Understanding and Treatment of Asthma in Dubai: Insights into Symptoms, Prevalence, and Ongoing Management

Introduction:

Asthma is a chronic respiratory condition that affects millions of people worldwide, including those residing in Dubai. This article aims to provide an overview of asthma, its prevalence in Dubai, the need for ongoing treatment, the impact on airways, and the role of severe asthma specialists like Dr. Rachel Kaminski in managing the condition.

Understanding Asthma:

Asthma is a chronic inflammatory disease that affects the airways, causing them to become narrow, swollen, and produce excess mucus. This leads to symptoms such as wheezing, coughing, shortness of breath, and chest tightness. These symptoms can vary in intensity and frequency, with some individuals experiencing mild symptoms while others face more severe attacks.

Prevalence of Asthma in Dubai:

Asthma is a significant health concern in Dubai, with a prevalence rate of approximately 13% among adults and 20% among children. The high prevalence can be attributed to various factors, including environmental triggers, genetic predisposition, and lifestyle choices.

Ongoing Treatment Needs:

Asthma is a chronic condition that requires ongoing treatment to manage symptoms, prevent exacerbations, and improve overall quality of life. Even when symptoms are not present, it is crucial for individuals with asthma to continue their prescribed medications and follow their treatment plan to maintain control and prevent future attacks.? The inflammation is still there, and stopping treatment put individuals at high risk of future severe, even life-threatening attacks.

Understanding Airways in Asthma:

In individuals with asthma, the airways become hyper responsive, meaning they react more strongly to certain triggers, such as allergens, pollutants, or exercise. This hyper responsiveness leads to inflammation, constriction of the airway muscles, and increased mucus production, resulting in the characteristic symptoms of asthma.

Environmental Factors in Dubai:

Dubai's unique environmental factors, such as high levels of dust, sandstorms, and air pollution, can exacerbate asthma symptoms. These factors can trigger asthma attacks and make it more challenging for individuals with asthma to maintain control over their condition.

Severe Asthma and Biologic Injections:

Severe asthma refers to a subset of asthma cases that are difficult to control despite optimal treatment. In such cases, biologic injections, also known as targeted therapy, may be recommended. These injections target specific molecules involved in the inflammatory process, helping to reduce symptoms and improve asthma control.? It is possible to induce remission in patients with severe asthma, meaning they don’t have any symptoms, and their airways are no longer hyper-responsive.

?When you visit a hospital to investigate asthma, the following tests and examinations may be conducted:

?1. History and Examination by a Specialist: A specialist will take a detailed medical history, including symptoms, triggers, and previous treatments. They will also perform a physical examination to assess lung function and identify any potential underlying causes or complications.

?2. Chest X-ray: A chest X-ray may be performed to rule out other respiratory conditions and assess the overall health of the lungs. It helps identify any structural abnormalities or signs of infection that may contribute to asthma symptoms.

?3. Spirometry with Reversibility: Spirometry is a lung function test that measures how much air you can inhale and exhale and how quickly you can do so. This test helps determine the severity of airflow limitation and assesses the response to bronchodilators (medications that open up the airways). Reversibility testing involves performing spirometry before and after using a bronchodilator to evaluate the potential benefit of medication in improving lung function.

?4. Feno Testing: Feno (fractional exhaled nitric oxide) testing measures the level of nitric oxide in your breath. Elevated levels of nitric oxide indicate ongoing airway inflammation, which is a characteristic feature of asthma. Feno testing helps in diagnosing and monitoring asthma, as well as assessing the response to treatment.? This also indicates how much risk you have of future attacks, steroid responsiveness, and the likelihood of certain biological treatments working for you.

?5. Blood Tests: Blood tests, such as a complete blood count (CBC), can provide valuable information about the presence of eosinophils, a type of white blood cell associated with allergic inflammation. Elevated eosinophil levels may indicate allergic asthma. Total IgE and specific RAST (radioallergosorbent test) for allergies can help identify specific allergens that trigger asthma symptoms.

6. CT (computed tomography) scan is not typically used as a routine diagnostic tool for asthma. However, in certain cases, a CT scan may be recommended to evaluate the lungs and airways more thoroughly, especially when there are concerns about other lung conditions or complications.

A CT scan can provide detailed images of the lungs and help identify structural abnormalities, such as bronchiectasis (permanent widening of the airways) or lung nodules. It can also help assess the extent of airway inflammation and mucus plugging in severe asthma cases.

Treatment Options: The treatment for asthma depends on the severity and individual needs of the patient. Common treatment options include:

?1. Inhalers: ICS/LABA inhalers are a common and effective treatment option for asthma. ICS stands for inhaled corticosteroids, while LABA stands for long-acting beta-agonists. These two medications are combined in a single inhaler to provide both anti-inflammatory and bronchodilator effects, helping to control asthma symptoms and prevent exacerbations.

?ICS/LABA inhalers work by reducing airway inflammation and relaxing the muscles around the airways, making it easier to breathe. The inhaled corticosteroid component (ICS) helps to reduce inflammation in the airways, while the long-acting beta-agonist component (LABA) helps to open up the airways and keep them open for a longer duration.

2. Long-Acting Muscarinic Antagonists (LAMA): LAMA medications, such as tiotropium, are sometimes prescribed in addition to LABA/ICS inhalers for individuals with severe asthma to further improve lung function and symptom control.? It also help relax smooth muscles in the airways and work in combination with ICS/LABA

?3. Antihistamines: Antihistamines may be prescribed to manage allergic symptoms and reduce the impact of allergens on asthma control.

?4. Montelukast. These are by blocking the action of leukotrienes, which are inflammatory substances that can cause narrowing and swelling of the airways in individuals with asthma. Montelukast is typically prescribed as an add-on therapy for individuals with mild to moderate persistent asthma, especially those who experience symptoms at night or have exercise-induced asthma.

?4. Biologics: The future of asthma treatment.

Biologic medications, such as Nucala, Fasenra, Xolair, and Tezepelumab, are targeted therapies used for severe asthma cases that are not well-controlled with standard treatments. These medications work by targeting specific molecules involved in the inflammatory process, helping to reduce symptoms and improve asthma control.? These treat the biology of what is going on in the airways and can cause remission of any symptoms.

It is important to note that the specific treatment plan will be determined by the severity of asthma, individual patient factors, and the recommendations of the treating physician, such as Dr. Rachel Kaminski, a severe asthma specialist.

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Dr. Rachel Kaminski: Severe Asthma Specialist:?

About me and how I might help. I am a renowned severe asthma specialist in Dubai. With 17 years of expertise and experience in the United Kingdom, I focus on diagnosing and managing severe asthma cases, providing personalized treatment plans, and offering guidance on the latest advancements in severe asthma management, including biologic injections.? I have an empathetic and calming bedside manner, and will always get to the root cause of the problem, asthma or not. I have been involved in cutting-edge research, taught pulmonologists across the world about airway disease and infection, and am a? member of many respiratory societies, British Thoracic Society, the European Respiratory Society, and the Emirates thoracic society.? I am part of an international steering committees for asthma management and have written guidelines for treatment.? I have provided medical expertise and performed interviews for the BBC, Financial Times, prime-time radio shows, and Radio One.

For more information or to book an appointment visit Dr. Rachel's clinic or call 8002211.

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