Immunology of Bronchial Asthma Immunological Characteristics Immune disease (allergic disease) (involve immunopathogenesis) Involve IgE (IgE-mediated

) when patient inhaled allergen into lungs (atopic allergy) Immunopathogenesis of Asthma Allergen processing by APC Immunological Test Skin prick test

Wheal & Flare reaction (Type 1 Hypersensitivity reaction) Serum IgE ELISA IgE predict allergy (non-specific) Specific IgE Toward a specific allergen Involve Type 1 Hypersensitivity reaction Allergen house dust mites, pollens (stimulate IgE production) Mast Cell Sensitization & Allergic Reaction

Produced IgE will bind to mast cell surface (sensitize mast cell) If patient is exposed again to the allergen, allergen will bind to Fab portion of IgE molecule (on mast cell) Degranulation of mast cell Release mediators (eg. histamine, ECF) Histamine will cause y Smooth muscle contraction y Secretion of excess mucous Narrowing of respiratory tract Wheezing Symptoms resolve when histamine release is stopped If clinical symptoms are not controlled, chronic phase will occur Involve other inflammatory cells y Neutrophils y Eosinophils y Lymphocytes Narrowing of respiratory tract become worse Exacerbation of Asthma Genetic factor (family history) Tendency to release IgE T cell dysfunction Immune system dysfunction Air quality URTI Stress

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