You will choose one specific disease that is of interest to you, and write a 3-5

Question

You will choose one specific disease that is of interest to you, and write a 3-5 page paper describing the cause(s) of the disease, the symptoms and physiologic effects associated with the disease, treatments available, and any other historical notes or relevant information you find interesting. The principal component of your paper should be àn analysis of the impact of the disease on the physiology of the various organ systems of the human body. Historical, psychological, or social implications can be included as supplements, but they should definitely not be the focus of this assignment.

Explanation / Answer

Asthma is a chronic inflammatory disease of the airways (reversible obstruction of the airflow). It is characterized by the hyper tracheobronchial tree responsiveness to a multiplicity of stimuli. The patient suffers from difficulty in breathing due to the bronchoconstriction and accumulation of mucus.

Thus, the two major classes used in the treatment of asthma are bronchodilators and anti-inflammatory drugs. They cause broncho-dilatation and reduces the bronchial hyperresponsiveness are given to promote the ventilation.

Aetiology: Individuals of all ages are prone to Bronchial asthma, predominantly at early life. Major risk factor for the development of the asthma is Atopy. Major risk factors of asthma are as follows.

Pathophysiology: Asthma caused due to persistent subacute inflammation of the airways. The clinical features and physiology of the asthma is due to the interaction of the infiltrating and resident inflammatory cells, inflammatory mediators and cytokines with the airway surface epithelium.

Due to the inhalation of the allergens or due to luminal stimuli, Inflammatory mediators (endothelin-1, PGE2, 15-HETE), Cytokines (GM-CSF, IL-8, RANTES) and growth factors (EGF, IGF-1, PDGF) are released. Endothelin-1 causes bronchoconstriction. PGE2, PGI2, 15-HETE results in vasodilation. Cytokines cause inflammation and growth factors cause fibrosis and smooth muscle hyperplasia.

Inflammatory response during the immediate phase asthma: Allergen stimulates mast cells and mononuclear cells -à Releases spasmogens such as prostaglandins, leukotrienes (LTC4, LTD4 and LTE4) and histamine. Also, chemokines and chemotaxins are released. Results in bronchospasm. The immediate phase symptoms can be effectively relieved by adrenergic beta-2 receptor agonists (salbutamol).

Inflammatory response during the late phase asthma: Chemotaxis and chemokines (from the immediate phase) cause infiltration of cytokine releasing Th2 cells, and monocytes. Eosinophils and other inflammatory cells are stimulated. They (particularly eosinophils trigger the release of leukotrienes, NO, and neuropeptides; these trigger airway inflammation. Eosinophils also trigger the release of EMBP (eosinophil major basic protein) and ECP (Eosinophil cationic protein); they cause epithelial damage and airway hyper-reactivity. The late phase effects lead to bronchospasm and cough. The late phase responses can be effectively relieved by glucocorticoids (prednisolone).

Drugs used in the treatment of asthma: Cysteinyl leukotriene antagonists, Thromboxane antagonists (zilutin), corticosteroids (prednisolone), Long-acting beta 2 receptor agonists (salbutamol), Monoclonal antibodies, anticholinergics (ipratropium), and ephedrine.

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