Asthma and sarcoidosis Flashcards
Describe 2 pathophysiological components of asthma
1) Bronchoconstriction: Results from hypersensitivity to stimuli. Parasympathetic reflex in bronchioles leads to smooth muscle contraction (contrary to other areas of body).
2) Inflammation: Immune response from TH2 cells that are antigen presenting cells. Mast cells secrete histamines.
Describe the innervation of bronchioles by the autonomous nerve systems
A posterior pulmonary nerve plexus lies at the root of the lung and comprises sympathetic (T2–4) and parasympathetic (vagal) fibres. Fibres pass from thence around the lung root to form an anterior pulmonary plexus. Fibres pass from these plexuses into the lung along the bronchi and blood vessels.
What is the hygiene hypothesis?
Childhood exposure to various antigens (for example, endotoxins) increases immune tolerance.
What is the pathological feature of a sarcoidosis lesion?
Non-caseating granulomas - mass of immune cells
What is the difference between caseating vs non-caseating granuloma?
Caseating means necrosis at the center of the mass
When does mTOR pathway become activated, and how does it affect granuloma?
Too much mTOR = more granuloma
Granuloma is the result of increased proliferation of macrophages. The mTOR pathway can drive this proliferation.
What are the characteristics of inflammation?
1) Rubor (redness)
2) Tumor (swelling)
3) Calor (heat)
4) Dolor (pain)
Sarcoidosis
An inflammatory disease that leads to the formation of abnormal masses or nodules (called granulomas) that can occur in all parts of the body. Mostly occurs in the lungs and lymph glands.
Name treatment methods for asthma?
1) Adrenergic receptor (β) leads to smooth muscle relaxation in bronchioles. Therefore treatment involves inhaling β agonists
2) Can use a corticosteroid.
What are some symptoms of sarcoidosis?
1) Restrictive lung symptoms
2) Skin nodules
3) Lymph node enlargement
4) Organomegaly
Sarcoidosis vs Tuberculosis
Tuberculosis leads to the formation of caseating granuloma (necrotic cells at center of mass).
Noncaseating granulomas are characteristics of sarcoidosis. Granuloma does not contain necrotic cell core.
Name a treatment method for sarcoidosis?
Corticosteroids (prednisone). Can also resolve itself on its own.
T/F: Sarcoidosis may involve all organ systems.
True
T/F: Intracellular pathogens cause central necrosis of granulomas.
True, tuberculosis. Sarcoidosis is non-caseating.
T/F: mTOR activity is positively correlated with clinical progressiveness of sarcoidosis
True, more mTOR means more sarcoidosis
