Summary of Asthma : Etiology, Pathogenesis, Clinical features, Diagnosis and Treatment

Summary of Asthma: Etiology, Pathogenesis, Clinical Features, Diagnosis, and Treatment

Scientific Concepts and Discoveries:

• Asthma as an Obstructive Lung Disease: Characterized by hyperreactivity of the airways, leading to reversible obstruction and chronic inflammation.
• Types of Asthma:
  • Allergic (Atopic) Asthma: Most common, often begins in childhood, associated with atopy, and has a good response to treatment.
  • Non-allergic (Intrinsic) Asthma: Typically occurs in adults without a family history, triggered by infections, irritants, or drugs.
• Risk Factors:
  • Family history of Asthma
  • Past allergies
  • Low socioeconomic status
  • Prenatal factors (e.g., maternal age, smoking)
• Genetic and Environmental Interactions: Multiple susceptibility genes interact with environmental factors, including polymorphisms in interleukin genes and the presence of certain allergens.
• Pathogenesis:
  • Acute Phase Reaction: Initial allergen exposure leads to the production of specific IgE antibodies, causing rapid degranulation of mast cells and release of inflammatory mediators.
  • Late Phase Reaction: Occurs hours later, involving an influx of inflammatory cells (e.g., eosinophils, T lymphocytes) leading to further airway constriction.
• Cellular Roles in Asthma:
  • Eosinophils: Key players in inflammation and airway remodeling; produce mediators that contribute to smooth muscle contraction and tissue damage.
  • Mast Cells: Increase in number in asthmatic airways; release bronchoconstrictors and inflammatory mediators.
  • T Helper 2 Lymphocytes: Produce cytokines that promote eosinophil survival and contribute to allergic responses.
• Pathology: Characterized by airway remodeling, smooth muscle hypertrophy, mucus plugging, and eosinophilic infiltration.

Clinical Features:

• Symptoms include episodic wheezing, chronic cough, and difficulty breathing, often triggered by allergens or irritants.
• Physical exam may reveal prolonged expiration, increased chest diameter, and signs of respiratory distress.

Diagnosis:

• Diagnosis involves pulmonary function tests to demonstrate reversible bronchial obstruction.
• Additional tests include bronchial provocation tests and monitoring eosinophil levels.

Treatment:

• Acute Exacerbation Management: Use of Bronchodilators (e.g., Albuterol), corticosteroids, and supplemental oxygen.
• Long-term Management:
  • Intermittent Asthma: Managed with short-acting beta agonists as needed.
  • Mild Persistent Asthma: Requires low-dose Inhaled Corticosteroids and quick-relief medications.
  • Moderate to Severe Persistent Asthma: Managed with higher doses of Inhaled Corticosteroids and long-acting beta agonists.
• Medications:
  • Short-Acting Beta Agonists (SABAs): E.g., Albuterol for acute relief.
  • Inhaled Corticosteroids (ICS): E.g., Budesonide for long-term control.
  • Leukotriene Receptor Antagonists: E.g., Montelukast for maintenance therapy.
  • Biologics: Monoclonal antibodies targeting specific pathways in severe Asthma cases.

Featured Researchers or Sources:

The video does not explicitly mention researchers or sources but discusses general findings in Asthma research and management.

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