Asthma: Prevalence, Pathophysiology, and Treatment


Asthma is a condition that makes the airways of a person swell, become narrow, inflamed, and produce extra mucus that makes breathing difficult. The symptoms include wheezing, coughing, chest pains, and difficulty in breathing. Symptoms are preventable using controllable inhalers. Asthma is incurable, but its symptoms are controllable. Oral steroids are treatments for severe asthmatic cases. The severity of asthma may be minor or life-threatening.

Incidence and Prevalence of Asthma

  • Suffer: 300 million
  • Deaths annually: 250,000
  • Overall prevalence: 3%-10%
  • Highest prevalence: Australia, Sweden, United Kingdom, Netherlands, Brazil.
  • Factor under investigation: change to indoor lifestyle.

According to the World Health Organization (WHO), approximately 300 million individuals suffer from asthma worldwide (Maselli et al., 2019). Approximately 250,000 deaths, according to WHO, occur annually due to asthma. The overall prevalence rate of asthma is approximately 3%-10% of the general population. Australia, Sweden, United Kingdom, Netherlands, and Brazil are the countries with the highest clinical prevalence rates of asthma in the world. Change of lifestyle from outdoors to indoors among several populations is a factor under investigation for the increased prevalence of asthma worldwide.

Pathophysiology of Asthma


Three key abnormalities are involved in the pathophysiology of asthma. These include mucus impaction, airway inflammation, and bronchoconstriction. The inflammatory infiltrates in the bronchial submucosa of persons suffering from asthma consists of neutrophils and monocytes. According to Bardin et al. (2017), eosinophils appear in the airway epithelium below chemotactic signals, including cell surface adhesion molecules.


The assessment of lymphocytes depends on the profile of cytokine production. The cytokine production profile consists of Th1 or Th2 cytokines. The Th1-Th2 dichotomy does not completely explain the pathophysiology of asthma. CD4+ T cells in the epithelium have the potential to amplify the inflammatory process. Lymphocytes play a significant role in causing severe asthmatic attacks.

Mast Cells

Mast cells consist of leukocytes and normally appear in a degranulated form. Mast cells also play a significant role. The regulation of fibroblast proliferation involves a major mechanism that seems to be the activation of PAR-2 (Protease-Activated-Receptor) present on the cell surface of lung fibroblasts.


Macrophages consist of recently migrated blood monocytes. The release of pro-inflammatory signals by macrophages is when they appear activated. They produce pro-inflammatory mediators. Macrophages are capable of secreting high amounts of metalloproteases in asthmatic individuals. These metalloproteases are growth factors involved in the activation of leukocytes.


There are high degrees of proactivity molecules for neutrophils in severely asthmatic patients. The neutrophilic inflammation that takes place in the airway is corticosteroid resistant. Backman et al. (2019) state that upon the activation of neutrophils, they become responsible for the releasing oxidants. The relationship between the persistence of microorganisms and neutrophilic bronchitis is still not clearly established. The role of specific genes is still under investigation.

Assessment and Treatment

Short-acting B2-agonists, as well as inhaled corticosteroids, are probably the most popular control medications for asthma. Combination inhalers are also effective asthma medications as they contain a long-acting beta-agonist as well as an inhaled corticosteroid. Theophylline is an effective daily medication for asthmatic attacks. Biologics and particularly Nucala, which is an injectable medication, is an effective asthmatic treatment for children.

Patient Education, Cultural and Spiritual Management of Asthma

The model of self-regulation is arguably the most effective model for the management of asthma treatments in diverse situations and circumstances. The caregiver is educated in this model and is an active problem solver (Braido et al., 2018). The central cognitive construct in this model involves showing caregivers the symptoms of asthma. Situational stimuli accompany the dispensation treatment plan. The cultural and spiritual concerns of the patient are incorporated into the management and treatment plan.

How Asthma affects Children/Infants

The frequency and severity of symptoms in children vary greatly. It is important to seek medical advice promptly. Most common symptoms among this age group include chest tightness, being irritable, feeling tired, trouble eating or sucking, and coughing (especially at night or in the morning).


Backman, H., Jansson, S. A., Stridsman, C., Eriksson, B., Hedman, L., Eklund, B. M.,… & Rönmark, E. (2019). Severe asthma—a population study perspective. Clinical & Experimental Allergy, 49(6), 819-828.

Bardin, P. G., Price, D., Chanez, P., Humbert, M., & Bourdin, A. (2017). Managing asthma in the era of biological therapies. The Lancet Respiratory Medicine, 5(5), 376-378.

Braido, F., Tiotiu, A., Kowal, K., Mihaicuta, S., Novakova, P., & Oguzulgen, I. K. (2018). Phenotypes/endotypes-driven treatment in asthma. Current Opinion in Allergy and Clinical Immunology, 18(3), 184-189.

Maselli, D. J., Hardin, M., Christenson, S. A., Hanania, N. A., Hersh, C. P., Adams, S. G.,… & Martinez, F. J. (2019). Clinical approach to the therapy of asthma-COPD overlap. Chest, 155(1), 168-177.

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NursingBird. (2023, April 3). Asthma: Prevalence, Pathophysiology, and Treatment. Retrieved from


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NursingBird. "Asthma: Prevalence, Pathophysiology, and Treatment." April 3, 2023.