Immunology

A review of the pathology of asthma and COPD, including the role of the immune system, along with the mechanisms behind the hypercapnia and hypoxemia of COPD...  

Just a small molecular resume of complement system I made for my inmunology exam. Some parts are in spanish, because I speak Spanish. However, molecular details are the same in English.  

When using a pressurized metered-dose inhaler, how does improper technique affect the dose delivered?  

 

slide presentation of childhood asthma, covering about epidemiology, pathology, presentation, investigation and management and prognosis.  

 

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Immunology - Antibody Somatic (VDJ) Recombination Antibody Production http://www.facebook.com/ArmandoHasudungan  

Describes how genes that make light and heavy chains can be randomly assorted to produce a unique type of antibody and so wil bind to a specific antigen~ Facebook : http://www.facebook.com/ArmandoHasudungan  

 

Histamine H1-receptor antagonists These are not used in the management of respiratory conditions. They are mostly effective against mast cell activated inflammatory reactions. In asthma, mast cells are involved in the early stages of the reaction, but their role is not great enough to respond to therapeutic modification. These drugs are useful in patients with very mild atopic asthma, such as in cases of hay fever.  

  Allergy – Inappropriate immune response to normally harmless allergen. Allergen – Foreign particles which produce an IgE-mediated hypersensitivity reaction in sensitive individuals.  

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Many may be familiar with aspergillosis as the infecting agent in acute cases where the patient is severely immunocompromised - but there is more to this fungus' repertoire. There are rare cases where the patient's immune system is overwhelmed by a large inhalation of spores e.g. after gardening, but these are insignificant in terms of total numbers effected. The following are far more common:- Aspergillus and other fungi are increasingly identified as the active agent in sinusitis - if you have cases that don't respond to antibiotics this is worth thinking about. Chronic pulmonary aspergillosis (CPA & aspergilloma) is an infection of immunocompetent people, causing respiratory difficulty, coughing and haemoptysis. The UK NHS has a specialist centre for these patients In Manchester (National Aspergillosis Centre (NAC)). NAC has particular expertise and extensive facilities for the diagnosis of CPA, ABPA, SAFS and use of systemic antifungal drugs. Allergic infection (Allergic Bronchopulmonary Aspergillosis - ABPA and chronic sinusitis) is thought to be heavily underdiagnosed and undertreated. ABPA is particularly common in Asthma, Cystic Fibrosis patients and those with bronchiectasis. There is estimated to be 25 000 cases in the UK alone. Many (50%) of the most severe asthma cases are sensitive to fungi (SAFS) - in particular Aspergillus. These tend to be the most unstable cases that don't respond to antibiotics and several studies have been published that show giving an antifungal helps reduce the use of steroids for these patients. Last but not least - Tuberculosis is on the rise in the UK and the rest of the world. It is estimated that 2% of cases progress to CPA and should be treated using an antifungal - this is usually not done until considerable time has passed and much damage has been done. In total it is estimated that many millions of people across the world suffer from aspergillus - ABPA - 5 million, Tb - 400 000 per year and Asthma (SAFS - 1 - 4 million cases in EU & US). Sinusitis cases may number many tens of millions worldwide. So - the next time you assume aspergillus infections and aspergillosis are rare and confined to those who are profoundly immunocompromised - think again! If you have a patient who has increasingly severe respiratory symptoms, doesn't respond to multiple courses of antibiotics then give aspergillus a thought. Browse around these articles for further information Aspergillus Website Treatment Section. NB For a broader look at the prevalence of fungal diseases worldwide the new charity Leading International Fungal Education (LIFE) website is worth looking at.  

 

Microorganisms that cause disease in humans and animals enter the body at different sites and produce disease symptoms by a variety of mechanisms. Microbial invasion is initially countered by innate defenses that preexist in all individuals and begin to act within minutes following encounter with the infectious agent. Only when the innate defenses are bypassed, evaded or overwhelmed is an adaptive immune response required. The innate immune system (IIS) is usually sufficient to prevent the body from being routinely overpowered by these organisms. However, once they have gained a hold, they require the concerted efforts of both the IIS and the adaptive immune system (AIS). In the first part of this chapter, different arms and principles of the IIS and the AIS will be briefly discussed.  The second part of the chapter will discuss the process of fighting a bacterial and a viral infection, with an emphasis on the cross talk between the two parts of the immune system.  

Every year many people in the UK develop asthma because they are exposed to dangerous substances at work. This is called occupational asthma.  

Epinephrine is the most important drug in the management of anaphylaxis. It is so important because it saves lives! This is no hyperbole. This edition of the Why we do what we do series focuses on the evidence behind the use of IM Epi in Anaphylaxis.  

A useful review of Immunology.