Reconsiderando el asma: ¿es realmente crónico e incurable?

En esta carta se busca revisar las pruebas que demuestren que la definición actual del asma como una inflamación crónica de las vías respiratorias no está corroborada científicamente. Lo más problemático es que esta definición está alejando al mundo científico de intervenciones terapéuticas cuyos resultados positivos han sido corroborados en numerosos ensayos clínicos.

asthmainhalerEn los años 50 se definía el asma como una obstrucción reversible de las vías respiratorias causada por la hiperreactividad del musculo liso bronquial a varios agentes químicos.

En línea con esta definición, gran parte de la investigación que se ha llevado a cabo sobre el asma se ha centrado en identificar los agentes que podían desencadenar una contracción del músculo liso bronquial, fenómeno conocido también como broncoconstricción o broncoespasmo. Es muy destacable que uno de los agentes descubiertos era el dióxido de carbono, gas que nuestro organismo produce en el proceso metabólico y que expulsa por la exhalación. Un gran número de estudios experimentales demostraron que una reducción de los niveles de dióxido de carbono, fenómeno conocido como hipocapnia, causa broncoconstricción, mientras que niveles altos de dióxido de carbono inducen broncodilatación debido a la relajación del músculo liso (referencias de la 9 a la 22 en Bruton and Holgate 2005 y referencias 1-10 en Lindeman, et al. 1998). Ya que la respiración regula los niveles de dióxido de carbono, este descubrimiento dio impulso a una serie de estudios clínicos que buscaban analizar los efectos del entrenamiento respiratorio en los síntomas del asma. La mayoría de estos estudios obtuvieron resultados positivos, representados por una reducción substancial del uso de broncodilatadores y corticosteroides y una mejora en la calidad de vida (para una revisión sistemática léase Burgess et al. 2011). Continue reading “Reconsiderando el asma: ¿es realmente crónico e incurable?”

My new Facebook page on breathing education is launched

This week I launched a new Facebook page on breathing education. The idea is to regularly upload information, images and tips on breathing normalisation. Hopefully it will become a new space for information exchange and debate on respiratory and general health issues.

You can like and follow the page here: https://www.facebook.com/educacionrespiratoria

Diapositivas de mi curso de Educación Respiratoria en el Colegio de Psicólogos

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Slides of my 2-day course on Breathing Education for Psychologists. The presentation includes slides on respiratory physiology, acute and chronic hyperventilation, respiratory muscles and breathing modification.

Diapositivas de mi curso de dos días sobre Educación Respiratoria en la sede del Colegio Oficial de Psicólogos. El material incluye diapositivas sobre la fisiología respiratoria, la hiperventilación aguda y crónica, los músculos respiratorios y la modificación de la respiración.

The Laboratory for Network Physiology launches its official website

NetworkPhysiology-logoThe Laboratory for Network Physiology directed by Plamen Ch. Ivanov recently launched its official website. Professor Ivanov, with whom I collaborate closely for the past six years, is leading a unique team of statistical physicists, neuroscientists, applied mathematicians and biomedical engineers that have as their mission to understand how organ systems dynamically interact and collectively behave as a network to produce health or disease. This coordinated effort proposes a new scientific field, Network Physiology, to probe the network of interactions among diverse physiologic systems.

In the website interested readers can find information about the group’s research projects, publications, news, job opportunities and more.

Visit the website here.

Losing money is more stressful than bribing! Our new Frontiers article explores the physiology of corrupt behavior

In our recently article published in “Frontiers in Behavioral Neuroscience“, we show that high emotional arousal is not solely associated to unethical economic behavior —such as tax evasion— as previous research had revealed. Instead, people get emotionally aroused also when making ethical choices if these choices imply the loss of monetary reward. In other words, it seems to be more stressful for someone to lose money than to make an unethical decision that causes a loss of money to others. This means that, in certain circumstances, our bodies reward unethical decisions in order to minimise the unpleasant feeling produced by decisions that cost us money. This behavior is inverted when the possibility of punishment exists. In that case corrupt decisions become more stressful than ethical ones.

These results support the existence of severe external control in economic transactions and bare important consequences for the political fight against corruption.

You can read the full article here

Asthma revisited: is it really chronic and incurable?

In this article I review evidence showing that the current definition of asthma as chronic airway inflammation is not scientifically substantiated. Importantly, this problematic definition is distracting the medical community away from inexpensive therapeutic interventions that have proven to be remarkably efficient in numerous clinical trials. Read the published version of this article here.

Back in the 1950s asthma was defined as a reversible airway obstruction caused by the hyperresponsiveness of the Airway Smooth Muscle (ASM) to a variety of agents. Consistent with this definition, a large part of research on asthma focused in identifying several agents that could trigger a contraction of the ASM, also known as bronchoconstriction or bronchospasm.

Interestingly, carbon dioxide —a gas that our organism produces with metabolism and expels through exhalation— was found to be one of those agents. A large body of experimental evidence demonstrated that a reduction in carbon dioxide concentrations, known as hypocapnia, causes bronchoconstriction, while high carbon dioxide levels induce bronchodilation through relaxation of the ASM (references 9–22  in Bruton & Holgate, 2005 and references 1–10 in Lindeman et al., 1998). Since carbon dioxide levels are directly regulated by breathing, these findings stimulated a series of clinical studies testing the effects of breathing training on asthma symptoms. Most of these studies reported positive outcomes marked by a substantial reduction in the use of bronchodilators and corticosteroids, and improved quality of life (for a systematic review of clinical trials see Burgess et al., 2011). Continue reading “Asthma revisited: is it really chronic and incurable?”

Our new PLoS ONE paper on the Emotional and Attentional Impact of Exposure to One’s Own Body in Bulimia Nervosa

originally published at: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0102595

We recently published a research article where we examined the effects of viewing a video of one’s own body on the physiological (eye-blink startle, cardiac defense, and skin conductance) and subjective (pleasure, arousal, and control ratings) responses elicited by a burst of 110 dB white noise of 500 ms duration. The results showed that, when viewing their own bodies, women with BN experienced (a) greater inhibition of the startle reflex, (b) greater cardiac acceleration in the first component of the defense reaction, (c) greater skin conductance response, and (d) less subjective pleasure and control combined with greater arousal, compared with the control participants. The findings suggest that, for women with BN, peripheral-physiological responses to self-images are dominated by attentional processes, which provoke an immobility reaction caused by a dysfunctional negative response to their own body.