WEBVTT 00:00:07.595 --> 00:00:10.575 It starts with a cough, 00:00:10.575 --> 00:00:12.051 or a wheeze. 00:00:12.051 --> 00:00:14.374 Soon, your chest feels tight. 00:00:14.374 --> 00:00:17.216 Your breathing speeds up and gets shallower, 00:00:17.216 --> 00:00:19.594 making you feel short of breath. 00:00:19.594 --> 00:00:23.385 These are common symptoms of an asthma attack. 00:00:23.385 --> 00:00:27.746 Around the world, more than 300 million people suffer from asthma, 00:00:27.746 --> 00:00:32.423 and around 250,000 people die from it each year. 00:00:32.423 --> 00:00:37.627 But why do people get asthma and how can this disease be deadly? 00:00:37.627 --> 00:00:39.904 Asthma affects the respiratory system, 00:00:39.904 --> 00:00:42.378 particularly the smaller airways, 00:00:42.378 --> 00:00:45.415 such as the bronchi and bronchioles. 00:00:45.415 --> 00:00:48.816 These airways have an inner lining called the mucosa 00:00:48.816 --> 00:00:52.436 that's surrounded by a layer of smooth muscle. 00:00:52.436 --> 00:00:56.366 In people with asthma, the airways are chronically inflamed, 00:00:56.366 --> 00:01:00.097 which can make them hyper-responsive to certain triggers. 00:01:00.097 --> 00:01:03.297 Some of the many asthma triggers include tobacco smoke, 00:01:03.297 --> 00:01:04.425 pollen, 00:01:04.425 --> 00:01:05.212 dust, 00:01:05.212 --> 00:01:06.137 fragrances, 00:01:06.137 --> 00:01:07.066 exercise, 00:01:07.066 --> 00:01:08.096 cold weather, 00:01:08.096 --> 00:01:09.698 stress, 00:01:09.698 --> 00:01:11.476 and even the common cold. 00:01:11.476 --> 00:01:14.917 When people with asthma are exposed to these triggers, 00:01:14.917 --> 00:01:19.537 an asthma attack, or exacerbation, can occur. 00:01:19.537 --> 00:01:24.608 But how exactly do such everyday factors lead to an asthma attack? 00:01:24.608 --> 00:01:26.997 If an asthmatic is exposed to a trigger, 00:01:26.997 --> 00:01:30.967 the smooth rings of muscle that circle the small airways in their lungs 00:01:30.967 --> 00:01:33.748 contract and become narrow. 00:01:33.748 --> 00:01:36.928 Simultaneously, the trigger worsens inflammation, 00:01:36.928 --> 00:01:40.047 causing the mucosal lining to become more swollen 00:01:40.047 --> 00:01:42.697 and secrete more mucus. 00:01:42.697 --> 00:01:44.188 Under normal conditions, 00:01:44.188 --> 00:01:49.498 the body uses this mucus to trap and clear particles, like pollen or dust, 00:01:49.498 --> 00:01:51.233 but during an asthma attack, 00:01:51.233 --> 00:01:57.528 it blocks the narrowed airways, making it even harder to breathe. 00:01:57.528 --> 00:02:00.639 These effects lead to this symptoms of asthma. 00:02:00.639 --> 00:02:04.969 Smooth muscle constriction results in the feeling of chest tightness. 00:02:04.969 --> 00:02:08.639 Excess mucus and increased inflammation can cause coughing. 00:02:08.639 --> 00:02:10.050 And the wheezing noise? 00:02:10.050 --> 00:02:12.579 That happens because as the airways constrict, 00:02:12.579 --> 00:02:18.469 air whistles as it passes through the narrowed space. 00:02:18.469 --> 00:02:22.189 These symptoms may make a person feel like they're running out of air. 00:02:22.189 --> 00:02:25.277 Yet counterintuitively, during an asthma attack, 00:02:25.277 --> 00:02:29.459 the inflammation can make it harder to exhale than inhale. 00:02:29.459 --> 00:02:33.589 Over time, this leads to an excess of air in the lungs, 00:02:33.589 --> 00:02:36.339 a phenomenon known as hyperinflation. 00:02:36.339 --> 00:02:40.531 The trapping of air inside the lungs forces the body to work harder 00:02:40.531 --> 00:02:43.283 to move air in and out of them. 00:02:43.283 --> 00:02:49.353 Over time, this can lead to reduced oxygen delivery to the body's organs and tissues. 00:02:49.353 --> 00:02:52.670 Sometimes, in untreated severe asthma attacks, 00:02:52.670 --> 00:02:54.529 the body can't keep up, 00:02:54.529 --> 00:02:58.099 which can lead to death from lack of oxygen. 00:02:58.099 --> 00:03:01.880 So how do we prevent these uncomfortable and potentially fatal attacks 00:03:01.880 --> 00:03:04.029 in people who have asthma? 00:03:04.029 --> 00:03:07.388 One way is to reduce the presence of triggers. 00:03:07.388 --> 00:03:10.353 Unfortunately, the world is an unpredictable place 00:03:10.353 --> 00:03:13.893 and exposure to triggers can't always be controlled. 00:03:13.893 --> 00:03:18.717 This is where inhalers, the primary treatment for asthma, come in. 00:03:18.717 --> 00:03:23.690 These medications help asthmatics both control and prevent their asthma symptoms. 00:03:23.690 --> 00:03:27.419 Inhalers transport medication along the affected airways 00:03:27.419 --> 00:03:33.071 using a liquid mist or fine powder to treat the problem at its source. 00:03:33.071 --> 00:03:35.018 They come in two forms. 00:03:35.018 --> 00:03:36.754 There are reliever medications, 00:03:36.754 --> 00:03:40.802 which treat symptoms immediately and contain beta-agonists. 00:03:40.802 --> 00:03:43.911 Beta-agonists relax constricted muslces, 00:03:43.911 --> 00:03:50.132 allowing the airways to widen so more air can travel into and out of the lungs. 00:03:50.132 --> 00:03:53.609 The other form of inhalers serve as preventive medications, 00:03:53.609 --> 00:03:56.363 which treat asthma symptoms over the long term, 00:03:56.363 --> 00:03:58.572 and contain corticosteroids. 00:03:58.572 --> 00:04:02.943 Corticosteroids reduce airway sensitivity and inflammation, 00:04:02.943 --> 00:04:05.763 so asthma can be kept under control. 00:04:05.763 --> 00:04:08.544 They're also crucial in preventing long-term damage 00:04:08.544 --> 00:04:10.090 from chronic inflammation, 00:04:10.090 --> 00:04:12.272 which can cause scarring of the airways. 00:04:12.272 --> 00:04:15.044 Inhalers are known to be very effective, 00:04:15.044 --> 00:04:17.873 and have helped many people live better lives. 00:04:17.873 --> 00:04:20.581 Although we've come a long way in improving how we treat 00:04:20.581 --> 00:04:22.563 and diagnose asthma, 00:04:22.563 --> 00:04:24.770 we still don't know its exact causes. 00:04:24.770 --> 00:04:29.402 We currently believe that a combination of genetic and environmental factors 00:04:29.402 --> 00:04:30.681 play a role, 00:04:30.681 --> 00:04:33.715 potentially acting during early childhood. 00:04:33.715 --> 00:04:37.734 Recent research has even linked poverty to asthma incidents. 00:04:37.734 --> 00:04:39.465 This may be due to reasons ranging 00:04:39.465 --> 00:04:43.139 from exposure to additional pollutants and environmental irritants 00:04:43.139 --> 00:04:46.975 to difficulties in obtaining medical care or treatment. 00:04:46.975 --> 00:04:49.135 As our understanding of asthma improves, 00:04:49.135 --> 00:04:53.973 we can continue to find better ways to keep people's airways happy and healthy.