good education for good medical care

1. Asthma Pathophysiology [email_address]

4. Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998 06/16/09 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

5. Pathogenesis: 06/16/09 INFLAMMATION Airflow Limitation SYMPTOMS Cough Wheeze Dyspnoea TRIGGERS Allergens, Exercise, Cold Air, SO2 Particulates Airway Hyperresponsiveness Genetic* INDUCERS Allergens,Chemical sensitisers, Air pollutants, Virus infections

7. Pathogenesis - Atopic Asthma: 06/16/09

8. Mast cells in Asthma Pathogenesis: 06/16/09

9. Eosinophils in Asthma Pathogenesis: 06/16/09

11. Lung Hyperinflation in Asthma 06/16/09

12. Thick bronchi with Mucous plugs 06/16/09

13. Mucous plug in asthma: 06/16/09

15. Asthma Microscopic Pathology 06/16/09 Obstructed Inflammed Bronchi

18. Asthma – TH2 lymphocytes immunostaining) 06/16/09

19. Eosinophils in Asthma: 06/16/09

20. Curschmann's spirals: 06/16/09

22. 06/16/09 5-LO inhibitors Antileukotrienes Arachidonic Acid Leukotrienes LTC4, D4, E4 Cyclooxygenase 5-Lipoxygenase Prostaglandins Prostacyclins Cell Damage Cell Membrane Phospholipids Steroids NSAID

25. 06/16/09 Asthma Pathology - Modern view Barnes PJ Leukotrienes C4, D4 & E4 Allergen Mucus hypersecretion Hyperplasia Vasodilatation New vessels Plasma leak Oedema Bronchoconstriction Hypertrophy/hyperplasia Cholinergic reflex Subepithelial fibrosis Sensory nerve activation Eosinophil Mast cell Th2 cell Neutrophil Macrophage/ dendritic cell Mucus plug Epithelial shedding Nerve activation

26. 06/16/09 Mast cell Degranulation Barnes PJ Normal 5 Seconds 60 Seconds

27. 06/16/09 Mast cell Degranulation Barnes PJ

28. 06/16/09 Type I Hypersensitivity: Barnes PJ

29. 06/16/09 Therapy - Pathology: Barnes PJ