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PHRD5985 Pharmacotherapy Lecture 8 - Airway & Lung Diseases
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cells that distinguishes asthma from other airway diseases
eosinophils - infiltrate airways
4 characteristics of asthma
1) chronically inflamed airways
2) airway hyperreactivity
3) airway SM hypertrophy
4) IgE-mediated immune response
resultant immune response in Hygiene Hypothesis
dec Th1 response (infection fighting)
inc Th2 response (allergic diseases)
how long asthmatic episode hyperreactivity can last for
several weeks
early response asthmatic episode due to...
mediator release from mast cells
late response asthmatic episode due to...
mediator release from inflammatory cells recruited by substances released from mast cells
non-specific stimuli that can inc airway reactivity (3)
1) cold air
2) inhaled irritants
3) exercise
key clinical (immunological) feature of asthma
immediate hypersensitivity (type I) response (allergic reaction) -> IgE mediated
used in bronchial provocation test
methacholine
syndrome of progressive
non-reversible
airflow limitation caused by chronic inflammation of
small airways & alveoli
COPD
COPD is an umbrella term that encompasses what 3 diseases?
1) chronic bronchitis
2) emphysema
3) small airways disease
cells involved in chronically inflamed airways of COPD pts
macrophages
CD8+ lymphocytes
neutrophils
4 features of COPD
1) chronically inflamed airways
2) imbalance between protease & antiprotease activity
3) airway remodeling
4) pulmonary vascular changes
list 2 proteases
1) MMPs
2) neutrophil elastase
list 2 protease inhibitors
1) TIMPs
2)
1
-antitrypsin (AAT)
cause irreversible expiratory flow limitation
airway narrowing + peripheral airway destruction
what is wrong with the immune cells involved in COPD?
macrophages & neutrophils have a reduce capacity to phagocytize bacteria & are less responsive to effects of CCS's
why might an undiagnosed pt w/ COPD only show up to the clinic when their disease is very severe?
pulmonary function can deteriorate BEFORE symptoms manifest
main inflammatory cells involved in COPD
macrophages
neutrophils
CD8+ lymphocytes
main inflammatory cells involved in asthma
eosinophils
mast cells
CD4+ (Th2) lymphocytes
airways involved in asthma vs COPD
asthma
: central
COPD
: small/peripheral
majority of pts w/ CF have this mutation
Phe508del
what happens when Phe508 is deleted?
failure of channel to be expressed in cell membrane leads to decreased Cl- secretion
4 effects of defective chloride channels
1) inc Na+ reabsorption
2) inc H2O reabsorption
3) hyperviscous mucus
4) dec sol fluid
how inflammatory cells cause tissue damage
ROS & protease release
diagnostic test for CFTR mutation
sweat chloride testing
pulmonary therapeutic objectives for treatment of CF
1) relieve mucus obstruction/make it easier to breathe
2) treat lung infection
Author
daynuhmay
ID
269714
Card Set
PHRD5985 Pharmacotherapy Lecture 8 - Airway & Lung Diseases
Description
Airway Lung Diseases
Updated
2014-04-08T09:08:14Z
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