GENERAL CONCEPTS IN ASTHMA TREATMENT

Lloyd K. National Medical University

Department of Internal MedicineKyiv Ukraine

Teacher: Irina Olegivna

Introduction

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

Key Elements

Marked Improvement with treatment.

Hyper-responsive airways

Excessive narrowing in response to trigger factors.

Patients are often atopic.

Factors to consider

Etiology

Pathogenesis

Symptoms

Etiology

Endogenous

Genetic predisposition

Atopy

Hyper-responsiveness

Environmental factors

Allergens

Smoking

Occupation

Trigger factors

Pathogenesis of Asthma

Pathogenesis

Pathology

Main symptoms

Wheezing

Coughing that won’t stop

Shortness of breath

Tightness in chest.

Classification of severity

Classification of Asthma drugs

Steps of treatment

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.

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).

Immunoglobulin E (IgE) and anti-IgE Treatment is given by injection (shots) once

or twice a month.

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 inhibiting Type 1 cytokines.

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.

New findings

A novel molecule that prevents T-cells from orchestrating asthma brought on by allergens has been identified.

The molecule is a sulfate monosaccharide, that inhibits the signal that recruits T-cells to the lungs to start an asthma attack

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

New findings

Blocking this interaction stalled the recruitment of the T-cells that trigger inflammation

References

Harrison's principles of internal medicine. –New York : McGraw-Hill Medical, 2008. – Т. 2. – С. 1918-1925.