Asthma Pathophysiology

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manoj dias on Feb 07, 2013 Says :

good presentation.

awadhesh tiwari on Nov 23, 2012 Says :

superb ppt sir sir plz send ths to me plzzz sir my id is awadhesh8989@gmail.com

charan vallabhu on Jul 06, 2012 Says :

superb presentation

arsh on Jan 24, 2012 Says :

thnx........

li on Feb 25, 2011 Says :

good

doc on Dec 07, 2009 Says :

too goog

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Slide 1 :

?!*$# “Twenty years from nowyou will be more disappointedby the things you didn't do than by those you did.” ...Catch the trade winds in your sails, explore, dream, discover & live….! ” - Mark Twain

Slide 2 :

Jun-09 Asthma Pathophysiology Dr. Venkatesh M. Shashidhar. Senior Lecturer in Pathology Fiji School of Medicine

Slide 3 :

Jun-09 Asthma: Chronic Inflammatory disorder of bronchi characterized by Episodic, reversible bronchospasm resulting from an exaggerated bronchoconstrictor response to various stimuli (allergy) Affects 10% of children & 5%-7% adults Highest in NZ, Low in Fiji ~ 1% ?

Slide 4 :

Jun-09 Asthma Facts ? Asthma is “all in the mind.” You will “grow out of it.” Asthma can be cured, Not very serious disease and nobody dies from it. You are likely to develop asthma if someone in your family has it. You can “catch” asthma from someone else who has it. Moving to a different location can cure asthma. People with asthma should not exercise. Asthma does not require medical treatment. Medications used to treat asthma are habit-forming. Someone with asthma can provoke episodes anytime. Asthma can spread to other persons through caughing. Asthma is born with you. Familial/genetic.

Slide 5 :

Jun-09 Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998 0 0.5 1.0 1.5 2.0 2.5 3.0 Proportion of 1965 Rate 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 –59% –64% –35% +163% –7% Coronary Heart Disease Stroke Other CVD COPD All Other Causes

Slide 6 :

Jun-09 INFLAMMATION Pathogenesis:

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Jun-09 Asthma Pathogenetic Types: Extrinsic (Allergic/Immune) Atopic - IgE Occupational - IgG A. Bronchopulomonary Aspergillosis - IgE Intrinsic (Non immune) Aspirin induced Infections induced

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Jun-09 Pathogenesis - Atopic Asthma:

Slide 9 :

Jun-09 Mast cells in Asthma Pathogenesis:

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Jun-09 Eosinophils in Asthma Pathogenesis:

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Jun-09 Lung Morphology in Asthma Bronchial inflammation Edema, Mucousplugging Bronchospasm Obstruction Over inflation/Atelectasis COPD

Slide 12 :

Jun-09 Lung Hyperinflation in Asthma

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Jun-09 Thick bronchi with Mucous plugs

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Jun-09 Mucous plug in asthma:

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Jun-09 Asthma - Micropathology Patchy necrosis of epithelium Sub-mucosal glandular hyperplasia Hypertrophy of bronchial smooth muscle Eosinophils, mast cells; lympho (TH2, CD4) Mucous plugs, Curschmann spirals, Charcot Layden crystals.

Slide 16 :

Jun-09 Asthma Microscopic Pathology Obstructed Inflammed Bronchi

Slide 17 :

Jun-09 Asthma - Bronchial morphology inflammation Eosinophils Gland hyperplasia Mucous plug in lumen Hypertrophy of muscle layer

Slide 18 :

Jun-09 Asthma - Bronchial morphology Inflammation Mucous Plug Eosinophils

Slide 19 :

Jun-09 Asthma – TH2 lymphocytesimmunostaining)

Slide 20 :

Jun-09 Eosinophils in Asthma:

Slide 21 :

Jun-09 Curschmann's spirals:

Slide 22 :

Jun-09 New Pathology & Drugs in Asthma: Leukotriences - significant role in Asthma Mast cells and Eosinophil - Cytokines. Arachidonic acid - Lipo-oxygenase – LTD4 Bronchospasm – Cys-LT1 receptor Zileuton – Lipoxygenase inhibitor Montelukast & zafirlukast - inhibit CysLT1

Slide 23 :

Jun-09 5-LO inhibitors Antileukotrienes

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Jun-09 History of Leukotrienes: Samuelsson et al. (1979) Stockholm found arachidonic acid metabolites in anaphylaxis, (SRS) called them "leukotrienes.“ now known to be cysteinyl leukotrienes (LT-C4, D4 and E4). * Samuelsson later won the Nobel Prize

Slide 25 :

Jun-09 The Reality ? Asthma is not yet curable * Underdiagnosis & Undermanagement Therapy is still evolving Hope ? Better understanding of Pathology New line of Promissing Drugs. Proper management ? normal life.

Slide 26 :

Jun-09 Thank You… Dr. Venkatesh M. Shashidhar. Senior Lecturer in Pathology Fiji School of Medicine

Slide 27 :

Jun-09 Asthma Pathology - Modern view Barnes PJ Leukotrienes C4, D4 & E4

Slide 28 :

Jun-09 Mast cell Degranulation Barnes PJ Normal 5 Seconds 60 Seconds

Slide 29 :

Jun-09 Mast cell Degranulation Barnes PJ

Slide 30 :

Jun-09 Type I Hypersensitivity: Barnes PJ

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You are likely to develop asthma if someone in your family has it. .... Asthma is a complex disease more You are likely to develop asthma if someone in your family has it. .... Asthma is a complex disease involving many different cells; Current thinking on the ... less
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