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Bronchospasm
Bronchial hyperresponsiveness (BHR)
Inflammation
Eosinophile activation
Epithelial destruction
Glandular destruction
Collagen deposition
Cough and/or
Wheeze and/or
Shortness of breath or chest tightness
· Atopic diseases
Allergic rhinitis
Atopic dermatitis
A child with one atopic disease is at threefold risk of developing at least one of the others
· 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
· Viral UR/LRI causes increased bronchial hyperresponsiveness
· Exercise: Symptoms usually occur a few min after beginning exercise and resolve 20 min after