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ASTHMA, ECZEMA Michael Widjaja 08301016030 黄合乐 Outline Preconceived notions How allergic asthma is triggered Mechanism of asthma Methods of treatment of asthma Factors that lead to asthma Eczema and the factors that lead to it Link between asthma and eczema Conclusion Initial thoughts on asthma Asthma causes difficulty in breathing Consists of two parts Constriction of bronchi Overproduction of mucus in respiratory tract Caused by Allergies Drastic change in temperature Exercise Heritable? family history Initial thoughts on Eczema Dry itchy skin, redness, cracking, oozing or bleeding Causes Allergies Skin Irritants Dry weather Sweat Eczema linked to Asthma in some way Genetically linked disease? Anatomy of Asthma Triggers of Asthma Dust Pollen Cockroaches Cold air Smoke Animal dander, skin, dried saliva, hair Mast Cells and Plasma Cells Mechanism of Asthma Antigen enters body Plasma cell produce immunoglobulin E(IgE) IgE binds to surface of mast cells Future exposures to antigen results in binding of antigen to surface bound IgE Mast Cells degranulate releasing Histamine and Leukotriene Mast Cell Degranulation Steroid effects of the lung Leukotriene promotes contraction of smooth muscle of the bronchioles Histamine increases vascular permeability, causing capillary leakage and edema Treatment of Asthma Inhaled corticosteroids are preventive medications that treat inflammation of the airways Bronchodilators (long-acting beta-2 agonist) relax the muscles surrounding the airways for a long period of time Hereditary factors for Asthma Study done in Arizona involving 344 families Environmental factors for Asthma Genes related to Asthma Multifactorial 25 genes more commonly associated with asthma Related to immune system or inflammation Studies are inconsistent Environmental factors in Asthma Tobacco smoke Air pollutants Caesarean sections Psychological stress – modulates immune system Hygiene hypothesis Environmental Factors Reduction of indoor allergens moderately reduces risk of developing asthma Conversely exposure to cat and dog allergens during first year of life reduced allergy to cat and dog allergens and developing asthma Eczema- inflammation of epidermis Redness Crusting Flaking Blistering Cracking Oozing Bleeding Edema Types of Eczema Atopic Eczema- due to an overactive immune system Contact Eczema- contact with allergens Xerotic eczema – results from dry skin during the winter Seborrhoeic dermatitis- cause cradle cap in infants Histology of Eczema Filaggrin gene encodes protein profilaggrin which forms a protective barrier that keeps moisture in and infectious organisms out Similar to asthma, allergens can bind to IgE receptors on mast cells causing histamine to be released and edema to occur Filaggrin gene Linked: Asthma, Eczema, Hay Fever Location: 1q21.3 Function: Bundles keratin intermediate filaments Promotes disulfide-bond formation among the intermediate filaments mammalian epidermis Treatment of Eczema Moisturizer to fight dry skin Steroid cream to repress immune system and reduce swelling Genetics of Eczema Similar to asthma related to family history of allergies Multiple genes factor control our immune system Also similar to asthma, environmental factors Filaggrin gene SPINK5(Serine protease inhibitor Kazal-type 5) gene plays a role in anti-inflammatory and antimicrobial protection of mucous epithelia Link between Asthma and Eczema Atopic march 50-70% of children with severe eczema developed Asthma 2/3 of these children will also develop allergic rhinitis Link between Asthma and Eczema Research done by Washington University School of Medicine Experimented on mice Mice were engineered to have defective skin similar to eczema in humans produced TSLP ( thymic stromal lymphopoietin) and developed asthma Mice with normal skin but overproduced TSLP also developed asthma Link between Asthma and Eczema TSLP( thymic stromal lymphopoietin) TSLP also produced in Asthma patients Secreted into blood stream when skin is damaged, indicating its protective barrier is damaged and further protections are needed Both lung and skin in contact with open environment Inflammatory disease of skin also causes inflammation of lungs when TSLP flows in bloodstream to the lungs TSLP causes lungs to be very sensitive to allergens Summary Mechanism of Asthma Triggers of Asthma Genetic and Environmental factors of Asthma Cause of Eczema Genetic and Environmental factors of Eczema Link between Asthma and Eczema Citations http://acc6.its.brooklyn.cuny.edu/~scintech/asthma/Genetics2.htm http://www.mamashealth.com/allergies/breathbet.asp http://en.wikipedia.org/wiki/Asthma http://en.wikipedia.org/wiki/Eczema http://www.blisstree.com/articles/filaggrin-gene-and-eczema/ http://www.thetech.org/genetics/ask.php?id=161 http://www.blisstree.com/articles/filaggrin-gene-and-eczema/ http://news.bbc.co.uk/2/hi/health/8055038.stm http://www.news-medical.net/news/2009/05/18/Researcherslook-at-eczema-asthma-link.aspx Questions? Comments?