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Asthma

Definition

Asthma is a respiratory condition in which an air way become narrow and produce large amount of mucus and cause a shortness of breath.

OR                

Asthma is a chronic lung disease that in flames and narrow the air way.

Mechanism

First to understand the asthma, it is essential to understand how air way works. The air way or tube that carry air in and out of lungs these tube become inflammation cause swelling the air way react with muscles and tight them passage of air and narrow it so less air enter the lungs. Swelling cause air way narrow cell that make mucus increase its production as compared to normal.

Airway (trachea, larynx, bronchi, bronchioles)               inflammation         swelling              muscles tight                 air way narrow                              decrease of oxygen             lungs function lost

Asthma Attack

Sometime they are mild and they can be treated with medicine and sometime become more intense and cause asthma attack. In some asthma attack, the air way is block so that oxygen filled to enter the lungs. It usually begins with mild chest pain and dry cough as an attack intensifies and wheezing develop and increase in pitch. Breathing becomes difficult and coughing produce thick sticky mucus. As the air way inflammation prevent some of the oxygen rich in air from reaching the alveoli of the body start to born oxygen at a higher rate and increase the demand of oxygen. This also prevents the oxygen from entering into the blood stream and travelling to body vital organ. Due to asthma attack concentration of carbon dioxide is increased and oxygen is decreased. Carbon dioxide is poisonous for the body which is produce as a result of metabolism reduces the amount of oxygen in a blood.

Incurable

Asthma has no cure even when you feel fine, you will still suffer with this disease but the person can live normal life. However, asthma cannot be cure completely but use of medication can reduce up to some extent

Cause:

There is various cause of asthma but some of the basic and important are given as:

1.    Small and light weight particle such as such as pollen, animal dander, dust particle and mites.

2.    Climatic change

3.    Maternal smoking during pregnancy

4.    Low socioeconomic status

5.    Obesity

6.    Family history of allergic condition

Activation of immunoglobin E protein:

Allergen produces a response of immune system in which specific antibody such as immunoglobin E initiate the inflammatory response. The some allergens cause little or no reaction in non allergic person. Asthma may also occur in those people who are very sensitive to a certain chemical or other products that having a strong fragrance. For example some people are sensitive to certain chemical such as industrial chemical such as plastics and air pollen which include wood smoke and sculpture dioxide.

Diagnosis

Lugs function testing

  • Blood test
  • Lungs function testing:

Lungs function testing can be checked with the help of spirometery. This test measure lung function as patient breathes if a lung function improve significantly and cause  bronchi diameter such as albaterol this essential  confirm the asthma.

Blood testing:

Blood testing can be helpful for determining the different type of asthma this test is helpful because it include checking the level of allergic antibody such as immunoglobin or specialiaised white blood cell call eosinophills which are associated with allergic.

Medication for controlling asthma:  although asthma is not curable but it can be reduce by using a following medication:

Medications used for asthma short acting bronchodilator such as arbitral (proventril, ventolin, xopenex) provide a quick relief.

Long acting bronchodilator (salvetrol (serevent) formoterol (foradail it can be adapted to ICS as additive therapy.

Leukothine modifier: montelekusat (singular) zafirlukast (accolade) serve anti inflammatory agent.

Numerous additional monoclonal disease monoclonal antibodies are also being currently studies and will likely be available.

Asthma medication can be administrated via inhaler either with or without the spacer or nebulizer the solution. It is important to note that individual has a proper technique with an inhaler the amount of medication deposited into the blood

A history of hospitalization especially ICU admission or   in cubation.

Physiology of asthma and its effect on the air passage:

Asthma effect the physiology of air way which includes the following factors:

Narrowing of bronchi/Bronchoconstriction:

in asthma most  progressive event involve  narrowing of bronchi, as bronchi is made up of smooth muscles and due to shortness of breathing and various kind of allergic causing agent cause a quick narrowing of bronchi ,release of IgE, from mast cell  that include histamine, trytase, lekotriens. And sometime anti inflammatory drugs may also become the cause of asthma.

Airway edema:

With the passage of time this asthma disease increase and become more progressive due to following factors:

1.    Increase the inflammation of bronchi

2.    Increase the mucous secretion

3.    Edema

4.    Structural changes of smooth muscles (hypertrophy, hyperplasia)

5.    All of the above changes in the air way cannot be treated in usual treatments

Persistent asthma:

Asthma becomes persistent if following change takes place inside the body such as:

When neutrophills of mast cell, eosinophills, dendrite cell and fibroblast cell is start inflammation.

 Some environmental factor and secretion of mucous from smooth muscles is another cause of persistent asthma.

Airway hyper response:

Air way response become hyper when body receive different response or stimuli, the air way hyper response is caused due to, inflammation in air ways and dysfunctional of neuroregulation. Airway hyper response can be treated by reducing air way inflammation.

Effect of asthma on air way passage:

The person who is suffering in asthma disease cannot be treated properly but it is partially reversible because due to bronchi constriction the air passage and its structure change permanently which lead to loss of function. Airway remodeling cause to activation of many structural cells which lead to permanent change in the airflow and increase the obstruction of airflow.  Structural change cause thickening of basement of air membrane, smooth muscles, hypertrophy, hyperplasia, and blood vessel dilation and over secretion of mucous. However regulation of the repair and remodeling process is not established and both have limitation of therapeutic disease.

         Prevention:

We can prevent asthma if we follow asthma action plan:

 We have three zones for asthma action such as green, yellow and red zone.

  • Green zone: when feel good and have no symptoms .it is possible that your medicine control your asthma
  • Yellow zone: it means that you are not feeling good and you are still suffering in dry cough and cold. It is important to start your medicine regularly.
  • Red zone: in this zone you feel hard to breathing and need to call a doctor.
  • Take your medicine regularly
  • Regular visit to your HCP: keep your regular scheduled visit with your HCP so that your asthma can be monitored and treated before it gets out of control.
  • Stay healthy: eat nutrition food and get regular exercise, avoid people who smoke and those may have infection such as cold and fever.
  • How do I know asthma is controlled?

1.    Sleep all night

2.    Not cough or wheezing during day and night

3.    Be active



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