Question:

Your 4- to 5-page Literature Review must include the following sections: Title page: Include your name, date, course and section, and title of paper. Pathophysiological Analysis: In a section entitled “Pathophysiology of (insert the name of the disease or condition),” provide a concise description of the pathophysiology of the disease or condition. Your objective should be to provide the reader with some of the latest scholarly observations about the risk factors and mechanisms of action for the damage that is done to the body by this condition. Aim for a scholarly audience, which means that you should be using correct terminology and relying on scholarly, published research findings to discuss this topic. Don’t forget to cite the sources in your paper as you refer to them and make sure each source also appears in the Reference list at the end of the paper. Current Research: In a section entitled “Current Research on (insert name of disease/condition),” discuss some of the recent (within the last 3 years) research related to your focus area. Include the aim of each study, the specific methods used, and results of each study. Public Health Application: In your final section, entitled “Public Health Application,” explain the value and application of the research findings you discussed. Cite the studies where you refer to them, and provide some examples of how this information is or can be used in public health policy, programs, and practice. Explain which of the “10 Essential Public Health Services” the public health activities you described would relate best to and why. Reference List: In a separate page (use a page break) at the end of your paper, you must provide APA-formatted references for all resources you used. Note: The references page does not count towards the paper’s page requirement. Attachments area.

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Literature Review on Asthma

Pathophysiology of Asthma

Generally, asthma is considered as a chronic disorder in the airways which comprise of obstruction of the airflow, bronchial hyper-responsiveness and inflammation. The collaboration of these characteristics plays an important role in determining the severity and clinical manifestation of asthma as well as management. The notion that asthma may be described as a variety of these processes to the manifestation of the condition is important to understanding the pathophysiology of asthma.

The concept of airflow obstruction in asthma is recurrent and results from various changes occurring in the airway and these comprise of bronchoconstriction, airway hyper-responsiveness, and airway edema (King et al., 2018). Bronchoconstriction is regarded as the dominant event in asthma and involves narrowing of the airways and obstruction with airflow. In acute asthma, bronchoconstriction is attributed to be caused by exposed to different agents of stimuli such as allergens. Airway edema occurs with the severity of asthma and the progress of the inflammation to inhibit airflow. Airway hyper-responsiveness is a key characteristic of asthma and mainly involves response to a broad range of stimuli. It is influenced by several mechanisms such as inflammation, structural changes, and dysfunctional neuro-regulation (King et al., 2018). In some asthma patients, the limitation of airflow could lead to airway remodeling which involves permanent structural changes in the airway. The structural changes can occur in form of subepithelial fibrosis, thickening of sub-basement membrane, smooth muscle hyperplasia and hypertrophy, as well as proliferation and dilation of blood vessels (Hikichi et al., 2018).

Under the pathophysiology of asthma, airway inflammation plays an integral role. Inflammation entails the interaction of several types of cells and mediators in the airway that culminate to manifestation of asthma in symptoms such as shortness of breath, wheezing, and recurrent coughing episodes. The cells that are involved in airway inflammation include the lymphocytes, mast cells, neutrophils, eosinophils, macrophages, dendritic cells, epithelial cells, and the resident cells in the airway.  Cytokines, chemokines, cysteinyl-leukotrienes, and nitric oxide are regarded as the major mediators in causing airway inflammation in relation to asthma (Hikichi et al., 2018). Also, under airway inflammation, the immunoglobulin E (IgE) plays a role in activating allergic reactions and pathogenesis of allergic conditions.

The pathogenesis of asthma as a process of inflammation is subject to a variety of host factors and exposure to the environment. Under host factors, innate immunity is primary element and there has been significant interest in how adaptive and innate immunity are related to the growth and regulation of airway inflammation (Klein et al., 2019). Genetics, as a host factor, has always been considered at the core of asthma development. Several genes have been associated to manifestation of asthma and related features. Gender or sex also plays out a host factor and it has been found that asthma is prevalent in boys during early life. However, its incidence takes a shift as it is found in women than in men.

In relation to environmental factors, allergens and respiratory infections have been attributed to the persistence and development of asthma. Even though the role of allergens is not completely resolved or defined, exposure to allergen has been concluded as a risk factor to the development of inflammation and the possibility of exacerbation (Klein et al., 2019). Other factors in the environment that have associated with developing the risk of asthma include air pollution, diet, smoking tobacco, and occupation

Current Research on Asthma

Research on asthma is an ever-ending process as it is chronic disease that does not have cure up to date. For this reason, most of the current research on asthma mainly surrounds approaches to treatment and management. In that context, this section will review current research articles in regards to progress of asthma control and management.

The first research article seeks to evaluate the effectiveness of omalizumab administration to severe asthma patients. The authors acknowledge that there has been a significant increase of incidence, mortality, and morbidity of asthma where severe asthma constitute 10% of all asthma patients (Alhossan et al., 2017). Omalizumab is mainly administered to regulate the clinical elements of asthma. The authors conducted a study by reviewing 24 effectiveness studies of the treatment and involved 4117 severe asthma patients. The author assert that the evidence found highlights the importance of using anti-IgE through attaining asthma control, enhancing the lung function, reducing exacerbations, and improving the quality of life (Alhossan et al., 2017). The author also found out the administration of omalizumab had benefits that could extend up to 4 years.

The second research article focuses on the long term effect of pulmonary rehabilitation for patients with severe asthma at home. The research article addresses the problem associated with severe asthma patients having recurrent symptoms and exacerbations which requires the patients to be hospitalized or receive emergency care. The authors consider pulmonary rehabilitation as a suitable approach to severe asthma among other pulmonary conditions (Grosbois et al., 2019). This is because it has been linked to improve symptoms of asthma as well as the quality of life. The authors conducted a retrospective study with 28 severe asthma patients and 164 COPD patients who had undergone pulmonary rehabilitation at home (Grosbois et al., 2019). The severe asthma patient underwent the home-based rehabilitation program for six month and then compared to the COPD patients. The study found no difference in outcome between the severe asthma and COPD patients. It was concluded that pulmonary rehabilitation is linked to improving the quality of life for severe asthma patients in the long term.

The third research article seeks to evaluate the effect of laser acupuncture stimulation in children with asthma. The research study was conducted in the condition that variable asthma therapy has not achieved good control over asthma. The authors acknowledge low-level laser acupuncture as an appropriate non-invasive modern medicine. The objective of the research study was to evaluate the effectiveness of laser acupuncture in asthmatic children to improve asthma (Dabbous et al., 2017). The study included 48 asthmatic children who were grouped into control group and case group. The case group was subjected to 12 sessions of low-level laser acupuncture. The groups were then evaluated after the intervention. The authors found out that the use of laser acupuncture on asthmatic children was effective in improving asthma in comparison to administration of medications (Dabbous et al., 2017).

Public Health Application

As a public health professional, findings in the research is an important source of information in regards to understanding asthma control and management. First of all, based on the findings of the first article, omalizumab has been recommended due to its benefits which could extend to four years in improving the quality of life in asthma patients. Thus, it would be appropriate to inform, educate, and empower patients with severe asthma to use omalizumab as an asthma prescription due to its long term benefits.

In relation to results of investigating the long term effects of pulmonary rehabilitation, a public health professional should put in mind that this approach is cost effective as it involved physical exercises. Thus, it is important educate and mobilize community partnerships on pulmonary rehabilitation as a program for the severe asthma patients. Moreover, health policies should be implemented to ensure that home-based pulmonary rehabilitation conforms to standards of controlling asthma.

Based on the findings of effectiveness of using laser acupuncture in asthmatic children, a public health professional should consider this approach as a better alternative to using medications. The health policies to be developed should account for factors such as affordability and availability. Thus, this would call for providing laser acupuncture at an affordable cost and ensuring such services are accessible.

References

Alhossan, A., Lee, C. S., MacDonald, K., & Abraham, I. (2017). “Real-life” effectiveness studies            of omalizumab in adult patients with severe allergic asthma: meta-analysis. The Journal         of Allergy and Clinical Immunology: In Practice, 5(5), 1362-1370.

Dabbous, O. A., Soliman, M. M., Mohamed, N. H., Elseify, M. Y., Elsheikh, M. S., Alsharkawy,             A. A., & Abd al Aziz, M. M. (2017). Evaluation of the improvement effect of laser    acupuncture biostimulation in asthmatic children by exhaled inflammatory biomarker     level of nitric oxide. Lasers in medical science, 32(1), 53-59.

Grosbois, J. M., Coquart, J., Fry, S., Le Rouzic, O., Grosbois, T., Wallaert, B., & Chenivesse, C.   (2019). Long-term effect of home-based pulmonary rehabilitation in severe             asthma. Respiratory medicine, 157, 36-41.

Hikichi, M., Hashimoto, S., & Gon, Y. (2018). Asthma and COPD overlap pathophysiology of             ACO. Allergology International, 67(2), 179-186.

King, G. G., James, A., Harkness, L., & Wark, P. A. (2018). Pathophysiology of severe asthma:   we’ve only just started. Respirology, 23(3), 262-271.

Klein, M., Dijoux, E., Dilasser, F., Hassoun, D., Moui, A., Loirand, G. … & Bouchaud, G.            (2019). New protagonists in asthma pathophysiology. Presse Medicale (Paris, France:   1983), 48(3 Pt 1), 255-261.

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