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Respiratory > Allergic airways disease > Flashcards

Allergic airways disease Flashcards

1
Q

What are the three main areas where allergic diseases can occur?

A
  • upper airways (allergic rhinitis)
  • bronchi (asthma)
  • alveoli (allergic alveolitis)
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2
Q

What do T helper 1 cells fight against?

A
  • viruses
  • Bacteria
  • Fungi
  • protozoa
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3
Q

What do T helper 2 cells fight against?

A
  • helminths

- ectoparasites (parasites on skin)

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4
Q

What is an allergy?

A

An exaggerated immune response to an allergen which could be inhaled/swallowed/injected etc. It is a mechanism not a disease.

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5
Q

What is hypersensitivity?

A

An exaggerated response

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6
Q

What are examples of non immunological hypersensitivities?

A
  • Food intolerance
  • enzyme deficiencies
  • Pharmacological
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7
Q

What are examples of immunological hypersensitivities?

A
  • Non IgE mediated allergic diseases

- IgE mediated allergic diseases e.g. hayfever, eczema and asthma

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8
Q

What happens during an IgE mediated allergic reaction?

A

The body has an inappropriate response to an allergen and IgE is made. This binds to the mast cells and stays there for months/years. IgE is continuously made. On the second encounter, the allergen will cross link the antibody on mast cells and they degranulate. This causes the acute symptoms of allergies.

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9
Q

What causes the chronic symptoms of allergies?

A

The allergen binding to other receptors. It is identified by Th2 cells and more cytokines/chemokines are made.

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10
Q

Which cytokine is involved in airway remodelling?

A

IL13

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11
Q

What do IL4, IL5,IL9 and IL13 do in allergies? (Th2)

A

4 - IgE synthesis
5 - esoinophil development
9 - mast cell development
13 - IgE synthesis and airway hyperesponsiveness

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12
Q

What does atopy mean?

A

Hereditary predisposition to produce IgE antibodies against common environmental allergens. Means you have antibodies in your blood.

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13
Q

What are some atopic diseases?

A
  • allergic rhinitis
  • asthma
  • atopic eczema
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14
Q

What are some types of asthma?

A
  • Early-onset allergic asthma (Th2)
  • Late-onset eosinophilic (IL-5, allergy less pronounced)
  • Exercise induced (Th2)
  • Obesity-related
  • Neutrophilic (Th17/IL-8)
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15
Q

What are some allergens causing allergic rhinitis?

A
  • house dust mite
  • cats
  • dogs
  • horses
  • cockroach
  • alternaria
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16
Q

Extrinsic allergic alveolitis

A

disease of the alveoli
caused by inhaling small particles of allergens which can end up in the air sacs. They come into contact with antibodies in the blood. Rare - only 0.1% of pop

17
Q

What are some types of extrinsic allergic alveolitis and their causes?

A
  • farmer’s lung -> mouldy hay
  • bird fancier’s lung -> bird droppings
  • air conditioner’s lung -> air conditioner mould
  • mushroom worker’s lung -> mushroom compost
  • malt worker’s lung -> mouldy malt or barley
  • coffee worker’s lung -> unroasted coffee beans
  • miller’s lung -> infested flour
  • hot tub lung -> bacterial contamination
18
Q

What is the prevalence of allergic diseases?

A
  • 5.7 million people in England have been diagnosed with asthma in their lifetime
  • 3.3 million people in England have been diagnosed with allergic rhinitis
  • Increase in no. people with peanut allergy
  • Number of hospital admissions due to anaphylactic shock has increased
19
Q

What is the trend in infectious disease, allergies and autoimmune disease?

A

Decrease in infectious disease mirrors an increase in allergic and autoimmune disorders.

20
Q

Why are allergies on the rise?

A

combination of environment and genes
Potential theories:
- In Western countries the immune system is deprived of the microbial antigens that stimulate regulatory T cells/Th1 cells, because the environment is clean, vaccinations and the widespread use of antibiotics for minor illnesses in early life - hygiene hypothesis
- Some scenarios are protect against allergy e.g. a large family size, a traditional way of life, the mixing of children in day care nurseries, and, some infections such H. pylori
- Our gut flora has changed so that it no longer protects against allergy. Organic food is beneficial.

21
Q

What is happening to the levels of asthma?

A

Levels of asthma are plateauing

22
Q

What are some of the social problems associated with allergies?

A
  • In Western societies, work absences related to allergies represents a large cost to the economy.
  • Hayfever symptoms disrupt children’s sleep and often impair their performance at school and asthma has been associated with school absences.
  • Allergic disorders can make social interactions difficult as even simple everyday activities can pose a major health risk
23
Q

Which three conditions often occur together?

A

Asthma, eczema and allergic rhinitis often occur together

24
Q

What are the three main principles of allergic disease treatment?

A
  • allergen avoidance
  • anti-allergic medication
  • immunotherapy (desensitisation/hyposensitisation)
25
Q

What is allergen immunotherapy?

A

Giving small amounts of allergen to train the immune system to know it isn’t dangerous.

26
Q

Which drugs are used to treat allergic rhinits?

A

Drugs used to treat allergic rhinitis are antihistamines (for relief of symptoms) and topical corticosteroids for suppression of allergic inflammation.
Histamine H1-receptor antagonists examples include loratadine, cetirizine and fexofenadine

27
Q

What are some of the mechanisms through which immunotherapy is believed to work?

A

Through these mechanisms: downregulating Th2 response, increasing Th1 response, upregulating regulatory T cells.

28
Q

What are the advantages and disadvantages of immunotherapy?

A

Advantages

  • Effective
  • Produces long lasting immunity

Disadvantages

  • Occasional severe allergic reaction
  • Time consuming
  • Standardisation problems
29
Q

What is asthma a disease of and what happens to the lung?

A

Asthma is a disease of the lower airways - lots of smooth muscle and mucus

30
Q

What is the prevalence of hayfever in the UK?

A

Hayfever - UK prevalence highest in Europe

Seasonal rhino-conjuctivitis aka rhinitis (hayfever)

31
Q

3 main phenotypes of asthma…

A
  • intermittent and mild
  • persistent but manageable
  • chronic and severe; infection is important not allergy

Respiratory (23 decks)

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