For the 25 million Americans who suffer from some form of asthma, the condition can be serious and interfere with daily life. Shortness of breath, wheezing, and chronic chest pain are just a few of the symptoms many sufferers describe. While severity can vary from person to person, one form, eosinophilic asthma (or e-asthma), can be especially troublesome.
What are Eosinophils?
This term is most likely unfamiliar to many people, but eosinophils are a specific variety of white blood cells that appear to change color when exposed to eosin, an acidic dye. When a person develops e-asthma, their levels of eosinophils increase in their blood and lung tissue, forcing mucus into the respiratory tract and blocking airways. This is not a recent discovery either; the first mention of eosinophil and asthmatic condition dates back over 100 years ago.
What is E-asthma?
Unlike many types of asthma, which develop in childhood, e-asthma normally appears in adults aged 35-50 (although it is possible to have it occur in children, too). Breathing becomes labored due to an increase in fluid and mucus in airways that have become inflamed, creating a chronic lung disease that causes shortness of breath and hard wheezing. Spasms can develop as a result, worsening the situation.
What is unique about e-asthma is that it seemingly comes out of nowhere. Patients that develop e-asthma do not generally have a history of asthmatic symptoms of any kind, nor are they necessarily results of allergic reactions. Although e-asthma can result from these conditions, there are several cases where the patient has a completely fine respiratory system, only to develop e-asthma when they reach adulthood for no apparent reason. While it is unknown what causes e-asthma, what is known is that increased levels of eosinophil have been shown to correlate with future risk of developing e-asthma, as well as its intensity.
What are the Symptoms of E-asthma?
As mentioned above, the symptoms of e-asthma are similar to other forms of asthma, albeit much more severe. The person may experience strong wheezing and coughing, shortness of breath, a tightening of the chest, inflamed membrane in the nose, chronic rhinosinusitis, and/or an abnormality in the lung. These symptoms normally don’t go away with rest or fluids either, which indicates that simple allergies or a virus are not to blame.
How is E-asthma Diagnosed?
In order to find the correct asthma treatments for the individual patient, a medical professional needs to properly evaluate the situation and conduct tests. One way this is accomplished is through a blood sample that measures the amount of eosinophil in a person’s blood. Other conditions, such as hypereosinophilic syndrome, can impact these levels, so a patient’s medical history is taken into account when making a diagnosis. Another method is to examine the amount of eosinophil in the patient’s mucus, which a medical professional may obtain by the patient spitting up mucus from their throat (called sputum).
There is also a more invasive procedure where a bronchoscope is inserted through the patient’s nose or mouth for the extraction of fluid samples. This procedure is normally done in a hospital under anesthesia and may also require the patient to stay hospitalized for a few days after.
How is E-asthma Treated?
Treatments for e-asthma consist primarily of reducing the amount of mucus that is clogged inside airways, which will ultimately help the patient breathe better. Medication is a virtual necessity, but some patients respond better to certain medications than others. Some of the more common medicines are:
Nucala – This is prescription acts as an add-on maintenance treatment for people with severe e-asthma. It’s an injection and should not be used to treat a sudden onset of breathing problems like a rescue inhaler is. The price tag might seem intimidating—between $8,000-12,000 per year—but medical insurance can cover a significant portion of the bill.
Fasenra – Fasenra is an injection that is used in conjunction with other treatments for e-asthma. The price for Fasenra is high as well—about $28,000-33,000 per year—but it is also normally covered by insurance and/or qualified patients.
Spiriva – Spiriva has shown to be extremely effective in combatting e-asthma. It is a once-a-day inhaler with 30 capsules per refill. It is not generally covered by insurance but only costs $300 a month.
Symbicort – An inhaler, Symbicort should start to show results after about two weeks. It costs roughly $260 for 120 doses, making it one of the cheaper options on the market today.