Exam 2 Asthma, COPD, EVALi and CF Flashcards
Why are pulmonary drugs on the market growing?
- a growing prevalence of chronic obstructive pulmonary disease (COPD)
- the potential advantages of the pulmonary route as an alternative to oral and parenteral delivery methods
- rising incidence of lung disease → due to pollutants, irritants
What is a new pulmonary disease that is emerging?
E-cigarette/vaping product use Associated Lung Injury (EVALI)
What is the normal function of the lungs?
- has elastic property → can expand/deflate
- gas exchange in which O2 in being taken in and CO2 is being exhaled
- site of exchange are at the alveoli (around 480 million)
- cilia and mucus clean the lungs from dust and microbes
What is the triad of inducers?
genetic, medications, environmental
What is the definition of asthma?
- wheezing, coughing, shortness of breath
- narrowing of the airway
- inflammation and airway hyperreactivity
- release of inflammatory mediators
- constriction of airway smooth muscle
- excess secretion of mucus
- edema of respiratory mucosa
What is the wheezing mechanism?
normal airway → slightly narrowing of airway, velocity increases while pressure decreases → greater narrowing, velocity decreases while pressure increases → alteration of slight and great narrowing (flutter)
What is the difference between a normal airway, an asthmatic airway, and an asthmatic airway during attack?
normal airway → relaxed smooth muscles, walls are not inflamed or thickened
asthmatic airway → relaxed smooth muscles, walls are inflamed and thickened
asthmatic airway during attack → tightened smooth muscles, wall inflamed and thickened, air trapped in alveoli
What happens during the early reaction (immediate bronchoconstriction)?
- antigen binding to IgE antibodies triggers release of histamine, tryptase, LTC4, LTD4, and prostaglandins from mast cells
- bronchial smooth muscle contraction and vascular leakage
What happens during a delayed reaction (2-8 hours)?
- sustained bronchoconstriction
- activation of TH2 lymphocytes → release of GM-CSF, IL-4, IL-5, IL-13
- mucus hypersecretion → goblet cells
- cellular infiltration → eosinophils
How are mast cells activated?
- IgE is bound to FcR
2. crosslinking by the antigen leads to mast cell degranulation
What are some terms and phrases regarding asthma?
- IAR → immediate asthmatic response
- LAR → late asthmatic response
- FEV1 → forced expiratory volume
- ECP → eosinophil cationic protein (a cytotoxic secretory protein and marker of inflammation)
- PAF → platelet activating factor (hyper-responsiveness)
- neutrophil proteases → may activate eosinophils
- periostin → matrix protein that is used as an asthma biomarker
What are the different phases of asthma?
- immediate asthma response → minutes and characterized by bronchoconstriction
- late asthma response → hours and characterized by submucosal edema, hyperresponsiveness
- chronic asthma → days and characterized by epithelial cell damage, mucus hypersecretion, hyperresponsiveness
Which phase of asthma is ECP and PAF associated with?
late asthma response and chronic asthma
How are cytokines produced in asthma?
allergen activates TH2 cells that activate/produce cytokines which then induce goblet cells along with bacterial products, proteinases, and oxidants to lead to the hypersecretion of mucus
What proteins on goblet cells lead to the development of hyperplasia?
EGFR and CLCA
