The first descriptions of asthma come from ancient China, when Shen-Nung (Chinese Emperor of Fire, 2838-2698 BC) described the first asthma-like symptoms and observed the therapeutic effect of the mahuang plant, from which ephedrine was extracted. In ancient Rome, ephedrine taken with wine was used to treat asthma.
Herbal vapors and extracts have been used for centuries to relieve symptoms, although the underlying mechanisms and pathways were not known. The contemporary "Papyrus of Georg Ebers" found in Egypt indicates more than 700 remedies for respiratory ailments.
Later, in 1792 BC, the "Code of Hammurabi" was created. He documented symptoms of breathlessness in a group of individuals in Babylon.
HISTORY OF ASTHMA BEFORE THE NEW ERA AND THE NEW ERA
The first descriptions from the 2nd century BC. they come from Aratei from Cappadocia.
In 327 BC, during the era when Alexander the Great was expanding his invasion of India, the smoke of stramonium (plant with anticholinergic effect) was used to relieve difficulty breathing.
In ancient Greece, Hippocrates (377 BC) was the first to describe asthma, and Claudius Galen, in the second century AD. defines it as a disease accompanied by bronchial obstruction.
The first descriptions from the 2nd century BC. they come from Aratei from Cappadocia.
During 200-500 AD, the Jewish Talmud advocated the use of "hiltite", a resin found in carrots, to treat asthma symptoms.
Moses Maimonides (1135-1204), a Jewish physician, in 1200, recommends that people suffering from asthma should avoid stressful situations and points to the beneficial effect of climate change. He indicates that fluid intake and chicken soup, good personal hygiene and restful sleep have a beneficial effect on asthma.
A HISTORY OF ASTHMA: THE MEDIEVAL ERA
In the Middle Ages, knowledge about asthma and its treatment began to advance little by little. Europeans began using tobacco as an expectorant to help clear mucus around 1500 AD.
The Belgian researcher, Jean Baptiste Van Helmont, around 1700 AD, mentioned that asthma started in the "lung tubes". Bernardino Ramacini was the first to discover the link between asthma and dust and identified "exercise-induced asthma".
The Aztecs used ephedra to clear mucus in Central America. In South America, the Incas used a dried leaf similar to cocaine to treat asthma. Arsenic was recommended by several doctors for the treatment of respiratory distress around 1800 AD
Konrad Schnaeider, in 1600, identified dust and other irritants as the cause of asthma.
Tomas E. Willis (1621-1675) and John Floyer (1649-1734), in 1700, were the first to introduce the term ˝paroxysmal asthma˝, which is undoubtedly the forerunner of the term ˝severe asthma˝. At the same time, they indicate the adverse effect of tobacco smoke on asthmatics. J. Floyer also points to a hereditary predisposition to asthma.
In 1835, Leanec invented the stethoscope, which enabled doctors dealing with asthma to hear wheezing in asthmatics for the first time.
Gerhard, in 1850, classified chemical odors as possible triggers of attacks in asthmatics.
Salter H.H, in 1860, was the first to describe asthma as "paroxysmal dyspnea of a strange character, generally periodic with intervals of healthy breathing between attacks".
Paul Ehrlich (1854-1915), in 1879, was the first to discover the role of mast cells and eosinophils in atopic allergy.
HISTORY OF ASTHMA: THE MODERN ERA
Pediatrician, Clemens von Pirquet, on July 24, 1906 in the Munich Medical Journal, published the term "allergy" which means "specifically altered reactivity of the organism".
Samuel Meltcer, in 1910, concluded that asthma is a functional disease of the respiratory tract, not a neurosis.
Carl Prausnitz (1876-1963) and Heinz Küstner (1897-1963) demonstrate passive skin sensitization in 1921, which is referred to as the Prausnitz-Küstner test (PK-test).
Perez Camps, in 1929, was the first to use adrenaline by inhalation in the treatment of asthma.
Edward Rendall, (Mayo Clinic), in 1936, was the first to isolate cortisone from the cortex of the adrenal gland.
Feldberg and Kellaway in 1938 describe the slow-reacting substance-SRS.
Doctors began prescribing aminophylline suppositories and tablets and adrenaline injections for asthma in the 1940s and 1950s.
The metered dose sprayer was used in 1956.
In 1959, Wright and McKerrow constructed a peak expiratory flow meter or peak flow meter.
K. and T. Ishizaka, in 1960, published several papers indicating that the antiserum blocks the PK-test, calling it reagin.
Pharmacist Roger Altounzan, in 1965, isolated chromones from the amni visnage plant, which would be the basis for disodium cromoglicate in 1967.
S.G.O. Johanson from Uppsala, in 1965, detected in the serum of a patient with myeloma the M-component, which is defined as the fourth class of antibodies, immunoglobulin E (IgE).
In 1969, the first selective beta-2 agonist was isolated: Salbutamol.
In 1971, the Non-adrenergic-non-cholinergic (NANC) nervous system in the lungs was described for the first time.
1972. Inhaled corticosteroid is used for the first time: Beclomethasone dipropionate (BDP).
Richardson and Beland, in 1976, discovered vasoactive intestinal peptide (VIP), a substance that participates in smooth muscle contraction.
In 1976, Samulsson and Hamberg (Karolinska Institute) and Pierre Borgeat from Canada discovered a new catalyzed lipoxygenase dehydroxy acid (5-lipoxygenase pathway) which represents the birth of the leukotriene family.
Peterson et al., in 1977, discovered that a mast cell activated by IgE releases histamine.
Chen Wy and Harton D, 1977, describe asthma on exertion caused by loss of temperature and fluid.
As the understanding of allergen exposure and the subsequent release of chemical mediators that cause airway narrowing and remodeling became clearer, around 1980, targeted treatment options were established, including antileukotrienes, chromones, and anti-IgE therapies.
In 1991, the first long-acting beta-2 agonist - Salmeterol - began to be used.
In 1992, the first "International Consensus for the Diagnosis and Treatment of Asthma" was published by the National Heart, Lung and Blood Institute (USA).
In 1995, the Global Initiative for Asthma - GINA was published in cooperation with the National Heart, Lung and Blood Institute (USA) and the World Health Organization and reads: ``Global strategy for the treatment and prevention of asthma.'' It is still based on complements and renews contemporary literature.
In 1998, the use of Montelukast, an antagonist of the CYSLT1 receptor, was approved for the control of asthma.
HISTORY OF ASTHMA: TWO DECADES OF THE 21ST CENTURY
In the first two decades of the 21st century, extensive discoveries were made at the genetic and molecular level of importance for the pathogenesis of asthma. Efforts are being made to adjust asthma therapy at the individual level according to phenotypes (clinical characteristics of asthma) and endotypes (biological markers that indicate the subtype of asthma), the so-called personalized curative approach.
Asthma is recognized as a heterogeneous disease, complex to treat.
In 2001, the initial sequencing of the human genome and early ˝family-based linkage studies˝ indicate numerous genetic loci that increase the risk of asthma.
In 2003, Omalizumab was introduced for the treatment of asthma, a monoclonal anti-IgE antibody for ages over 12, and in 2016 for ages 6 to 11.
In 2011, the American Thoracic Association issued guidelines for the clinical use of measuring exhaled nitrogen monoxide (FeNO).
In 2015, the American Drug Administration (FDA) approved the use of a long-acting antimuscarinic antagonist: Tiotropium bromide for the treatment of patients with asthma poorly controlled by high doses of inhaled corticosteroids and long-acting beta-2 agonists (at level 3 and 4. According to the recommendations of the European Respiratory Association).
In 2015, the approved use of Mepolizumab, a monoclonal antibody that inhibits IL-5 by binding to the receptor on the eosinophil surface, inhibits the recruitment, growth, differentiation and activation of eosinophils.
2016 Approved Use of Reslizumab, an IgG4k Monoclonal Antibody That Inhibits IL -5 Binding to the α Subunit of the IL-5 Receptor Complex on Eosinophils.
In 2017, the use of Dupilumab, a monoclonal antibody to the α subunit of the IL-4 receptor, was approved for the treatment of atopic dermatitis.
Advanced sequencing technologies indicate the role of genomics, epigenomics, transcriptomics, proteomics, metabolomics in defining asthma endotypes.
Animal models, epidemiological studies of supplementation demonstrate the influence of microbiota on the development of allergic response and allergic inflammation in the respiratory tract.
New interventions are being introduced in the treatment of severe asthma such as bronchial thermoplasty
Literature
Đorđević D. Epidemiology, etypotaogenesis and classification of bronchial asthma, historical overview. In: Bronchial asthma, ed. Faculty of Medicine in Niš. 2005: 7-25.
