Transcript
Dr. Modena: What allergic asthma is and what has been considered over these years is asthma induced by allergies.
The classic example of allergy induced asthma or allergic asthma is, "I'm allergic to a dog or a cat. I walk into a room with a cat or dog, and I play with the cat or dog, and then that induces asthma."
People with allergy-induced asthma also have asthma to other things too.
Even though we may label someone as allergy-induced asthma, they may also have asthma when they get a cold or viral induced asthma.
They may also have asthma if they have bad reflux.
They may also have asthma if they're exposed to things like cigarette smoke or toxic chemicals.
Allergic asthma has been used for many years to describe people with allergy-induced asthma, but these patients as we're finding out are much more complex than that, and they have probably multiple triggers to their asthma, not just the allergy component of it.
Allergic asthma in my mind is diagnosed a lot clinically.
Did they have one or more of these other atopic conditions?
Then also, you do skin testing to verify that they have allergies.
What that involves is you bring the patient into clinic.
You take the allergens or little proteins that we think people may be allergic to.
For example, cat protein, dog protein, pollens, we dip it into the protein and then we scratch the skin.
Then when you scratch the skin, if they're allergic or the individual's allergic, it'll swell up, become red and itchy.
Really the diagnosis of allergic asthma is both very much dependent on the clinical history of what they tell the doctor, but then also verified with some skin testing.
There's also a couple more testing that we do.
We do things called excel nitric oxide, where people breathe out and measures inflammation.
We see that is often elevated with allergic asthma, but it really is still very much dependent on the physician's history and a consideration of the person as an individual.
The treatment of allergic asthma should consist of avoidance.
Typically, the one that we worry the most about our pets indoors.
If there's no clear trigger that we can do anything about, like say for example, if the person test positive to pollens and they're diagnosed with allergic asthma, there is no avoiding pollens for most children.
Typically, we have rescue inhaler when they have symptoms, but then also we have a maintenance medication.
The maintenance medication is there to reduce inflammation, but you want to see a thoughtful process of, "My asthma's out of control.
I'm going to start using a maintenance medication.
I'm going to get it under control, and then I'm going to start thinking about tapering that."
It's best to do that with the physician so the physician can look at you objectively and help you wean your medications or decrease them over time.
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