Type-I (IgE),
Type II-IgG,
Type III-Immune complex,
Type IV-Cell mediated.
Autoimmune disorders
SLE, Rheumatoid, Rheumatic fever.
Type I hypersensitivity reaction
((Atopy
Pathogenesis:--
- First exposure to an antigen
stimulation of B-lymphocytes to
transform to IgE secreting plasma cells
( helped by CD4+ T-lymphocytes)
IgE binds to the surface of mast cells
and basophils
First exposure
Type I hypersensitivity reaction
Second exposure to the same antigen-
results in cross-linking of Ig E on the
surface of mast cells
Degranulation of the cells with release
of chemical mediators
FIRST EXPOSURE SECOND EXPOSURE
Chronic obstructive pulmonary
(disease (COPD
COPD is a disease state characterized
by airflow limitation that is not fully
reversible. The airflow limitation is
usually both progressive and associated
with an abnormal inflammatory response
of the lungs to particles or gases.
Obstructive Pulmonary Diseases
Classical COPDs
Emphysema
Chronic Bronchitis
Bronchial Asthma
Bronchial asthma
Increased responsiveness of the
bronchial tree to various stimuli that
results in paroxysms of Bronchospasm
reversible bronchospasm later
chronic bronchial inflammation develop
and airflow is limited by bronchoconstriction,
mucus plugs, and increased inflammation and
obstructive lung disease develop
It is episodic, reversible bronchospasm
resulting from an exaggerated
bronchoconstricton response to various
stimuli.
Incidence of asthma
It is a common disease affecting 5% of
. adults and 7-10% of children
There has been a significant increase in
the incidence of asthma in the
Western world in the past three
decades
-
-Clinically, it is manifested by
recurrent episodes of wheezing,
breathlessness, and cough. These
symptoms are usually associated with
bronchoconstriction and airflow
limitation that is at least partly
reversible, either spontaneously or
with treatment. Between the attacks,
patients may be virtually
asymptomatic
INFLAMMATION
Airflow Limitation
TRIGGERS
SYMPTOMS
Allergens, Exercise,
Cough Wheeze
Cold Air, SO2 Particulates
Dyspnoea
Pathogenesis
What initiates the inflammatory process in
the first place and makes some persons
susceptible to its effects is an area of active
investigation.
There is not yet a definitive answer to this
question . The expression of asthma is a
complex, interactive process that depends on
the interplay between two major factors—
host factors (particularly genetics) and
environmental exposures that occur at a
crucial time in the development of the immune
system early in life
Pathogenetic Types
Extrinsic and Intrinsic asthma
Occupational asthma
Bronchial Asthma
Pathogenesis
Atopic Asthma Nonatopic Asthma
Exposure of Virus-induced
presensitised IgE-coated inflammation of
mast cells to antigen respiratory mucosa
causes acute immediate lowers threshold of
response vagal receptors to
Chemical mediators irritants
(histamine, PAF, Aspirin-sensitive
leukotrienes) asthma
Late-phase reaction Occupational asthma
:Pathogenesis - Atopic Asthma
?What is the Pathophysiology
Trigger Factor
Mast cell
Mediators: histamine,prostaglandin,leukotrienes,as
well as cytokines.
Inflammatory cells
Contraction of airway smooth muscles
(Bronchoconstriction)
Airway wall swelling (mucosal edema)
Chronic changes
Hypertrophy of the smooth muscles, Airway
obstruction
Lung Morphology in Asthma
Mucous plugging
Bronchospasm
Over inflation
Lung Hyperinflation in Asthma
Thick bronchi with Mucous
plugs
Epidemiology/pathology
Normal Asthma
Barnes PJ
Asthma - Microscopic Pathology
Patchy necrosis of epithelium
Sub-mucosal glandular hyperplasia
Hypertrophy of bronchial smooth muscle
Eosinophils, mast cells; lympho (TH2, CD4)
Mucous plugs, Whorled mucous plugs
(Curschmann’s spirals)
Debris of eosinophils (Charcot-Leyden
crystals
Microscopic Pathology
Asthma Microscopic Pathology
Obstructed
Inflammed
Bronchi
Asthma - Bronchial morphology
inflammation
Gland hyperplasia
Mucous plug in
lumen
Asthma - Bronchial morphology
Inflammation
Mucous Plug
Eosinophils
Inflammation epithelial
damage
:Eosinophils in Asthma
:Curschmann's spirals
Bronchial Asthma
:Therapy - Pathology
Barnes PJ
?What is Asthma
Hypersensitivity – Allergy , Type I
of airways of lungs - Bronchi
Allergens – in the air, mast cell - IgE ab.
Increasing incidence …!