Introduction
Some of the etiologies of Asthma appear to be immune related in that a response to a superantigen - often results in an abundance of IgA, IgE, and IgM antibodies, depending upon the nature of the superantigen. Thus - if one's immune system is at less than peak performance - these antibodies may actually attack the host by causing inflammation of tissue. This is identical to the mechanism that is present in the formation of RSD and Diabetic Neuropathy - both are neuropathies.
In the case of the antibodies that cause Asthma - the inflammation occurs in the lungs and bronchi. Thus congested air passages result and - ergo - Asthma.
The Nature of the Causes
Here is an example of one such cause of a bronchial-pulmonary irritating disease and its profile.
ABPA is a disease state induced by arthus reaction to colonizing aspergillus in the bronchi in patients with bronchial asthma.
Clinical Picture
ABPA should be suspected whenever asthma is refractory and is associated with fever, cough and black or grey sputum. Chest x-ray often reveals evanescent pulmonary infiltrates. Marked eosinophilia and elevated IgE are noted.
Pathophysiology
Aspergillus colonizes in the bronchi in asthmatics because of thick secretions. A precipitating antibody is produced. A type III immunological reaction follows. Complement is activated. An inflammatory response occurs with damage to the bronchial wall and the bronchi get plugged with secretion. Segmental infiltrates and atelectasis follows.
Diagnosis
Aspergillus precipitating antibody is detected in serum. IgE levels and eosinophiles are elevated. Central bronchiectasis can be demonstrated by CT scan.
