Clinical trial of a novel drug Flashcards
Inflammatory cells in asthma?
Eosinophils, Mast cells, Th2 lymphocytes.
Inflammatory cells in COPD?
Neutrophils, Macrophages, Tc1 lymphocytes.
Inflammatory mediators in asthma?
IL-4, IL5
Inflammatory mediators in COPD?
TNF alpha, IL-8
How do you treat asthma?
Bronchodilators, Corticosteroids.
Asthma pathology?
Bronchoconstriction + mucus. Formation of mucus plug in airway lumen.
Types of COPD?
Chronic bronchitis, chronic bronchiolitis (small airways disease), emphysema.
Chronic bronchitis pathology?
Long-term inflammation on bronchi. Mucus hypersecretion resulting in luminal obstruction. Hyperplasia of goblet cells, hypertrophy of submucosal glands.
Chronic bronchiolitis pathology?
Occurs in bronchioles. Fibrosis and inflammation around airways. Fibrosis around airways leads to narrowed airways.
Emphysema pathology?
Lung tissue destruction (alveoli). Disrupted alveolar attatchments which can lead to collapsing of alveolar.
What are mucolytic drugs the most effective for treating?
Chronic bronchitis
What is a bronchoalveolar lavage
A saline solution is put through the bronchoscope to wash the airways and capture a fluid sample.
Why may a bronchoalveolar lavage be done?
To examine protease activity.
What test may be done to analyse severity of emphysema?
High resolution CT scanning. Counting number of holes and size of holes.
Why does smoking make chronic bronchitis worse?
Cigarette smoke slows down cillia and kills cillia. Less ciliated cells so less mucocilliary clearance.
What are the two types of emphysema?
Centriacinar emphysema and panacinar emphysema.
What causes centriacinar emphysema?
Smoking.
What causes panacinar emphysema?
A1AT deficiency.
Centriacinar emphysema vs panacinar emphysema?
Centriacinar involves loss of the respiratory bronchioles in the proximal portion of the acinus with sparing of distal alveoli. Panacinar involves all lung fields, particularly the bases.
What can help treat COPD?
Protease inhibitor.
Why don’t endogenous antiproteases inhibitors work in COPD?
You have lots of proteases in COPD. Oxidants decrease activity of antiproteases.
Why don’t bronchodilators work with COPD?
COPD doesn’t constrict airways.
