Understanding an Asthma Attack

Asthma attacks are scary: it's hard to breathe, and you start to cough, wheeze, and choke. Attacks occur because your airway becomes constricted, making it hard for oxygen-filled air to get to your lungs and blood stream. The constriction is caused when the smooth muscles around the airways clamp down in an effort to stop irritants from entering the body. But it is also exacerbated by inflammation, a natural body response to potentially dangerous foreign invaders. Use the slider to see how inflammation in the smooth muscle cells in the bronchioles can make your airways dangerously narrow.

As part of your body’s immune response, your airways begin to produce mucus in an attempt to clear itself of irritants and allergens like pollen, mold, and pet dander. With asthma, the airways overreact and create far too much mucus. Excess mucus causes infections and helps to bring on and exacerbate asthma attacks. 

By moving the slider from left to right, you can see how, during an asthma attack, the airways in your bronchiole (which are tubes leading to the lungs) can quickly become filled with mucus.

On any given day, chances are you are inhaling more than just oxygen from the air around you. You’re probably also inhaling irritants like dust, pet dander, pollen, and more. In a person with asthma, the body’s response to these irritants is overblown. 

In the video to the left, you can see an asthmatic response to an irritant. The irritant travels down the windpipe and down into the bronchioles, where it encounters an “antigen presenting cell” (APC). The APC sets off a chain reaction that eventually leads to the production of histamines. Histamines are what cause allergy symptoms like a runny nose, watery/itchy eyes, and mucus in your airways. 

Histamines play an essential role in the body’s immune response in a number of ways. For example, they trigger the mucus-producers—called "goblet cells" for their goblet-like shape—to create more mucus. The goal of the mucus production is to create a wetter, more fluid environment, so that allergens can be carried away from the body.

Unfortunately, in a person with asthma, the histamines overreact, producing far more mucus than is needed. In the video to the left, you can see the goblet cells releasing mucus into the airways over and over again.

Histamine is also responsible for the inflammation of the airways—it causes blood fluid to seep into an area the body believes is under attack. This is an attempt to deliver protective cells that heal the body. But asthma leads to unnecessary and often chronic inflammation that can damage airways permanently if left untreated. Luckily, there are effective treatment options for long-term asthma control: anti-inflammatory drugs like inhaled corticosteroids that reduce inflammation and bronchodilators that open up the airways. By moving the slider from left to right, you can see how controlling asthma mitigates long-term damage.

For many asthma sufferers, the key to treating asthma is twofold: preventing attacks and then mitigating them by using quick-relief medications like bronchodilators. For others, however, long-term control medications like corticosteroids (a type anti-inflamatory drug) are necessary to prevent dangerous complications.

For more info, check out Avoiding Triggers & Preventing Flare-Ups and Asthma Drugs & Medications.