Asthma in Mexico and the Steps to Better Control

Asthma is a chronic respiratory condition affecting millions worldwide. In Mexico, 8.5 million people live with this condition, contributing to the global figure of 300 million asthma sufferers. According to the Global Initiative for Asthma (GINA), 461,000 individuals have succumbed to asthma, with the majority of deaths occurring in low- and lower-middle-income countries. This alarming statistic highlights the urgent need for improved asthma management and treatment strategies, particularly in vulnerable populations.

In Mexico, the prevalence of asthma ranges from 5% to 12%, varying significantly across different regions. Coastal areas, in particular, see a higher incidence of asthma due to increased humidity, which promotes the proliferation of allergens such as pollens, dust mites, and cockroaches. These allergens are known triggers for asthma attacks, posing a greater risk to individuals living in these regions.

Asthma is one of the most common chronic diseases affecting both children and adults, with children being the most affected. The disease is characterized by inflammation of the airways, involving the smooth muscles that surround the respiratory tract. This inflammation leads to an excessive production of mucus, narrowing the airways and causing significant respiratory discomfort and limitation of physical activities, thus interfering with daily life.

The exact cause of asthma remains unknown, making it a challenging condition to treat. It is believed to be hereditary and can be triggered by various environmental factors. Despite these challenges, appropriate treatment can help most individuals manage their symptoms effectively, allowing them to maintain a good quality of life.

Among the member countries of the Organization for Economic Cooperation and Development (OECD), the United States has the highest number of annual deaths from asthma, with 4,145 deaths. Mexico follows with 1,521 deaths, while the United Kingdom, Japan, and Germany report 1,481, 1,158, and 1,046 deaths respectively. These statistics underscore the need for improved asthma management and prevention strategies globally.

Types of Asthma: Allergic and Non-Allergic

Asthma can be classified into two main types: allergic and non-allergic.

1. Allergic Asthma: This type is often induced by allergies to pollen, dust mites, pet hair, and cockroach particles. In infants, allergic asthma is commonly triggered by dust mites found in carpets, stuffed animals, and beds. Poor hygiene contributes to the proliferation of these tiny arthropods, leading to asthma attacks. Allergic asthma involves white blood cells called Th2 lymphocytes and eosinophils, and patients typically respond well to inhaled steroids or steroidal anti-inflammatory drugs.
2. Non-Allergic Asthma: Non-allergic asthma can be triggered by factors such as exercise, cold air, circadian rhythms, emotional stress, certain medications, and comorbidities like diabetes or obesity. This type of asthma is associated with Th-17 lymphocytes and neutrophilic inflammation, making it resistant to inhaled steroids and more challenging to treat.

Asthma prevalence and severity can vary significantly between genders. During childhood, boys are more likely to experience asthma attacks. However, from the age of 14, rising testosterone levels provide some protection against asthma, which persists until around age 50. Conversely, women have a higher prevalence of asthma attacks throughout their lives, influenced by estrogen and progesterone levels. Notably, asthma symptoms can vary during pregnancy, with some women experiencing improvement, others worsening, and some remaining unchanged.

Given the variability in asthma triggers and responses between individuals, personalized treatment plans are crucial for effective asthma management. Research at the Asthma Research Laboratory, led by Dr. Luis M. Montaño Ramírez at the UNAM Faculty of Medicine, focuses on tailoring treatments based on individual patient characteristics, including gender. For instance, studies using guinea pigs, which share physiological similarities with humans, have shown that males might require lower doses of medications like salbutamol during an asthma crisis.

Conclusion

Asthma, while not always severe, can be a debilitating condition that significantly impacts the quality of life. Effective management and treatment are essential to prevent severe asthma attacks and reduce mortality rates. Consulting with pulmonologists and adhering to personalized treatment plans can help individuals manage their asthma symptoms effectively. Ongoing research and awareness are vital in the fight against asthma, aiming for a future where this chronic condition can be better controlled and less life-threatening.