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Title: Cell and mediators of Asthma
Description: This is a lecture on Cell and mediators of Asthma as part of the St. Georges University Biomedical Science course in the Human Cardiovascular and Respiratory Pharmacology module.
Description: This is a lecture on Cell and mediators of Asthma as part of the St. Georges University Biomedical Science course in the Human Cardiovascular and Respiratory Pharmacology module.
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Asthma and allergy
Cells involved in asthma
Mediators involved in asthma
Difficulties in finding a cure
Definition
Asthma is a chronic inflammatory disease of the bronchial airways characterised by
episodes of:
Wheeze
Chest tightness
Dyspnoea
Cough
Exhibits variability (worse at night/early morning) - differs from COPD
Improves with treatment - (reversible)
Prevalence
Recent increase in prevalence worldwide
Commonest chronic respiratory disease in UK
Uk prevalence - 10-15%
Pathophysiology
Condition of intermittent airway obstruction caused by
Chronic airway inflammation (eosinophils, lymphocytes, mast cells)
Airway hyper responsiveness --> smooth muscle contraction
Increased Mucus production
If above not adequately controlled then --> Airway remodelling and fixed airway changes
over 10-15 yrs
If exercise causes wheezing then the asthma treatment isn't working
Inhalers prevent airway remodelling
They wouldn't work if the airways were already remodelled
Intrinsic vs Extrinsic Asthma
Extrinsic (allergic component)
Clear atopic component
Elevated IgE in blood
Can start at an early age
Intrinsic
No atopy (normal IgE)
Develops later in life
More sever and difficult to treat (Irreversible/harder to reverse - asthma or early
COPD?)
Atopy ('out of place')
Atopy is the hereditary predisposition to produce IgE antibodies against common
environmental allergens (typically hayfever)
The atopic diseases are:
Allergic Rhinitis
Asthma
Atopic eczema
Allergic tissue reactions (in atopic subjects) are characterised by infiltration of Th2 cells
Allergy is an exaggerated immunological response to a foreign substance (allergen)
which is either inhaled, swallowed, injected or comes in contact with the skin or eye
Common allergens include: grass, weed, tree pollens, house dust mites, fungal
spores, animal products and certain foods
Von Pirquets Original concept
Allergy
Expressing itself as either:
Clinical immunity (protection) (good)
Clinical hypersensitivity (Allergy) (bad)
Allergy now only refers to 'bad'
Anaphylaxis = opposite of prophylaxis
Cells involved in asthma
Allergen
Body should ignore it but DC doesn't
TH2 make IgE against pollen
IgE then coats mast cells
Asthma
Smooth muscle disorder
Large and medium airway vessels
Small distal vessels have no SM
COPD
Disorder of the small distal vessels
Allergic people are more TH2 dependant
Most people are TH1 dependant
If Treg gos wrong it can go down the TH2 path
TH2 cells are designed for helminths and worm infections (western world doesn't need
them as much)
Hygiene hypothesis - 'too clean' --> need to get more infections to get TH1 (?)
TH1 kills viruses etc
...
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Title: Cell and mediators of Asthma
Description: This is a lecture on Cell and mediators of Asthma as part of the St. Georges University Biomedical Science course in the Human Cardiovascular and Respiratory Pharmacology module.
Description: This is a lecture on Cell and mediators of Asthma as part of the St. Georges University Biomedical Science course in the Human Cardiovascular and Respiratory Pharmacology module.