Usefulness of Term "Asthma” Questioned

An editorial in The Lancet (London, UK) claims that asthma is unlikely to be a single disease, and that the term should therefore be abolished.

The word "asthma” comes from a Greek word that means "to breathe with open mouth or to pant.” It first appeared in Homer's Iliad as meaning "short of breath,” and probably was first used in a medical sense by Hippocrates. Use of bronchodilators started at the beginning of the 20th century, and it was not until the 1960s that airway inflammation was recognized as an underlying substrate.

This discovery led to the rationale of corticosteroids, now the mainstay of asthma therapy, as a potentially useful treatment. Since then, progress in understanding predisposition, underlying pathology, disease triggers and progression, and response to treatment has been slow and confusing with many contradictory findings.

The general consensus now emerging is that, even in adults, asthma is unlikely to be a single disease entity. Perhaps asthma as a symptom is really only the clinical manifestation of several distinct diseases. Dr. Fernando Martinez, of the Arizona Respiratory Center at the University of Arizona (Tucson, USA), was among the first, in 1995, to characterize in a Tucson birth cohort different wheezing or asthma phenotypes in children who did not all develop classic asthma. As Dr. Martinez explained, until the 19th century, fever was regarded as a disease and maybe in 20, 30, or 50 years' time doctors will look back at asthma in the same way.

"So why wait?” concluded the editorial in Lancet, published in the August 26, 2006, edition. "Rather than confusing scientists, doctors, and patients even further, is it not time to step out of the straightjacket of a seemingly unifying name that has outlived its usefulness? The conclusion should surely be that it is best to abolish the term asthma altogether.”



Related Links:
The Lancet
Arizona Respiratory Center at the University of Arizona