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Asthma

Pathophysiology of Asthma

Bronchospasm

Bronchial hyperresponsiveness (BHR)

Inflammation

Eosinophile activation

Epithelial destruction

Glandular destruction

Collagen deposition

Asthma Symptoms

Cough and/or

Wheeze and/or

Shortness of breath or chest tightness

Asthma is Inherited

Atopic diseases

Allergic rhinitis

Atopic dermatitis

A child with one atopic disease is at threefold risk of developing at least one of the others

Eosinophile Activation

Activation via IL5

Increase longevity

Hypodense and harder to kill

Prevented by high dose corticosteroids

Mechanisms of Asthma

Genetic disease

CD4(2) cell medicated

Eosinophil/macrophage induced inflammation

Viral LRI (RSV): as many as 50% will have recurrent wheezing

Smoking (active or passive)

Allergens (especially cat, dog, and house dust mite)

The disease is CD4(2) cell mediated

Eosinophil/macrophage induced inflammation

Asthma: Triggers

Viral UR/LRI causes increased bronchial hyperresponsiveness

Exercise: Symptoms usually occur a few min after beginning exercise and resolve 20 min after