Search
× Search

Respiratory Symptoms From Inhaled Substances

Respiratory Symptoms From Inhaled Substances

Allergens

An allergen is a substance which is capable of initiating an allergic reaction. The most important inhaled allergens are tiny invisible pollen grains, mold spores, house dust and animal danders.

Allergy-causing pollens come from plant flowers which at certain times of the year release large quantities of light buoyant pollen which can be carried for miles by the wind. These flowers are inconspicuous and often don’t really look like blossoms. They include trees which pollinate in spring, grasses in summer, and weeds in the fall. (See OAAC educational material handout Pollen Seasons) Ornamental flowers are generally not very important in allergy. They have large sticky pollen grains that are carried to other flowers by insects. They are not sufficiently abundant in the air to cause symptoms unless an allergic person is very close to them. However, some ornamental flowers are related to weeds. This is why some ragweed-allergic patients have symptoms when they are close to chrysanthemums, zinnias, asters, daisies, etc.

There are many types of molds in our environment. They have varying preferences for the types of places and conditions under which they grow into colonies. Some prefer to colonize indoors, some outdoors. The spores released by colonies are carried through the air to new places suitable for new colony formation. These spores are smaller than pollen grains but like pollens can cause allergic symptoms when they are inhaled.

The important constituents of house dust are the products of microscopic organisms found in most homes. House dust mites and molds thrive in warm moist conditions.

Like humans, fur-bearing animals continually grow new layers of skin. The indoor pet’s “dander” (tiny flakes of the outer layer of skin) falls off, disintegrates, and causes symptoms when inhaled. During early stages of allergy to a pet, patients are often unaware that the animal is contributing to their symptoms.

If a person is allergic to a pet, he/she should strictly avoid the animal. Outdoor pets are not of major concern. Pets that are confined to a limited part of the house (such as a tiled or wood-floored utility room and kitchen) are better then pets that contaminate the entire house. At the very least, pets should be kept out of the allergic person’s bedroom at all times. (See OAAC educational material handout Environmental Controls for Indoor Allergens.)

Irritants

An irritant is a substance which may trigger certain symptoms strictly because of its irritating effects. The symptoms mimic allergy, but in fact they are not really the result of an allergic reaction. Some individuals are extremely sensitive to these inhales substances (which incidentally bother the average person very little). The basis for this extreme membrane sensitivity is not well understood, but it is not allergy.

The most common offenders are smoke, cold air, wind, temperature changes, and weather fronts. Other provoking factors which bother some people in varying degrees include sharp pungent odors (paint, turpentine, aerosol sprays, perfumes, cleansers, cosmetics, chemical odors, exhaust smoke, insecticides, detergents and new fabric odors).

Respiratory infection is included in this category as is external wheezing in asthmatics.

Some substances are not only allergens or irritants but can be both. Examples include house dust, feed and grain dusts, and live Christmas trees. In any given patient allergens, irritants or a combination of both may be of major importance in the production of either asthma or nasal symptoms.

Occasionally patients who are sensitive to both irritants and allergens will have useful reduction in nasal and chest symptoms caused by irritants when their allergies are successfully treated. More commonly their susceptibility to irritants remains a separate problem and the treatment is by appropriate medication and avoidance. Irritant induced symptoms are more difficult to treat than those from allergens.

Recent News

SuperUser Account
/ Categories: News

Biologics for the Management of Severe Asthma

For many patients with asthma, their asthma is controlled by identifying and avoiding triggers, taking a daily inhaled or oral controller medication, and using a quick-relief inhaler when symptoms develop. For some patients though, these medications are not enough to control their asthma. Recently, several new medications, known collectively as “biologics,” have been approved for the treatment of moderate-to-severe asthma. Biologics are unique in that they target a specific antibody, molecule, or cell involved in asthma. Because of this, they are known as “precision” or “personalized” therapy.

What is a biologic?
A biologic is a medication made from the cells of a living organism, such as bacteria or mice, that is then modified to target specific molecules in humans. For asthma, the targets are antibodies, inflammatory molecules, or cell receptors. By targeting these molecules, biologics work to disrupt the pathways that lead to inflammation that causes asthma symptoms.  

When would you need a biologic?
A biologic is used for patients who continue to have symptoms despite use of standard daily controller medications. Symptoms of poorly controlled asthma include frequent coughing, wheezing, or shortness of breath; waking up at night with difficulty breathing; requiring a fast-acting reliever medication, such as albuterol, several times a day or week; and recurrent hospital admissions, emergency room visits, or need for oral steroids for exacerbations. Before prescribing a biologic, your doctor should make sure you are taking your other controller medications as instructed, avoiding any potential triggers for your asthma, and treat any other associated medical conditions that could be making your asthma worse.  

What are the benefits of a biologic?
The primary benefit of biologics has been a decrease in the frequency of asthma exacerbations, including emergency room visits, hospitalizations, and need for oral steroids. Other benefits include reduced asthma symptoms, reduced dosage of other controller medication, and less missed school and work days. Biologics have been shown to improve quality of life for patients with asthma. Some biologics have been found to improve lung function in patients with severe asthma.  

What biologics are available for asthma?
Currently there are six approved biologics for asthma – omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab – with several others currently in development. Omalizumab targets allergy antibodies known as IgE. Mepolizumab, reslizumab, and benralizumab all target pathways that affect eosinophils, a cell involved in allergic inflammation. Dupilumab targets a receptor for two molecules that drive allergic inflammation.  Tezepelumab blocks a chemical thought to be important in the initiation and persistence of airway inflammation. Your doctor will obtain screening tests, such as blood work or environmental allergen skin prick testing, to help decide which biologic would be best to treat your asthma. Omalizumab is approved for patients as young as 6 years old, while all the other biologics except for reslizumab are approved for patients as young as 12 years old. Reslizumab is approved for adults 18 and over.

How are biologics administered?
Unlike other medications for asthma, most biologics are currently administered in a doctor’s office either as a subcutaneous injection or as an intravenous infusion when beginning treatment. With some biologics, your doctor may want to observe you in the office between 30 minutes and two hours after administration. Many biologics may eventually be administered at home. The frequency of administration of each of these biologics are different, ranging from every two weeks to every eight weeks.

What are the side effects of biologics?
Overall, studies have shown biologics to be very safe. For one of these medications, omalizumab, there has been a small risk of anaphylaxis. In this case, your doctor will likely prescribe an epinephrine autoinjector to have in case of a severe reaction. With mepolizumab, your doctor may ask if you are at risk for certain types of parasitic infections or ask about your varicella vaccination status prior to administering. Other common side effects include soreness at the injection site, headache, sore throat, and fatigue.

How long do I need to be on a biologic?
There are currently no set recommendations on how long a patient should be on a biologic.  Guidelines recommend trialing the medication for at least four months to see if it is helping improve your asthma. Your doctor will work with you to decide how long to keep you on a biologic if your asthma is under good control.

How much do biologics cost?
Compared to other controller medications for asthma, biologics are more expensive, costing upwards of thousands of dollars per year or more. Given the cost, you and your doctor should work together to see if they are the best medications for you. You should also check with your insurance company to make sure they are covered prior to starting.

Source: https://www.aaaai.org/tools-for-the-public/conditions-library/asthma/biologics-for-the-management-of-severe-asthma

The post Biologics for the Management of Severe Asthma appeared first on Oklahoma Allergy and Asthma Clinic.

Previous Article Respiratory Illnesses Are Still Going Strong, But Things May Be Slightly Improving
Next Article Itchy Eyes
Print
17
Terms Of UsePrivacy StatementCopyright 2026 by Oklahoma Allergy and Asthma Clinic
Back To Top