, September 2007 (Vol 52: 9)
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