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The many facets of asthma

As if suffering from severe asthma – the anguish of breathlessness, the painful oppression of the chest, the cough that awakened him throughout the early hours of the morning, as he complained in his letters to his mother – were not enough, Marcel Proust also had to swallow the bitter pill of the lack of understanding of relatives, friends and doctors, who saw in his illness nothing more than the exaggerated manifestations of hysteria or of pure neurasthenia. The author of the extraordinary work A la Recherche du Temps Perdu [translated into English under the titles Remembrance of Things Past or In Search of Lost Time] went through life from crisis to crisis, becoming a semi-invalid shortly after the age of 30. The disease hounded him until his death from respiratory failure at the age of 52, in 1922. He was never given the benefit of the doubt as to the reality, or better still, the materiality of his disease. Yet at the end of the nineteenth century, there was some evidence already that severe asthma had an inflammatory character, at least according to one of the researchers whose new findings about the disease are the subject of the cover feature of this issue of Pesquisa FAPESP. For instance, Adrien Proust, an eminent physician and father of the suffering Marcel, chose to bet on the sickly character of his son as the source of his ailments.

This biased view of asthma in the nineteenth century does not come as a major surprise when one learns that this is still a health problem surrounded by myths and prejudices, even though it is common all around the world, even now, well into the 21st century. In Brazil, asthma affects 12% of adults. Among those who enjoy transforming all diseases into psychological ailments, there are some who establish a peculiar relation between asthma and poorly resolved anger – an odd type of psychological determinism for a disease that experts confess that they still barely understand and in the face of which respectable researchers question whether it is indeed just one disease, or several. What is certain is that asthma is a sorry condition, as it interrupts the naturalness of the most primary of exchanges between that which lies inside and the outside, an exchange that assures existence. It is painful and causes desperation, as it suffocates the person, who is impotent to inhale the air that provides the body’s indispensible oxygen, because each bronchus, each bronchiole, each alveolus is about to explode as a result of the accumulated CO2 that it is unable to expel.

Based on a discussion about the importance of asthma for public health, this issue’s cover feature takes a look at the advances that Brazilian researchers, in close collaboration with their foreign colleagues, are achieving in regard to acquiring a basic understanding of asthma and of how to prevent it and treat it. The person who did the bulk of “mining” the experts’ studies and interviews was Ricardo Zorzetto, our science editor, with my help. And though it may be far from exhausting the subject, the magazine certainly provides, in the text that begins on page 16, a contribution to increase the visibility of research into asthma, which is still a poorly understood condition.


Further highlights:

As it does every year, Pesquisa FAPESP publishes in this November issue the Nobel laureates. This time, however, the news is especially worthy of note because of the unusual number of women laureates – four in the scientific fields and one in literature. Our scientific and technological policy editor, Fabrício Marques, tells us how the position and recognition of women who shine in science, worldwide, is growing.

Lack of brilliance is one of the features of the synthetic diamonds that are the subject of the main technology article, by editor Marcos de Oliveira. Their dark, opaque color makes them useless as jewelry, but their resistance to corrosion, hardness and heat conduction are highly appreciated qualities in industry. Among many other applications, they are used in drills for oil well prospecting and as cover for parts subject to chemical attacks and wear from attrition.

As for the area of the humanities, Carlos Haag explains how all the foreigners who established themselves in São Paulo were fundamental in the physical, demographic, economic, social and cultural construction of Brazil’s largest and most diverse city. One of the highlights of the work of a team of researchers from four units of the University of São Paulo is a database with all the researched material, that will be available on the web for anyone who wants to learn more about the subject or carry out other scientific investigations. It provides the ideal ending for a research study that is full of substance.