Chiesi conducts research within asthma and COPD, the most common respiratory diseases

Chiesi is fully committed to the work of improving the care and quality of life of everybody suffering from respiratory diseases such as asthma or chronic obstructive pulmonary disease (COPD). Both asthma and COPD lead to substantially reduced quality of life, increased sick leave and increased risk of early death. According to the WHO's latest estimates, globally 235 million people are suffering from asthma and 251 million from COPD.^1,2

New strategies, fewer people will be affected by obstructive pulmonary disease

Interest in research and studies into the underlying causes of the disease have led to new strategies to reduce the number of people who are affected. Both diseases reduce respiratory flow, but the underlying causes and disease mechanisms are completely different. What causes asthma has not yet been fully understood, but it is thought that it is a combination of genetics and environment, e.g. breathing in pollution that can trigger allergic reactions and irritate the respiratory tracts. The cause of COPD is in most cases smoking, and an important measure to reduce incidence is to prevent people starting to smoke and making it easier to stop.^1,2

Training in connection with COPD and asthma

For both diseases, education, self-care and rehabilitation are important in reducing the burden of disease. In recent years research has shown that physical training is a very important part of the treatment of asthma and in particular of COPD as it can slow the disease in combination with other measures.^3,4 

ASTHMA

Asthma is a chronic inflammation in the airways' mucous membrane which periodically causes symptoms such as breathlessness, cough, sputum formation, squeaking or wheezing. In a healthy person or a person with well-controlled asthma, the air can flow freely in the lungs. With uncontrolled asthma, the respiratory tracts are more prone to inflammation that can trigger an asthma attack. The symptoms in an asthma attack often emerge during the early morning hours and are caused by the inflammation that makes the mucous membrane in the airways swell and the muscles around the small airways tighten. If the asthma attack is not treated, the small airways block and the condition can be very serious. There is no treatment that cures asthma, but it is possible to control the disease and have a good quality of life.^2,3

What causes asthma?

The underlying cause of asthma is still unknown, but what is known is that these factors increase the risk of asthma; allergy, female gender, obesity and ethnic origin have some significance. What causes an acute asthma attack varies and depends on which form of asthma the person has. It is common that asthma attacks occur in connection with airway infections or when the person is exposed to allergens from pollen or furry animals, tobacco smoke or air pollution. Physical effort, cold air and oversensitivity to certain drugs, for example, acetylsalicyclic acid, are also well-known trigger factors for asthma.^2,3

Asthma treatment

Modern maintenance treatment, primarily with inhalation drugs, has led to a decrease in the number of persons with acute asthma. There are many different forms of asthma and that needs to be taken into account in selection of treatment. Getting asthma under control and being able to live with a satisfactory quality of life requires an individual treatment plan that includes educating patients in self-care. Asthma is a disease which varies over time and it is important to identify and eliminate all triggering causes, including those which vary with the seasons. To avoid over- and under-treating asthma, the treatment should be continuously evaluated and re-evaluated , for example, using evaluation forms.^2,3

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

COPD is a pulmonary disease characterised by persistent bronchial obstruction associated with an increased chronic inflammatory response to hazardous particles or gases. An inflammation in the small airways makes the mucous membranes in the airways swell, leading to increased airflow resistance, on the other hand a progressive destruction of lung parenchyma (emphysema) can cause reduced elasticity in the lungs. It is important to emphasise that both mechanisms can co-exist, leading to reduced airflow throughout the lungs.^1,4

Symptoms of COPD

The classic symptoms of COPD are dyspnoea, chronic coughing and production of sputum. There is sometimes an acute deterioration of symptoms that can trigger an exacerbation. A double mechanism lies behind the bronchial obstruction with COPD.^1,4

What causes COPD?

First and foremost, there are genetic risk factors that may predispose some persons to developing the disease. Smoking is the predominant risk factor, after which comes exposure to air- and environmental pollution. Secondary factors are age, gender, socio-economic status, respiratory infections, asthma and chronic bronchitis. COPD patients are more prone to developing cardiovascular diseases, osteoporosis, diabetes, lung cancer and bronchiectasis, which in turn increases the risk of hospitalisation and dying prematurely. In distinction from asthma, COPD is a late onset disease as it involves a slow and progressive exposure to risk factors.^1,4

COPD treatment

As of yet there is no curative treatment for COPD. Treatment of COPD therefore aims to reduce ailments and symptoms, improve quality of life, prevent episodes of deterioration and exacerbations, as well as improve lung function and physical performance. For those who have COPD and still smoke, stopping smoking is the single most important measure. Treatment is adapted according to individual and severity and it includes numerous components, education in self-care, reduction of risk factors, stabilisation of the disease and reduction of the risk of exacerbations, as well as physical training.^1,4

COPD training programme

All patients with stable COPD benefit from physical training, which improves working capacity, dyspnoea and tiredness. European recommendations are available for training in connection with COPD.^4,5

1. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
2. https://www.who.int/news-room/fact-sheets/detail/asthma
3. http://www.ginasthma.org/
4. http://www.goldcopd.com/
5. https://err.ersjournals.com/content/22/128/178