Asthma Flashcards
Asthma is a ……. hypersensitivity reaction
type I
characterised by recurrent attacks of …. and ….
breathlessness and wheezing
(1) antigen presents to …. … cells
CD4 Th2
(2) CD4 Th2 cells release … and …
IL4 and IL5
(3) IL4 stimulates B cell production of …. antibodies
IgE
(4) IgE antibodies bind to …. and …. which release active mediators such as histamine, ……., prostaglandins which cause vasodilation and smooth muscle contraction of bronchi and bronchioles
mast cells and basophils; leukotrienes
2 asthma phenotypes =
Th2 high and Th2 low
2 types of asthma which are Th2 high
early onset allergic, late onset eosinophilic
Early onset allergic asthma is corticosteroid …..
responsive
Late onset eosinophilic asthma is responsive to antibody to ….. and cysteinyl leukotriene modifiers
IL5
2 types of asthma which are Th2 low
obesity related, neutrophilic
Obesity related asthma is responsive to (3)
weightloss, antioxidants and possibly hormonal therapy
Neutrophilic asthma is possibly responsive to
macrolide antibiotics
Atopic asthma - 5 asthma genes / gene complexes identified
ADAM33, PHF11, DPP10, GRPA, SPINK5
Atopic asthma - 5 asthma genes / gene complexes identified - expressed where
in terminally differentiating epithelium
4 severe asthma symptoms
cough, wheeze, breathlessness, tightness of chest
asthma is more common in males …. puberty
before
asthma is more common in females …. puberty
after
epidemiological definition of asthma
symptomatic bronchial hyper responsiveness
number of people who die per year from asthma
250 000
Asthma IL13 stimulates (2)
IgE production, mucus secretion
Asthma IL5 stimulates
eosinophilic inflammation
Asthma IL4 stimulates
IgE production
mast cells are increased in the …. and surface … of asthmatics
epithelium; secretions
eosinophils are found in large numbers in …. … and secretions of asthmatics
bronchial wall
number and activation of eosinophils decreased by
corticosteroids
eosinophils attracted to airways by eosinophopoietic cytokines (3) and chemokines that act on …. .. chemokine receptors
IL4, Il5, GM-CSF; type 3 CC chemokine receptors
Asthma - polarisation to Th2 mediated by …. cells
dendritic
Leukotrienes (3) prolong bronchoconstriction, increase vasodilation and increase mucus production
C4, D4, E4
In asthma, conducting airway epithelium is damaged > loss of … …. cells
ciliated columnar
in asthma, epithelium undergoes metaplasia (increase in number and activity of …..)
mucus secreting goblet cells
in asthma, there is deposition of repair collagens (3 types) on ……. beneath basement membrane
types I, III and V; lamina reticularis
principle cause of airway remodelling due to aberrant signalling between epithelium and
myofibroblasts
stimulation of nerve endings in epithelium and submucosa > release of acetylcholine > stimulation of ……. receptors on smooth muscle > contraction
M2 muscarinic
Asthma detectable by xray or not?
not detectable by xray
Narrowing of airways often caused by abnormal sensitivity of …. receptors
cholinergic
in asthma narrowing of airways is reversible or irreversible?
reversible
