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ADVANCE Perspective: Respiratory Views

New Insight into Asthma Triggers

Published July 28, 2014 3:33 PM by Rebecca Hepp
Could you unknowingly be aiding and abetting your patient's asthma triggers simply by labeling them as such? New research suggests that just might be the case when it comes to odor-triggered asthma. Researchers at the Monell Center have found "that simply believing that an odor is potentially harmful can increase airway inflammation in asthmatics for at least 24 hours following exposure," according to a press release.

So that patient who swears his aunt's perfume always triggers an asthma attack? It could be less about the smell actually being a trigger and more about his expectation that a strong perfume should be a trigger. The findings reveal the power the mind has to protect the body from what is a perceived threat.

"When we expect that an odor is harmful, our bodies react as if that odor is indeed harmful," said study lead author Cristina Jaén, PhD, a Monell physiologist, in the release. And the research goes beyond the study subjects' perceived irritation with a smell. They also measured lung function and airway inflammation before and after exposure, as well as a few hours later and even the next day.

Though a small study with only 17 participants with moderate asthma, the findings could have a big impact on how RTs and other care providers educate asthma patients on potential triggers.

Exposing participants to the odor phenylethyl alcohol (PEA), researchers told eight members of the group that the smell might have therapeutic benefits, and nine that it had the potential to cause respiratory issues.

Those who were warned of potential problems not only rated the smell to be more irritating, but their airway inflammation increased immediately following the 15 minutes of exposure to PEA ... and the inflammation was still there 24 hours after the experiment. Not surprisingly, the eight participants who were expecting a therapeutic effect showed no increase of inflammation, and rated the smell less irritating.

While more research is sure to follow, what does this preliminary data mean for you and the conversations you have with your patients? If the expectation of negative effects has the potential to worsen a patient's physical reaction, and thus their asthma, it might mean a little more caution when discussing possible odor-related triggers.

What do you think? Will you be revising your educational strategy for patients with asthma?

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I'll definately modify my educational strategy, especially with the geriatric population. thanks for the info.

Jorge Gallardo, RESP. CARE - RESP. CARE SUPV., HEALTHSOUTH RHSA August 20, 2014 5:13 PM

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