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Respiratory - Asthma (dropped image link (Types of Asthma (Cold-Induced…
Respiratory - Asthma
PathoPhys of ASthma
- note that in normal asthma, the most important factor is IgE since it is closest to an Ellergic reaction
- but in Atopic asthma specifically, eosinophils are very important = IL - 5 and IgA
- high Th2 / Th3 ratio in asthma
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Notes:
- note that histamine and leukotrienes are the first things to be released from activated masts cells in asthma
- late phase = hours later there are major basic proteins released
--> major basic proteins cause further inflammation
Asthma Medications
SABAs
Clinical Cases
SABAs
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Notes:
- SABAs are Beta-2 agonists that work through Gs protein coupled receptors
--> increase cAMP
--> increase PKA
--> PKA inhibits mysoin phosphorylation (-->?)
--> cAMP also lowers calcium levels (think "cAMP CLAMPS down calcium")
- note that Alpha-1 receptors are Gq couple receptors
--> these oppose Gs, indirectly but they increase calcium levels
- Alpha-2 are Gi receptors
--> decrease cAMP levels
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Types of Asthma
Cold-Induced Asthma
Clinical Cases
Cold-Induced Asthma
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Notes:
- aspirin induced / NERD asthma are similar to cold-induced asthma where anti-Leukotrienes are one of the best treatments, as opposed to exercise induce or other types of asthma where SABAs and SAMAs
- note in the above example the PFTs may show normal FEV1/FVC ratios, but clinically this may happen since they are not under exposure to their trigger
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Atopic Asthma
- note that in normal asthma, the most important factor is IgE since it is closest to an Ellergic reaction
- but in Atopic asthma specifically, eosinophils are very important = IL - 5 and IgA
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*OA = Occupational Asthma
- large subgroup of adult asthma = 25%
- if someone starts a new job with a new airway irritant and develops symptoms after a LATENT period
--> OA until proven otherwise with another trigger
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*Presentation of Asthma
- chest tightness"
--> key symptom of asthma
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