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Medizin (Fach) / Asthma (Lektion)
- layers of the bronchi ciliated columnar epithelial cells and goblet cells; mucus basement membrane lamina propria smooth bronchial muscle cells submucosa with submucosal glands cartilage plates
- asthma: symptoms Wheezing Breathlessness Coughing Chest tightness
- two different types of asthma atopic = allergic asthma airway hyperresponsiveness chronic inflammation chronic exposure B cell activation IgE production non-atopic asthma cold air, noxious gases
- exposure to allergen: atopic asthma CD4+ T helper 2 cells (adaptive immune system cells): Interleukin 4, IL 5, IL 13 IL 5 and IL 13 call for Eosinophils
- what do Eosinophils in atopic asthma cytotoxic proteins, fantastic to get rid of multicellular parasites, now recruited into the lamina propria ECP = Eosinophil Cationic Protein MBP = Major Basic Protein Eosinophil derived neurotoxin TGF beta = transforming growth factor beta ... acts on the airway smooth muscle cells: hypertrophy and hyperplasia... bronchial constriction
- antiasthmatic drugs: stage 1 treatment Stage 1 short acting beta 2 agonists --> aerosol inhalation, bronchodilation Salbutamol Terbutaline
- asthma treatment stage 2 Stage 2 inhaled Glucocorticoid given with dry inhalers twice a day Beclometasone, Budesonide, Fluticasone, Mometasone, Ciclosemide T helper 2 cells come into lamina propria and release Cytokines (IL4, IL5, IL 13), call for Eosinophils Stage 2 medication stops T helper 2 cells to produce these Cytokines
- asthma treatment: stage 3 Stage 3 long acting beta 2 agonists aerosol inhalation twice a day Salmeterol, Formoterol stops bronchial smooth muscle cells from being able to contract even if Histamine and Cysteinyl Leukotrienes are being generated in the extracellular fluid by the mast cells
- asthma treatment: stage 4 Stage 4 nonselective Phosphodiesterase inhibitors --> Xanthine drugs as Theophylline, Euprofylline (orally) Cysteinyl Leukotriene receptor antagonists work on CysLT1 on the surface of the bronchial smooth muscle cells
- asthma treatment: Stage 5 Stage 5 oral Glucocorticoids: Prednisone immunosuppression stopping the adaptive immune response
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