Asthma Flashcards
Is asthma acute or chronic?
chronic
What cells are involved in asthma?
- mast cells
- eosinophils
- T-lymphocytes
- macrophages
- neutrophils
- epithelial cells
What symptoms are associated with asthma?
- wheezing
- breathlessness
- chest tightness
- coughing
When are symptoms more common/worse?
at night or in early morning
Who does asthma affect the most?
the children
If we control asthma, we prevent _____ ?
COPD people!
What does natural history of a disease mean?
It means we let the disease run it’s course and do not intervene in any way.
What are predictors of adult asthma persistence?
- ON EXAM
- Slide 8
- diagnosis during school age
- presence of atopy (genetic tendency to develop allergic diseases)
- BHR (bronchial hyper reactivity)
What are 2 non-modifiable risk factors associated with asthma?
- genetics (atopy or BHR)
- gender (more common for males in childhood and females in adulthood)
What are modifiable risk factors associated with asthma?
- lower socioeconomic status
- family size
- obesity
- exposure to second-hand smoke
- respiratory syncytial virus exposure
- reduced exposure to childhood infectious agents
What is the hygiene hypothesis?
Basically if you keep your kid too clean and don’t allow it to do shit, it will never be exposed to things that will strengthen it’s immune system. Then when it finally is exposed, it’s immune system is so weak which makes it harder to fight infections.
What type of cells cause the inflammation in asthma?
mast cells
What are factors that can trigger asthma symptoms?
- respiratory tract infections
- allergens
- environment
- food additives
- exercise
- drugs/preservatives
- occupation
- emotion
Explain why asthma makes it hard for a patient to breathe.
The muscles of the bronchial tubes tighten and thicken and the air passages become inflamed and mucous-filled, making it hard for air to move.
What are the hallmarks of asthma pathology?
- BHR
- airway inflammation
- airway remodelling
- some degree of airflow obstruction
Describe BHR
- twitchy lungs
- increased tendency of bronchospasm
- exposure to irritants can trigger great spasmodic rxn
What type of antibodies bind to receptors on mast cells which produce inflammation?
IgE
After all the inflammation occurs, Type 2 helper cells are activated which produce ??
B cell activation which makes more IgE antibodies
What does chronic airway inflammation result from?
repeated exposure to the allergen
- we don’t want this bc it can lead to other lung probs
Explain mast cells.
- found in walls of respiratory tract
- increased number in pt’s with allergic asthma
- when exposed to allergen - mast cell degranulation
- allergen binds to IgE then mast cells release:
- bronchoconstrictors (histamine, leukotrienes, etc.)
- eosinophil and neutrophil chemotactic factors (attract more mast cells to area to make it worse)
Explain eosinophils
-once activated they release inflammatory mediators such as leukotrienes and granule proteins to injure airway tissue
Explain T-lymphocytes
- release cytokines that mediate the allergic rxn
- increase TH2 activity
Explain macrophages
- scavengers that engulf and digest bacteria
- release inflammatory mediators such as platelets activated factor and leukotrienes
- release neutrophil chemotactic factor and eosinophil chemotactic factor which amplify the inflammatory process
Explain epithelial cells
- can be activated by IgE dependent mechanisms, viruses, pollutants, histamine
- normally - clear mucocilliary and removal of noxious agents but in chronic asthma - epithelial shedding occurs
