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Andreea Daniela



Lomitapide proves effective in lowering cholesterol levels in rare genetic disease

According to a study published in the Lancet, lomitapide, a drug used to treat familial hypercholesterolaemia, had promising results in a phase 3 clinical study. The study was conducted by a team of researchers from the Perelman School of Medicine at the University of Pennsylvania.Lomitapide is a drug that inhibits microsomal triglyceride transfer protein (MTP), and is used to lower cholesterol. MTP is a protein involved in VLDL formation, very low density lipoprotein, which is a precursor of LDL. LDL cholesterol is known as bad cholesterol and is involved in atherosclerosis. High levels of LDL may be a consequence of a high-fat diet but in some cases may be caused by genetic factors, such as homozygous familial hypercholesterolemia orphan disease (HoFH).


MTP role was sensed by Dr. Daniel J. Rader now more than 20 years ago when he made the first discoveries about the genetic basis of HoFH. Senior study author, Chief and Division of Translational Medicine and Human Genetics, Dr. Rader found that MTP is a therapeutic target for this disease in the early 1990s. Rader and his colleagues then developed and improved an inhibitor of this protein,lomitapide, that is used to lower high cholesterol levels.HoFH is a rare disease characterized by very high levels of cholesterol (above 500mg/dl) and is due to mutations in the LDL receptor gene. In HoFH, LDL cholesterol is not transported from the blood to the liver, which means that the blood remains with an excess of cholesterol that will be deposited on artery walls. Duration of survival is low because patients with HoFH develop cardiovascular disease (stroke, heart attack), and treatment is limited. Although there are several drugs that lower cholesterol, HoFH patients are unresponsive to usual treatment (statins). A method somewhat effective treatment is apheresis, that is filtering blood cholesterol. But this method is time consuming.

Lomitapide has proven effective in lowering cholesterol levels in a study conducted on twenty-nine patient’s form all over the world. The patients enrolled in the study received an average of 40mg per day of lomitapide, along with other treatments to lower cholesterol (statins and apheresis). It was noted that cholesterol levels decreased by 50%. In addition, 30% of patients had cholesterol levels below 100mg/dl at some point during the study. Study’s lead author, Marina Cuchel, MD, PhD, research assistant professor of Medicine at Penn, said the findings are especially remarkable because these patients do not respond to conventional therapy.Lomitapide is expected to be approved by the FDA later this year for the treatment of familial hypercholesterolemia.


Researchers found the best cocktail of bacteria to treat Clostridium difficile infection

Researchers found a combination of six bacterial species to eradicate infection with Clostridium difficile. Clostridium difficile infection is difficult to treat and also a contributing factor to patient’s death. Clostridium difficile is an anaerobic gram positive bacterium causing serious infections in hospitalized patients with low immunity. Clostridium difficile infection occurs when bacterial intestinal flora is destroyed by antibiotics. When intestinal bacterial flora is destroyed, bacteria multiply in the gut excessively.

Clostridium Difficile Infection

Clostridium Difficile Infection

Symptoms of C. difficile infection are diarrhea, bloating, abdominal pain, highfeverand can even lead to death of the patient. C.difficile infection is called pseudomembranouscolitis and is a frequent complication especially in hospitals. This infection often begins with flu-like symptomsand can sometimes mimic clinical manifestations of inflammatory bowel disease. Most feared complication of infection with C.difficile is toxic megacolon. Although there several anaerobic agents ( metronidazole, vancomycin), ittshould be noted also that this infection is in most cases difficult to treat and there are several strains of C.difficile resistant to antibiotics such as strain O27.

Researchers at the WellcomeTrust Sanger Institute have conducted several studies on animals to find a way to eradicate infection with C.difficile. However, Dr Trevor Lawley, first author from the WellcomeTrust Sanger Institute, said C.difficile infected mice and treated with various antibiotics had numerous relapses. But after several attempts, researchers have found a method of treating infection: faecal transplantation from healthy mice. Dr Lawley added that this method resulted in treating infection and that there were no relapses in most cases.

Afterhaving found the solution to treat C.difficile infection, the researchers wanted to move forward with the discovery. They wanted to know what specific bacteriasuppressesC.difficile. In order to isolate the wanted strains, they have cultured many bacteria which are normally found in the intestine. Then researchers tested several combinations capable to suppress C.difficile bacteria. Professor Harry Flint, senior author from the University of Aberdeenl, said the combination of the six bacterial species has been shown to effectively suppress C.difficile infection. In addition, this combination restored normal intestinal flora of the intestine.

Theprocedure, calledfecal bacteriotherapyor faecaltransplantation, may help treat not only C.difficile infections and other diseases associated with microbial imbalances. Professor Gordon Dougan, senior author from the WellcomeTrust Sanger Institute, said: “Faecal transplantation is viewed as an alternative treatment but it is not widely used because of the risk of introducing harmful pathogens as well as general patient aversion”.


A healthy lifestyle can reduce diabetes risk later in life for women with gestational diabetes

According to a studysupported by the National Institutes of Health, a healthy diet after birth decreases the risk of diabetes for women who had diabetes during pregnancy. During pregnancy, gestational diabetes can occur in women who never had problems with hyperglycemiabefore pregnancy. This problem occurs more frequently in the third trimester of pregnancy. High blood sugar during pregnancy does not give symptoms and is usually diagnosed during routine pregnancy tests. Babies born to mothers with gestational diabeteshave increasedbirth weight ( macrosomia). In addition, they may have other problems such as hypoglycemia or jaundice. Moreover, the mother may have cesarean indication.


Diabetes Risk

Gestational diabetes occurs due to insulin resistance. Insulin is the hormone released by the pancreas that plays a role in blood sugar control. In other words, insulin mediates the entry of glucose into cells where it is used as an energy source. Lack of insulin or an insufficient amount of this hormone causes the glucose to remain in the blood and so hyperglycemia appear. Another factor that can cause hyperglycemia is insulin resistance. In pregnancy, it seems that this is the main mechanism by which diabetes occurs. There are several factors that cause insulin resistance: placental hormones, prolactin, estradiol, etc.. Because it can cross the placenta, maternal blood glucose stimulates insulin secretion in fetus. Insulin, in turn, stimulates fetal growth, so these children have increased birth weight.

Besides the effects on children, women with gestational diabetes have an increased risk of developing type 2 diabetes later in life. The researchers found that a healthy diet greatly decreases the risk of diabetes in these women who had problems with blood sugar during pregnancy. Consumption of vegetables, fruits, whole grains, that is part of a healthy lifestyle, help maintain the blood sugar levels. Senior author CuilinZhang, MD, Ph.D., of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), said that the study indicates that women with gestational diabetes havenot necessarilyincreased riskof type 2 diabetes later in life. He added that there is a certain control over blood glucose levels.

The study included 4413 women who developed gestational diabetes between 1991 and 2001. Of those who participated in the study, 491 developed diabetes. Researchers found that women who followed one of three diets (Mediterranean-style diet, the Dietary Approaches to Stop Hypertension or DASH-diet-and the Healthy Eating Index) did not develop diabetes or had a very low risk of diabetes . This small risk means that blood sugar level is also influenced by genes and physical activity.

A healthy lifestyle can reduce diabetes risk later in life for women with gestational diabetes


Age-Related Decline Of The Immune System

The human immune system weakens with the passing of time, thus making us more susceptible to cancer and infectious diseases. This aging also affects the ability of our organism to take advantage of vaccination. A new study conducted by scientists at the Stanford University School of Medicine shows that if a certain protein is blocked, the response of the cells to vaccines and other atingens like cancer or microbial antigens can be restored. The levels of this particular protein increase with age.

Doctor Jorg Goronzy, a professor of rheumatology and the lead author of the paper says that this discovery is very important for long-term therapies. He added that in the near future the possibility of countering the effects of aging on our immune system might be achievable through pharmacology. The paper was published on the 30th of September in the online journalNature Medicine.

The research team discovered a protein, named DUSP6 (Dual specificity phosphatase 6), that impedes the capacity of an entire class of immune cells, thus preventing them from interacting with foreign bodies or substances. These substances include pathogens and vaccines. Another finding was that of a possible compound that is able to restore the responsiveness of the immune cells back to normal, once the DUSP6 protein is inhibited.

Dr Goronzy says that the human immune system decades with aging, starting from around the age of 40. Goronzy added that even though almost 90% of adults below the age of 40 respond to vaccines, the rate of responsiveness drops to almost 40% after the age of 60. An example of poor responsiveness in older patients is that of influenza deaths, most of which are registered in patients older than 65.

Immune System

Immune System

A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and “remember” it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.

A part of cells involved in the process, the T-helper cells, stimulate the B cells, which have an important role in the response to prophylactic vaccines. The exposure to the pathogenic agent or the antigen found in vaccines leads to the activation and proliferation of B cells. This further leads to the production of antibodies. The antibodies will immobilize the pathogenic agent which will be destroyed by more powerful immune cells.

For patients that have a low responsiveness to vaccines, the dose of the vaccine can be increased in order to boost its potency. Another method to boost the potency of vaccines is to use adjuvant elements, such as chemicals or other molecules. Researchers note that a previous study, led by Dr Cornelia Dekker, has shown that the response of elderly patients to the seasonal flu vaccine was improved through the use of an experimental adjuvant.

The T-cells that make up a part of the immune system of the elderly patients are somewhat deteriorated, thus having a reduced activation and proliferation capacity. This factor reduces its cancer-fighting effectiveness so as the effect of vaccines that contain adjuvants. Dr Goronzy said that “Some age-associated defect or defects raise the threshold of responsiveness to the presented antigen, so a vaccine dose that triggers T-cell activation in a younger person doesn’t in an older person. Adjuvants can’t compensate for these defects”. His team of researchers tried to identify which of these age-related defects cause the deterioration of T-helper cells, whilst also trying to find a way to counteract them.

The circulating T-helper cells are divided into two large categories. The first category, called naïve T-helper cells, are the ones that have never encountered an antigen but are able to respond if they do. Almost two weeks are needed for these cells to reach their full capacity. The second category, called memory T-helper cells, are the cells that have already encountered an antigen. These cells are rapidly activated if they are exposed to the same antigen a second time.

T-Helper Cells

T-Helper Cells

In a previous study published by Dr Goronzy in the journal Proceedings of the National Academy of Sciences, it was shown that the defective regulation of the memory T-helper cells, caused by the increased levels of DUSP4, inhibits the cellular activation, thus leading to a subsequent failure in the activation of B-cells. The increased levels of DUSP4 was shown to be related to age.

In the current study, a similar effect was attributed to the increase of DUSP6. Researchers compared blood cells extracted from patients between the ages of 20 and 35 with the blood cells taken from patients between the ages of 70 and 85. Age-associated differences were only discovered in the naïve T-helper cells. These differences consisted in faulty activation, proliferation and differentiation. These laboratory tests linked DUSP6 with the damage sustained by the naïve T-helper cells. The levels of DUSP6 were significantly higher in elderly patients, compared to young patients.

Further research divulged that the increase of DUSP6 in these naïve T-helper cells is caused by a molecule called miR-181a, a micro-RNA precursor that regulates the production of proteins. Dr Goronzy and his team discovered that miR-181a is directly involved in the production of DUSP6 and revealed that the levels of miR-181a decreases with age, until around the age of 70, when it reaches its minimum level. This causes the growth of DUSP6. Through the use of artificial boosting, researchers managed to reduce the levels of DUSP6 in the naïve human T-helper cells, thus effectively increasing the effect of a given dose of influenza vaccine.

Another precedent study, published in 2009 in the journal Nature Chemical Biology, led by researchers from the University of Pittsburgh, showed that a certain compound, named BCI, was used to block the action of DUSP6 in zebrafish. This result was recorded in specific heart cells. Dr Goronzy’s team found out that if he increased the dose of BCI, the activation of naïve T-helper was accentuated.

“We are still far from application in the clinic. We need to keep tweaking the compound and testing it in mice to make absolutely sure it’s safe enough to try in humans. But improving vaccine responses to overcome age-related immune defects represents a unique opportunity to attain healthy aging”, concluded Dr Goronzy.

For more detailed information please read the study abstract which can be found here.


Male DNA in the Brain of Women

A novel study from the Fred Hutchinson Cancer Research Center, in Seattle, USA, shows that the brains of women have traces of male DNA. According to the researchers, this could be linked to a previous pregnancy, having a male fetus. Currently, the medical implications of this finding are unknown. However, precedent studies have shown that other kinds of microchimerism are related to different autoimmune diseases and several types of cancer. Microchimerism consists in the presence of a small number of cells that originate from another individual, thus being genetically different from the cells of the host. Microchimerism has been shown to have both positive and negative effects.

The study was published in the journal PLOS ONE, on the 26th of September. The lead author of the study is William Chan, from the Biochemistry Department from the University of Alberta. Chan worked with Dr Lee Nelson, an international authority in the field of microchimerism. Dr Nelson is the senior author of the published study.

According to the lead author, this is the first study to describe human male microchimerism in the brain of a human female. The findings of the research team show that it is possible for fetal cells to cross the human blood-brain barrier. This is the first study to support the idea that these fetal cells are capable of crossing the barrier in human subjects.

The brain autopsy of 59 women were analyzed by the research team. The subjects had died between the ages of 32 and 101. Almost 63% of the analyzed brains showed signs of microchimerism. These signs were spread throughout multiple brain regions. Scientists discovered signs of microchimerism in the brain of a woman who died at the age of 94, thus suggesting that this condition has the potential to persist a whole lifespan.



From the 59 women, 33 of them suffered from Alzheimer’s disease, whilst 26 of them had no neurological diseases. Scientists discovered that the brains of the females who were affected with Alzheimer’s had a smaller prevalence of microchimerism. However, they added that because the pregnancy history of the women was unknown, a link between the presence of microchimerism and Alzheimer’s disease could not be established.

“Currently, the biological significance of harboring male DNA and male cells in the human brain requires further investigation”, said Chan, whilst adding that this study doesn’t provide a link between the brain health of females and the presence of male microchimerism.

Notwithstanding, previous studies led by researchers from the Hutchinson Center have shown that male microchimerism is linked to the development of several autoimmune diseases and different types of cancer. For example, in breast cancer, scientists suggest that fetal cells can grant protection to the host. Despite their effect in breast cancer, fetal cells have been linked to an increased risk of colon cancer. Another study showed a link between fetal cells and a lower prevalence of rheumatoid arthritis for women who had already given birth, compared to women who hadn’t yet given birth to a child.


Researchers developed blood tests that can detect cancer in its early stages

Researchers at Kansas State University have succeeded in developing a new method of diagnosing cancer in early stages. Stefan Bossmann, professor of chemistry, and DerylTroyer, professor of anatomy and Physiology, created blood tests to detect lung cancer and breast cancer before these tumors produce symptoms. Possibility of early diagnosis of cancer means more chances of survival and even cure in some cases. Now, researcherswant to develop a similar test to detect pancreatic cancer earlier. Blood testshave the advantage of beingtime-savingasthe results can be ready in less than an hour. In addition, the tests may be repeated shortly and are noninvasive.

Blood test samples

Blood test samples

So far, lung and breast cancers are diagnosed especially when symptoms appear, that is when the patients begin to cough ( when lung cancer occur)or when women noticethe appearance of a lump or skin changes, such asnipple retraction (for breast cancer). The diagnosis is made in most situations in stage 2 or 3, when the survival rate is lower than stage 1 or 2. In addition, Bossmann said that very few people manage to discover they have cancer in early stages.

Breast and lung cancer are among the most common cancers in the world. It is therefore very important to find new methods for early diagnosis of these cancers. Troyersaid that this is a step forward in detecting cancer in humans. He added that these blood tests are particularly useful to people who are at risk of cancer such as heavy smokers or those with a family history. He added that those at risk can do so this test quarterly or once a year to see if they had cancer. In addition, the test may be repeated shortly. Furthermore, blood tests are a way to avoid unnecessary investigations such as computer tomography or magnetic resonance imaging. Only if blood tests are positive the patient can use other confirmatory tests.

Actually these blood tests are based on the activity of enzymes that are specific to certain cancers. These enzymes are detected using iron nanoparticlescoated with amino acids that are placed in the patient’s urine or blood. In addition, there can be avoided false positive testsbecause theseenzymes used as markers can differentiate between cancer or other diseasemsuch as inflamation or infection.These tests can be used not only for diagnosis but also for monitoring cancer treatment or after surgery to check if there are tumor cells left in the body.


BPA associated with obesity syndrome in children, study finds

Researchers at the NYU School of Medicine have found a link between bisphenol A and obesity in children. This is the conclusion reached after researchers found high levels of urinary BPA in obese children and adolescents.

Bisphenol A is a chemical compound that has been widely used in plastic materials industry. BPA is found in bottles, sippy cups, aluminum cans etc. But it was found that BPA is harmful to health, and the effects are especially on babies, children and adolescents due to its hormone-like propertiesBPA has. Concerns about BPA began by 2000, when the FDA warned about the possible dangers that BPA has. Subsequent the use of this chemical in baby bottles has been banned. However, BPA is still used in some products. Although some manufacturers claim that this chemical compound is an antiseptic barrier against microorganisms, some studies have found that exposure to BPA may affect body weight.

obesity syndrome


Regarding the health consequences of BPA, it appears that this compound exerts a number of adverse effects, such as obesity, hormonal dysfunction, neurological dysfunction, cardiovascular disease, infertility etc. Also, there have been studies that have shown a link between BPA and various types of cancer: breast cancer, prostate cancer, neuroblastoma, etc.. Now research published in the Journal of the American Medical Association, highlights a link between obesity in children and exposure to BPA. Lead investigator Leonardo drawing, MD, MPP, Associate Professor of Pediatrics and Environmental Medicine, said it is the first time to highlight the link between exposure to aenvironmental chemical and obesity through asample of children so representative. He added that although physical inactivity and unhealthy diet have a very important role, however there are also other factors involved in obesity. He also said that further studies are needed to understand the causes of epidemic obesity.
Researchers found that exposure to BPA among children is very high, over 92% of children aged 6 years were identified to have detectable levels of BPA in urine. They also have found that children exposure to BPA comes mainly from dietary sources.
The researchers concluded that BPA affects body weight after analyzing approximately 3000 children aged between 6 years and 19 years. The study results showed that children with the highest levels of BPA had obesity rate 2.6 times higher than those with low levels of urinary BPA. It should be noted however that this link between BPA and obesity was statistically significant only in one racial subpopulation: white children and adolescents.


Tobacco is a risk factor for ovarian cancer, according to epidemiological studies

According to epidemiological studies conducted by researchers at Curtin University’s School of Public Health, smoking is a risk factor for ovarian cancer.
Ovarian cancer is the second leading cause of cancer in women worldwide. Ovarian cancer occurs usually by less specific symptoms (pain, bloating, frequent urination) and has a poor prognosis. Ovarian cancer risk increases with age and decreases with the number of pregnancies. According to studies, the five-year survival in women with ovarian cancer is 40%.Among causes of cancer of the ovary, hereditarymutations play an important role. It is known that heritable genetic mutations in the BRCA1and BRCA2genes, which are also involved in breast cancer, increases the risk of ovarian cancer. Also, mutations in hereditary nonpolyposiscolorectal cancer genes increase the risk ofthis type ofcancer. In terms of protective factors, it seems that hormonal contraception, breastfeeding, multiparitydecrease the risk. Even Professor Binns said that weight loss (for obese women), exercise, green tea, fruits and vegetables and breastfeeding may protect against ovarian cancer.



Regarding smoking, therehas not been established so far that it is a risk factor for ovarian cancer. Prof Colin Binns, who took part as member of the Collaborative Group on Epidemiological Studies of Ovarian Cancer, said that so far the link between smoking and ovarian cancer was weak. Studies that highlighted the connection between tobacco and cancer of the ovary appeared only in 2009. But now epidemiological studies conducted by Curtin University’s School of Public Health, have demonstrated a clear link between smoking and a particular type of ovarian cancer: mucinoidtumors.

Researchers analyzed 28,114 ovarian cancer women and 94,942 women without cancer. They took into account several socio-demographicand personal factors such as body weight, alcohol consumption, hormone therapy and others. However, Prof Binnsadded that other studies are needed to explain how smoking affects ovarian cancer and especially mucinoid tumors. He also pointed out that the best advice would be for women to quit smoking. What is interesting is that so far the association between smoking and ovarian cancer was demonstrated especially in borderline tumors, and not malignant.It should be noted that mucinoidtumorsrepresent about 15% of all ovarian cancers and are tumors that can reach impressive dimensions, that is a few pounds. These tumors are of several types: benign, borderline and malignant. As their name implies, mucinoid tumors are filled with a mucus-like material and have a better prognosis if no metastases are present.


Gingko Biloba Brings no Benefit to MS Patients

The researchers found that the Gingkobilobasupplemets bring no benefit to patients with multiple sclerosis. Led by Dr. Jesus Lovera, Assistant Professor of Neurology at LSUHealth Sciences Center New Orleans, researchers wanted to verify the results of an earlier study conducted on a small group of patients with multiple sclerosis that showed an improvement in cognitive function. Gingkobilobais a drug extracted from a tree originating in China. Ginkgo biloba has been used over time as food and medicine for treating various diseases.

Gingko Biloba

Gingko Biloba

In medicine, Ginkgo bilobais used to treat neurological diseases such as multiple sclerosis or Alzheimer’s disease, although the results are controversial. It seems that Gingkobilobaimproves blood circulation and has antioxidant properties. But nowresearch shows that this drug is not of much use to MSpatients. Regarding the effects of this drug on blood flow, it seems that Gingkobilobaprevents platelet aggregation,in other words itprevents blood clots. In addition, it was also speculated that Gingkobiloba protects cells from oxidative stress through antioxidant effect. Also, Ginkgo biloba has been proposed as a treatment for Alzheimer’s disease because it was thought that improves memory. Memory effects are probably due the improvement inblood flow to the brain. In addition, there have been reported effects on neuronal metabolism and effects on the catabolism of neurotransmitters such as dopamine, acetylcholine and norepinephrine.

Now researchers at LSUHealth Sciences Center New Orleans, led by Dr. Jesus Lovera, evaluated the effects of Gingkobilobasupplements on one hundred twenty people with multiple sclerosis. Study participants were randomized to receive GingkoBiloba(120mg) twice a day or placebo tablets. The study lasted 12 weeks and after treatment patients underwent cognitive tests to see if theGingkobilobatherapyhad any effect. Both study participants and their families responded to standardized questionnaires about cognitive function. Dr. Loverasaid unfortunately study showed that Gingkobilobadoes not bring any improvementto multiple sclerosis patients. She added that although Gingkobiloba has been proposed as a treatment for Alzheimer’s patients, itis noteffective for those with multiple sclerosis.

However, the study conducted by researchers at LSUHealth Sciences Center New Orleans, has some limitations. Treatment duration was only 12 weeks, and the effects of Gingkobilobasupplements may improve cognitive function when administeredfora longer period. Also it mustbe taken into consideration that MS patients included in the study had this disease for 20 years. This means that Gingkobiloba can be effective if it were given earlier.


Smoking During Pregnancy

A recent studies revelas that children who were exposed to smoking during pregnancy pose a higher risk of developing asthma. According to epidemiological studies conducted by the Institute of Environmental Medicine at the KarolinskaInstitutet in Stockholm, Sweden, maternal smoking during pregnancy is involved in the development of asthma in children at school age. The study was published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

Studies on the relationship between maternal smoking and asthma in children have been performed in the past but a clear link whether maternal smoking during pregnancy or postpartum smoking exposure triggers asthma in children was never established. Now researchers in Sweden conducted a study that included more than 21,000 children. Of these, 700 children were exposed to smoking during pregnancy. Information was collected by means of questionnaires completed by parents.

Lead author, Dr.Neuman. MD, of the Institute of Environmental Medicine at the KarolinskaInstitutet in Stockholm, Sweden, said that these children had an increased risk of developing asthma and wheezing in preschool age. In addition, the study showed that the risk of developing asthma was greater as the number of cigarettes consumed by the mother in the first trimester was higher. Although the study has some limitations, as itwas based on questionnaires completed by parents, Dr. Neuman said that these findings highlights the harmful effects of smoking on the respiratory system of the child. Smoking is harmful especially in the first trimester when a woman may not even know she is pregnant. She also stressed that these findings should be an incentive for women to quit smoking especially during pregnancy.

Smoking during Pregnant

Smoking during Pregnant

Asthma is a respiratory disease characterized by paroxysmal crises of dyspnea (shortness of breath) accompanied by wheezing and cough.It is important to remember that between these bouts of breathlessness respiratory function is normal . The crisis usually end with the appearance of cough and whitish, coin shapedsputum. Asthma can be controlled with bronchodilators(salbutamol), anticholinergicmedication ( ipratropiumbromide), leukotriene antagonists ( montelukast), mast cell stabilizers ( cromolynsodium), corticosteroidsand others. Asthma occurs due to a chronic inflammation of the bronchithat istriggered by allergens (pollen) or irritants (cold, for example). Regarding triggers, there are two types of asthma: intrinsic (non-atopic) asthma and extrinsic (atopic) asthma. Lately, there has been an increase in cases of asthma. According to GINA (Global Strategy for Asthma Management and Prevention), in 2010 there were 300 million people with asthma.