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Why do Alphas with lung disease take asthma medicines?

Many people with emphysema, especially Alphas, have asthma (also known as reversible obstructive airways disease [ROAD], hyperreactive airways disease, or bronchospasm). One study indicates that over 70% of Alphas with lung disease have asthma. Asthma is defined as the component of the obstruction to the outflow (exhalation) of air from the lungs that can be reversed with medication. The obstruction caused by emphysema itself (thought to be due to loss of the connective tissue that holds the airways open during exhalation) is, in general, fixed and permanent. The component of the obstruction that can be reversed by bronchodilators, steroids, theophylline, etc., is by definition, asthma. This component is generally thought to be due to spasm of the muscles of the bronchial tubes (bronchospasm), inflammation of the airways with swelling, and increased mucus production blocking the airways.

If you have lung disease from Alpha-1, you can think of the emphysema component causing the slow steady decline in lung function that can’t be reversed (with current technology) and the asthma component as the part that gives you the daily, weekly, or monthly ups and downs in your breathing. Augmentation therapy, assuming it works, is designed to slow down the emphysema-related decline. The inhalers and pills (and emergency room IVs) that people take are designed to reverse the asthmatic side. Long-acting bronchodilators may also reduce the number and severity of exacerbations.

Big Fat Reference Guide – AlphaNet