The Asthmas: A Precision Medicine Approach to Treatable Traits, Diagnosis and Management

Description

The field of asthma has expanded in the last decade with specific drugs targeting the disease mechanisms. This book is an updated treatise covering diagnoses, phenotypes and endotypes of asthma along with its management. It includes diagnostic work-up which is required prior to medical assistance and basic immunology assessment, illustrating the types, severity, number of exacerbations due to disease activity, allergy or infections. As the treatment selection has changed from one size fits all to precision-based medicine, it aims to refine asthma management with right medication usage, neither overuse nor underuse, and initiation of the new hospital administered biologic drugs. Key Features • Covers both respiratory physiology and airway inflammation • Highlights the use of biologic drugs • Discusses precision-based medicine • Explores the comorbidities through clinical cases Cover Half Title Title Page Copyright Page Contents Preface Acknowledgements Authors Abbreviations 1. Introduction 1.1. Asthma: A historical perspective 1.2. A new era: Asthma phenotypes, endotypes, treatable traits and personalised management 2. Pulmonary – Treatable traits 2.1. Airflow limitation 2.2. What clinical problems does it cause? 2.3. How can it be detected? 2.4. How is it treated? 2.5. What is the result of treatment? 2.6. Type-2 airway inflammation 2.7. How is it treated? 2.8. What is the result of treatment? 2.9. Disordered airway mucosal immunity 2.10. Altered cough reflex sensitivity 2.11. Structural changes to the airway 2.12. Common patterns of asthma 3. Extrapulmonary – Treatable traits 3.1. Upper airway (UA) 3.2. UA – Vocal cord dysfunction (VCD) and exercise-induced laryngeal obstruction mechanism 3.3. Upper airway mechanisms in obstructive sleep apnoea 3.4. Exercise and asthma 3.5. Overlap between COPD and asthma 3.6. Gastro-oesophageal reflux disease 3.7. Depression and anxiety with asthma 4. Risk factors – Treatable traits 4.1. Tobacco exposure and the asthmas 4.2. The allergic history – And allergic asthma 4.3. Air pollution and the asthmas 4.4. Infection 4.5. Obesity 4.6. Adherence 5. Diagnostic tests in respiratory medicine 5.1. Diagnoses of respiratory allergies 5.2. Fraction of exhaled nitric oxide 5.3. Inflammatory cell counts: Eosinophilic and neutrophilic cells 5.4. Blood, sputum or bronchial alveolar lavage fluid cytokines 5.5. Lung function 5.6. Airway hyperresponsiveness 5.7. Fitness in asthma 5.8. Cough reflex sensitivity 6. Key cases – Treatable traits 6.1. Pulmonary cases 6.2. Extrapulmonary cases 6.3. Risk factors 7. Evaluation of the asthmas 7.1. A pragmatic, assumption-free approach to asthma diagnosis and management 7.2. Severity of respiratory symptoms 8. Organising an asthma clinic 8.1. Introduction 8.2. Principles of treatable traits in organisation of care 8.3. Severe asthma clinic 8.4. Other factors in organisation of care 9. The future of the asthmas 9.1. Introduction 9.2. Future research needs 9.3. Excellent asthma papers supporting treatable traits 10. Conclusion Index