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Bronchial Asthma pp 149–177Cite as

The Adult Asthmatic

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Abstract

Asthma in adults is a clinical syndrome that is largely allergic in nature, which manifests reversible to partially reversible airway obstruction. Asthma is underdiagnosed and undertreated in the United States, especially in those who are >40 years of age or older. Despite the reduction in asthma mortality since 1996, morbidity and healthcare resource utilization associated with asthma continue to increase. Forty to sixty percent of asthma patients do not achieve asthma control, and the basics of asthma care are missing for large segments of the population, including African Americans, Native Indians, Hispanics, and Asians. The annual cost for asthma is nearly $15 billion with 80% of the direct costs directed at only 10–20% of asthmatic patients. The inability to bring about well-controlled asthma in every patient by applying the current NIH-NAEPP guidelines should draw attention to disease heterogeneity and the urgent need to reconsider old paradigms with new ideas.

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Abbreviations

FEV1 :

Forced expiratory volume in the first second

AOA:

Adult onset asthma

LOA:

Late-onset asthma

GERD:

Gastroesophageal reflux disease

NAEPP-EPR3:

National Asthma Education and Prevention Program – Expert Panel Report 3

COPD:

Chronic obstructive pulmonary disease

CS:

Corticosteroid

ICS:

Inhaled corticosteroid

LABA:

Long-acting β-agonist

SABA:

Short-acting β-agonist

CDC:

Centers for disease control

HRT:

Hormone replacement therapy

CI:

Confidence interval

NSAID:

Nonsteroidal anti-inflammatory drug

COX:

Cyclooxygenase

LT:

Leukotriene

GOLD:

Global obstructive lung disease

cys-LT:

Cysteinyl leukotriene

BMI:

Body Mass Index

RANTES:

Regulated upon activation normal T-cell expressed and secreted

GWA:

Genome-wide association

NO:

Nitric oxide

NOS:

Nitric oxide synthase

AHR:

Airway hyperresponsiveness

FENO :

Fraction of exhaled nitric oxide

EBC:

Exhaled breath condensate

PEF:

Peak expiratory flow

LTRA:

Leukotriene receptor antagonist

PC20 :

The provocative concentration or dose of methacholine that causes a 20% decrease in baseline FEV1

FDA:

Food and drug administration

SARP:

Severe Asthma Research Program

ACRN:

Asthma Clinical Research Network

PPARγ:

Peroxisome proliferator-activated receptor-gamma

PDE4:

Phosphodiesterase 4

BDP:

Beclomethasonedipropionate

FP:

Fluticasone propionate

MDI:

Metered dose inhaler

DPI:

Dry powder inhaler

TNF:

Tumor necrosis factor

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California at Davis, Sacramento, CA, USA

    Amir A. Zeki MD, MAS & Nicholas J. Kenyon MD, MAS

  2. UC Davis Center for Comparative Respiratory Biology and Medicine, Davis, CA, USA

    Amir A. Zeki MD, MAS & Nicholas J. Kenyon MD, MAS

  3. VA Northern California Health Care System, Mather, CA, USA

    Amir A. Zeki MD, MAS, Nicholas J. Kenyon MD, MAS & Ken Yoneda MD

  4. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Ken Yoneda MD & Samuel Louie MD

Authors
  1. Amir A. Zeki MD, MAS
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  2. Nicholas J. Kenyon MD, MAS
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  3. Ken Yoneda MD
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  4. Samuel Louie MD
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Correspondence to Amir A. Zeki MD, MAS .

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Editors and Affiliations

  1. School of Medicine, Division of Rheumatology, Allergy &, University of California, Davis, Davis, 95616, California, USA

    M. Eric Gershwin

  2. , Pulmonary and Critical Care, UC Davis Medical Group, J St. 2825, Davis, 95816, California, USA

    Timothy E. Albertson

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Zeki, A.A., Kenyon, N.J., Yoneda, K., Louie, S. (2012). The Adult Asthmatic. In: Gershwin, M., Albertson, T. (eds) Bronchial Asthma. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6836-4_6

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