Allergic Asthma.Care & specialists in Germany

Allergic asthma is the most common type of asthma, in which airway inflammation is triggered by IgE-mediated immune responses to inhaled allergens such as house dust mite, pet dander, mould, and pollen. It causes episodic wheeze, cough, breathlessness, and chest tightness.

Allergic asthma is the subtype driven by allergen-specific IgE and Type 2 inflammation. Non-allergic asthma can be triggered by irritants, infection, exercise, or unknown causes without identifiable allergen sensitisation. Both share airway inflammation and respond to inhaled corticosteroids.

Symptoms include episodic wheeze, dry cough, chest tightness, and breathlessness, often worse at night, with exercise, cold air, or specific allergen exposure. Many patients also have allergic rhinitis (sneezing, blocked nose, itchy eyes) and a personal or family history of atopy.

Diagnosis combines typical symptoms with objective evidence of variable airflow obstruction on spirometry (post-bronchodilator FEV1 increase ≥12% and 200 mL) or peak flow variability. Allergy assessment with skin-prick test or specific IgE confirms aeroallergen sensitisation.

Common triggers include house dust mite, cat and dog dander, mould, pollen (tree, grass, weed), cockroach allergens, and occupational sensitisers. Viral upper respiratory infections, air pollution, tobacco smoke, cold air, exercise, and aspirin or NSAIDs can also provoke attacks.

Inhaled corticosteroid-formoterol combinations are first-line, used as-needed in mild disease and as maintenance plus reliever in moderate to severe disease. Long-acting muscarinic antagonists are added at higher steps, and biologics (omalizumab, mepolizumab, dupilumab, tezepelumab) are reserved for severe disease.

Biologics for asthma (omalizumab, mepolizumab, benralizumab, reslizumab, dupilumab, tezepelumab) have an excellent safety profile in trials and registries. Common side effects include injection-site reactions; rare anaphylaxis with omalizumab occurs in under 0.2% of patients.

There is no cure, but most patients achieve excellent control with inhaled therapy. Up to 50% of children with allergic asthma improve substantially or enter clinical remission by adolescence. Allergen immunotherapy can be disease-modifying in selected patients.

Allergy testing with skin-prick or specific IgE panels is recommended in most patients with allergic features (rhinitis, eczema, family history, suspected trigger). Results guide avoidance, immunotherapy, and biologic selection (omalizumab needs documented sensitisation).

About 30-50% of children with allergic asthma have substantial improvement or remission of symptoms by late adolescence, but airway hyperresponsiveness may persist. Risk of recurrence in adulthood is higher in those with severe early disease, persistent atopy, or smoking.

Yes. Heritability of asthma is 60-80% in twin studies. A first-degree relative with asthma, eczema, or hay fever increases asthma risk 2-4 fold. Multiple susceptibility loci have been identified including 17q21 (ORMDL3) and IL33.

Encase mattresses, pillows, and duvets in mite-impermeable covers; wash bedding weekly at 60 °C; use hard flooring or low-pile carpet; vacuum weekly with a HEPA-filter device; and maintain indoor humidity below 50%. These measures reduce mite allergen by 50-80%.

Yes. Regular aerobic exercise improves cardiovascular fitness and asthma control. Use a 10-15 minute warm-up and a pre-exercise reliever (ICS-formoterol or salbutamol) when exercise-induced symptoms occur. Swimming in chlorinated pools may worsen symptoms in some patients.

Yes, in selected patients. Subcutaneous or sublingual immunotherapy for 3-5 years reduces medication needs and may prevent asthma in children with allergic rhinitis. Best evidence is for house dust mite and grass pollen. Patients need FEV1 above 70% predicted and well-controlled disease.

A personalised written plan describing daily controller medication, what to do for worsening symptoms (yellow zone), and when to seek emergency care (red zone). Action plans reduce hospitalisations by 30-40% and are recommended by GINA for every asthma patient.

Asthma worsens in about a third of pregnancies, improves in a third, and remains stable in a third. Uncontrolled asthma is more harmful to mother and baby than asthma medications. Inhaled corticosteroids, formoterol, salbutamol, and most biologics are considered safe in pregnancy.

Most allergic asthma is mild to moderate and well controlled with inhaled therapy. Severe asthma affects 5-10% of patients and is associated with frequent exacerbations and reduced quality of life. Worldwide, more than 1,000 people die of asthma every day; access to inhaled corticosteroids reduces deaths dramatically.

Refer to allergy or respiratory specialists for frequent exacerbations (more than two per year), persistent symptoms despite medium-dose ICS-LABA, FEV1 under 70% predicted, oral corticosteroid dependence, suspected occupational asthma, or consideration of biologics or immunotherapy.

Removing the offending pet from the home reduces exposure but allergen persists for months. Keeping pets out of bedrooms, weekly washing of the animal, and HEPA air filtration help when removal is not possible. Sensitised patients with severe asthma usually benefit from rehoming.

Active and second-hand smoking worsen asthma control, reduce ICS effectiveness, accelerate airway remodelling, and increase exacerbations. Smoking cessation rapidly improves lung function and reduces exacerbations and emergency visits.

Bronchial thermoplasty delivers controlled radiofrequency heat via bronchoscopy to reduce airway smooth muscle in severe asthma. Three procedures 3 weeks apart reduce severe exacerbations by 32% at 12 months with effects sustained at 5 years, used in patients failing biologic therapy.