Asthma is a chronic respiratory disease that mostly affects the airways in our lungs. It’s a chronic disease that many people in the United States and all across the world have to deal with. There are different types of asthma. Asthma is almost an umbrella term. There are many different kinds of disease—or what we call phenotypes—different levels of severity, different kinds of disease that that affect different types of populations and certain diseases that are related to asthma such as allergic conditions.

Are you born with asthma or is it a condition you develop?

Some children are born with asthma, either because of what’s happened to them during development or they’ve inherited it from their family members. There are certain types of asthma that develop in adulthood.

What are the symptoms of asthma?

People present in many different ways. I’ve had patients tell me they get short of breath, that they get some form of chest tightness, sometimes people hear wheezing. But that’s not always the case. In kids, often times, we see coughing. So, this triggers us as pulmonologist to consider many different kinds of respiratory symptoms as potentially being asthma.

What is an asthma attack?

An asthma attack is a flare up, or, when you lose control of your disease. This might present as someone who has worsening respiratory symptoms if they’re exposed to a particular trigger. Their asthma can flare and they will have more shortness of breath or more symptoms. These flares, unfortunately, can be life-threatening.

How does an asthma attack affect the body?

The lungs get inflamed, particularly the airways that branch out into the different parts of your lung. The inflammation in the lungs causes the muscles around the airways to constrict. This affects the way air can flow in and out of the lungs. In a way, an asthma flare is like an alarm system in the body to say that there’s been some inhaled substance which is causing the body to react in an abnormal way.

Can asthma be treated and what treatment options are available?

We’ve been fortunate that there have been emerging therapies for asthma over the last couple decades. We generally think of asthma therapies as falling into one of several categories. One is what we call rescue inhalers, which help you get out of a tricky situation if you have a symptom. Inhalers are very short-lived. For people who have chronic asthma, we oftentimes need to give them medications that are longer-lasting, what we call maintenance therapy. Over the last several decades, we’ve developed even more long-acting medications that affect your immune system. We call these biologics. We’ve been fortunate that many of these biologics address the upstream inflammation that’s going on so that we can keep severe asthma under better control.

Is asthma curable?

I wish. I wish it was curable. Unfortunately, we don’t have a cure for asthma. The best we can do is to keep it under control.

Can asthma be prevented?

Yes, asthma can be prevented if we are very careful about what kind of environment we live in. Certainly we’re learning more about this, but we are finding that certain early life exposures to chemicals and pollutants can generate asthma later in life. Part of our efforts has been to try to minimize those exposures early on before they become a problem.

Can allergies irritate a person’s asthma condition?

Unfortunately, yes. People who have allergies know that those allergies sometimes trigger an asthma flare. Our advice is to try to keep your allergies under control. We know that allergies that affect your upper airway, like your nose and your throat, can cause inflammation that then trickles down into the chest and triggers an asthma flare. So, the bad news is, yes it can be related especially in those people who are sensitive.

What are any tips or advice you can offer to those living with asthma?

I often tell my patients to do a few things. One is to look really carefully at the environment around you. Living in New York City, we are exposed to pollutants, secondhand cigarette smoke; things that we don’t realize are triggers. Definitely avoid those. I would also say to be sure to be adherent to your medication. Take it correctly, especially the maintenance therapies that we require to keep your asthma in check. We know that if your asthma gets out of control that can have lasting effects. The third thing I would say is to keep your doctor informed of your asthma. Don’t wait until it’s a big problem. If you start noticing that your asthma is getting out of control, talk to somebody as soon as possible.

What locations can you get treated for asthma at the Mount Sinai Health System?

The Respiratory Institute has two locations: one is on 102nd Street and we also have a location at Union Square. That’s where you can find us.

Sonali Bose, MD, MPH, is an Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) and an Assistant Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai. Her focus is on public health research and clinical trials aimed at improving asthma outcomes for both children and adults. One of her additional academic interests is the effect of early life exposures on airway development and respiratory health. She practices at the Mount Sinai – National Jewish Health Respiratory Institute. The Respiratory Institute has locations on the Upper East Side and in Union Square.

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