Allergic asthma

Dr. Liz Coronado
Dr. Aline Gallois-Schmit

Asthma affects 7% of the Swiss population. Allergic asthma is associated with sensitisation to aeroallergens, which may be perennial (present all year round, such as house dust mites, animal hair, etc.) or seasonal (pollens). This sensitisation leads to inflammation of the airways and respiratory symptoms; this is the most common form of asthma. Respiratory symptoms vary in intensity, with difficulty in breathing (dyspnoea), coughing, wheezing and chest pain.

Allergic asthma is often accompanied by non-respiratory symptoms, such as skin symptoms (atopic dermatitis) and/or ENT symptoms (allergic rhinitis). Biomarkers (blood, skin, pulmonary respiratory tests with measurement of exhaled gas) are used to diagnose allergic asthma. Treatment includes pharmacological therapies as well as environmental control measures, to be adapted according to the allergens involved. The cornerstone of pharmacological treatment for allergic asthma is inhaled corticosteroid therapy (which aims to curb inflammation) combined or not with inhaled betaagonists (which aim to dilate the bronchial tubes). It is important to note that the correct technique for inhaling the medication is essential, and you should not hesitate to review this with your lung specialist. In more severe cases, oral corticosteroid therapy is also indicated, and its duration should be adapted to the situation. Depending on the allergic profile and if the asthma is not too severe, allergen immunotherapy (desensitisation) may be offered with good efficacy. There are two forms, sublingual or subcutaneous, the choice of which is left to the allergist.

For patients suffering from allergic asthma that is poorly controlled despite the above treatments, new biological therapies have been available on the market for several years with good results. These are drugs that target inflammation molecules, and there are different types to choose from, depending on the characteristics of the asthma as determined by the lung specialist (through questioning, blood tests, an allergological assessment and breathing tests). The choice of biotherapy is made by the lung specialist, with multidisciplinary discussion (with other specialists) if necessary.

In conclusion, there are effective treatments for allergic asthma that need to be tailored to the patient's clinical (symptoms), allergic and biological (blood markers, skin, exhaled gas) profile.


Reference : 

Asthme Ligue Pulmonaire Suisse - Allergic Endotypes and Phenotypes of Asthma Nicole Akar-Ghibril, J Allergy Clin Immunol Pract. 2020 February ; 8(2): 429–440. doi:10.1016/j.jaip.2019.11.008.