Asthma and Allergy

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asthma and allergy ppt

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Asthma and Allergy:

Asthma and Allergy Atopy v Allergy Asthma Aeroallergens – indoor & outdoor Occupational allergens

Atopy:

Atopy The propensity to produce IgE to allergens Demonstrated using Skin prick tests to common inhalant allergens

Allergen-Antibody interaction:

Allergen-Antibody interaction

Prick Test Reagents:

Prick Test Reagents

Skin Prick Tests:

Skin Prick Tests

Allergy:

Allergy IgE mediated inflammatory tissue damage in response to an allergen causing clinical disease

Asthma - epidemiology:

Asthma - epidemiology X 2- 3 increase last 30 years Concomitant similar increase in atopy, hayfever and eczema ? Environmental Change ? Less infections ( hygiene hypothesis )

Allergens:

Allergens Outdoor Pollens- Tree Grass Moulds- Alternaria Aspergillus Cladosporium Penicillium

Allergens:

Allergens Indoor Cat Dog Cockroach Birds

Inhalation of allergen:

Inhalation of allergen Immediate response ( IgE mediated ) Max: 20 min. Ends : 60 min. Late response in 50% (Eosinophil ) Onset 3h Max 12 h End 24 h Responsible for airways hyperreactivity Allergen ID and avoidance therefore very important

Pollenosis and BHR:

Pollenosis and BHR

Allergic history and negative skin tests:

Allergic history and negative skin tests Remember grass pollen allergy

Pollenosis:

Pollenosis Prof. Paul Potter, Cape Town Big role for grass pollens in respiratory allergy Kikuyu grass Bermuda grass Buffalo grass ( l’herbe bourrique ) SPT regents to detect allergy to these being developed Mauritus has all of these grasses in abundance

Why study pollens:

Why study pollens Potential for immunotherapy

Indoor allergens-avoidance:

Indoor allergens-avoidance House dust mite allergen Large Not easily air-borne Needs close proximity to bedding to be inhaled

House dust mite avoidance:

House dust mite avoidance Mite impermeable mattress covers Hot wash bedding linen ( 55 C ) Remove moquettes Light curtains Vacuum clean with high filtration cleaner

Mattress Covers:

Mattress Covers

Vacuum cleaners:

Vacuum cleaners

Pet allergens:

Pet allergens Remove the pet Clean it Remove carpets ( x 100 fold antigen)

Cat Eviction:

Cat Eviction

Asthma- none of usual aeroallergens:

Asthma- none of usual aeroallergens Think of occupational asthma

Occupational Asthma:

Occupational Asthma Asthma initiated by an agent inhaled at work Cf. Work-related asthma Pre-existing asthma provoked by an irritant in the workplace

Occupational asthma:

Occupational asthma Only a % of workers affected Latent period before onset ( 2 Yr.) Improvement during periods away from work Once established can be triggered by really small doses of antigen

Usual suspects:

Usual suspects HMW ( Biologic ) Latex Flour ( 334 ) Laboratory mammals(188) Bacillus subtilis LMW ( haptens ) Colophony ( 175 ) Wood dust Diisocyanates ( 658 ) Platinum salts Acid anhydrides ( 364 ) Glutaraldehyde Plastics workers Bone cement

Occupational Asthma:

Occupational Asthma

Serial Peak Flow- latex:

Serial Peak Flow- latex

Bronchial Provocation Testing:

Bronchial Provocation Testing

Inhalation Challenge:

Inhalation Challenge

Inhalation Challenge:

Inhalation Challenge

Occupational Asthma:

Occupational Asthma

Occupational asthma:

Occupational asthma Diagnosis will have major impact on patient’s life False + ve : needless loss of job False – ve : Needless continuing exposure Be careful

Thank You:

Thank You Discussion

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