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Bronchial Asthma Presentation

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BRONCHIAL ASTHMA INTRODUCTORY LECTURES Bronchial Asthma ASTHMA • Asthma is a disease characterized by chronic airway inflammation with increased airway responsiveness resulting in symptoms such as wheezing, cough, dyspnoea and airway obstruction which is variable over short periods of time or reversible with treatment. Asthma aetiology • Multifactorial • Complex interaction of genetic and environmental factors • Seems likely that airway inflammation occurs when genetically susceptible individual are exposed to certain environmental factors • Atopic patients have a high prevalence of Asthma, allergic rhinitis, urticaris and eczema PATHOLOGY • Bronchial epithelial infiltration by Eosinophils, mononuclear cells and T. lymphocytes • Endobronchial mucus plugging • Mucosal oedema/ microvascular leak • Distrupted epithelium/Shedding • Hypertrophied smooth muscle • Fibrosis under basement membrane, Subepithelial fibrosis (deposition of type III and V collagen) Inflammation and bronchoconstriction: a two-part problem Damaged airway passage wall Normal airway Inflammation Airway inflammation and bronchoconstriction Asthma is a 2 component disease Smooth muscle dysfunction ⚫ Bronchoconstriction ⚫ Bronchial hyperreactivity ⚫ Hyperplasia ⚫ Inflammatory mediator release Airway inflammation/ remodelling ⚫ Inflammatory cell infiltration/activation ⚫ Mucosal oedema ⚫ Cellular proliferation ⚫ Epithelial damage ⚫ Basement membrane thicken ...
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