New Symptoms: A Sign of Disease Progression
This has been a week of discoveries. I had been having some new symptoms that I just could not seem to shake. I am currently investigating what may be a root cause. It has been determined that my asthma is maybe progressing. Say what? I was nervous that my good streak of at least mostly stable disease was changing? How can this be possible? It seemed like it took me forever to get me to this point of stability.
My disease is considered to be mostly lung-based, however, a recent diagnosis of nasal polyps seems to be shifting the tide to asthma with chronic rhinosinusitis with nasal polyps CRSsNP). This has been associated with poorer asthma control.3 The current plan is to get a handle on the polyps and see if sinus surgery may be helpful and a reevaluation of lung function to see if there are other progressions that have also occurred. This had me considering, how did I get here?
The progression of asthma
It is considered that asthma progression in adulthood is measured by a loss of lung function. 1 While there have been a couple of studies that have primarily focused on the loss of lung function as criteria for disease progression, there are thoughts that this theory may be inconclusive. Researchers are still working on exact causes and processes.
With the rise in precision medicine, this theory will expand and be more definitive. In general, it is thought that during severe exacerbations, airway remodeling accelerates and results in a decrease in lung function. While there has been significant focus on a loss of lung function, it may not be the only player. Identifying patients that may be at the greatest risk for loss of lung function over time poses clinical challenges.2
What about the role of exacerbations in disease progression?
Acute exacerbations contribute to disease progression through the possible impact of airway structural changes. These changes may contribute to airway and peripheral lung remodeling, or alveolar wall changes and loss of elastic recoil.3
Researchers are currently looking at defining the biological mechanisms of exacerbations. With the mechanism we can identify what may lead to changes, hopefully, the development of treatments will follow.
Have you gone through disease progression? I would love to hear about your experiences.
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