Asthma Pathophysiology

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too goog
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  Notes
 
 
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:
Slide 7 : Jun-09 Asthma Pathogenetic Types: Extrinsic (Allergic/Immune) Atopic - IgE Occupational - IgG A. Bronchopulomonary Aspergillosis - IgE Intrinsic (Non immune) Aspirin induced Infections induced
Slide 8 : Jun-09 Pathogenesis - Atopic Asthma:
Slide 9 : Jun-09 Mast cells in Asthma Pathogenesis:
Slide 10 : Jun-09 Eosinophils in Asthma Pathogenesis:
Slide 11 : Jun-09 Lung Morphology in Asthma Bronchial inflammation Edema, Mucousplugging Bronchospasm Obstruction Over inflation/Atelectasis COPD
Slide 12 : Jun-09 Lung Hyperinflation in Asthma
Slide 13 : Jun-09 Thick bronchi with Mucous plugs
Slide 14 : Jun-09 Mucous plug in asthma:
Slide 15 : 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
Slide 24 : 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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