general concepts in asthma treatment
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General concepts in asthma treatmentTRANSCRIPT
GENERAL CONCEPTS IN ASTHMA TREATMENT
Lloyd K. National Medical University
Department of Internal MedicineKyiv Ukraine
Teacher: Irina Olegivna
Introduction
Asthma is a syndrome characterized by airflow obstruction that varies markedly, both spontaneously and with treatment.
Key Elements
Marked Improvement with treatment.
Hyper-responsive airways
Excessive narrowing in response to trigger factors.
Patients are often atopic.
Factors to consider
Etiology
Pathogenesis
Symptoms
Etiology
Endogenous
Genetic predisposition
Atopy
Hyper-responsiveness
Environmental factors
Allergens
Smoking
Occupation
Trigger factors
Pathogenesis of Asthma
Pathogenesis
Pathology
Main symptoms
Wheezing
Coughing that won’t stop
Shortness of breath
Tightness in chest.
Classification of severity
Classification of Asthma drugs
Steps of treatment
Specific allergen immunotherapy ("Allergy Shots")
Decreases sensitivity to the things to which the person is allergic.
Increases the person’s resistance to the things causing their allergies.
Vaccines are made from pollens, mold spores, animal dander, dust mites or bee venom.
In the future, vaccines may be nose sprays or drops under the tongue.
Immunoglobulin E (IgE) and anti-IgE
Immune system includes cells and proteins.
The proteins include antibodies and cytokines.
Immunoglobulin E (IgE) is the type of antibody that causes allergic reactions
If IgE could be stopped from binding to the cells, the chemicals would not be released.
Omalizumab is a man-made antibody against IgE (anti-IgE).
Immunoglobulin E (IgE) and anti-IgE Treatment is given by injection (shots) once
or twice a month.
Cytokines and cytokine inhibitors
Chemists have been making new treatments called cytokine inhibitors.
These prevent the cytokines (Type 2) from inducing production of other cytokines and inhibiting Type 1 cytokines.
Peptide immunotherapy ("Allergy shots")
In research, peptide allergy shots have been used to treat people allergic to cats.
People who were given peptide allergy shots had fewer allergy problems in their nose and lungs.
New findings
A novel molecule that prevents T-cells from orchestrating asthma brought on by allergens has been identified.
The molecule is a sulfate monosaccharide, that inhibits the signal that recruits T-cells to the lungs to start an asthma attack
New findings
The molecule substantially lessened asthma symptoms such as inflammation, mucus production, and airway constriction
Synthetic sulfate monosaccharide blocks the interaction between chemokine CCL20—a T-cell signaling protein—and heparin sulfate, a molecule that protects and immobilizes CCL20 on epithelial cells in the lung.
New findings
Blocking this interaction stalled the recruitment of the T-cells that trigger inflammation
References
Harrison's principles of internal medicine. –New York : McGraw-Hill Medical, 2008. – Т. 2. – С. 1918-1925.