Bronchial asthma is a very common disease that we know a lot about, but from pulmonology we still do not know enough about it. To begin with, it should be pointed out that there is no asthma, but asthmatics, it seems obvious but it is practical.
I always tell my patients: “all asthmatics are the same and all are different”. The origin of bronchial asthma is different in each case, even so it has a genetic basis, but not an absolute one. An example of this is that among univitelline twins there is only a 15% concordance.
In general, there is a worldwide tendency for bronchial asthma to increase, but there are currently no conclusive Spanish epidemiological studies.
Causes of bronchial asthma
Among the causes that have been adduced to explain the increase in bronchial asthma, there is the hygienist theory, which in a very schematic way would suggest that protection from infections in the first years of life “displaces” immunity towards allergy and asthma. In addition, it has also been related to the increase in obesity in childhood, since there is an unknown link between asthma and obesity.
In Spain it is accepted that 5% of children are asthmatic. Depending on each country this rate varies, with countries such as Lapland where it is very rare or countries where it is very frequent, such as New Zealand. However, it has been said that by the age of fifty, half of the population has had at least one episode of asthma.
In children, some diseases such as syncytial virus bronchiolitis (RSV) is a trigger. Allergy or immunity mediated by Immunoglobulin E plays a great role, source of them are for example pets or dust mites. In children whose asthma is accompanied by food allergy it is more difficult. Each geographical location has its own triggers, such as cockroaches in some areas of the United States.