Asthma Case Study - Mariam Al-Saef

Children who experience viral respiratory infections may develop chronic asthma.

Maternal smoking during pregnancy increases the likelihood of asthma in children.

Obesity is associated with worse asthma symptoms, increased medication use, and poorer control over the condition.

<p>Allergic asthma is characterized by a history of allergic diseases and high IgE levels, often responding well to inhaled corticosteroids.</p> Signup and view all the answers

<p>Non-allergic asthma may show neutrophilic, eosinophilic, or minimal inflammatory cell profiles, with a lesser short-term response to ICS.</p> Signup and view all the answers

<p>Adult-onset asthma frequently occurs in women who present with asthma for the first time in adulthood.</p> Signup and view all the answers

<p>Exposure to ozone, a key component of smog, raises asthma risk, particularly among those living in urban areas.</p> Signup and view all the answers

<p>Th2 cells release cytokines like IL-4, IL-5, IL-9, and IL-13, which orchestrate allergic airway inflammation. These cytokines promote the differentiation of B cells into plasma cells, which produce IgE. IgE binds to mast cells, leading to their activation upon exposure to the allergen.</p> Signup and view all the answers

<p>Mast cell activation by allergens via IgE receptors leads to the release of histamine, leukotrienes, and other inflammatory mediators. These mediators cause bronchoconstriction, airway edema, and mucus hypersecretion, contributing to the characteristic symptoms of asthma, such as wheezing, breathlessness, and chest tightness.</p> Signup and view all the answers

<p>Physical activity can trigger asthma symptoms due to increased airway reactivity. Exercise-induced bronchospasm (EIB) occurs because cold, dry air can stimulate the release of inflammatory mediators, leading to bronchoconstriction. Additionally, strenuous exercise can lead to dehydration and hyperventilation, exacerbating airway narrowing.</p> Signup and view all the answers

<p>GERD can trigger asthma symptoms by allowing stomach acid to reflux into the esophagus and potentially irritate the airways. This acid reflux can stimulate the release of inflammatory mediators and increase airway sensitivity, leading to bronchospasm and other asthma symptoms.</p> Signup and view all the answers

<p>Identifying specific triggers allows for personalized management strategies. By avoiding or minimizing exposure to known triggers, individuals can reduce the frequency and severity of asthma exacerbations. This leads to improved quality of life, better symptom control, and a reduced need for medication.</p> Signup and view all the answers

<p>Beta blockers are medications that block the effects of beta-adrenergic receptors, which are involved in bronchodilation. By blocking these receptors, beta blockers can lead to bronchospasm and worsen asthma symptoms. In some cases, beta blockers can even trigger a severe asthma attack.</p> Signup and view all the answers

<p>IgE is an antibody that plays a central role in allergic reactions. In asthma, IgE binds to mast cells, and upon exposure to the allergen, triggers their activation. This leads to the release of inflammatory mediators that contribute to bronchospasm, inflammation, and other asthma symptoms.</p> Signup and view all the answers

<p>Bronchial challenge tests assess airway responsiveness by exposing the airways to a stimulus, such as methacholine or hypertonic saline. If the airways are hyperreactive, they will constrict in response to the stimulus, indicating asthma. This test helps to confirm a diagnosis of asthma and assess the severity of airway hyperresponsiveness.</p> Signup and view all the answers

<p>T-lymphocytes, specifically Th2 cells, play a key role in initiating and perpetuating allergic inflammation by releasing cytokines that drive the production of IgE. Mast cells, on the other hand, are activated by IgE upon allergen exposure, releasing inflammatory mediators that directly contribute to the symptoms of asthma.</p> Signup and view all the answers

<p>Asthma is characterized by chronic inflammation of the airways. This inflammation is driven by multiple inflammatory cells and mediators, and it contributes to the persistent airway hyperresponsiveness, bronchospasm, and other symptoms experienced by individuals with asthma.</p> Signup and view all the answers

<p>IgE plays a central role in allergic reactions. When an allergen binds to IgE attached to mast cells and other immune cells, it triggers the release of various mediators like histamine, leukotrienes, and cytokines. These mediators cause a rapid inflammatory response characterized by bronchoconstriction, airway edema, and mucus hypersecretion. The inflammation further attracts other immune cells, perpetuating the allergic response.</p> Signup and view all the answers

<p>Acute asthma exacerbations are characterized by rapid airway obstruction due to bronchoconstriction, airway wall thickening (edema), and mucus hypersecretion. These mechanisms differ from the chronic inflammation in asthma, which is characterized by persistent airway inflammation and remodeling. The acute changes are triggered by exposure to specific triggers and involve a more immediate release of inflammatory mediators, leading to rapid airway narrowing.</p> Signup and view all the answers

<p>Inflammatory mediators released during an acute asthma exacerbation directly contribute to airway obstruction by causing bronchoconstriction, edema, and mucus hypersecretion. However, these mediators also play a role in chronic inflammation by recruiting immune cells and promoting tissue remodeling. The persistent inflammation in asthma is driven by prolonged exposure to inflammatory mediators, leading to structural changes in the airways.</p> Signup and view all the answers

<p>Airway wall thickening, particularly due to edema, is a significant factor in acute asthma exacerbations. The edema arises from increased vascular permeability caused by inflammatory mediators, leading to fluid leakage into the airway wall. This thickening narrows the airway lumen, hindering airflow and contributing to the characteristic wheezing and dyspnea associated with asthma attacks.</p> Signup and view all the answers

<p>Recruitment of inflammatory cells, such as eosinophils, neutrophils, macrophages, and mast cells, plays a crucial role in asthma pathogenesis. These cells are attracted by chemokines released during the inflammatory response and contribute to the chronic airway inflammation and tissue remodeling. Each cell type has distinct roles, such as eosinophils releasing pro-inflammatory mediators and neutrophils contributing to airway hyperresponsiveness.</p> Signup and view all the answers

<p>Cysteinyl leukotrienes (LTC4, LTD4, and LTE4) are potent bronchoconstrictors that contribute to airway narrowing, edema, and inflammation in asthma. They are primarily released from mast cells but can also be produced by other cells. Their effects lead to symptoms such as breathlessness and cough. They are a therapeutic target because they are the only lipid mediators whose inhibition or antagonism has been shown to effectively improve asthma control.</p> Signup and view all the answers

<p>Eosinophils contain cytotoxic proteins like MBP, ECP, and EDN. When released, these proteins damage airway epithelial cells, disrupting the protective barrier. This damage allows allergens to penetrate deeper into the submucosa, sustaining and amplifying the inflammatory response, leading to a vicious cycle and worsening of asthma symptoms.</p> Signup and view all the answers

<p>Sensory nerves in the airways can be activated by various stimuli, including cold air, leading to reflex responses like bronchoconstriction, edema, mucus hypersecretion, and coughing. They also release inflammatory neuropeptides like substance P (SP), neurokinin A (NKA), and neurokinin B (NKB) which further contribute to these symptoms.</p> Signup and view all the answers

<p>Cholinergic nerves release acetylcholine (Ach) in response to various stimuli, including inflammatory mediators and afferent nerve activation. This release triggers bronchoconstriction and mucus secretion, contributing to airway narrowing and worsening asthma symptoms. They are particularly involved in severe asthma and exacerbations, highlighting their importance in disease severity.</p> Signup and view all the answers

<p>Cytokines are essential in asthma because they orchestrate and regulate the inflammatory response, influencing its duration and severity. They act as signaling molecules that direct the immune system's response. Examples of key cytokines in asthma include IL-4, IL-5, IL-9, and IL-13, each contributing to different aspects of the inflammatory process.</p> Signup and view all the answers

<p>Chemokines are crucial for recruiting inflammatory cells to the site of injury in the airways. They act as chemical messengers that attract immune cells to the inflamed area. Some chemokines are cytokines, like RANTES and IL-8, while others are lipid mediators, like LTB4 and PAF, all contributing to the inflammatory cell influx in asthma.</p> Signup and view all the answers

<p>Activated mucosal mast cells release bronchoconstrictor mediators, such as histamine and cysteinyl leukotrienes (LTC4, LTD4, and LTE4), which trigger a rapid narrowing of the airways and contribute to the early phase of the asthma response. This rapid response is characterized by immediate symptoms like wheezing and breathlessness.</p> Signup and view all the answers

<p>Histamine and leukotrienes, released from mast cells, are potent mediators of the inflammatory response in asthma. Histamine causes immediate bronchoconstriction, increased mucus production, and vasodilation, leading to airway narrowing. Leukotrienes, particularly cysteinyl leukotrienes, contribute to bronchoconstriction, airway edema, and increased vascular permeability, further perpetuating the inflammatory process and worsening asthma symptoms.</p> Signup and view all the answers

<p>IgE is a key antibody involved in allergic responses, including asthma. When an individual is sensitized to an allergen, IgE antibodies bind to mast cells and basophils. Upon re-exposure to the allergen, IgE cross-links, triggering the release of inflammatory mediators like histamine and leukotrienes from these cells, initiating the allergic response that contributes to asthma symptoms.</p> Signup and view all the answers

<p>Cold air can trigger asthma symptoms by stimulating sensory nerves in the airways. The cold temperature irritates these nerves, leading to bronchoconstriction, mucus hypersecretion, and coughing, contributing to an asthma attack. This response is likely due to the activation of a reflex pathway involving the vagus nerve and the release of inflammatory mediators.</p> Signup and view all the answers

<p>FEV1 stands for Forced Expiratory Volume in one second, and it is significant because it helps determine the severity of asthma by measuring the amount of air exhaled in the first second of a forced breath.</p> Signup and view all the answers

<p>FEV1 values of more than 80% predict mild asthma, 60-80% for moderate asthma, and less than 60% predict severe asthma.</p> Signup and view all the answers

<p>Reversibility indicates the positive response to bronchodilator therapy, essential for confirming asthma by showing significant increases in FEV1 post-treatment.</p> Signup and view all the answers

<p>A positive diagnosis requires an increase in FEV1 of more than 12% and more than 200 mL after bronchodilator use.</p> Signup and view all the answers

<p>In children, asthma is diagnosed if there is an increase in FEV1 of more than 12% predicted after treatment.</p> Signup and view all the answers

<p>Corticosteroids are crucial as they lead to significant increases in lung function after 4 weeks, supporting asthma management.</p> Signup and view all the answers

<p>FVC stands for Forced Vital Capacity, and it is often reduced similarly to FEV1 in asthma, providing a comprehensive view of lung function.</p> Signup and view all the answers

<p>Increased bronchial reactivity can lead to reduced FEV1, indicating asthma severity and facilitating diagnosis.</p> Signup and view all the answers

<p>A positive bronchodilator response indicates that the airways are reactively obstructed and guides clinicians in selecting appropriate asthma treatments.</p> Signup and view all the answers

A long-term respiratory condition often developed after viral infections in children.

Smokers and those exposed to secondhand smoke have higher asthma risks.

High levels of ozone pollution increase asthma risk, especially in urban areas.

Being overweight raises the risk of asthma, linked to inflammation and worse symptoms.

Distinct asthma types based on causes, characteristics, and responses to treatment.

Most common type of asthma, often starting in childhood with a history of allergies.

Asthma not linked to allergies, presents with various inflammatory cell profiles.

A device used to measure lung function, especially the volume of air inhaled and exhaled.

Forced Vital Capacity (FVC) is the total amount of air exhaled forcefully after taking a deep breath.

Forced Expiratory Volume in 1 second (FEV1) measures how much air a person can forcefully exhale in one second.

A measure that indicates the proportion of a person's forced vital capacity that they can exhale in one second; used to assess lung function.

Classification of asthma based on FEV1 values: mild (>80%), moderate (60-80%), severe (<60%).

A test to determine if lung function improves after using a bronchodilator medication; shows reversibility of airflow limitation.

Treatment using steroids to reduce inflammation and improve lung function; effectiveness assessed by FEV1 changes.

Diagnosis made if FEV1 increases by >12% and >200 mL after bronchodilator use. Different criteria apply to children.

The expected FEV1 value for an individual based on age, gender, and height; used as a benchmark for assessing lung health.

An antibody responsible for allergic reactions and inflammation.

A cell with many IgE receptors that plays a key role in allergic reactions.

Sudden constriction of airways, often due to allergen exposure.

Substances released by activated cells that contribute to inflammation and bronchoconstriction.

Swelling in the airway due to increased fluid leakage caused by inflammation.

Factors that can provoke asthma symptoms, varying per individual.

Substances like pollen and pet dander that can trigger asthma.

Infections such as the common cold that can exacerbate asthma.

Chilly temperatures that can provoke asthma symptoms.

Cells that release cytokines causing allergic airway inflammation.

Proteins like IL-4 and IL-5 that influence inflammation in asthma.

Immune response involving B lymphocytes producing antibodies against allergens.

Substances like smoke that can worsen asthma symptoms.

Condition that can trigger asthma symptoms through stomach acid reflux.

Cells that release histamine and leukotrienes, causing bronchoconstriction.

White blood cells containing cytotoxic proteins that damage airway cells.

Narrowing of the airways leading to difficulty in breathing.

Mediators that help in recruiting inflammatory cells to injury sites.

Bronchoconstrictors that cause edema and recruit inflammatory cells.

Nerves that release acetylcholine, involved in bronchoconstriction.

Substances released by sensory nerves causing bronchoconstriction.

Antibody linked to allergic responses and asthma.