Asthma Flashcards
what are the three cardinal features of asthma?
airway nflammation
reversible airflow obstruction
airway hyperresponsiveness
what type of T cell is present in allergic asthma?
Th2 cells
what are the cytokines associated with allergic asthma and Th2 cell response?
IL4,5,13
what is a common Xray finding with asthma?
hyperinflated lungs with flattened diaphragm
name the seven immune cells that can be present in airway inflammation of asthma
B cell T cell Innate lymphoid cell eosinophil neutrophil mast cells dendritic cells
what is the first step in starting allergic asthma reaction
dendritic cell recognizes antigen
what is the second step in allergic asthma response?
dendritic cell presents the antigen to the T cells and makes Th2 cells
what do Th2 cells in allergic asthma release that stimulates B cells? What do B cells release in response?
T cells release IL-4 and B cells respond to the IL-4 by releasing IgE
in allergic asthma, the IgE from the B cells are in charge of what?
mast cell degranulation by crosslinking
mast cell degranulation leads to three important responses…name them
bronchoconstriction
vasodilation
mucus production
in allergic asthma, Th2 cells release a cytokine that induces eosinophils…what cytokine is it?
IL-5
in allergic asthma, what do eosinophils cause?
inflammation in the airways
Th2 cells in allergic asthma release IL-13, what are its functions (2)
mucous cell metaplasia…goblet cells
airway smooth muscle hypertrophy
in late onset eosinophilic asthma, what are the three cytokines released from epithelial cells that drive the asthmatic reaction?
IL-25
IL-33
TSLP
what are the cytokine mediators that lead to the response in late onset eosinophilic asthma?
IL5 and 13…ac
compared to allergic asthma, what key cytokine and immune response is missing in late onset eosinophilic asthma?
IL-4 and mast cell degranulation via IgEs
in late onset eosinophilic asthma, the cytokines IL-25,33 and TSLP all go to a cell and make it secrete other cytokines…what is this type of cell?
innate lymphoid cell
what cytokines does the innate lymphoid cell secrete?
IL- 5 and IL-13
what does AERD stand for?
aspirin exacerbated respiratory disease
explain how AERD occurs
since Aspirin blocks the cyclooxygenase pathway from arachidonic acid…the acid mainly goes down the lipoxygenase pathway and into leukotrienes
what is the symptom triad for AERD
aspirin use
nasal polyps
asthma
what type of T cell is in neutrophilic asthma?
Th17 cell
what cytokine is really important in neutrophilic asthma? what cell secretes it?
IL-17
Th17 cell
what is IL-17s role in neutrophilic asthma?
leads to a chemokine for neutrophils to migrate out of vasculature
is eosinophilic asthma sensitive to steroids?
yes
is neutrophilic asthma sensitive to steroids?
yes
which type of asthma is severe and which type is mild/moderate? choices of eosinophilic or neutrophilic
eosinophilic is mild
neutrophilic is severe
name the three hallmarks of airway remodeling in asthma
thickened basement membrane
airway smooth muscle hyperplasia
mucous metaplasia
what is asthma affect on DLCO?
it is sometimes elevated or normal
what is an odd trigger of asthma that is important to remember?
STRESS
name the four symptoms usually seen in asthma presentation
cough
dyspnea
chest tightness
wheezing
does wheezing occur during expiration inspiration or both? what about stridor?
wheezing is during expiration…stridor can be during both
what is a chemical that induces asthmatic airway hyperresponsiveness but does not induce in normal airway?
methacholine
explain why methacholine is used for asthma testing
methacholine causes hyperesponsiveness in the asthmatic airways but does not in normal airways
what are three diagnostic tests for asthma?
spirometry
peak flow variability
methacholine challenge testing
what chemical do inflammed epithelial cells release that can be tested for asthma?
nitric oxide (NO)
in what type of asthma will NO be elevated from the epithelial cells?
eosinophilic
what cells release NO in eosinophilic asthma?
epithelial cells
what type of asthma is induced sputum used for? is this common?
eosinophilic…cause can see the eosinophils…not common
name the rescue asthma treatment
albuterol
what are the three controller asthma medication options
inhaled glucocorticoids
long acting beta agonists
leukotriene modifier
what is the leukotriene modifier that is used for asthma?
montelukast
