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Asthma

Allergic Asthma

Asthma triggered by allergens with IgE-mediated sensitization.

IgE/allergen sensitizationtestingimmunotherapybiologics
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Overview

Allergic asthma is the most common type of asthma, affecting approximately 60% of adults and 80% of children with asthma. It's triggered by exposure to allergens to which the patient is sensitized.

mechanism

When a sensitized individual is exposed to an allergen, IgE antibodies trigger mast cell degranulation, leading to airway inflammation, bronchoconstriction, and asthma symptoms.

allergens

  • Pollen (trees, grasses, weeds)
  • Dust mites
  • Pet dander
  • Mold spores
  • Cockroach allergens

evaluation

testing

  • Skin prick testing to identify specific allergens
  • Serum IgE testing (component-resolved diagnostics)
  • FeNO testing to assess eosinophilic inflammation
  • Spirometry with bronchodilator response

history

Correlation between allergen exposure and symptoms

treatment

standard

  • Inhaled corticosteroids (controller)
  • Allergen avoidance strategies
  • Rescue medications (SABA) as needed

immunotherapy

  • Allergy shots (subcutaneous immunotherapy) - can modify disease course
  • Sublingual immunotherapy tablets - for specific allergens
  • Most effective when started early and continued for 3-5 years

biologics

  • Omalizumab (anti-IgE) - for moderate to severe allergic asthma
  • Dupilumab - for severe asthma with type 2 inflammation
  • Consider when standard therapy is insufficient

prevention

  • Identify and avoid triggers
  • Use air purifiers and allergen-proof bedding
  • Keep windows closed during high pollen seasons
  • Regular cleaning to reduce dust mites and mold

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