Asthma nervosa: old concept, new insights

Dyspnoea: a multidimensional and multidisciplinary approach

“…High anxiety/depression patients perceived increased dyspnoea [38][39][40][41] and may be associated with worst prognosis [42], while dyspnoea can cause increased anxiety and depression [43,44]. Unpleasant respiratory sensations can therefore be associated with significant psychological suffering (anxiety and depression), which in turn have a significant impact on daily functioning, treatment adherence, hospitalisation and mortality.…”

Asthma nervosum

“…This is in direct contrast to recently published studies that used a similar cohort of patients [2]. A closer look at the results of the study by WANG et al [1] revealed that while the authors used authentic quantitative PCR techniques to identify C. pneumoniae DNA, they utilised sputum samples for detection. It has been well established that C. pneumoniae resides primarily in the lower airway and is recovered much more reliably from bronchoalveolar lavage (BAL) fluid, as clearly demonstrated by MARTIN et al Responding to a question about the future of PCR as a diagnostic tool for respiratory Chlamydia and Mycoplasma respiratory tract infection, M. Kraft, a co-author of the manuscript by MARTIN et al…”

“…We read with interest the article by WANG et al [1], which explored inflammatory phenotypes in adults and children with acute asthma. Their findings noted a striking paucity of Chlamydophyla pneumoniae organisms, even in patients with acute, neutrophilic asthma, and they concluded that: ''The aetiology of neutrophilic asthma is unknown and is not explained by the presence of current active C. pneumoniae infection.''…”

“…Indeed, viable C. pneumoniae have been successfully cultured from the BAL fluid of paediatric patients with chronic, severe asthma and the culture data correlated with the PCR (all culture-positive samples were also PCR-positive) [2]. Therefore, the absence of C. pneumoniae in the sputum samples used by WANG et al [1] is not surprising. There is no question that under certain conditions of severe respiratory disease caused by C. pneumoniae the organism will be found in the sputum.…”

An Asthma Patient with Steroid-resistant Decrease in Peak Expiratory Flow after the Great East Japan Earthquake Showing Spontaneous Recovery after 1 Month

“…The pathophysiology of asthma includes reversible airflow limitations induced by underlying allergic inflammation in the airways. Although the main cause of this inflammatory reaction may be an allergic response, it is often thought that psychological stress may contribute to asthma exacerbation (10)(11)(12)(13)(14). A predisposition to psychological stress is also positively correlated with the prevalence of asthma (15).…”