Fighting against allergic asthma: Spring allergy season is coming, beware of “breathing pain”!

Cough, cough, cough... A series of irritating coughs made Ms. Wang, a 36-year-old white-collar worker, exclaim: "I am going to cough out my lungs!" This kind of cough has troubled Ms. Wang for more than a month, and it is also accompanied by symptoms of chest tightness and shortness of breath. This made Ms. Wang's family very anxious, so they came to the Department of Respiratory and Critical Care Medicine of Hunan Provincial Second People's Hospital (Provincial Brain Hospital) for diagnosis and treatment.

The examination found that Ms. Wang was allergic to pet hair and was highly sensitive to dust mites, dust, pollen, etc. It was spring, and the catkins and pollen floating in the air made her symptoms worse. After a lung function test, she was finally diagnosed with "acute attack of seasonal allergic asthma."

What is allergic asthma?

Zeng Xiangbo, director of the Respiratory and Critical Care Department of the Second People's Hospital of Hunan Province (Provincial Brain Hospital) , said that allergic asthma can be described as an "over-sensitivity" of the immune system. The essence of allergic asthma is that the immune system overreacts to harmless substances (such as dust mites and pollen).

When allergens enter the airways, immune cells release inflammatory mediators such as histamine and leukotrienes, which is medically known as "type 2 inflammation". Unlike infectious inflammation such as bacteria and viruses, these inflammatory mediators cause bronchoconstriction and increased mucus secretion, leading to the triad of wheezing, coughing, and chest tightness. According to statistics, about 30% of asthma patients in my country have clear seasonal exacerbations.

Why is spring a "high-risk season"? Three major culprits must be prevented

1. Pollen army : Particles such as poplar and willow catkins and cypress pollen can be spread by wind for several kilometers, and particles with a diameter of less than 10μm can directly reach small bronchi;

2. Dust mites are active : In a spring environment of 20-25°C and humidity >55%, the reproduction rate of dust mites in mattresses increases by 50%;

3. Alternating between hot and cold : When the temperature difference between day and night exceeds 8°C, airway sensitivity increases, which can easily induce bronchospasm.

How to prevent and control it scientifically? Experts teach you four steps to prevent and control it scientifically

1. Environmental control: cut off allergens

- Pet management: clean the pet's nest with a mite remover every week and set up a "pet-free bedroom";

- Dust mite prevention and control: Use anti-mite bedding with a pore size of ≤ 0.6μm, and wash and dry bedding in hot water above 55℃ every week;

- Pollen season survival guide: Close windows during the pollen peak period from 10:00 to 16:00, and wear N95 masks + goggles when going out.

2. Stepwise drug therapy

- Control drugs: Use a combination of inhaled glucocorticoids (such as budesonide) and long-acting β2 receptor agonists (such as formoterol) as prescribed by your doctor;

- First aid medicine: carry albuterol aerosol with you and seek medical attention immediately if wheezing does not subside within 20 minutes;

- New biological agents: Monoclonal antibodies targeting IgE (omalizumab), suitable for patients with moderate to severe disease, need to follow the doctor's advice.

3. Immunotherapy: Regulating immunity from the root

Subcutaneous specific immunotherapy (desensitization therapy) can achieve long-term remission in 50% of patients. It is recommended to start in the non-pollen season and gradually increase the exposure to allergens over 3-5 years to reshape immune tolerance.

Special spring reminder for people with allergies:

- Be alert to "thunderstorm asthma": Avoid going out 2 hours before and after a thunderstorm. Strong winds before a thunderstorm will roll a large amount of pollen (especially grass pollen) or mold spores into the clouds. The high humidity in the clouds causes pollen grains to absorb water, swell and burst, releasing tiny particles (such as starch particles or fragments, about 1-3 microns in diameter). The downdrafts of thunderstorms bring these tiny particles back to the ground, where they can penetrate deep into the respiratory tract and trigger allergic reactions and bronchial spasms.

- Make good use of air purifiers: choose products with a CADR value ≥ 300m³/h and equipped with H13-level HEPA filters;

- Diet adjustment: increase the intake of ω-3 fatty acids (deep-sea fish, flax seeds) to reduce airway hyperresponsiveness;

Director Zeng Xiangbo emphasized that although allergic asthma cannot be cured, 85% of patients can be well controlled through the three-dimensional management of "environmental control + standardized medication + immune regulation".

If you have symptoms such as chronic cough, waking up at night, and wheezing after exercise that last for more than 4 weeks, it is recommended that you seek medical attention as soon as possible for lung function + FeNO (exhaled nitric oxide) testing. Remember: Asthma patients who receive standardized treatment can also enjoy the freedom of running and the blooming of flowers in spring.

Hunan Medical Chat Special Author: Tian Aiyu, Department of Respiratory and Critical Care Medicine, Hunan Second People's Hospital (Provincial Brain Hospital)

Follow @湖南医聊 to get more health science information!

(Edited by YT)