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(CLINICAL PRESENTATION (dyspnea, wheezing, chest tightness, productive…
PATHOPHYSIOLOGY
Bronchial mucosa exposure to antigen
activates dendritic cells and trigger helper cellsTH2
TH2 release inflammatory cytokines and interleukins IL-4 and IL-5
activates eosinophils and B-lymphocytes
plasma cells produce antigen-specific IgE & bind to mast cells
mast cell degranulation & release of inflammatory mediators
interleukins
platelet activating factor
prostaglandins
leukotrienes
bradykinins
histamine
LATE ASTHMA RESPONSE
EARLY ASTHMA RESPONSE
EPIDEMIOLOGY
common in industrialize country with prevalence rate 2-10%
Unites States
higher in whites than in blacks
Canada
England
Australia
Germany
New Zealand
Common in Ages
children
elderly
common in gender
boys during chilhood
females after puberty
CLINICAL PRESENTATION
dyspnea
wheezing
chest tightness
productive cough with thick, clear or yellow sputum
hyper-resonant lung field
diminished breath sound
rapid pulse
profuse perspiration
anxiety
DIAGNOSIS
Personal & Medical history
Comprehensive physical examination
Lung function test
Spirometry test
Peak airflow test
Trigger test
Arterial Blood Gas
chest xray
complete blood count
RISK FACTORS
hereditary
genetics
having another allergic condition
overweight or obesity
smoker
pollution
age
GERD
TREATMENT
short and long acting beta-agonist
oral or inhaled corticosteroids
leukotriene modifiers
combination inhalers
theophylline
mast cell stabilizer
Omalizumab medication
