10 Interesting Facts About the History of Asthma
Growing up with high risk asthma, and probably while puffing on my inhaler, I wondered what it would be like living with asthma if I was born before 1970. This inspired a quest back in time to find out. Here are ten interesting facts I learned about our history.
- 1801. Asthma cigarettes are introduced to the West. By 1500 B.C., in ancient Egypt, physicians placed dried and crushed belladonna leaves onto heated rocks. By 100 A.D., in ancient India, dried and crushed stramonium was stuffed into pipes. The smoke was inhaled by asthmatics to obtain mild relief. In 1801, this treatment made its way to Europe and the U.S., and this created a craze that lasted until the 1950s. Belladonna, stramonium, Indian Hemp, or lobelia were stuffed into cigars, cigarettes, pipes, or burned on ozone paper.
- 1858: The first nebulizer was invented. It was hand operated and produced a fine mist for inhaling. The problem was it required labor to operate, something not ideal for asthmatics. So, while other similar models were invented, asthmatics would have to wait another 75 years to obtain the benefits of nebulized medicine. Yet they wouldn’t have to wait quite that long for an asthma rescue medicine.
- 1901: Epinephrine is discovered. It was soon injected into an asthmatic who obtained quick relief. This was the first use of asthma rescue medicine. The effects lasted 1-1.5 hours. The modern quest to understand and treat asthma began with this discovery. By 1907, physicians discovered it dilated airways.
- 1930s. Electric nebulizers enter the market. Epinephrine injections worked great, but they had unwanted side effects, such as increased blood pressure, and increased heart rate and force. Physicians learned inhaling it offered asthmatics the same relief with less side effects, and soon nebulizers operated with rubber squeeze bulbs were available for home use. However, these required lots of work to obtain little relief. Electric nebulizers gave asthmatics another option, although they were expensive, bulky and fragile. So, while some asthmatics had access to epinephrine at home, most continued to smoke dried and crushed herbs.
- 1948: Isoproterenol (Isuprel) enters the market. The quest was on to create a safer rescue medicine. The first modification of epinephrine was Isuprel. It gave the same relief, lasting 1-1.5 hours, although without the increased blood pressure. It did, however, continue to have a strong cardiac effects. Still, it was another option for asthmatics who yearned for quick relief. It was only available as a solution to use with a nebulizer.
- 1957. The first metered dose inhalers enter the market. An epinephrine inhaler was called Medihaler Epi, and an isoproterenol inhaler was called Medihaler Iso. They were the first devices to offer a mist in a uniform dose. They were small, lightweight, portable, and convenient. They were ideal for home or travel. As you can imagine, these were big hits among the asthma community.
- 1973: Metaproteronol (Alupent) enters the market. It was similar to Isuprel, although it had slightly less cardiac effects and lasted 4-6 hours. This made it the rescue medicine of choice for most physicians. It was available as a solution to be nebulized and as an inhaler.
- 1982: Beclomethasone (Becotide, Vanceril, Beclovent) enters the market. By the early 1950s, cortisol was found to benefit asthmatics. However, physicians soon learned the side effects were too severe for regular use. This inspired researchers to develop an inhaled corticosteroid. Initially, doctors didn’t know why it worked, nor if it was safer than systemic corticosteroids. So, it was usually prescribed to treat acute symptoms. Today, the product is called Qvar, and is considered safe and effective for controlling asthma.
- 1982: Albuterol enters the market. This was the first asthma rescue medicine to have negligible side effects while still offering quick asthma relief, and lasting 4-6 hours. It quickly became the favorite rescue medicine by physicians and asthmatics alike, and would go on to become the best selling asthma medicine of all time. If you have asthma, you probably own one.
- 1989: The first asthma guidelines are introduced. Prior to this time, most asthma physicians were unaware of the latest research, so they often resorted to referring their severest asthmatics to the experts at expensive research hospitals. Likewise, the emphasis of most asthma treatment programs focused on treating acute symptoms. Asthma guidelines made it so regional physicians had access to all modern asthma wisdom. These guidelines established that all asthmatics had some degree of airway inflammation, and that daily use of asthma controller medicine would help to prevent and control asthma. Most guidelines recommend all asthmatics have rescue medicine nearby at all times to treat acute symptoms.
Conclusion: As I review this history, I can see clearly that I was born just at the right time. By the early 1980s, I had my very own Alupent and Vanceril inhalers, and by 1985 I had my very own albuterol inhaler, and I still have one. Since then many asthma controller medicines have entered the market, each one offering us asthmatics one more option for obtaining ideal asthma control.