Hyperresponsiveness in Asthma

Asthma is a chronic condition where your body reacts to allergens and certain environmental triggers. Asthma is characterized by 2 different responses:

• Hyperresponsiveness, also called the early phase of asthma
• Inflammatory Response, also called the late phase of asthma

You can almost think of this as twitchiness. Your lungs are irritated by an allergen that ultimately leads to asthma symptoms. Your lungs become exposed to the allergen, which kicks off the pathophysiology of asthma. You then end up with asthma symptoms such as:

• Wheezing
• Chest tightness
• Shortness of breath
• Cough

In hyperresponsiveness, the airways of your lungs get smaller when exposed you are to an allergen. While all people's lungs respond in this way to irritants like secondhand smoke, asthma patients have a special response that makes it more difficult to breathe. This acute phase of asthma can be prevented with certain medications like inhaled steroids, but the acute symptoms need to be treated with a beta agonist like albuterol.

In people without hyperresponsiveness, the airways relax to help you expel the irritant. In some people with asthma, the airways do not relax and actually get smaller. This narrowing of the airways makes it more difficult to breathe. When you use your rescue inhaler, you feel better because the medication relaxes your airways and makes them larger so that air can flow more easily.

Hyperresponsiveness occurs soon after exposure to an allergen and is the first part of an asthma attack. There are also changes that occur later that are more compatible with inflammation.

There are a number of strategies to treat hyperresponsiveness associated with asthma. First, avoiding triggers is key. Second, medicine like inhaled steroids that help prevent reactions in the lung when you are exposed to an irritant or trigger. Finally, there is acute treatment of symptoms brought on by exposure to some sort of allergen.

However, not everything that causes asthma-like symptoms is really asthma. Not all that wheezes is asthma. The symptoms of asthma can be due to hyperresponsiveness in the near term and ultimately due to inflammation in the long term. The different phases of asthma are treated with different medications. The short-term hyperresponsiveness generally responds to short-acting medications while the chronic inflammation is more responsive to anti-inflammatory medications like inhaled steroids.