Evidence-based Practice

From the onset, the article offers a discussion regarding the life of an innovative researcher, Maurizio Vignola. He is a writer of various biology papers relating to the condition of asthma, and most of his writings relate to the methods of remodeling and asthma inflammation conducted on individuals suffering from asthma. The current asthma definition was developed out of most of his observations about the allergic condition, and thus, he is also a contributor to the various methods of asthma treatment. For instance, he contributed to the development of clinical concepts of bronchial asthma, as per the biomarkers interests in monitoring the disease and employment of appropriate therapeutic methods of treatment. The article by Bonsignore et al. (2015) focuses on identifying the pathophysiological concepts of asthma, the development of the condition, clinical processes involved, insights and treatment of the condition.

The concept of pathophysiology relates to the medical conditions associated with a certain disease, physiological processed involved in the development of the condition, diagnosis and treatment. It explains the diverse processes and mechanisms of treatment of a stated condition, including the adverse impacts it generates on a person. For instance, the article offers clear insights into the development of asthma as an inflammatory condition which has a characteristic intrusion of the t-helper cells, eosinophils and mast cells. Eosinophils develop from chemical gradients that are emitted from chemotactic agents, and if a patient experiences prolonged processes of detecting the condition, it damages the epithelial (Bonsignore et al., 2015). Because asthma is an allergic disorder, its damages to the immune system can be adverse. Wherever a person inhales those allergens, there results bronchial hyper-reactivity before they invade other cells. They end up causing damages to the lower and upper airways. The outcomes include triggered inflammatory cascade and a comprised body functioning system that cannot adequately control the allergic reactions. From the clinical viewpoint, monitoring such occurrences as the remodeling and inflammation of the patient’s airways is essential in promoting appropriate diagnosis, treatment and control of asthma. Noninvasive approaches can be employed in achieving this, and such methods include blood samples and induced sputum among others.

According to Bonsignore et al. (2015), asthma phenotypes have to be controlled on time before they adversely impact an individual. they are the ones that describe bronchial asthma, with longitudinal assessments employed to describe their stability in adults. An ideal method to use in identifying the phenotypes is induced sputum as they are not too stable in their physiological variables. Thus, using phenotyping mechanisms has to be a long-term approach and integrate repeated measures to produce various outcomes. To control the development of bronchial asthma in the body, the upper airways should be continually involved in the inflammation process. Individuals affected by asthma condition show the symptom of inflammation of their upper airways, enhancing the need to control their eosinophils and epithelium activities. And, since most of these patients are likely to develop a chronic condition known as rhinosinusitis, which progresses due to the topographic scans, clinicians employ surgical treatment methods to control the condition. The outcome of the process includes improved symptoms of asthma as well.

The reality is that the pathophysiology of asthma is complex, and requires the inflammation of airways and bronchial responsiveness among other measures to control and treat the condition. However, the airway smooth muscle is integral in the treatment of the condition. It is involved in acute bronchoconstriction, which enhances impaired relaxation and hyper-responsiveness. And, Glucocorticosteroids are currently employed in the treatment of allergic conditions such as asthma through use of inhaled glucocorticosteroids. They are mostly administered to children and adults as the first-line treatment. Main actions of glucocorticosteroids include switching off the activated inflammatory genes responsible for encoding the receptors, inflammatory enzymes, cytokines, and adhesion molecules. By understanding the molecular mechanisms associated with suppression of corticosteroids, it explains how glucocorticosteroids can inhibit the inflammatory pathways, thus suppressing the pro and anti-inflammatory genes like correlated kinase proteins.

There are proposed new therapeutic approaches to the treatment of asthma. For instance, a humanized anti-IgE known as Omalizumab can be introduced into the treatment, and it reacts by interrupting the allergic cascade to prevent it from binding with the receptors on target cells. It is a clinically proven method that advanced from clinical trials and can be used to patients with moderate and severe allergic asthma. Advanced biotechnology has also enhanced the development of other therapeutic measures such as the use of synthetic hypoallergenic fragments. It is more of a personalized therapeutic approach that targets specific features of the disease. And finally, the use of non-pharmacological therapies can aid in treatment. Such approaches include engaging in physical exercises, which promote human health and prevent the development of the asthma condition (Bonsignore et al., 2015). The treatment process requires careful diagnosis and following appropriate treatment processes as prescribed by the physician. Since it is a chronic condition, the treatment should be based on clinical interventions discussed by a professional physician.





Bonsignore, M. R., Profita, M., Gagliardo, R., Riccobono, L., Chiappara, G., Pace, E., & Gjomarkaj, M. (2015). Advances in asthma pathophysiology: stepping forward from the Maurizio Vignola experience. European Respiratory Revie


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