Success Chemistry

Discover who you are | Become unforgettable

Lung Health

Cordyceps

Lung Health, GlossarySuccess Chemistry Staff

ATP, adenosine triphosphate; GM-CSF, granulocyte

macrophage colony-stimulating factor; GRAS, generally

recognized as safe; HDL, high-density lipoprotein; IFN,

interferon; Ig, immunoglobulin; IL, interleukin; iNOS,

calcium-insensitive nitric oxide synthases; LD50, median

lethal dose; LDL, low-density lipoprotein; NK cell, natural

killer cell; PAH, polyaromatic hydrocarbons; PAMP,

pathogen-associated molecular patterns; TCM, traditional

Chinese medicine; TLR, Toll-like receptor; TNF, tumor

necrosis factor.

INTRODUCTION

 

Species of the genus Cordyceps (Fr.) Link (also known

as Chinese caterpillar fungi, or Tochukaso in Japanese;

Clavicipitaceae, Ascomycetes) are the fungi found growing

on insect larvae, mature insects, or fruiting bodies

of truffles of genus Elaphomyces.

 

Cordyceps has a long history as a rare and exotic medicinal fungus. It has been a

highly regarded cornerstone of Chinese medicine for centuries;

one that reportedly has a number of far reaching

medicinal effects. Most people in the West have only

come to know of Cordyceps within the last twenty years,

during which time, modern scientific methods have been

increasingly applied to the investigation of its seemingly

copious range of medicinal applications, in an attempt

to validate what Chinese practitioners have noted for

centuries (2).

Diversity and Artificial Cultivation

There are currently more than 680 documented species

of Cordyceps, found on all six inhabited continents and in

many climatic zones and habitats, and occurring parasitically

or commensally with a range of hosts

 

Due to the rarity and high prices of the wild collected variety,

attempts have long been made to cultivate C. sinensis. By

the mid 1980s, the majority of C. sinensis available in the

world’s marketplace was artificially cultivated (4).

Many companies now produce artificially cultivated

C. sinensis products, both from the mycelium as well as

from the fruit bodies. The increase in supply has given

rise to variations in purity and quality, creating a situation

in which there are a large number of counterfeit and

adulterated products being sold (3). Recently, there have

been introduced, new methods for assaying the quality of

Cordyceps spp. products (5). The large variations in quality

found in cultivated C. sinensis has lead many consumers

to believe the wild collected variety is medicinally better

than the cultivated type. But with new advances in

biotechnology, this is rapidly changing (6).

Contamination and Adulteration of Cordyceps

As found in its natural state, C. sinensis is attached to the

mummified body of the caterpillar, from which it arose. It

is harvested whole in this way, dried, and supplied into

the market. Because C. sinensis is sold by weight and intact

fruiting bodies fetch higher prices in traditional markets,

collectors have historically inserted a small bit of twig into

many of the caterpillars, resulting in an increase in weight

and the appearance of intact fruiting bodies (5). This is

probably a harmless practice, as long as the object inserted

is from a nontoxic source. However, modern collectors

have inserted lead or other metal in order to boost the

weight, so anyone who chooses to use the wild collected

C. sinensis, rather than the cultivated variety, would be

well advised to break each one of the caterpillars in half

before use, so that any bits of foreign matter can be readily

discerned and removed.

History and Traditional Uses

The first written record of the Cordyceps mushroom comes

from China, in the year AD 620, at the time of the Tang Dynasty,

bringing substance to the once intangible allegorical

narrative, which spoke of a creature, whose annual existence

alluded to a transformation from animal to plant,

in summer, and then again from plant to animal, in winter

(1). Tibetan scholars wrote of the healing animal/plant

through the 15th to 18th centuries, and in 1757, the earliest

objective and scientifically reliable depiction of the Cordyceps

mushroom was written by the authorWu-Yiluo in the

Ben Cao Congxin (“New Compilation of Materia Medica”),

during the Qing Dynasty (2–3).

C. sinensis is found at high altitudes on the Himalayan

Plateau, and thus, is difficult to harvest. Due

to such difficulties, Cordyceps has always been one of the

most expensive medicinal fungi known. Its high price had

relegated it almost exclusively to members of the Emperor’s

court and others among the Chinese nobility, historically

beyond the reach of the average Chinese subject.

Despite its cost and rarity, the unprecedented litany of

medicinal possibilities for Cordyceps spp. has made it a

highly valued staple of the TCM.

The name Cordyceps comes from the Latin words,

cord and ceps, respectively meaning, “club” and “head.”

The Latin word conjunction accurately describes the appearance

of these club fungi, whose stroma and fruit body

Cordyceps sinensis in natural habitat (4550 m in Tibet, China).

extend from the mummified carcasses of insect larvae,

usually that of the Himalayan ghost Moth, Thitarodes armoricanus

(Hepialis armoricanus). In historical and general

usage, the term “Cordyceps” normally refers specifically

to the species C. sinensis. However, the name “Cordyceps”

has come to be used for a number of closely related species

over the last few years, which have been found to be much

easier to cultivate. While C. sinensis may be the most wellknown

species, there are many other species in the genus

Cordyceps, in which modern science may have uncovered

potentially valuable medicinal properties.

The medicinal values of Cordyceps spp. have been

recognized since ancient times in China and the surrounding

Orient; but knowledge of this only reached Western

scientific audiences in 1726, when it was introduced at a

scientific meeting in Paris. The first specimens were carried

back to France by a Jesuit priest, who chronicled his

experiences with the Cordyceps mushroom during his stay

at the Chinese Emperor’s court (1,4).

The range of therapeutic uses claimed for Cordyceps

spp. is far reaching; although most of them have yet to

be sufficiently investigated. In TCM, C. sinensis has been

used to treat conditions including respiration and pulmonary

diseases, renal, liver, and cardiovascular diseases,

hyposexuality, and hyperlipidemia. It is also used in the

treatment of immune disorders and as an adjunct to modern

cancer therapies (chemotherapy, radiation treatment,

and surgery) (1). C. sinensis is believed by many, particularly

in and around Tibet, its place of origin, to be a

remedy for weakness and fatigue; and it is often used as

an overall rejuvenator for increased energy while recovering

from a serious illness. Many also believe it to be a

treatment for impotence, acting as an aphrodisiac in both

men and women. C. sinensis is often prescribed for the

elderly to ease general aches and pains. TCM practitioners

also recommend the regular use of C. sinensis in order

to strengthen the body’s resistance to infections, such as

colds and flu, and to generally improve the homeostasis

of the patient.

CHEMISTRY AND PREPARATION OF PRODUCTS Nutritional Components

Cordyceps spp. contains a broad range of compounds,

which are considered nutritional. C. sinensis contains all

of the essential 18 amino acids. The content of amino

acids after hydrolysis is mostly reported in the range of

20% to 25%. The highest contents are glutamate, arginine,

and aspartic acid, and the major pharmacological components

are arginine, glutamate, tryptophan, and tyrosine

(7). Also found are vitamins E, K, and the water-soluble

vitamins B1, B2, and B12. In addition, Cordyceps spp. contain

many sugars, including mono-, di-, and oligosaccharides,

and many complex polysaccharides, proteins,

sterols, nucleosides, macro- and microelements (K, Na,

Ca, Mg, Fe, Cu, Mn, Zn, Pi, Se, Al, Si, Ni, Sr, Ti, Cr, Ga, V,

and Zr) (2,5).

Polysaccharides

C. sinensis contains a large amount of polysaccharides,

which can be in the range of 3% to 8% of the total weight,

and usually comes from the fruiting bodies, the mycelium

of solid fermentation submerged cultures and the broth

(7). Four -D-glucan exopolysaccharides from C. militaris

with different molecular masses ranging from 50 to

2260 kDa were reported by Kim et al. (8). In the case of

C. sinensis, most of the heteropolysaccharides contained

mannose, galactose, glucose, and mannose in higher levels

with smaller amounts of arabinose, rhamnose, fructose,

and xylose, respectively. The average molecular mass

varies between 7 and 200 kDa. C. militaris polysaccharides

consisted mostly of glucose, galactose, and mannose

with traces of rhamnose and xylose and average molecular

weight approximately 60 kDa (9).

Proteins and Nitrogenous Compounds

Cordyceps spp. contain proteins, peptides, polyamines, all

essential amino acids, some uncommon cyclic dipeptides,

including cyclo-[Gly-Pro], cyclo-[Leu-Pro], cyclo-[Val-

Pro], cyclo-[Ala-Leu], cyclo-[Ala-Val], and cyclo-[Thr-

Leu]. Small amounts of polyamines, such as 1,3-diamino

propane, cadaverine, spermidine, spermine, and putrescine,

have also been identified (4). Many nucleosides

have been found in Cordyceps spp., including uridine, several

unique deoxyuridines, adenosine, dideoxyadenosine,

hydroxyethyladenosine, cordycepin [3deoxyadenosine],

cordycepin triphosphate, guanidine, deoxyguanidine,

and other altered and deoxygenated nucleosides, many

of which are found nowhere else in nature (Fig. 2). Chen

and Chu (10) found cordycepin and 2-deoxyadenosine in

an extract of C. sinensis.

Sugar-binding proteins named lectins were isolated

from C. militaris. N-terminal amino acid sequence differed

Cordyceps 187

Normal adenosine Cordycepin

Hydroxyethyladenosine Dideoxyadenosine Deoxygenated at the 3' and 2' position

Figure 2 Some of the unique nucleosides found in C. sinensis.

greatly from other lectins (11). Production of the nonribosomal

peptides cicapeptins I and II from C. heteropoda

were reported by Krasnoff et al. (12).

Sterols

A number of sterol-type compounds have been found in

Cordyceps spp.: ergosterol, -3 ergosterol, ergosterol peroxide,

3-sitosterol, daucosterol, and campeasterol, to name

a few (1). Another compound, sterol H1-A was found by

Chen et al. (13) and it was claimed to be effective in the

treatment of autoimmune disorders.

Other Constituents

Twenty-eight saturated and unsaturated fatty acids with

the function of decreasing blood lipids and protecting

against cardiovascular disease, and their derivatives, have

been isolated from C. sinensis. The unsaturated fatty acid

content includes Cl6:1, Cl7:1, Cl8:l, and Cl8:2 (7).

Polar compounds of C. sinensis extracts include

many alcohols and aldehydes (1). Particularly interesting

is the range of polycyclic aromatic hydrocarbons produced

by many C. sinensis strains, named PAH compounds, for

which it was proposed to react with the polypropylene

used in common mushroom culture bags, resulting in the

production of byproducts toxic to C. sinensis and stunting

growth as time progresses (5). Of particular note are various

immunosuppressive compounds found in Cordyceps

spp., including cyclosporin from C. subsessilis (anamorph:

Tolypocladium inflatum) (14), and also compounds found

in Isaria sinclairii, a species closely related to the genus of

Cordyceps (3).

 

Preparation of Products

Various pure compounds, extracts, whole fungus, and

other preparations have been used in preclinical and clinical

studies, and several products are now available in the

market, mostly used as food supplements. In TCM, hotwater

extraction of whole fruiting bodies is traditionally

used. Nowadays, extracts of polysaccharides are mainly

obtained by hotwater extraction followed by ethanol precipitation

(15). For pure compounds, different types of

chromatography are used, mainly affinity, ion-exchange

or size-exclusion chromatography. It should be noted that

different types of extracts give different results in the studies

mentioned, but all of them show positive medicinal

value.

 

PRECLINICAL STUDIES

The widespread use of Cordyceps spp. in TCM has been

discussed above in the section on History and Traditional

Uses. One of the most significant proposed activities of

medicinal mushrooms is their role as immunomodulators.

Other activities ascribed to Cordyceps spp. are antitumor,

antimetastatic, immunomodulatory, anti-oxidant,

anti-inflammatory, insecticidal, antimicrobial, hypolipidaemic,

hypoglycemic, anti-aging, neuroprotective and

renoprotective activities (2).

 

Cancer

A possibly valuable therapeutic application of Cordyceps

spp. is its potential as a treatment for cancer, and as an adjunct

to chemotherapy, radiation, and other conventional

and traditional cancer treatments (2,4). The mechanism

by which Cordyceps inhibits the growth of various cancer

cells might occur by one of several means: by enhancing

immunological function and nonspecific immunity; by selectively

inhibiting RNA synthesis, thereby affecting the

protein synthesis; by restricting the sprouting of blood

vessels (angiogenesis); by inducing tumor cell apoptosis;

by regulation of signal pathways; anti-oxidation and antifree

radical activity; anti-mutation effect; interfering with

the replication of tumor-inducing viruses; and by inducing

nucleic methylation (7).

Growth inhibition of various cancer cells by enhancing

immunological function and nonspecific immunity is

usually linked to polysaccharides, especially -D-glucans,

which present major cell wall structural components in

fungi and are also found in plants and some bacteria

but not in animals. Consequently, they are considered to

be classic pathogen-associated molecular patterns, called

as PAMPs (16). PAMPs potently trigger inflammatory responses

in a host, as if it was infected by a fungus. Studies

have shown that -D-glucans initiate biological response

with binding to complement receptor 3 (CR3) located

on the surface of the immune system effector cells, like

macrophages, thereby setting up different intercellular activities

of the immune system and leading to production

of cytokines, such as TNF-, interleukins, interferons, and

finally apoptosis of tumor cells (17). Toll-like receptors (especially

TLR-2) and dectin-1 receptor play an important

role in internalization and signaling responses to fungal

-D-glucans (18).

The anti-tumor effect also has been related to the

inhibition of DNA and RNA synthesis (19). Studies (20)

have demonstrated that cordycepin can selectively inhibit

mRNA synthesis, which affects protein synthesis by competing

with adenosine nucleoside phosphatase. The inhibition

may be blocked by adenosine. Cordycepin can also

kill leukemia cells and extend the period of mitotic cells

in the S and G phases. Nakamura et al. (21) found that,

with respect to cancer cells and normal cells, cordycepin

caused an inhibition rate of cell division on cancer cells of

55% while only 1.5% on normal cells.

Results show that cordycepin may have a very slight effect on the human body while treating cancer.

Another mechanism is inducing tumor cell apoptosis.

Extracts of C. militaris inhibited cell growth of human

leukemia cells in a dose-dependent manner (22), which

was associated with morphological change and apoptotic

cell death, such as formation of apoptotic bodies andDNA

fragmentation. Results indicated that the antiproliferative

effects were associated with the induction of apoptotic cell

death through regulation of several major growth regulatory

gene products (23).

In cancer research, there have been many studies

made with Cordyceps spp. extracts using animal models.

C. militaris inhibited the growth and metastasis of Lewis

lung cancer cells and the growth of sarcoma S180 cells

implanted in mice. In addition, the survival period of

the mice was increased (24). A study using murine models

verified that oral administration of a hot water extract

of C. sinensis consequently resulted in the activation

of macrophages, thereby increasing the production of

GM-CSF and IL-6, which act on the systemic immune

system (25). In another study (26), mice treated with

cyclophosphamide, which suppresses immune function,

and with C. sinensis hot water extract saw their immune

function return to normal, as measured by the IgM and

IgG response and macrophage activity.

 

Fatigue

Trials in the mouse swim test, conducted using C. sinensis

added to a standard diet compared with use of the untreated

standard diet, have invariably shown the use of

C. sinensis to significantly increase the time to exhaustion

in laboratory animals over their control groups (4). The use

of C. sinensis by athletes stems from publicity surrounding

the performance exhibited by the Chinese Women’s

Track and Field team at the Chinese National games in

1993. In this competition, nine world records were broken

by substantial margins. The team’s coach attributed

their success to C. sinensis (27). An increase in cellular ATP

level results in an increase in useful energy, in contrast

to the perceived increase in energy, which occurs from

the use of other stimulants, such as caffeine, ephedrine,

and amphetamines, ultimately resulting in an energy

deficiency (28).

Hypoglycemic Effects

In animal studies, isolated polysaccharides, have been

shown to improve blood glucose metabolism and increase

insulin sensitivity in normal animals, to lower blood sugar

levels in genetically diabetic animals, and to positively effect

blood sugar metabolism in animals with chemically

induced diabetes (29–31). The common thread throughout

all these trials is the increase in insulin sensitivity

and hepatic glucose-regulating enzymes, glucokinase and

hexokinase.

Lung Ailments

Mice treated with C. sinensis were able to survive up to

three times longer than those left untreated, demonstrating

a more efficient utilization of the available oxygen.

Such efficacy alludes to the use of C. sinensis as an effective

treatment for bronchitis, asthma, and chronic obstructive

pulmonary disease. A study was conducted using

in vivo mouse model-induced acute pulmonary edema,

which causes systemic lack of oxygen, acidic body, and

death. Research results show that animals taking C. sinensis

had a significantly greater survival rate of 20% mortality

in comparison with 80% mortality of the control

group (33).

Male & Female Sexual Dysfunction

C. sinensis has been used for centuries in TCM to treat

male and female sexual dysfunction, such as hypolibidinism

and impotence. Preclinical data on the effects of

C. sinensis on mice showed sex steroid–like effects (4), and

human clinical trials have demonstrated similarly the effectiveness

of C. sinensis in combating decreased sex drive

and virility (34). Treatment of rats on a diet supplemented

with C. militaris mycelium resulted in an increase of serum

cordycepin concentration, serum testosterone, and serum

estradiol-17 concentrations. They proposed that supplementation

with C. militaris improves sperm quality and

quantity in rats (35).

Cordyceps Antiviral Activity

The recognition of bacteria, viruses, fungi, and other microbes

is controlled by host immune cells with many innate

immunity receptors, such as Toll-like receptors, Ctype

lectin receptors, and immunoglobulin-like receptors.

Studies indicate that the immune modulating properties

of C. sinensis could be attributed to their polysaccharide

components. These polysaccharides specifically interact

with and activate surface receptors involved in innate immunity

(36). It was shown that intranasal administration

of an acidic polysaccharide, isolated from the extract of

C. militaris grown on germinated soybeans, decreased

virus titers in the bronchoalveolar lavage fluid and the

lungs of mice infected with influenza A virus. Furthermore,

it increased TNF-, IFN-, IL-1, IL-6 and IL-10 levels,

enhanced nitric oxide production, and induced iNOS

mRNA expressions in murine macrophage cells (37).

 

Cordycep CLINICAL STUDIES

Due to the historically high cost of the fungus and the

only recently developed methods for artificial cultivation,

clinical trials of C. sinensis and its extracts are still

relatively new endeavors. Earlier trials, although few in

number, have set the precedent from which modern trials

are building, expanding, and cementing our understanding

of Cordyceps spp. The majority of clinical trials

mentioned in this section used standard double-blind

placebo-controlled protocols. Approval was granted in the

countries where the trials were performed, but in most

cases the trials were conducted in China.

Cancer

The belief in the efficacy of C. sinensis against cancer is

widespread in the Orient, and many cancer patients in

Japan, Korea, and China are taking C. sinensis, or some

other mushroom-derived immunomodulators [such as

PSKTM, PSPTM, LentinanTM, AHCCTM, Immune AssistTM

(a heteropolysaccharide complex formula), and arabinoxylanes

(MGN3TM)], while undergoing conventional

treatment (1). Clinical studies involving cancer patients

have been conducted mostly in China and Japan (38,39).

In one study of 50 patients with lung cancer, who were

administered C. sinensis at 6 g/day, in conjunction with

chemotherapy, tumors were reduced in size in 46% of the

patients studied. A trial involving cancer patients with

several different types of tumors found that C. sinensis,

taken over a two-month period at 6 g/day, improved subjective

symptoms in the majority of patients. White blood

cell counts were kept at 3000/L, or higher; and even

with radiation or chemotherapy, other immunological

parameters showed no significant change, while tumor

size was significantly reduced, indicating an improved

tolerance for radiation and/or chemotherapy (1). In addition,

natural C. sinensis has been shown to enhance the

NK cell activity of normal patients by 74% and increased

the NK activity of leukemia patients by 400% (39).

Fatigue

In a placebo-controlled clinical study of elderly patients

with chronic fatigue, results indicated that most of the

participants treated with C. sinensis reported a significant

clinical improvement in the areas of fatigue, cold intolerance,

dizziness, frequent nocturia, tinnitus, hyposexuality,

and amnesia, while no improvement was reported in the

placebo group (4,40–42). Another study involving healthy

elderly volunteers, with an average age of 65, tested the

output performance and oxygen capacity of participants

while exercising on stationary bicycles. A portion of the

volunteers consumed C. sinensis for six weeks, while others

consumed a placebo. The results demonstrated that

the C. sinensis group had a significant increase in energy

output and oxygen capacity over the placebo group after

six weeks of the study (43). The presence of adenosine,

cordycepin, D-mannitol, polysaccharides, vitamins, and

trace elements may be, at least partially, the cause for such

effects.

Kidney Ailments

Traditional views of the Cordyceps spp. held that its consumption

strengthened the kidneys. In a study of 51 patients

suffering from chronic renal failure, it was found

that C. sinensis significantly improved both the kidney

function and overall immune function of treated patients,

compared with the untreated control group (44). Patients

with chronic renal failure or reduced kidney function often

suffer from hypertension, proteinuria, and anemia. After

a one-month treatment with C. sinensis, patients showed

a 15% reduction in blood pressure, reduction in urinary

protein, and increases in superoxide dismutase (44). Fiftyone

percent improvement of chronic kidney diseases was

shown only one month after taking C. sinensis supplement

(45). In another clinical study, treatment with C. sinensis

of patients having gentamicin-induced kidney damage resulted

in the recovery of 89% of their normal kidney function

after six days, compared with only 45% recovery by

patients treated with more conventional methods (1).

Hypoglycemic Effects

In a randomized trial, 95% of patients treated with C. sinensis

showed improvement in their blood sugar profiles,

while the control group showed only 54% improvement

with treatment by other methods (46).

Cordyceps Lung Ailments

There have been many trials in humans, using Cordyceps

spp. to treat many respiratory illnesses, including asthma

and bronchitis, either alone or as an adjunct to standard

antibiotic therapy, and it appears to be useful for all of

these conditions (47–50). Extracts of C. sinensis have been

shown to inhibit tracheal contractions, especially important

in asthma patients, since it allows for increased airflow

to the lungs. In addition, its anti-inflammatory properties

may prove to bring further relief to asthma patients,

whose airways become obstructed, due to an allergic reaction

resulting in the swelling of the bronchial pathways

(1). In a double-blind placebo-controlled study with 30

elderly volunteers, C. sinensis significantly improved the

maximum amount of oxygen these people were able to

assimilate (51).

Heart Ailments

It has been shown that C. sinensis, which often has a significant

quantity of adenosine, along with adenosine-type

nucleotides and nucleosides, has an effect on coronary and

cerebral circulation (52,53). In studies of patients suffering

from chronic heart failure, the long-term administration of

C. sinensis, in conjunction with conventional treatments,

promoted an increase in the overall quality of life (42). This

included general physical condition, mental health, sexual

drive, and cardiac function, compared with the control

group. Studies have also shown the benefits of C. sinensis

on heart rhythm disturbances, such as cardiac arrhythmias

and chronic heart failure (54).

Liver Ailments

In the Orient today, C. sinensis is commonly used as an

adjunct in the treatment of chronic hepatitis B and C. In

one study, C. sinensis extract was used in combination with

several other medicinal mushroom extracts as an adjunct

to lamivudine, for the treatment of hepatitis B. The group

receiving C. sinensis along with other medicinal mushroom

extracts had much better results in a shorter period

of time than the control group, who received only

lamivudine (55). Treatment of 22 patients, diagnosed with

posthepatic cirrhosis, with C. sinensis (56), showed improvement

in liver function tests, and in another trial on

patients with hepatitis B and patients with cirrhosis taking

C. sinensis supplement showed around 80% improvement

of liver functions (57).

Hypercholesterolemia

In both human and animal studies, administration of

C. sinensis has been associated with cholesterol and triglyceride

reduction and an increase in the ratio of HDL to

LDL cholesterol (1). As such it may prevent, arrest, and

even reverse coronary atherosclerosis (58). The studies

have demonstrated that C. sinensis helps to lower total

cholesterol up to 21% and triglycerides up to 26%.

At the same time it helps to increase HDL cholesterol

up to 30% (54).

Antiviral Activity

After three months of treatment of chronic hepatitis B

patients using C. sinensis, CD4 and CD4/CD8 ratios increased

significantly (59). The results suggest that beneficial

effects might be obtained through adjustment of the T

lymphocyte subsets level. Treatment of 65 cases (with 20

cases in the control group) of patients with posthepatic cirrhosis

has shown similar results (60). Extracts of Cordyceps

spp. are also effective against HIV infections. A C. sinensis

containing formula named Immune Assist 24/7TM has recently

been introduced throughout West Africa for use in

treating HIV infections and other immune-deficient states

(2), and is quite popular with both the doctors and the

patients due to its low toxicity and cost when compared

with other antiretroviral drug options.

Dosage

Because clinical data on Cordyceps spp. is relatively new,

and even more so in Western Countries, recommended

dosage requirements may vary, depending on the source.

In general, clinical trials have been conducted using 3 to

4.5 g of C. sinensis per day, except in cases of severe liver

disease, where the dosage has usually been higher, in the

range of 6 to 9 g per day (4). There are some practitioners

known to these authors, who keep their cancer patients

on 30 to 50 g of C. sinensis per day. While this may seem

excessive, the clinical results seen with this treatment regimen

are promising, and Cordyceps spp. related toxicity has

never been reported.

C. sinensis has been traditionally taken in tea or eaten

whole, either by itself or cooked with a variety of meats.

Today, in addition to the established traditional means of

consumption, powdered mycelium and mycelial extracts

are also available in capsulated and noncapsulated form.

At present, there are no reliable standards by which to

compare different brands, but in general, the quality of

Cordyceps spp. is improving, as methods of more efficient

cultivation are investigated; and as more clinical trials are

conducted, a clearer picture of recommended dosages for a

particular condition will become more standardized. Considering

the quality of cultivated Cordyceps spp. available

in the market today and the risk of lead exposure as well

as the cost, such as with wild C. sinensis, the use of natural

Cordyceps spp., over the artificially cultivated variety, is

not recommended. Obtaining Cordyceps spp. from a reliable

source, with complete analytical data provided, is the

safest way to purchase species of Cordyceps.

Safety Profile

None known contraindications.

Drug Interactions

There is observational evidence that the alteration of the

body’s blood glucose metabolism in patients consuming

Cordyceps spp. often results in the reduction of oral or

injected anti-diabetic medications. It is also posited that

the naturally occurring antiretroviral compounds found

in C. sinensis (e.g., 2,3-dideoxyadenosine) are marketed as

a major anti-HIV drug under the name Videx and Didanosine,

as well as 3-deoxyadenosine (which has the

same or at least similar activity); C. sinensis could result

in increased effectiveness or decreased dosage requirements

for patients undergoing concurrent therapy with

other antiretroviral drugs. Caution should be exercised

in these patients, especially considering the newer, more

potent hybrid strains of Cordyceps spp. being developed,

and the targeted medicinal compounds being selectively

cultivated.

Adverse Side Effects

Very few toxic side effects have been demonstrated with

Cordyceps spp. use, although a very small number of people

may experience dry mouth, nausea, or diarrhea (1).

One study reported that a patient had developed a systemic

allergic reaction after taking a strain of cultivated

C. sinensis called Cs-4 (61); however, this type of reaction

is not common. There is little published data on the use

of Cordyceps spp. in pregnant or lactating women, or in

very young children, and appropriate precautions should

be taken with these types of patients.

 

Toxicity

No human toxicity has been reported, and animal models

failed to find an LD50 (median lethal dose) injected IP in

mice at up to 80 g/kg per day, with no fatalities after seven

days (2). Given by mouth to rabbits for three months, at

10 g/kg per day (n = 6), no abnormalities were seen from

blood tests or in kidney or liver function (62).

REGULATORY STATUS

Cordyceps spp. remains, in many nations throughout

the world, an unrecognized substance. Other than import/

export taxes and restrictions, which vary from country

to country (many of which ban the import of any

such substance), most governments do not require a prescription

to purchase or use Cordyceps spp. Among the

few countries that do require a doctor’s prescription are

Portugal, Romania, and Austria. Many governments require

that vendors obtain a special license to distribute

any product relating to human health.

In the United States, Cordyceps spp. are marketed

privately and considered by the FDA as a dietary supplement.

GRASapplications referring to Cordyceps spp. status

as a food additive are unavailable; however, a premarket

notification to the FDA regarding species of Cordyceps,

containing in-depth information relating to preclinical trials

and toxicology studies, has been available to the public,

via the FDA website.

CONCLUSION

When a natural product, such as C. sinensis, has such a

long history of use, it seems logical that there is quite likely

some truth behind the myths. Our challenge in the modern

age is to scientifically unravel the many claims and

conflicts. With C. sinensis this challenge has been greater

than with many other herbals due to the enormous cost

and scarcity of the material. We are fortunate that we

live in an age of such rapidly expanding biotechnological

progress. For now, we have ways at our disposal to

produce Cordyceps spp. in large enough volume, and at a

low enough cost, that research becomes possible to nearly

anyone interested in looking at this unique organism.

lungs

Glossary, Lung HealthSuccess Chemistry Staff

How does the lung work?

The lungs are one of the big vital organs. It ensures that the oxygen from the breathing air gets into the blood. It is then transported via the bloodstream to all body cells. The lungs are well protected from the ribs in the upper thorax. The structure of the lung resembles that of a tree that is upside down: two branches, the main bronchi, descend from the trachea to the right and left of the two lungs. They ramify in the lungs in ever thinner branches and end in the alveoli.

How does the pulmonary circulation work?

With every breath, oxygen-containing air flows through the trachea and bronchi into the alveoli. These so-called alveoli are crucial for the gas exchange: they are grape-like on the bronchial branches. A healthy lung contains about 300 million alveoli. They are all surrounded by fine blood vessels (capillaries).

Through the thin envelope of the alveoli , the oxygen from the inhaled air passes into the blood vessels. This process is also called diffusion. Through the bloodstream, the oxygen is distributed in the body and reaches every cell . At the same time that the blood takes in oxygen, it also releases carbon dioxide. Carbon dioxide (C O 2 ) is produced as a by-product of cell metabolism and is disposed of with exhalation. It takes the opposite route as oxygen: from the blood through the walls of the alveoli and the airways to the outside.

What happens during breathing?

As you inhale, the ribcage expands and the lungs expand. As you exhale, the lungs contract again. Both are controlled by movements of the diaphragm and the intercostal muscles. The breathing is unconscious.

Adults breathe calmly 14-16 times a minute. With every calm breath about half a liter of air is inhaled. When exerted, the breathing becomes faster and deeper, so that more oxygen gets into the blood .

A person's performance depends heavily on how the lungs and heart work. Pulmonary function can be measured using various breath tests.

How is the lung structured?

The trachea is about ten centimeters long in adults and divides at its end into the main bronchi (right and left main bronchus). These main bronchi branch into smaller lobar bronchi - three in the right lung, two in the left lung. There is less space because the left lung partially encloses the heart.

The lobar bronchi, in turn, branch out into several segmental bronchi. The right lung is divided into ten, the left lung into nine lung segments. Each segment is supplied by a segment bronchus and a branch of the pulmonary artery. In case of severe lung disease or injury, a segment can therefore be removed individually if necessary.

The trachea and bronchi are lined with mucus-producing cells and millions of tiny cilia . Together, they ensure that inhaled pollutants such as dust or other particles do not accumulate in the lungs: The mucus binds the foreign particles, is continuously transported out of the lungs by the movement of the cilia and finally swallowed or coughed up in the pharynx. When larger foreign bodies enter the trachea, the respiratory tract responds with a reflex-like coughing sensation.

 

lung cancer

Glossary, Lung HealthSuccess Chemistry Staff

What is lung cancer?

Lungs tumors are malignant in over 90 percent of cases. They can basically develop in all lung sections, but most often they are found in the upper part of the lung. This region is more ventilated during respiration and thus comes increasingly in contact with harmful substances.

Lung cancer is one of the most common malignancies in Germany with about 40,000 deaths per year and is rarely curable. According to the Federal Statistical Office, 28,652 men and 10,634 women died of bronchogenic carcinoma in 2003. Lung cancer is the most common cause of death in men and the third most common cause of cancer death among women. Due to changing smoking habits, the number of deaths among women is currently on the rise, with a slight decline in men since the mid-1980s.

Lung cancer predominantly occurs from the age of 40 years. The risk of disease increases with age. Most lung cancer patients are around 65 years old on average.

lung cancer causes

lung cancer causes.jpg

Today, lung cancer is based on a multi-stage concept: on the first level, there is contact with a carcinogenic substance, such as tobacco smoke or asbestos (see also Risk Factors ). The second stage is caused by the carcinogen damage to the genetic material (so-called mutations) of the cells in the lower respiratory tract (bronchi) or in the lungs ( alveoli, ie alveoli ). On the third stage comes - after a certain period of rest ( latency) of up to 40 years or even earlier - to a degenerate, unchecked growth of the damaged cells. This is how malignant tumors and cancer develop. Cigarette smoking is both the most important trigger and the most important driver of the disease. Basically, cancer always seems to always start from one cell.

lung cancer risk factors

lung cancer risk factors.jpg

Many different factors can work together in the development of lung cancer. First and foremost, harmful substances in the respiratory air cause the mucosal cells of the bronchi to gradually transform into cancer cells. By far the most important risk factor for lung cancer is smoking. But pollutants at work and in the air are also considered risk factors. Furthermore, diet, infections and occupational disease (eg silicosis ) and possibly also hereditary preload play a role. Although there is no clear evidence for the latter, one can observe a familial accumulation of lung cancer.

Smoke & lung health

90 percent of lung cancer cases are attributable to smoking. The cigarette smoke contains numerous carcinogenic substances. The risk of developing bronchial carcinoma is for a smoker about 10-15 times as high as for a never-smoker. Of course, this risk increases with the number of cigarettes smoked daily and the duration of smoking. About every thirtieth smoker falls ill in the course of his life. For pipe and cigar smokers who do not inhale the smoke, the risk for lung cancer is significantly lower than for inhaled cigarette smoking, but still high compared to that of a non-smoker. However, there is a subgroup of cigars and pipe smokers who inhale like cigarette smokers. Here the risk is comparable to that of the cigarette smoker. Even passive smokers (people who do not smoke themselves, but stay in rooms where people smoke) have an increased risk of cancer: passive smoking increases lung cancer risk by a factor of 1.3.

Pollutants & lung health

The occupational lung cancer risk is significantly lower than the risk of smokers. About one percent of all cases of bronchogenic carcinoma is caused by the inhalation of substances that people have to deal with at their workplace. Asbestos is responsible for more than 90% of cases, but arsenic, beryllium, cadmium, chromium, nickel, aromatic hydrocarbons, and diesel exhaust also play a role. These substances are mainly used in metalworking, in coal gas and coke production, in foundries or in rubber production. Even with workers in uranium mines, the risk of lung cancer is due to contact with the naturally occurring radioactive noble gas radon elevated. Heavy air pollution - especially from diesel soot - can also increase lung cancer risk (1.5 times). Particularly in smokers pollutants - whether at work or in the outside air - lead to an additionally significantly increased lung cancer risk.

Nutrition & lung health

A low-vitamin diet increases the risk of developing lung cancer to about twice - especially among smokers. That's why it's important to eat fruits and vegetables regularly. For example, beta-carotene from leafy vegetables and carrots is said to have a protective effect against lung cancer. However, vitamins in the form of dietary supplements or high-dose supplements are not an alternative: In smokers, they do not seem to lower the risk of cancer, but even increase it. In relation to the damaging influence of smoking, however, the contribution of nutrition in the development of lung cancer is low overall.

lung Infections & injuries

Generally, scars in the lungs are associated with an increased risk of cancer due to previous inflammation or infection (such as tuberculosis or silicosis) or injuries. Because cancer develops preferentially in those areas of the lung, which are scarred as a result of tuberculosis or other illness. Here, too, smokers are additionally endangered.

Genetic strain

A hereditary bias can also increase the risk of lung cancer. If one parent suffers from a bronchial carcinoma, the risk of children increases by two to three times.

Genetic Lung disease

Genetic Lung disease

Different types of lung cancer

Physicians distinguish two types of lung cancer the small-cell lung cancer (SCLC: small cell lung cancer ) that is growing very quickly and accounts for about 15 percent of cases, and non-small cell lung cancer ( NSCLC: non-small cell lung cancer ), which with about 85 percent occurs most frequently.

Non-small cell lung cancer is further distinguished between what is known as squamous cell carcinoma (40-50% of all lung cancers), adenocarcinoma (10-15%) and large cell carcinoma(5-10 percent). Non-small cell bronchial carcinomas grow more slowly and therefore have a better overall prognosis. What type of tumor is involved can only be determined by a microscopic examination of the cancerous tissue.

All carcinomas rarely cause discomfort at the beginning of their growth. Therefore, they are almost always discovered at random at an early stage, for example in x-ray examinations performed for a different reason. It is only in advanced stages that symptoms may appear that may indicate a carcinoma but other causes are also conceivable.

Possible complaints in a bronchial carcinoma

Early signs that may indicate lung cancer are especially persistent cough for four weeks, wheezing and chest pain. However, such symptoms are firstly not necessarily typical for a tumor disease, secondly, they also occur in many other diseases. In this respect, lung cancer is often not discovered early enough. On the other hand, there are good chances of recovery only if a bronchial carcinoma is treated as early as possible. In advanced disease stages, there is often rapid weight loss, bloody sputum, difficulty breathing and/or fever, usually triggered by concomitant infections.

The following symptoms may indicate a bronchial carcinoma and should, therefore, be clarified by the doctor:

  • "Smoker's bronchitis" (ie a persistent cough with sputum due to years of cigarette smoking)

  • A stubborn cough that does not fade even after several weeks, and then suddenly changes

  • Persistent hoarseness

  • Bronchitis or a cold that does not improve despite treatment with antibiotics

  • difficulty in breathing

  • Constant pain in the chest

  • Nocturnal sweating

  • Expectoration with or without blood

  • Swelling of the neck and face

  • Loss of appetite or heavyweight loss

  • General malaise and decay of strength

  • paralysis

  • Strong pain

  • fevers

Usually in later stages of the disease, especially in small cell bronchial carcinoma, cancer deposits in the brain (so-called brain metastases) can arise. Nerve damage causes headaches, nausea, impaired vision, and balance or even paralysis. Some tumors also release hormones into the blood and thus disrupt the natural hormone balance.

Grading & staging of a tumor

In a microscopic examination, not only the type of tumor but also the aggressiveness and growth rate of a tumor - and thus its prognosis - can be estimated. In the so-called "grading" the tumors are divided into four grades:

  • G1 tumors: very similar to their original tissue, still well differentiated, growing slowly and not as aggressive.

  • G2 tumors: moderately differentiated

  • G3 tumors: poorly differentiated

  • G4 tumors: undifferentiated, barely recognizable as a bronchial cell, grow rapidly and tend to grow aggressively into adjacent tissue.

However, information on the degree of differentiation due to "grading" only makes sense for squamous cell and adenocarcinomas. Large cell and small cell carcinomas always correspond to Grade 4 tumors.

The spread of lung cancer is assessed by "staging" according to the so-called TNM classification. The stage of cancer is characterized by the following three criteria:

  • the size and extent of the tumor (T1-4),

  • the number and location of the affected lymph nodes (English nodes, N0-3) and

  • the absence or presence of metastases (M0 or M1).

For example, small tumors (such as T1 and T2) with no lymph node involvement (N0) and no daughter tumors (M0) have a more favorable prognosis. In small cell lung cancer, physicians also distinguish between a limited and a more extensive disease. While in limited disease the tumor is limited to one lung, it is said to be of advanced disease when cancer has spread to adjacent tissue in the chest and other parts of the body.

Complications & effects

Complications & effects

Depending on the position of the tumor, it can narrow the air or esophagus or even close the large bronchi. Frequently, lung cancer patients also develop pneumonia and tumor bleeding. Those affected spit blood and suffer from venous congestion in the head and neck area. There may be fistulas, accumulation of blood in the pericardium and pleural effusions - also due to lymphatic drainage disorders. Disintegrating cancer can cause a high fever.

Lung cancer prevention

Lung cancer prevention

If lung cancer is suspected , the patient is first questioned by the doctor in detail about his symptoms and possible risk factors, and then thoroughly examined physically. This involves examining both blood and sputum in the laboratory and x-raying his lungs. A subsequent bronchoscopy allows the doctor to look into the lungs. In some cases, he has to confirm his diagnosis with additional methods such as ultrasound , computed tomography (CT) or fine needle biopsy (see below), which may require the patient to be admitted to a pulmonary clinic.

If lung carcinoma has been diagnosed, further examinations should follow, which should show, in particular, how far the tumor has already spread, whether lymph nodes are affected or even secondary tumors ( metastases ) have formed in other parts of the body. The stage of cancer is crucial for choosing the treatment strategy.

laboratory examination

The blood values reflect the general condition of the patient and provide information about the functioning of individual organs such as kidneys and liver. In addition, the blood can be checked for the occurrence of so-called tumor markers - these are certain substances that are increasingly formed by tumor cells. However, as tumor markers can not be detected in all lung cancer patients and can also occur in healthy people, they do not play a major role in the diagnosis. They are more likely to be used in aftercare to control the disease process.

In a sputum examination , the patient's coughed mucus is examined under the microscope for abnormal cells. Such cells may indicate tumors that are not yet visible on the radiograph. However, their absence does not automatically mean all-clear. Therefore, this test can not be used for the early detection of lung cancer .

BRONCHIAL CARCINOMA

bronchoscopy

During bronchoscopy , the doctor introduces a flexible tube ( endoscope ) into the bronchial tubes via the nose and trachea to patients who are anesthetized locally or under anesthesia . Using an optical device at the end of the endoscope, the doctor can examine the mucous membranes and use a small forceps, which is located next to the optical unit, to take a tissue sample (biopsy). Only the microscopic examination of this sample reveals whether a malignant tumor is present - and if so, which form of cancer it is. During the same examination, the doctor can also aspirate secretions from deeper bronchial sections and examine them, similar to the sputum, under the microscope for cancer cells .

Fine-needle biopsy

If the cancerous area is unreachable due to its location for bronchoscopy, the doctor will perform a fine needle biopsy. He pushes from the outside a long, thin hollow needle through the patient's chest into the suspicious area and sucks some tissue. The whole thing happens today usually under ultrasound - or computer tomographic control. The tissue is then examined microscopically for the presence of cancer cells.

Computed tomography (CT)

With the help of this special X-ray method, the doctor examines the patient's body layer by layer. In the computer tomogram, he can detect the extent of the tumor and determine whether it has already affected adjacent organs. Thus, he receives important information about the extent to which vital organs are affected, whether the tumor can even be surgically removed and - if so - how extensive the operation is likely to be. In patients with bronchial carcinoma, computed tomography is also used to look for or eliminate the presence of cancer cells (metastases) in the head, but also in the chest and abdomen.

Magnetic Resonance Imaging (MRI)

Lying in a strong magnetic field, the patient is exposed to radio waves during this examination. The water molecules in the body "respond" to this signal at different speeds - depending on the type of tissue they are sitting in. From the resonance of their respective wave patterns, the computer calculates an image of the organs. In nuclear spin (as magnetic resonance tomography is also colloquially called) different structures stand out than with computed tomography. In addition, dislocations of cancer cells (metastases) in the brain, spinal cord and skeleton can be more clearly recognized. The waves and the magnetic field are innocuous for the patient.

Ultrasonic

Similar to magnetic resonance imaging ( MRI ), an ultrasound examination makes the internal organs visible without burdening the affected patient with harmful radiation. Using ultrasound, the doctor can determine whether the lung cancer has already spread to other organs such as the liver, kidneys, spleen and lymph nodes. An ultrasound examination of the heart can provide information about the performance of the heart muscle, which in turn is crucial for the choice of treatment method. Often affected people not only the lungs are damaged by regular tobacco consumption , but also their cardiac output (due to constricted coronary arteries).

Bone scintigraphy

With the help of bone scintigraphy, the doctor can detect whether the lung cancer has already spread secondary tumors into the bones (bone metastases). To do this, he injects small amounts of a radioactive substance into the bloodstream, which accumulates primarily in diseased bones. A camera recording radioactive radiation locates suspicious areas. A scintigraphic examination does not put a lot of strain on the patient as the radiation fades away very quickly.

Mediastinoscopy

Lung cancer often spreads through the lymphatics, and especially the lymph nodes of the mediastinum, which are close to the lungs, are particularly frequently attacked. In order to assess their condition, the physician must perform a mediastinoscopy : For this, he introduces the anesthetized patient via a small incision above the breastbone an optical probe in the space between the lungs. Using the endoscope, he can remove suspicious lymph nodes and then examine these tissue samples for the presence of cancer cells.

 

SMALL CELL LUNG CANCER

The choice of treatment depends on whether a small cell or non-small cell lung carcinoma is present and how far the disease has progressed. Since lung cancer patients almost always have a chronic inflammation of the bronchi with constriction, additional treatment of chronic bronchitis is very important in the treatment of bronchial carcinomas . Also respiratory distress, cough and pain can be alleviated.

Treatment of non-small cell lung cancer

In the treatment of non-small cell lung tumors, surgery and radiation are in the foreground: during surgery, the surgeon cuts out the tumor and a piece of adjacent healthy lung tissue. Frequently, the entire affected lung lobe (lobectomy) or a whole lung (pneumectomy) is removed, but in many cases can also be operated to maintain the organ. A surgical procedure is only possible if the general condition of the patient is good and the remaining lung sections can take over the respiratory function.

 

LUNG CANCER RADIOTHERAPY

If this is not the case, or if the tumor already reaches neighboring, vital organs, radiotherapy must be performed. In this case, the cancer cells are irradiated from the outside with high-energy waves (taking advantage of the effect of ionizing radiation) and destroyed. Are being introduced X, Alpha, gamma or electron radiation. In the best case, the tumor is reduced by the radiation so far that it can still be surgically removed afterwards. Radiation therapy may also be performed following surgery (adjuvant radiotherapy) to destroy any remaining cancer cells. The prospect of success is limited, however, as often not all tumor cells can be destroyed or even the smallest tumor deposits have formed. In non-small cell lung cancer, chemotherapy is increasingly being used in combination with surgery and / or radiotherapy. The success of this treatment is currently being tested in clinical trials worldwide.

LUNG RADIOTHERAPY

Treatment of small cell bronchial carcinoma

In small-cell bronchial carcinomas, which due to their rapid growth and early spread of secondary tumors (metastasis) can be operated on only rarely, chemotherapy is more effective than non-small cell carcinoma. The patient is given so-called cytostatics. These are drugs that inhibit cell division and act especially on the fast-growing cancer cells - less on healthy cells. Even if surgery is performed, chemotherapy is always performed before or after surgery to combat other possible (non-surgical) tumor cells. If distant metastases have already formed, the doctor tries to delay the course of the disease by means of chemotherapy. Thus, he can cure the patient only in a few cases, but possibly extend his life. As long as a small cell Lung cancer has a small extent, a combination of radiation and chemotherapy can be considered. Since small-cell lung tumors often form metastases in the brain, the patient's skull is sometimes irradiated preventively. This radiation should help prevent the onset of cancer in the brain.

Active substances in the chemotherapy of bronchial carcinomas

Non-small cell lung carcinoma

Small cell bronchial carcinoma

Adriamycin
carboplatin
cisplatin
etoposide
ifosfamide
vindesine
docetaxel
erlotinib + gefitinib
gemcitabine
mitomyin
paclitaxel
vinorelbineAdriamycin
Carboplatin
Cisplatin
Etoposide
Ifosfamide
Vindesine
Cyclophosphamide
4-Epirubicin
Irinotecan
Teniposide
Topotecan
Vincristine

Treatment of tumor pain

In the advanced stages of lung cancer, the so-called tumor pain (for example, as a result of an infestation of the pleuraor the chest wall), and their control in the foreground. They often affect the quality of life of the person affected more than other effects of the tumor. The doctor has a range of painkillers to morphine injections available to relieve the suffering. For painful bone metastases sometimes helps a targeted irradiation. If the entire skeleton is affected by the tumor, the doctor can administer to the person concerned radioactive substances that accumulate in the diseased bone and irradiate it from the inside (radionuclide treatment). Also, chemotherapy can relieve tumor-related pain in more than half of the patients and prevent worsening of the general condition. However, healing is no longer possible at this time.

lung cancer prevention

lung cancer prevention

About 85 to 90 percent of all malignant lung tumors are due to smoking . Therefore, one can prevent lung cancer still best when on tobacco use completely eliminated and not be gathered up in smoke filledrooms . Even at an advanced age and after many years of smoking it is worthwhile stopping for many reasons. Those who are in contact with carcinogenic substances at the workplace should strictly adhere to the safety precautions. A healthy, vitamin-rich diet helps the body fight against cancer. The risk prevention is in lung cancer especially important because its chances of recovery are rather poor and there is currently no one hundred percent safe screening for early detection.

Aftercare & rehab

Lung cancer Aftercare & rehab

The purpose of follow-up examinations for lung cancer is to detect and treat a possible recurrence of the tumor (recurrence) in good time. Follow-up visits often follow a set schedule of visits to the doctor in the first year at 1, 3, 6, 9 and 12 months, the second year every 3 months, then every 6 months. However, significant differences are possible depending on the individual course. Unfortunately, the prognosis of the patient (ie, his chance of survival) does not improve decisively simply by the control examinations - but without the symptoms changing. In addition to a detailed conversation and a physical examination, the blood is often analyzed during follow-up examinations and an X-ray of the chest (thorax)made. After surgery, sometimes bronchoscopy (lung reflection) may be useful at longer intervals .

Inpatient rehabilitation stays should preferably be sought at particularly experienced tumor after-care clinics that are familiar with the specific needs of lung cancer patients. The aim is to improve the overall quality of life of those affected - that is, physically, socially, psychologically and professionally. Whether a rehabilitation measure in individual cases makes sense and is possible, decides the treating pulmonologist.

pulmonary emphysema

Glossary, Lung HealthSuccess Chemistry Staff

What is pulmonary emphysema?

In pulmonary emphysema are the alveoli, in which the exchange of oxygen and carbon dioxide takes place, partially destroyed and overstretched, so that its inner surface is reduced. As a result, the exhalation is difficult because the small bronchi, which flow into the alveoli, collapse. In addition, there is increasing hyperinflation of the lungs. The pulmonary alveoli spread apart in the healthy about an area of 200 m². In emphysema, the area becomes smaller due to the destruction of the inner surface. Because the respiratory flow is disturbed by this, the oxygen content in the blood decreases - initially only under load. Typical symptoms include respiratory distress especially during exercise, fatigue and in advanced stages of weight loss. Pulmonary emphysema is a chronic disease that does not regress despite various treatment options. Bronchitis on. Both diseases are summarized by the term COPD ("chronic obstructive pulmonary disease").

The number of emphysema patients cannot be stated with certainty, as pulmonary emphysema is often not registered as a separate disease, and those affected are instead grouped together as COPD patients. However, it can be assumed that about 1,000,000 people in Germany have pulmonary emphysema, with smokers men and women above the age of 50 being particularly affected.

Worldwide, COPD is currently the fourth leading cause of death. If the proportion of inhaled smokers, which increasingly includes women, does not abate, COPD in 15 years (2020) is likely to take the third place (after cardiovascular disease and stroke ) among the leading causes of death.

There is also a hereditary form of pulmonary emphysema, which is rare: around 1% of emphysema patients suffer from a congenital alpha-1-antitrypsin deficiency.

Pulmonary emphysema causes

The most common cause of emphysema is cigarette smoke or a persistent inflammatory process (eg severe viral bronchitis) that causes an imbalance between certain proteins. Protein-degrading enzymes ( enzymes ) are taking over, destroying the air sacs over the years step by step (see also "What happens in the airways"). Chronic inflammation leading to emphysema can occur, for example, as a result of poorly or improperly treated chronic obstructive bronchitis, or after many years of uncontrolled bronchial asthma or severe pneumonia.

Much less frequently do pollutants in the environment (for example sulfur dioxide, nitrogen oxides, and ozone) or at the workplace (eg silicates, wood, paper, grain, and textile dust) play a role.

Narbenemphysem

When chronic inflammation is due to years of inhalation of quartz-containing dust, it is called scar emphysema, with emphysema forming around a nodule triggered by the quartz. Such changes are practically only due to occupational, strong exposure to dust, as occurs especially in coal mining, foundry, quarry or similar loads. Again, the disease is greatly favored by tobacco consumption.

Hereditary disease

In rare cases, genetic causes may also underlie: One percent of patients with emphysema suffer from a congenital deficiency of a particular protein ( alpha-1-antitrypsin deficiency ). Only when those affected smoke or constantly have respiratory infections, they already suffer from the symptoms at a young age. Non-smoking carriers of the congenital defect contract, if at all, only at a higher age.

Altersemphysem

With increasing age, the elasticity of the connective tissue generally decreases, so that the partitions of the alveoli also lose their elasticity due to age. Therefore, we also know the so-called age emphysema, but - in contrast to the previously mentioned emphysema forms - asymptomatic and not a disease.

Other types of pulmonary hyperinflation

In addition to pulmonary emphysema, there are subtypes of pulmonary hypovolemia, such as the so-called large bullhead emphysema. These are large blisters that sometimes appear after inflammation or even innate. If they occur in isolation, they usually have no disease value (exception: increased occurrence of pneumothorax). But they can also be part of generalized pulmonary emphysema. If they continue to expand, they can still displace healthy lung tissue and increase the breathlessness. Such large bubbles are relatively easy to remove by surgery.

What happens in the respiratory tract?

The development of pulmonary emphysema is based on a chronic inflammatory process, which leads to an imbalance between certain proteins ( enzymes ), namely between the degrading proteases (eg elastase - an enzyme that degrades elastic tissue) and the protective anti-proteases (eg Alpha-1 Antitrypsin, which inhibits the enzyme elastase). The prevalence of the degrading enzymes leads to the destruction of the alveoli: their previously elastic walls become more and slacker, and some of the bubbles cause a few dysfunctional sacs.

Of course, this has an effect on breathing: Normally, the inherent elasticity of the alveoli and respiratory muscles ensures for the lung to contract itself after being expanded during inhalation while exhaling. In patients with pulmonary emphysema, however, this passive expiratory mechanism does not function adequately. The alveoli and small bronchi (bronchioles)fall down during exhalation and hinder the Austamen. This leaves a little more air in the lungs after each breath than normal. This makes it even more difficult to breathe in: the less the exhausted air, which would actually have to be exhaled, can flow out of the lungs, the less space there remains in the lungs to breathe fresh air. Although the lungs are inflated with air, this additional amount of air is not breathable, so to speak. Therefore, the shortage of air.

emphysema Symptoms

The symptoms develop slowly and gradually over months or years and therefore often go unnoticed. In the beginning, those affected only suffer from shortness of breath during exercise. Also, bluish discolored lips and nail beds ( cyanosis ), triggered by increased amounts of carbon dioxide in the blood, may occur - but only if there is a simultaneous constriction of the bronchi (obstruction). In advanced stages, some patients will experience weight loss.

For the severity of the disease is crucial to what extent and in which areas the lung tissue is damaged or destroyed. Depending on the degree of destruction of the gas-exchanging lung surface, sooner or later there will be a shortage of air.

The main symptom of pulmonary emphysema is respiratory distress. It occurs initially and in lighter forms only with physical exertion, in the advanced course of the disease but also at rest. In the final stage, the least stress becomes torture and those affected are permanently dependent on an oxygen device.

There is also obstruction of breathing(Obstruction), decreases in the affected the oxygen content of the blood, while the carbon dioxide content increases. In addition to the feeling of shortness of breath, patients often have additional respiratory problems during sleep ( sleep apnea ). As a result, there is slight fatigue during the day, reduced performance and a poor general condition.

Patients with chronic bronchitis additionally suffer from a chronic cough with sputum and are assigned to the bronchitis type (see COPD ). In contrast to the pure emphysema type, which rarely complains of coughing and expectoration.

A typical external feature is the so-called Fassthorax - a short and wide, chest-shaped chest, which develops as a result of increasing lung hyperinflation and whose mobility is limited.

Impact & Forecast

Decisive for the further course of the disease in smokers is, at what age they started with the nicotine consumption, how many cigarettes they already smoked (number of so-called packyears) and what individual smoking habits they have. In patients who continue to smoke, the one-second capacity drops by 70-100 ml per year, whereas by nicotine abstinence it drops by 30-40 ml.

Life expectancy depends, among other things, on the results of lung function testing. With a reduction of the lung surface below 30% of the value of a healthy person (target value, measured by CO diffusion capacity), the life expectancy is significantly reduced. If there is also a severe obstruction, the prospects are even less favorable. Of the patients whose one-second capacity is below 750 milliliters, 30 percent die within one year and 95 percent within ten years. Other unfavorable factors are a high age and a greatly reduced oxygen content or a greatly increased carbon dioxide content of the blood and weight loss. On the other hand, the prognosis is more favorable if the narrowing of the airway with drugs can be reversed significantly.

The emphysema is a chronic disease that develops slowly and unnoticed for decades. Patients with severe pulmonary emphysema can no longer cope with their everyday life on their own due to the increasing shortness of breath. Some people are in need of care. The increasing stress breathing can lead to a serious impairment of the family, sexual and social life. Mental illness and quality of life limitations are common with disease progression.

Not infrequently occurs even in younger patients on a so-called spontaneous pneumothorax. Here are small, lying on the lung tip Emphysemblasen that spontaneously burst, the most common cause.

As a further late consequence in patients with additional obstruction fatigue of the respiratory muscles can occur, which is chronically overstressed due to the increasing obstruction of the respiratory flow. Then there is the need for home ventilation.

signs of pulmonary emphysema

If signs of pulmonary emphysema are present, the physician will first try to rule out a number of conditions that may also be responsible for the symptoms (shortness of breath), such as asthma, cardiac pulmonary congestion, bronchiectasis, lung cancer, tuberculosis, foreign body aspiration, and many others.

Following a patient's survey of risk factors, such as tobacco consumption or possible exposure to dust at the workplace, a thorough investigation follows. A typical symptom of pulmonary emphysema is a weakened breathing sound and a so-called nesting sound when listening (hypersonic knocking sound).

With a pulmonary function test (Spirometry ) can determine the extent of airway constriction and the severity of hyperinflation. Above all, the value of the so-called one - second capacity ( FEV1 = forced expiratory volume in one second) is of interest here. The more the bronchi are narrowed, the less air the person can exhale in one second. In order to measure the lung surface, further investigations must be carried out. This includes, in particular, the CO diffusion measurement, which is carried out by the lung specialist.

If there is a lack of air under physical exertion, a lung function measurement under load on the ergometer ( ergo-spirometry) or in the form of a 6-minute walk test with analysis of blood gases . The best way to distinguish asthma from chronic obstructive pulmonary disease is the so-called bronchospasmolytic test: this is done by spirometry followed by repetition of measurement after drug administration to see how the airway narrowing can be reversed by bronchodilators. In borderline cases, the pulmonary surgeon has other methods available to differentiate these diseases (eg bronchial provocation test ).

X-rays reveal signs typical of emphysema, such as "dark lungs" with possibly large emphysema blasts, a deep diaphragm that barely moves during respiratory motion, and horizontal (rather than oblique) ribs due to the chest-like deformation (hyperinflation), A particular help in diagnostics is, in particular, the computed tomogram.

The lung areas affected by the emphysema can also be identified with the aid of a lung scintigram. This method is needed (in conjunction with a computed tomogram, for example, to clarify whether surgery is necessary.) For right heart overload, deliver ECG, ultrasound from the heart (echocardiography) and right heart catheter important information. Laboratory tests play a role especially in cases of suspected alpha-1-antitrypsin deficiency.

 

 

Emphysema Therapy

The underlying changes in the lung tissue during emphysema are irreversible or no longer curable. However, treatment can delay the progression of the disease and allow the best possible use of the remaining reserves. First of all, the effect of pollutants ( smoking or work-related) must be eliminated (see Prevention ).

Drug therapy depends on the severity of the illness and is complemented by non-drug treatments such as patient education, physiotherapy, and physical training. In severe cases, surgery or lung transplantation may be considered. In addition to preventive measures is also important to treat concomitant diseases (eg, chronic obstructive bronchitis ) that can affect the development of emphysema. If the patient continues to smoke, medical measures are meaningless in the long term.

Medical therapy

To treat the often additionally existing airway constriction (obstruction) or pulmonary hyperinflation in pulmonary emphysema, the same active ingredients are used in principle as in asthma and COPD :

For example, anticholinergics and beta-2-sympathomimetics as dosing sprays, and Theophyllinpräperate in tablet form. These expand the airways and improve the self-cleaning function of their mucous membrane (mucociliary clearance).

Anticholinergics have a greater effect on patients with pulmonary hypovolemia than asthmatics and are considered the drugs of the first choice. Used in combination with beta-2-sympathomimetics, the effect is additionally enhanced. The beta-2-sympathomimetics formoterol and salmeterol, in addition to their bronchial anticonvulsant effect in addition, the frequency of deterioration bouts (exacerbations) lower. Theophylline preparations are appropriate if inhaled medication is insufficient. However, only about every second patient speaks to them. On the other hand, older patients, on the other hand, are very sensitive (with cardiac arrhythmia and nausea), so care should be taken when dosing.

Anti-inflammatory drugs
For example glucocorticosteroids. However, these are only effective in some of the patients (those who have a pronounced "asthma component") and can also be sprayed directly into the lungs in the form of aerosols, but in tablet form, they should only be used in severe cases because of side effects be applied at short as possible.

There are also combination preparations (such as the beta-2-sympathomimetic salmeterol combined with the glucocorticosteroid fluticasone so that the patient has to inhale only medicine and can strike it was two birds with one stone.

antibiotics
against a bacterial superinfection Macrolides, gyrase inhibitors, tetracyclines or cephalosporin tablets are used. At the latest when the sputum (the expectorated cough - expectoration ) is discolored for more than 10 to 14 days by pus yellowish or greenish, an antibiotic should be prescribed in any case. Cotrimoxazole is sometimes quite effective against Haemophilus influenza pathogens, which often complicate viral flu, although it is no longer officially recommended by medical societies.

Substitution Therapy
for  Alpha-1-Antitrypsin Deficiency  In a so-called substitution therapy, the missing protein is supplied by means of regular infusions. The effect of this therapy is, however, weaker than one hoped. Besides, it is very expensive.

Non-drug treatment

Patient
Education Patient education is performed in small groups on an outpatient basis, during a hospital stay or during the post-treatment phase. There, the patient is trained to correctly recognize signs of disease and deterioration and to adjust his medication accordingly. An important part of patient education is smoking cessation . After professional guidance, various cough techniques (bronchial toilets) and breathing-facilitating methods can be learned, such as storage drainage, knocking or vibration massage, dosed lip brake, breath-facilitating postures and breathing and relaxation techniques.

Long-term oxygen therapy
The administration of oxygen can eliminate or at least reduce oxygen deficiency. However, success only occurs if the lack of oxygen has been proven to occur during sleep, followed by treatment for at least 12 to 16 hours a day. As a result, secondary diseases such as cor pulmonale can be prevented or delayed. If the lack of oxygen only occurs under load, portable devices with liquid oxygen are particularly suitable. They barely limit the mobility of mobile patients and sometimes significantly improve their ability to exercise. In the 6-minute walk test, the distance traveled by the patient can double. In severe pulmonary emphysema associated with a narrowing (obstruction) of the respiratory tract ( COPD) may cause exhaustion of the respiratory muscles due to the constant overuse , which can be seen in the increased carbon dioxide content of the blood. In addition, a night self-ventilation by nose mask or face mask is required, so that the respiratory muscles can recover overnight.

Operational measures
In severe cases of pulmonary emphysema, there is the possibility of special operations. In volume reduction therapy, the destroyed lung tissue is specifically removed and hyperinflation reduced. This is necessary, for example, when large emphysema blisters squeeze adjacent, functional lung tissue (bullectomy). Unilateral, large emphysema blisters can also be removed by a so-called surgical resection, thereby sustainably improving lung function . However, the complication rates are relatively high and the improvement is usually only temporary.

A lung transplant is considered only as a last resort in the final stage. Patients must be younger than 60 years of age, have high motivation, and have no additional complications. A survival advantage of transplanted patients compared to non-transplanted patients could not be proven. However, transplanted people usually have a significantly better quality of life.

 

Acute deterioration (exacerbation)

Complications may include respiratory infections caused by viruses or bacteria, pneumonia, pneumothorax and worsening of an already existing cor pulmonale. Certain (bronchodilating) medicines, rarely even heavy air pollution can also be triggered. The consequence is a sudden worsening with increasing complaints (shortness of breath, cough, if necessary expectoration with strong, partially purulent mucus formation), which require a change of the treatment. In severe cases, hackle breathing, clouding of consciousness, accelerated or irregular heartbeat and lack of oxygen occur with bluish discoloration of the lips and nail beds ( cyanosis) on.

The treatment depends on the severity of the severity of the disease. For this purpose, the aforementioned drugs can be combined and used in increased doses. In bacterial superinfection with discolored sputum, the administration of antibiotics and cortisone important in tablet form. In severe cases, the administration of oxygen and non-invasive ventilation via a nasal or facial mask is required. In contrast, invasive ventilation by means of a tube should be avoided as far as possible, since this greatly increases the risk of additional deterioration (exacerbation). If necessary, the latter therapy must be performed in a clinic - unless the patient already has a respirator at home. In some cases, bronchoscopic bronchial toilets may be required to remove excessive mucus.

Even if it comes to bacterial superinfection, the health status of emphysema can change patients so badly deteriorated that it becomes life-threatening. Therefore, a specialist (pulmonologist) should be consulted. The effect of antibiotics is enhanced when short-term (for about 7 to 10 days) high dose anti-inflammatory glucocorticosteroid tablets are taken. These lead to a swelling of the mucous membrane so that the contagious and waste-containing mucus can be better transported away again.

If the sputum during antibiotic treatment after 3 to 4 days not decolorized again, the selected antibiotic has apparently no effect and should be replaced by a combination preparation (for example, a macrolide antibiotic combined with quinolone or amoxicillin combined with clavulanic acid). If a patient does not respond to the second antibiotic treatment, consider referring the patient to a clinic.

emphysema prevention

Avoid irritants

Patients should take their condition seriously in order to prevent complications and avoid exacerbation of deterioration. So they should not expose themselves to irritants that affect the lungs. First and foremost, this means abstaining from tobacco and avoiding secondhand smoke. In addition, work-related air pollution and workplace pollutants should be avoided.

Movement and respiratory therapy

When emphysema patients limit their physical activities due to their shortness of breath and low physical capacity, they do not do anything well, but rather set a vicious circle in motion: physical protection leads to an even worse physical condition (especially of the cardiovascular system) Muscles become weaker, bone density decreases and the risk of osteoporosis increases. A loss of mobility also means a loss of independence, of social contacts and life satisfaction.

Physical activity improves general health and bone growth. Sometimes the effects of physical training are so positive that less medication is needed. The level of physical stress should always be discussed with the attending physician. Exercise in the fresh air such as walks or cycling is recommended for almost all those affected. Especially with underweight muscle building training should be promoted by a high-calorie diet with fatty foods, even if the patient has an elevated cholesterol level (hypercholesterolemia). It may be necessary to provide oxygen during exercise.

Patients with chronic obstructive pulmonary diseases are to be systematically trained training hours under appropriate guidance in so-called lung sports groups to recommend. The pulmonary sport has nothing to do with competitive sports but is a great way to work together with other people affected by limited mobility, to enjoy sports and to profit in many ways. The goal of lung sports is:

  • To learn breathing and relaxation techniques

  • To reduce the fear of physical stress

  • To train endurance

  • Strengthen muscle and strength

  • Improve movement and skill

Also, physiotherapists (physiotherapists) who specialize in respiratory therapy, together with the patient can create a training plan, which then also includes respiratory therapy exercises. It is important to learn breath-relieving techniques, such as lip brakes, bronchial techniques, and certain breath-relieving postures. During walking and stair-climbing training, these techniques are also practiced under physical stress.

vaccinations

Patients with pulmonary emphysema are particularly susceptible to respiratory infections. Therefore, regular vaccinations are recommended. The pneumococcal vaccine must be refreshed every three to five years, and the flu vaccine once a year. Especially during the cold season, large crowds should be avoided as much as possible to avoid respiratory infections, which are mainly transmitted by coughing and sneezing.

A special value should lay affected on normal body weight. Obesity puts a strain on the body and can increase respiratory distress. By contrast, being underweight often increases susceptibility to infections and slows down the recovery process, because the body has nothing to add in an emergency.

asthma

Glossary, Lung HealthSuccess Chemistry Staff

What is asthma?

The term asthma comes from the Greek and means oppression. It is a chronic (that is, long-lasting) and seizure-like, inflammatory disease of the respiratory tract, which is associated with increased sensitivity of the bronchi to various stimuli (so-called bronchial hyperresponsiveness ). Typical asthma symptoms are wheezing breathing, coughing, tightness in the chest, shortness of breath and shortness of breath. They often occur at night and early in the morning.

One hallmark of asthma is that the symptoms recede, at least in part, either spontaneously or after taking certain medications. Also, asthma sufferers often change the disease level: After a symptom-free period, for example, it can lead to temporary periods with coughing and dyspnoea or even to an acute asthma attack.

One differentiates between allergic asthma, non-allergic (intrinsic) asthma and mixed asthma (see also different asthma forms).

Asthma frequency

In the 70s to 90s, asthma has become more prevalent worldwide, affecting up to 30% of the population, depending on the region. It is estimated that around 100 million asthma patients in the world. Asthma is most common among New Zealanders and Australians of European descent, most rarely Southeast Asian and Pacific natives. Interestingly, there was less hay fever and asthma right after the fall of East Germany than in West Germany. Since 1996, this difference has diminished, probably because the living conditions (especially the type of air pollutants and nutrition) in the former GDR and the Federal Republic have converged.

Why the onset of asthma increased in the 70s to 90s cannot yet be conclusively explained. Although genetic factors play a key role in the development of the disease, only changes in living conditions are the cause of this increasing trend. Paradoxically, this includes increasing hygiene which leads to a completely new strain on the immune system. After all, over millions of years, humans were used to eating perishable food contaminated with bacteria and fungi. Also, its environment (for example the living environment) was previously contaminated with more germs than today. On the other hand, however, many more viral infections occur today, as contacts with foreign virus strains have exploded as a result of the increasing frequency of travel over the past 100 years. Although today's improved hygienic conditions have contained the infectious diseases (for example, tuberculosis, plague, cholera, etc.), the immune system, However, this is virtually under-challenged, so that it can lead to an overvaluation of other foreign substances. Apparently, therefore, in recent decades, the tendency is that allergy-causing substances ( allergens ) play an increasingly important role in the home and work environment.

In Germany, about 10 to 15% of children and about 5-7% of adults suffer from asthma - that's about 8 million people. Especially children are affected - bronchial asthma is the most common chronic childhood disease (see also asthma in children). About every 8th child under the age of 10 and every 10th child under the age of 15 suffers from asthma in Germany. Boys are twice as likely as girls. With increasing age of the children, however, this gender difference fades again.

In adulthood, the proportion of women who suffer from asthma prevails. About 6% of adults in Germany are affected. While in childhood asthma is predominantly allergic, adults (especially in the second half of life) are more likely to experience a non-allergic (intrinsic) form of the disease in 30-50% of adult asthmatics. Thus, a purely allergic cause can be detected from the age of 20 only in less than a fifth of cases.

Luckily, mortality is quite low: In Central Europe, 1-8 people out of every 100,000 people die of asthma each year. Despite advances in the treatment of asthma, these figures have not changed for 30 years. Although asthma deaths in Germany have fallen since the 1980s, the mortality rate in Germany is still relatively high by international comparison (4-8 people per 100,000 inhabitants and year - see also Impact & Forecast ). In addition to the increasing prevalence of asthma between the 1970s and 1990s, one of the possible reasons for this is that patients often underestimate the severity of their condition and are not reliable in following their doctor's treatment instructions.

In recent years (as of 2015), according to the 2014 White Paper on Lung, both the frequency and severity of asthma have increased. There are many theories that could explain this. Pollen may have become more aggressive due to environmental factors, which can make allergic asthma worse. According to data from the Robert Koch Institute, the lifetime prevalence among adults between 2003 and 2009 increased from 6.0 to 10.1 percent for women and from 5.2 to 8.3 percent for men.

Different types of asthma

The exact reason why people develop asthma is not yet understood in every detail. However, it is known that both genes and environmental factors play a role. Thus, those people are more prone to asthma, which come from an allergic family and even react to certain substances allergic. Others develop asthma because of their job because they are exposed to certain substances there.

Depending on the trigger, a distinction is made between the following forms of asthma, which may be allergic or non-allergic, but also occur in combination with one another and are then referred to as mixed-form:

  • Allergic (extrinsic) asthma

  • Non-allergic (intrinsic) asthma

  • Mixed asthma

  • Occupational asthma

  • Triggering of asthma by infections

  • Triggering of asthma by drugs.

  • Exertional asthma (stress asthma)

  • Asthma with gastroesophageal reflux

  • Brittle Asthma

  • Variant Asthma

  • Asthma forms with the transition to COPD

Allergic (extrinsic) asthma

This asthma form is triggered by allergens and leads to the so-called allergic early reaction with an increased formation of immunoglobulin E (and thus increased Ig E levels in the blood serum). This early reaction is often followed by the so-called late allergic reaction, which causes asthmatic symptoms. Allergic asthma often occurs in some families, is genetic and often begins in childhood or adolescence. The allergic type of asthma also includes seasonal asthma, which occurs as a result of an allergy to certain pollen and depends on the respective pollen count. This often affects hay fever patients, their pollen allergy has made a level change from the upper to the lower respiratory tract so that they also have asthmatic complaints in addition to hay fever. Outside the pollen season, however, there are no complaints and the lung function is back to normal.

Non-allergic (intrinsic) asthma

In non-allergic asthma defense reactions also occur in the body, but these are not evidenced by an allergen (but by another trigger ), because it is less likely to increase immunoglobulin E. That is, the allergic early reaction does not take place, but only the asthmatic late reaction. See also video clips (right) about granulocytes and mast cells.

This late reaction also puts the inflammatory cells in a long-lasting readiness to defend themselves and thus leads to the asthmatic symptoms. Typically, in non-allergic asthma, the paranasal sinuses are almost always chronically inflamed. Later, it comes to polyp-like mucosal proliferation (nasal polyposis), which can significantly hinder breathing through the nose.

In about 30 to 50% of adults with asthma, allergy (with the formation of Ig E antibodies to environmental allergens) is undetectable. Non-allergic asthma often does not begin until late in the fourth decade of life, typically following a respiratory viral infection. That is, this form of asthma is often triggered or aggravated (triggered) by respiratory infections. Variations in the severity of the disease are less pronounced than in allergic asthma. However, intrinsic asthma often shows a severe form right from the start.

Mixed asthma

In asthma, hybrids are often present between the allergic and non-allergic forms of the disease. Mostly, mixed-type asthma develops from originally allergic asthma. Over time, non-allergic (intrinsic) causes to gain the upper hand - often due to repeated infections. On the other hand, both types of asthma exhibit asthmatic reactions to nonspecific triggers, such as cold air, mist, smoke, cooking fumes, perfume, etc., but these irritants do not cause asthma, they just bump it.

Occupational asthma

Certain occupations that come into daily contact with potential allergens are associated with an increased risk of asthma. These include, for example, bakers (Mehlstaub Allergie), hairdresser (nickel and care allergy), carpenters (wood dust allergy) and printing workers (dyes and solvents). People with known allergies should consider their career choices accordingly.

Occupational asthma is not always the result of an allergy. Certain chemical substances can irritate the bronchial system to such an extent that asthma develops without any allergic reaction. For example, the inhalation of chlorine gas (for example, in accidents) or so-called isocyanates (which are used, inter alia, for the production of plastics, paints, and adhesives or as a hardener) can lead to inflammatory reactions.

First signs of illness in the workplace often occur only after years of contact with the trigger. Typical of occupational asthma is the increase in workplace discomfort, as they recover on weekends and on vacation.

Triggering of asthma by infections

Viral infections often lead to inflammation of the respiratory tract and then often trigger an asthma attack. This applies to all types of asthma.

Triggering of asthma by drugs

About 10-20% of asthmatics - especially those with non-allergic form - are hypersensitive to certain medications. This is especially common in middle-aged women. Triggers are mainly analgesics (with the active ingredient acetylsalicylic acid) and anti-inflammatories (so-called non-steroidal anti-inflammatory drugs), but also chemically related anti-rheumatic drugs (so-called non-steroidal anti-inflammatory drugs) can trigger an asthma attack.

This is not based on any causative allergy, but a (probably hereditary) drug intolerance. It is, therefore, a non-allergic (intrinsic) asthma form. Drug asthma often occurs in combination with other, mostly allergic, forms of asthma. This form of asthma often manifests with sneezing and watery nasal flow.

Another group of drugs, beta-blockers, are problematic for asthmatics because they often increase asthma. Some, especially sensitive patients even get a severe asthma attack after taking the tablet. But even if patients seem to tolerate these medications (usually used to treat high blood pressure or heart failure), the severity of asthma attacks, such as those caused by an infection, is exacerbated.

Exertional asthma (stress asthma)

Especially at the beginning of and after physical exertion, most children affected by asthma and about every third asthmatic adult suffer from asthmatic complaints. In many children, asthma attacks occur predominantly only during exercise, while (as long as they do not get an infection) have no signs of the disease. The asthmatic inflammation is caused by cooling and dehydration of the bronchial mucous membranes (especially in cold air) due to the increased respiration during exercise.

Asthma with gastroesophageal reflux

Here it comes to the strengthening of asthma because gastric juice passes into the esophagus. It comes to reflex-like cramping of the bronchi. This type of asthma may be compounded by certain asthma medications (such as theophylline and other adrenalin-like drugs known as beta-2 sympathomimetics) because they may paralyze the movement of the esophagus.

Brittle Asthma

This is a very rare form of recurrent, severe and life-threatening asthma attacks with no previous signs of worsening disease status. This asthma variant is apparently based on completely different inflammatory mechanisms than the other forms of asthma.

Variant Asthma

This is a mild form of asthma, which mainly involves an irritating cough but no shortness of breath as a condition. It usually precedes later asthma.

Asthma forms with the transition to COPD

Not infrequently (about 20-30% of asthma-related illnesses) there are also forms that later develop transitions to chronic obstructive pulmonary disease (COPD). These transitional forms are characterized by the patients having coughing and expectoration not only during the asthma attack or infection.

What happens in the bronchi of an asthmatic?

In asthmatics, there is a constant inflammatory and defensive readiness in the lower respiratory tract (bronchi and bronchioles), which is reinforced by certain influences ( triggers ). Due to the frequent inflammation, the bronchi of an asthmatic are hypersensitive and react to actually harmless stimuli with a violent defense reaction: they contract convulsively, the mucous membranes in the bronchial walls swell and often form excessively tough mucus. This leads to wheezing and buzzing breathing sounds, dry cough with tough glassy mucus, which is difficult to cough up, tightness in the chest and shortness of breath.

As a result, the diameter of the bronchi becomes narrower and the respiratory air can no longer flow freely in and out (obstruction). This overloads the respiratory muscles, which is the main cause of respiratory distress. In addition, exhaling is difficult in asthmatics. Thus, after each breath, a little more air remains in the lungs than normal, until a new equilibrium is reached. As a result, the lungs inflate a little more with each breath (acute pulmonary emphysema ). This is also the further inhalation more difficult: the less the exhausted air, which would actually have to be exhaled, can flow out of the lungs, the less space there remains in the lungs to breathe fresh air. Although the lungs are inflated with air, this additional amount of air is not breathable, so to speak. This increases the shortness of breath.

You can feel well about what an asthmatic must feel during an asthma attack when trying to breathe through a straw for a few minutes. While it is still reasonably possible to inhale through the straw, it is almost impossible to breathe quickly enough through a straw. After a short while, you will stop as a result of shortness of breath.

Total prolonged exhalation occurs because of the narrowing of the lower respiratory tract To more friction and thus to an increase in the flow noise: whistling (the doctor calls the gills) and hum are clearly heard.

The constant inflammatory and defense readiness of the respiratory system do not cause asthmatic complaints. At times, they are little or not affected. The only contact with a trigger causes and amplifies the asthmatic symptoms and can also cause an asthma attack. When asthma so two things come together: A constant inflammatory readiness and an external influence (trigger), which amplifies the existing inflammation (triggers) and thus causes the asthmatic symptoms.

Asthma triggers

One distinguishes the following asthma trigger:

  • Trigger for Allergic Asthma

  • Trigger for non-allergic asthma

  • Trigger for all types of asthma

Trigger for Allergic Asthma

Allergic (or extrinsic) asthma is caused by actually harmless substances that an asthmatic person is allergic to ( allergens ), for example:

  • Pet allergens (animal hair, bird feathers)

  • Environmental allergens (tree and grass pollen)

  • Domestic allergens (feces of house dust mites and spores of molds)

  • Certain foods

  • Certain medications

  • Chemicals (allergic and non-allergic)

  • Occupational Allergens (see also Occupational Asthma )

Trigger for non-allergic asthma

  • virus infections

  • Bacterial infections

  • Certain, mostly occupational substances

Trigger for all types of asthma

All asthmatics respond to nonspecific stimuli in the sense of an increase in asthma or obstruction. Such stimuli include:

  • Infections of the upper and lower respiratory tract

  • Physical exertion (exertional asthma)

  • Mental stress and stress as a result of the resulting increased respiration (hyperventilation). Mental conflicts that cause asthma, there are, in contrast to previous information not!

  • Cold (fog, cold air)

  • Air pollutants in the environment (exhaust gases such as nitrogen and sulfur dioxide, ozone, dust - also caused by stirring up at home)

  • Tobacco smoke (active and passive smoking )

  • Certain medications (aspirin, non-steroidal anti-inflammatory drugs, beta-blockers)

Asthma risk factors

Certain circumstances and conditions are particularly common in asthmatics and are therefore considered as risk factors, which are usually requested by the doctor. Most of the following risk factors are related to allergic asthma, only some (eg smoking ) apply to all asthmatics:

  • Family Disease: Family members also have asthma and/or allergies (such as hay fever or atopic dermatitis )

  • Underweight at birth: Children born underweight are a little more likely to develop asthma than children who are of normal weight at birth.

  • Illnesses as a child: As a child, the person affected suffered from allergies, atopic dermatitis, cradle cap or eczema (recurring itchy skin)

  • Smoking parents: Children of smoking parents (especially mothers) suffer much more frequently already as infants under whistling breathing (wheezing) and other breathing problems. They develop asthma more often than children from non-smoking parents.

  • Excessive hygiene that promotes the occurrence of allergies

  • Common infections by (unknown or novel) viruses

  • Early Weaning

Allergic diseases such as hay fever, atopic dermatitis, and allergic asthma are considered atopic and are associated with the excessive formation of immunoglobulin (Ig E antibodies) against in itself harmless environmental allergens. The propensity to allergies is genetic and one of the strongest risk factors for asthma, especially in children. However, the exact interplay between inherited genetic allergy addiction and other factors (for example, frequent infections or stressors, nutrition), which can be added in the first years of life and can lead to inflammation of the respiratory tract and eventually to asthma, is only partially understood.

Asthma first symptoms

First signs

Breathlessness, pain behind a sternum and irritable cough are often at the onset of an asthma attack. Other first signs include difficulty in breathing and/or at rest, exhalation sounds, respiratory rate increases to 20 breaths per minute, and heart rate to more than 100 beats per minute.

Typical signs of asthma include:

  • Shortness of breath occurs in fits and starts, often at night and in the early morning

  • Especially the exhalation is difficult and takes longer than normal

  • shortness of breath

  • Whistling or humming breath sounds (wheezing)

  • Tightness in the chest

  • Seizure dry cough

  • In mild cases often occurs only a dry, irritant cough (see variant asthma)

  • An irritable cough with glassy-viscous mucus, which can hardly be coughed off, can - but need not always - be present. After acute worsening, a so-called productive cough with a lot of mucus may develop, especially in chronic asthma sufferers

  • The complaints are caused and amplified by certain triggers

  • The most symptom-free time between two seizures called the doctor as an interval. However, in a more advanced stage of the disease, dyspnoea and coughing are more likely to occur between attacks

  • Disease symptoms are mostly only available in the meantime and vary in their severity and in their severity

  • Accordingly, in asthmatics, the measurements of their lung function often vary. This so-called peak-flow variability is also a typical feature of asthma

  • Characteristic of asthma is the (at least partial) reversibility of respiratory distress symptoms by certain asthma medications. This distinguishes asthma from other (obstructive, ie, narrowing the respiratory tract ) lung diseases, which also include respiratory distress, such as emphysema of the lungs and chronic obstructive bronchitis

  • In allergic asthma, asthmatic symptoms typically occur within minutes of exposure to the substance causing an allergic reaction ( allergen ). After 6-10 hours, the second episode of discomfort occurs in half of the cases.

  • In children, respiratory arrhythmias occur in the chest (see also " Children with asthma ")

Various forms of the disease

Depending on the symptoms that occur, one differentiates:

  • Asthma attack: During the attack, the symptoms increase within a few hours. In doing so, they can rapidly or gradually lead to severe impairment of the patient (acute deterioration) and death without treatment.

  • Status asthmaticus: This is an asthma attack that continues despite the use of all available drugs ( cortisone, beta-2-sympathomimetics and / theophylline ) and lasts more than 24 hours.

  • Permanent asthma: sufferers suffer from chronic (ie lasting for weeks to years) symptoms of varying severity and severity.

  • Most severe seizures: They cause unconsciousness within minutes, but luckily they are very rare (see Brittle Asthma).

Signs of a severe asthma attack and "status asthmaticus"

  • shortness of breath

  • fast but superficial breathing (more than 25x breaths per minute)

  • additional use of the auxiliary respiratory muscles (which are parts of the thoracic, spinal and shoulder girdle musculature which the patient includes in addition to the normal respiratory muscles because of the increased respiratory effort)

  • Inability to speak longer sentences

  • heavily cramped bronchial tubes with missing or very attenuated breathing noise ("silent lung")

  • Pulsus paradoxus

  • Consciousness disorders, restlessness

  • Lack of oxygen (bluish discolored nail beds and lips)

Four disease stages

In order to assess the severity of asthma objectively, the doctors distinguish four disease stages - depending on how often and what symptoms occur in the patient. Recently, the current guidelines five different types of asthma therapy.

Asthma impact

Early detection of the disease in asthma is particularly important. However, the first signs are often misinterpreted by those affected and relatives. For example, exertional asthma in children often occurs only in physical education and is then simply excused as a poor condition. On average, five years pass before the disease is treated.

Although you can not cure asthma, the treatment options today are very good. The quality of life of a patient must therefore by no means be limited. When asthma is under control and treated well, it has full physical capacity. About 10% of Olympic athletes in athletics have asthma. At the same time, the patient can do his / her own bit for a favorable course of the disease by dealing with his illness correctly and reliably (see Prevention and asthma patient training ).

Asthma is a chronic, ie long-lasting or lifelong disease. An exception to this is the disease in some children: With early detection of the disease and good, reliable treatment, one in three children with asthma has the chance to be cured at the latest in adulthood. However, the body's excessive preparedness remains alive for life.

In general, the prognosis of childhood asthma is very good. Most children have only mild discomfort. In 30 to 50% of cases, asthma disappears during puberty but can reappear in adulthood. The more severe asthma in childhood, the more likely it is that those affected will suffer as adults as well. But also from mild childhood asthma may develop in later life in 5-10% of cases. The lung function of an adult who had asthma as a child is often moderately limited.

Even adults can extend the seizure-free periods by good treatment and relieve their symptoms. A "good treatment" presupposes that the asthmatic concerned becomes an expert in his own illness and develops and consistently pursues a treatment strategy that is personally tailored to his doctor.

Only with untreated asthma, especially if no medication is taken against the inflammation of the airways, it is to be feared with increasing duration of the disease that the respiratory tract of the patient take permanent damage and then permanent complaints occur. Basically, deterioration bouts and asthma attacks can be severe and even death without proper treatment, no matter how fast they develop.

Of the approximately 30 million asthmatics in Europe, about 70% are able to live well with their treatment thanks to appropriate medication and treatment. However, 1.5 million Europeans suffer from severe asthma with at least one menacing attack per week. Especially in Western Europe, there are still some patients who die as a result of an asthma attack. At the top is Portugal, with more than 8 deaths per 100,000 population per year as a result of asthma. But in Germany too (with 4-8 out of 100,000 people per year) more patients die of asthma than in other European countries (such as France: 2-4, Spain: <2). Around 90% of these deaths could be avoided through improved education and better treatment.

With appropriate treatment, the outlook for a favorable disease outcome is good in the long run. The life expectancy of a well-treated asthmatic corresponds to that of a healthy person. Permanent damage to the lung tissue as a result of the development of chronic obstructive bronchitis (with or without emphysema ) is rare.

Asthma therapy

Although asthma has not healed yet, it is treatable in most cases. A variety of therapeutic aids are available for the treatment of asthma. Their goal is for asthma patients to participate as normally as possible in their daily lives.

In principle, a good treatment consists of four pillars:

  • Asthma medications (see below) to alleviate the symptoms and manage asthma attacks, whereby the patient must learn to use his remedy reliably and properly so that it can take full effect.

  • Avoiding asthma triggers (allergen avoidance and triggeravoidance).

  • A good asthma patient training and the implementation of the learned in daily life.

  • Control of the course of the disease by the doctor (depending on the severity, for example, every three months to check the symptoms, lung function, follow the treatment plan and then, if necessary, course-oriented adjustment of treatment).

Treatment should seek optimal or best possible control of asthma by reducing inflammation in the airways and have the following goals:

  • Freedom from symptoms or as long as possible seizure-free phases

  • undisturbed night sleep (without coughing or shortness of breath)

  • as rare as possible deterioration bumps

  • preferably no emergency treatments

  • Lowest possible consumption of medicines (especially if possible no additional use of demand medicines such as the rapidly acting beta-2-sympathomimetics)

  • normal lung function or best possible peak flow values, with readings of less than 20% (or as little as possible) varying over the day

  • as unlimited as possible and participate in the activities of daily life

  • also, allow physical activity or other physical stress

  • as few side effects from medication as possible

  • To ensure normal growth and normal (mental, physical and mental) development in children

As part of drug therapy, these topics are discussed in more detail below:

  • Medications for inhalation

  • Medication

  • Required medicines (Reliever)

  • Side effects of relievers

  • Long-term medication (controller)

  • Side effects of controllers

  • Other asthma medications

  • Staging scheme in the treatment of asthma

  • Acute asthma attack

Alternative Asthma therapy

The treatment of asthma is not limited to medication. Equally important are the additional measures:

  • Asthma patient education

  • Respiratory and physiotherapy, breathing gymnastics

  • Normalization of body weight

  • Regular sports

  • relaxation techniques

  • Avoid triggers

  • Abstinence from nicotine, avoidance of secondhand smoke, possibly smoking cessation

  • if necessary, rehabilitation

Prevention Tips
A prerequisite for the effective treatment of asthma and a favorable course of the disease is that you take part in the precautionary measures as an affected patient and actively do something for yourself. They should:

  • Being well informed about causes, triggers, examination and treatment options

  • Learn how to handle your illness

  • master the handling of your inhaler

  • can assess the respiratory reaction well

  • Identify problems or difficulties and discuss with your family doctor.

About half of all asthmatic illnesses could be avoided if affected patients consistently implemented existing knowledge about the risk factors of asthma. This may include, for example, separating from a pet, treating a hay fever early with specific immunotherapy ( hyposensitization ) or giving up smoking. Prevention is about avoiding acute asthma attacks and limiting long-term damage to bronchial asthma. This includes:

  • Avoid asthma triggers

  • do not smoke

  • Learn breathing techniques and do breathing exercises

  • Learn relaxation techniques

  • Play sports, to asthma sports groups, participate

  • Attend patient education, inform yourself

  • Exchange in self-help groups

For seizure prevention, a good medical treatment is a basic requirement. This includes ensuring that you are taking your asthma medication reliably and regularly, as well as regularly monitoring the success of the treatment and adjusting the therapy if necessary. Patients with problems should, for example, measure their respiratory function at home several times a day using the peak flow meter in order to independently control and control illness progression and therapy (see also patient training ). Here you can print a Peak-Flow-Protocol or Asthma-Diary (as pdf).

The most important measure is to avoid known and further possible triggers. Every patient should become an expert in his illness. This also includes finding out which triggers are problematic for him. For example, many asthmatics develop animal hair allergy when they live in close contact with animals. Therefore, pets (even avian) are conceivably unfavorable. If the triggers ( allergens ) cannot be avoided, specific immunotherapy (hyposensitization) may also be necessary.

Avoid triggers and triggers
Once you find out what is causing or exacerbating your asthma symptoms, you should avoid these triggers and triggers as much as possible. However, this is not always easy in everyday life: Environmental influences such as temperature fluctuations or ozone smog, pollen or house dust cannot simply be avoided. Nevertheless, you can do something yourself to make your life with allergic asthma as free of complaints as possible by following the tips below. However, before you renovate your apartment sometimes expensive, should definitely be one of the following mentioned Asthmaursachen. A skin or blood test is usually not enough. It is better to prove the suspicion of the allergen in question by means of provocation tests.

Dust mite
dust There are house dust mites in every home. They are probably the most common cause of allergic asthma his. The causative allergen is not the mite itself, but their excretions. Remove unnecessary "mite scavengers" from your bedroom such as woolen carpets, curtains, extra pillows and blankets, but plastic carpets are much less problematic than previously thought, with a smooth floor (tiles, cork, laminate, parquet, etc.) that is at least 3 Use a vacuum cleaner with a fine filter to keep the room cool and dry The effectiveness of mite sprays is controversial, but mite-proof mattress covers are safer and wash the sheets regularly at a minimum of 60 degrees Celsius. The top bed and pillows should also be made of washable material and should be completely washed 4 times a year at 60 ° C in the machine. If possible, these "bad neighbors" should be washed once a month at 60 ° C, or once a month for 12 hours in the freezer (kill the mites) and then be washed (removes the allergen).

Dandruff from hairy pets (cats, dogs, horses, etc.)
It is certainly hard to part with a beloved pet because of an allergy. But especially in children, there is a chance that allergic asthma subsides, as soon as the allergen no longer acts. In addition, allergies do not necessarily last a lifetime. Thus, the allergic reaction to a particular animal can decrease again and disappear completely. In the case of at-risk children (one parent is allergic), keeping cats and rodents should be avoided, although dogs are often less problematic. In the case of high-risk children (both parents are allergy sufferers), it is essential to refrain from any pet ownership.

Mold Spores
Moist walls must be rehabilitated. Shower rooms and bathrooms should always be wiped with a dry, clean towel after use and well ventilated. Compostable waste should only be stored for a short time in a closed container in the kitchen. Do without plants in the bedroom.

Foods
Certain foods (eg cow's milk, chicken eggs, soy nuts, etc.), additives (eg for preservation) or food components (eg gluten) can cause respiratory problems or asthma attacks in allergies. When avoiding certain staple foods that one is allergic react, a change of diet to a comparable nutritious substitute food is necessary (eg on dairy products of goat and sheep in case of intolerance of cow's milk). Here you should be informed by your doctor and, if necessary, by a nutritionist specializing in allergies (addresses can be obtained from the DAAB, email: info@daab.de). A versatile, balanced and vitamin-rich diet is not only important for children. Generally not recommended for asthmatics are non-targeted diets and expensive supplements.

Drugs
A worsening of symptoms sometimes occurs in conjunction with the following drugs:

  • antibiotics

  • Painkillers such as aspirin, novalgin, diclofenac or ibuprofen

  • Naturopathic remedies such as Royal Jelly or Echinacea

  • Beta-blockers (used against hypertension and heart failure, but are also included in some eye drops!)

When using medication, it should be noted that antipyretic drugs with the active ingredient acetylsalicylic acid can cause asthma. Especially in older children, an intolerance of the drug is known. Therefore, they should better use paracetamol-containing preparations. Sometimes the following drugs of the same class can cause trouble: ibuprofen, diclofenac, indomethacin. Asthma sufferers should also not take antihypertensive agents (beta-blockers). Because beta-blockers are antagonists of bronchodilator asthma drugs (beta-2-sympathomimetics): they constrict the bronchi and should therefore not be taken by asthmatics.

Tobacco smoke
, the smoke must necessarily be abandoned. If necessary, you can also take advantage of professional support (smoking cessation programs). Smoking aggravates the asthma symptoms, as it additionally irritates and damages the inflamed mucosa of the bronchi. This can increase both the frequency with which asthma occurs and the severity of the disease.

This also applies to passive smoking, because even passive smoking increases allergy readiness! Asthmatics should avoid rooms where smoking takes place . Especially in the presence of asthmatic children, smoking is prohibited (especially not in the home, in the car and generally indoors).

Contaminants
At home or in the workplace, vapors (eg paint vapors or fumes from household cleaners and sprays) and odorous substances (eg in cosmetics) can occur, which can be dangerous for asthmatics and may need to be avoided.

Air pollution
Air pollutants and fine dust irritate the respiratory tract and can also damage it. The suspicion that they are effective as triggers of asthma has not yet been confirmed. However, it appears that children living near a busy street have a slightly increased risk of asthma.

Ozone
Asthma attacks and discomfort accumulate during summer ozone moguls. Therefore, it is particularly important for those asthmatics who are sensitive to ozone, the current evidence of ozone pollution (in radio, newspaper or Internet - for example, on the website of the Federal Environment Agency) to take seriously and in such phrases as possible not outdoors. This may be difficult to understand, especially for children, but should be consistently maintained for their benefit.

Pollen
Track regional pollen forecasts via telephone services and radio or in the Internet. This will allow you to adapt to the main flight times of the pollen you are allergic to, with practical measures or medications. In addition, ventilate in the city only in the early morning or at night, in the country preferably in the evening - at this time, less pollen in the apartment. Meanwhile, there are also pollen filters for the windows, which catch at least 85% of the pollen. And remember to also install a pollen filter in your car!

Insect Bites
Asthmatics who are hypersensitive to insect bites (eg wasps or bees) should always have an emergency medication and specific immunotherapy ( hyposensitization ) - because, with this allergy formula, the success rate is over 95%!

Climate
Since dry indoor air is a stimulatory factor for the bronchi, one should pay attention to a sufficient humidity in the room. The climatic irritability also differs individually and should be taken into account when choosing the resort. In general, there are fewer allergens in the air in high mountains and at sea. In the case of pollen allergy, it may be helpful to select the place of vacation after the expected pollen count (the sea and high mountains are particularly low in pollen).

Weather
Fast and pronounced temperature changes, especially the change from heat to cold (eg from heated rooms into the cold outside air in winter) or fog (cold and humidity) can cause breathing difficulties or asthma attacks in some people.

Pathogens of respiratory diseases
Bacteria and viruses that cause inflammation of the bronchi or lungs, but also a common cold, aggravate the symptoms of many asthmatics. Vaccination against pneumococcal and flu is therefore useful and appropriate in many asthmatics. However, if a bacterial inflammation of the sinuses or bronchitis caused by bacteria, rapid and consistent antibiotics should be taken.

Physical
Exertion Although physical exertion can trigger asthma, it is important for asthma patients to exercise. Four out of five asthmatics experience symptoms such as shortness of breath or coughing during or after exercise. In order to still be able to do sports, it is important to inhale bronchodilator drugs before exercise and to listen to warning signals from the body and to react if necessary. With a corresponding medical accompaniment, this is possible without danger. In some cities, there are also sports groups that are specially designed for asthma patients (pulmonary sports groups). Suitable are endurance sports such as walking, cycling, running and especially swimming. Since cold and dry air can cause seizures, swimming may be preferable.

Mental stress
Factors that play a major role in asthma are undoubtedly psychological factors: they influence how a patient copes with his illness and thus also determine the extent of the disease. Time pressure and stress, excitement and anxiety can lead to coughing and shortness of breath. Since anger and tension cannot always be avoided, learning special relaxation techniques such as Jakobson progressive muscle relaxation, autogenic training and yoga are helpful.

how to remove mucus from lungs naturally

Lung HealthSuccess Chemistry Staff
shutterstock_270670244.jpg

Free the airways

If mucus membranes make breathing difficult, loosening and coughing up the mucus to clear mucus from lungs is a very important role to take. As a rule, a regular anti-inflammatory therapy with inhaled steroids is sufficient for you. In addition, however, there are a number of other measures that can help you rid your airway.

Clear mucus from lungs

Clear mucus from lungs

Clear mucus from lungs with deep breathing

Exercises like “autogenic drainage” and special cough techniques can be very effective. Autogenic training is a technique developed by the German psychiatrist Johannes Schultz by which a psycho-physiological relaxation outcome is obtained With the “autogenous drainage” you can remove the mucus gently and without help from the lungs. Breathe in calmly and deeply and as far as possible through the nose. You can sit there, but also lie on your back or side. Give the air two to three seconds to disperse in the lungs and then let it out against the so-called lip brake. The upper lip should be slightly advanced and the lower lip slightly withdrawn so that the air can escape downwards. Then exhale actively. Through the deep breaths, your bronchi expand and contract more. This dissolves the mucus better. The lip brake causes that the bronchi remain open longer, so the mucus can be better “transported away”. To perform this exercise well, you should definitely seek professional help.

Throat clearing instead of coughing

Throat clearing instead of coughing

Throat clearing instead of coughing

When coughing a very high pressure in the chest and in the lungs. For unstable bronchi it is dangerous because it can push it shut. Then the mucus is carried out only incompletely. In this case one speaks of “productive-ineffective” coughing. On the other hand, it helps to exhale first against the lip brake and then to transport the mucus not with a coughing but with a throat clearing from the airways. This will avoid excessive pressure. However, too frequent a throat clearing pollutes the vocal cords. Therefore, you should not use this technique too often when clear mucus from lungs.

After many years of coughing, the cough muscles are very exhausted. Then she should be supported by the arms. Sit upright, cross your forearms and put them in front of your stomach like a corset. Then take a deep breath and support the following coughing burst by pressing your arms down on your stomach.

In addition, long-term coughing sometimes leads to urinary incontinence. On the other hand, there is a simple technique: the so-called rotational position. Sit upright and take a deep breath. Turn your upper body aside during the following coughing fit.

Respiratory therapy equipment

A similar effect as the exhale against the lip brake achieve respiratory therapy devices that help with clear mucus from lungs. They also serve to keep the airways and the mucus solution. There are also devices that create vibrations to loosen the mucus. Whether you should use a device and, if so, which one, you should discuss with your doctor or therapist. We at Success Chemistry are focusing on creating the best lung supplement on the market that can clear mucus from lungs and detox your lungs from smog or smoke. If you want to give it a try we have added a coupon at the end of this article.

Medicinal aids

In cases of increased formation of viscous bronchial mucus, the treatment can be supplemented in the short term by expectorant drugs such as acetylcysteine or ambroxol. Naturopathic thymic or primrose-based slime removers or essential oils can also help. Likewise, regular inhalations with saline may be helpful. In general, cough suppressant medicines are not recommended because they can cause the mucus to solidify.

Thank you for visiting If you have not shopped with us before be sure to use coupon code FIRST10 for a 10% discount on your order. If you give our lung cleanse and detox supplement NEW LUNG a try we want to warmly extend our gratitude to you.

 — SuccessChemistry.com

lung cleanse and lung detox

lung cleanse and lung detox