Asthma Pathology

Question 1

Bronchodilation receptor, NS, and neurotransmitter

Answer 1

sympathetic
β2-adrenergic receptors, activated by epinephrine.`

Question 2

Bronchoconstriction receptor, NS, and neurotransmitter

Answer 2

parasympathetic (dominant in maintaining smooth muscle tone)
- M3 receptor, stimulated by acetylcholine

Question 3

Bronchoconstrictors NANC

Answer 3

neuropeptides

Question 4

Bronchodilators NANC

Answer 4

nitric oxide, vasoactive intestinal polypeptide

Question 5

IL-25 function

Answer 5

-stimulates TH2 and ILC2 func
-production of IL-4, IL-5 & IL-13

Question 6

IL-33 function

Answer 6

-production of IL-5 & IL-13
-attractant for TH2
activate esnophils

Question 7

TSLP – thymic stromal lymphopoietin

Answer 7

-Activates DCs to stimulate T cell differentiation to TH2
-Depresses Treg activity

Question 8

IL-4 function

Answer 8

-b cells to produce IgE
-Eosinophil proliferation, survival

Question 9

IL-5 function

Answer 9

Recruits eosinophils

Question 10

IL-13 function

Answer 10

-Goblet cell hyperplasia
-Mucus production
-Smooth muscle hyperplasia

Question 11

Airway epithelial cells

Answer 11

first line of innate immune sensing, produces initial cytokine response

Question 12

Toll-like receptors (TLR)

Answer 12

• Nucleic acid sensing
  -Lipopolysaccharide

Question 13

Retinoic acid-inducible gene (RIG)-like receptors (RLR)

Answer 13

Recognizes replicating RNA viruses

Question 14

Protease activated receptors (PAR)

Answer 14

-senses for Nonfungal allergens

Question 15

Nucleotide-binding oligomerization domain (NOD)

Answer 15

-senses for bacterial peptidoglycans

Question 16

C-type lectin receptors

Answer 16

-senses fungal patterns

Question 17

What provides a good maternal microbiome for the fetus?

Answer 17

-high microbial diversity and dietary fiber
-low antibiotic exposure and pyschosocial stress

Question 18

What causes a decrease in allergic disease and asthma for an infant?

Answer 18

pathogen clearance(high Th1,17 and IRF7) and enhanced regulatory immunity (Treg)

Question 19

What is the link between cleanliness and asthma?

Answer 19

There is none, cleanliness isnt an associated risk. BUT, the bacterial exposure in house dust contributes to it.
* resp infections & ear infections in early childhood can develop asthma

Question 20

Extrinsic – Type 2 asthma

Answer 20

IgE mediated, “allergic asthma”

Question 21

Intrinsic-Type 1/17 asthma

Answer 21

serum IgE levels normal or low, unknown precipitating factor, and presents with a later onset esp in female

Question 22

Occupational Asthma

Answer 22

Allergic- sensitization required to a specific chemical
OR
Irritant-induced- develops after a single, very high exposure to an irritant chemical, not immune related

Question 23

What are the Cellular Metabolic Abnormalities associated with asthma?

Answer 23

↑ glycolysis in epithelium, eicosanoids, NOS and arginase, NO exhaled, pro-inflammatory cytokines

Question 24

What activates mast cells?

Answer 24

allergens, bacteria, cytokines, drugs, fungi, peptides, toxins, virsues

Question 25

What do mediators release from the mast cell do to the Respiratory system?

Answer 25

nasal congestion, pruritus,SOB, swelling, wheezing

Question 26

What mediators does the mast cell release that effects the Respiratory system?

Answer 26

Histamine, IL-6, CysLTs, PAF, PGD2

Question 27

What are the 2 phases of asthma?

Answer 27

Early Phase: bronchospasm Late Phase: Inflammation (worse)

Question 28

What does smooth muscle in the lungs tend to favor?

Answer 28

bronchoconstriction

Question 29

What happens to the pathology of the lung when there is an asthamtic airway obstruction?

Answer 29

constriction, mucus plug+ accumulation, hyperinflated alveoli, degranulation of mast cell

Question 30

How is the airway remodeled in asthma?

Answer 30

huge amount of smooth muscle, small lumen, increased number of blood vessels, collagen disposition

Question 31

Dendritic cells types and how they are different

Answer 31

cDC- conventional, finish development in lung (all the Th's) pDC- plasmacytoid, fully develop in bone marrow moDC- monocyte derived, only present in normal “steady state” lungs, antiviral responses

Question 32

Macrophage types and main function

Answer 32

Alveolar(Antigen presentation and cytokine release) and Interstitial(homeostasis, tissue remodeling)

Question 33

What are the 3 subsets of Innate Lymphoid Cells?

Answer 33

ILC1- NK Cells, release IFNy ILC2- IL4,5,9.13; released by IL25, 33; ILC3-IL 22, 17; released 23, (COPD development)

Question 34

Why are Mycobacteria & helminths important in the Hygiene Hypothesis of Allergy?

Answer 34

infections caused by these agents generate regulatory mechanisms that restore immune balance. Stimulate TH1 responses.

Question 35

What is Asthma?

Answer 35

reversible obstruction of the bronchi w hyperresponsiveness or irritation, that cause atopy and increase release of mediators by mast cells