General concepts in asthma treatment

1. GENERAL CONCEPTS IN ASTHMA
TREATMENT
Lloyd K.
National Medical University
Department of Internal Medicine
Kyiv Ukraine
Teacher: Irina Olegivna

2. Introduction
 Asthma is a syndrome characterized by
airflow obstruction that varies markedly, both
spontaneously and with treatment.

3. Key Elements
 Marked Improvement with treatment.
 Hyper-responsive airways
 Excessive narrowing in response to trigger
factors.
 Patients are often atopic.

4. Factors to consider
 Etiology
 Pathogenesis
 Symptoms

5. Etiology
 Endogenous
 Genetic predisposition
 Atopy
 Hyper-responsiveness
 Environmental factors
 Allergens
 Smoking
 Occupation

6. Trigger factors

7. Pathogenesis of Asthma

8. Pathogenesis

9. Pathology

10. Main symptoms
 Wheezing
 Coughing that won’t stop
 Shortness of breath
 Tightness in chest.

11. Classification of severity

12. Classification of Asthma
drugs

13. Steps of treatment

14. 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.

15. 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).

16. Immunoglobulin E (IgE) and
anti-IgE
 Treatment is given by injection (shots) once
or twice a month.

17. 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
inhibitingType 1 cytokines.

18. 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.

19. New findings
 A novel molecule that preventsT-cells from
orchestrating asthma brought on by allergens
has been identified.
 The molecule is a sulfate
monosaccharide, that inhibits the signal that
recruitsT-cells to the lungs to start an asthma
attack

20. 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—aT-
cell signaling protein—and heparin sulfate, a
molecule that protects and immobilizes
CCL20 on epithelial cells in the lung.

21. New findings
 Blocking this interaction stalled the
recruitment of theT-cells that trigger
inflammation

22. References
 Harrison's principles of internal medicine. –
NewYork : McGraw-Hill Medical, 2008. –Т. 2.
– С. 1918-1925.