哮喘的演变：不仅仅是一种肺病
Most people stillthink of asthma as只是肺病。This makes sense considering the telltale sign of asthma is difficulty breathing. A rising slew of evidence, however, now has researchers believing asthma is more than just a lung disease, that it is a syndrome affecting many bodily systems. Here's a list of systems researchers now think are linked to asthma.
Immune System。First and foremost, asthma is now considered an autoimmune disorder. This means the immune systems in those susceptible to developing asthma (those with the asthma gene) develop an abnormal response whereby it treats inhaled substances innocuous (harmless) to most people (dust mites for example) as enemies (like harmful bacteria). The immune system then sets off a series of chemical reactions aimed at killing and getting rid of the enemy. This response involves the release of inflammatory markers that cause inflammation (swelling) of cells lining the respiratory system. This is what causes both allergies and asthma.
Respiratory System。Inflammatory markers may cause inflammation of any tissues lining the respiratory tract, from the sinuses and nose to the smallest air passages.
过敏。This leads to allergies and allergy symptoms like red and itchy eyes, stuffy and runny nose, sneezing and coughing. This may also increase your risk of developing sinusitis (sinus infections) or conjunctivitis (pink eye) and even eczema (itchy skin).
Asthma。连续接触哮喘触发器（如尘螨）可能导致气道长期发炎，使其过敏。随后暴露于该触发器导致这种炎症恶化，导致哮喘症状，如喘息和呼吸急促。
Intestinal Tract。Researchers have observed a link between the esophagus, the stomach, and asthma. Stomach contents may work their way back up the esophagus enter the lungs. This is called aspiration, or gastrointestinal reflux (GERD). The amount of stomach contents inhaled may be so minute you don’t even realize it’s happening. Researchers don’t yet know whether this is due to asthma itself or the medicines used to treat it. This may explain why you’ll find many asthmatics on anti-reflux medicines.
Nervous System。伟大的19世纪医师，亨利海德蝾螈，令人信服的哮喘是一种心灵的疾病，导致医生用抗焦虑补救措施治疗哮喘。这一理论在20世纪50年代被反驳，尽管一些医生继续以这种方式对待哮喘，直到20世纪80年代。现在我们知道，虽然焦虑不会引起哮喘，它可能充当哮喘触发。也就是说，研究人员已经观察到哮喘，过敏和焦虑之间的联系，一个理论是炎症标志物也可能导致焦虑。除此之外，过敏和哮喘袭击可能会引起相当多的焦虑。
Cardiovascular Systems。2015年发表的一项研究表明，与没有哮喘的个体相比，哮喘和慢性头痛之间发表的哮喘和慢性头痛之间的联系是发展慢性偏头痛的两倍。单独的研究显示哮喘和心脏病之间的联系，其中哮喘学患有高血压和高胆固醇的可能性的两倍，而不是没有哮喘的个体。许多哮喘引领久坐病人或可能超重的事实可以解释这些发现。另一个理论是炎症标志物再次成为罪魁祸首。
Other systems:
Sleep。Anywhere from 50 to 75 percent of asthmatics say they have a hard time sleeping at night. This may be due to asthma attacks being more likely to occur at night, although even asthmatics with good asthma control report insomnia. The reason remains unknown, although some suspect that asthma medicines are the culprit. Of course, it’s also possible inflammatory markers are guilty here too.
脂肪组织。Various studies have linked obesity with asthma. This may be due to asthmatics being more sedentary, or it may be that fat tissue releases inflammatory markers. High fat foods have also been linked to asthma, and one theory is that their bodies treat saturated fat as an enemy, thus setting off the immune response that increases inflammatory markers inside the body.
What to make of all this。Okay, so you could say this new evidence as painting a more grim picture of asthma. But this shouldn’t be the case. For years asthmatics have suffered from anxiety, reflux, insomnia, and high blood pressure, and these things have gone unrecognized and untreated. By learning that asthma is more of a syndrome than just a lung disease, doctors now understand they must screen their asthma patients for these other conditions that may occur in conjunction with asthma. This should help all asthmatics live better with it.
