One of the integral components in the management of asthma in children is control of allergies. Asthma, a condition of chronic lung inflammation of the airways and surrounding tissues, causes symtpoms such as intermittent episodes of cough, wheezing and respiratory distress. Strategies to prevent asthma attacks include allergy medicines, as allergies can exacerbate asthma symptoms.
Significance
According to the American Academy of Pediatrics, asthma affects about 5 million children and allergies affect close to 50 million children in the United States. According to the Asthma and Allergy Foundation of America, asthma attacks resulted in 200,000 hospital stays and about 340 deaths among people younger than 25 years old.
Function
Allergies occur when the body's immune system identifies certain seemingly harmless substances, like pollen or pet dander, as harmful. These substances, called "allergens," provoke a series of reactions within the cells involved in the immune response that leads to the release of certain molecules like histamine, which can trigger or worsen an asthma attack. Children in particular are prone to allergic reactions because their immune systems may have never encountered these allergens before. Therefore, they can exhibit severe symptoms upon exposure.
Features
Histamine, the main protein released by cells involved in an allergic reaction, is responsible for several allergy symptoms. It contributes to the body's inflammatory reaction to allergens, and it triggers constriction of smooth muscle, including those surrounding the airways. Both inflammation and bronchoconstriction (the narrowing of the airways) decrease air exchange in the lungs, triggering the symptoms of asthma. Children exhibit the typical symptoms of asthma, like cough and wheezing, but can also show atypical symptoms, like vomiting, poor sleep, and decreased weight and growth rate.
Considerations
There are several medicines that work to reduce the effects of histamine, therefore decreasing allergic reactions and their worsening effect on asthma patients. Histamine provokes the release of inflammation-producing substances and causes bronchoconstriction by attaching to a receptor in certain cells. Antihistamines act on these receptors to decrease the secretion of histamine, therefore decreasing its action. Over-the-counter antihistamines are well tolerated in children, but care must be taken to administer the right dose.
Prevention/Solution
Other preventive strategies to decrease the effect of allergies on asthmatic children include nasal steroids to reduce the inflammation that allergens cause inside the nose, and mast cell stabilizers, which are medicines that prevent the release of histamine by the mast cells--the primary cells involved in the allergic reaction. It is also important to keep children away from other allergens and asthma triggers, like cigarette smoke, pet dander and dust mites.
