Professional Documents
Culture Documents
01/11/09
Asthma-Pathology -3
Asthma:
Chronic Inflammatory disorder of
bronchi characterized by Episodic,
reversible bronchospasm resulting
from an exaggerated
bronchoconstrictor response to
various stimuli (allergy)
Affects 10% of children & 5%-7%
adults
Highest in NZ, Low in Fiji ~ 1% ♥
01/11/09 Shashi
Asthma-Pathology -4
Asthma Facts ?
Asthma is “all in the mind.”
You will “grow out of it.”
Asthma can be cured,
Not very serious disease and nobody dies from it.
You are likely to develop asthma if someone in
your family has it.
You can “catch” asthma from someone else who
has it.
Moving to a different location can cure asthma.
People with asthma should not exercise.
Asthma does not require medical treatment.
Medications used to treat asthma are habit-
forming.
Someone with asthma can provoke episodes
anytime.
Asthma can spread to other persons through
01/11/09 Shashi
Asthma-Pathology -5
Percent Change in Age-
Adjusted Death Rates, U.S.,
1965-1998
Proportion of 1965 Rate
3.0
Coronary Stroke Other CVD COPD All Other
2.5 Heart Causes
Disease
2.0
1.5
1.0
0.5
–59% –64% –35% +163% –7%
0
1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998
01/11/09 Shashi
Asthma-Pathology -6
Pathogenesi INDUCERS
s: Allergens,Chemical sensitisers,
Airway Air pollutants, Virus infections
Hyperresponsiveness
Genetic*
INFLAMMATION
Airflow Limitation
TRIGGERS
SYMPTOMS
Allergens, Exercise,
Cough Wheeze
Cold Air, SO2 Particulates
Dyspnoea
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Asthma-Pathology -8
Pathogenesis - Atopic
Asthma:
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Asthma-Pathology -9
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Asthma-Pathology -10
Eosinophils in Asthma
Pathogenesis:
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Asthma-Pathology -11
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Asthma-Pathology -12
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Asthma-Pathology -13
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Asthma-Pathology -14
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Asthma-Pathology -15
Asthma - Micropathology
Asthma Microscopic
Pathology
Obstructed
Inflammed
Bronchi
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Asthma-Pathology -17
inflammation
Eosinophils
Gland
hyperplasia
Mucous plug in
lumen
Hypertrophy of
muscle layer
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Asthma-Pathology -18
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Asthma-Pathology -19
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Asthma-Pathology -20
Eosinophils in Asthma:
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Asthma-Pathology -21
Curschmann's spirals:
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Asthma-Pathology -22
LTD4
Bronchospasm – Cys-LT1 receptor
CysLT1
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Asthma-Pathology -23
Cell Damage
Cell Membrane
Phospholipids
Steroids
Arachidonic
Acid Cyclooxygenas
5-Lipoxygenase
NSAID e
Prostaglandins
Leukotrienes
Prostacyclins
LTC4, D4, E4
5-LO inhibitors
Antileukotrienes
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Asthma-Pathology -24
History of Leukotrienes:
Samuelsson et al. (1979) Stockholm
found arachidonic acid metabolites in
anaphylaxis, (SRS) called them
"leukotrienes.“ now known to be
cysteinyl leukotrienes (LT-C4, D4 and
E4).
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Asthma-Pathology -25
The Reality
Asthma is not yet curable *
Underdiagnosis &
Undermanagement
Therapy is still evolving
Hope
Better understanding of
Pathology
New line of Promissing Drugs.
01/11/09
Proper management normalShashi
Thank You…
Th2 cell
Leukotrienes
Neutrophil
C4, D4 & E4
Eosinophil
Mucus plug
Epithelial shedding
Nerve activation
Subepithelial
fibrosis
Plasma leak
Sensory nerve
Oedema activation
Vasodilatation Cholinergic
Mucus New vessels reflex
hypersecretion
Hyperplasia Bronchoconstriction
Hypertrophy/hyperplasia
01/11/09
Barnes01/11/09
PJ Shashi
Asthma-Pathology -28
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Barnes01/11/09
PJ Shashi
Asthma-Pathology -29
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Barnes01/11/09
PJ Shashi
Asthma-Pathology -30
Type I Hypersensitivity:
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Barnes01/11/09
PJ Shashi
Asthma-Pathology -31
Therapy - Pathology:
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Barnes01/11/09
PJ Shashi