Asthma in Transition, Staying with Your Changes

As more research is being done to understand different types of phenotypes, endotype, and genotypes that researchers are currently investigating, I find this pretty fascinating. It may just be my super nerdy asthma self but I am all for learning more to understand my particular asthma quirks. Recently, I heard doctors describe me to their fellow as an enigma. I wasn't sure if I should be flattered or concerned. I have been wondering if my asthma has been changing. Please, note this is my personal experience and while I am working with my docs to fully understand it, there is much still to be learned for both myself and researchers...

What is severe asthma

I needed to look at this information that I was learning through the lens of what is severe asthma or refractory asthma, how have current trends in treatment affected my current understanding and where things are going.

What I found is that it is super complex. For example, there is so so much to wrap your head around. The facts that are involved in understanding refractory asthma include the relationships between and the understanding of the individual processes of airway epithelium, airway smooth muscles, immune cells, immunoglobulin E (IgE) and cytokines to name just a few. If you throw in the rest of stuff that makes us unique such as our individual genetics and comorbid disease factors¹. It makes things super complicated. It was a tall order to even get my brain around the first layers of these concepts. In relation back to my initial question of trying figure out my own cellular make-up and its contributing factors: could my asthma be changing?

What I do know is that I have significant eosinophilic components, however, what I need to do is further determine the importance or relationship of these eosinophils. The presence of eosinophils alone does not mean that they are a dominant effector cell or that allergic inflammation is completely driving my asthma¹.

What components impact treatment

Here lies my million dollar question. How do different components affect treatment etc.? if you have more control or improvement in one area, do other symptoms become more prevalent? Will treating one thing help something else? How does this tie into the new biologics that are out there? Some days I feel like I am the queen of the biologics I have tried. They all have had some benefit and I am learning more each day that there is not a one size fits all solutions. However, It has had me question more about the specifics of my disease. Researchers are not quite at the answers yet so I will have to be more patient for more details. However, they are making strides in getting closer to demystifying and helping improve the lives of asthmatics with more treated therapies.