Asthma, Eczema

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Asthma, Eczema

• Michael Widjaja
• 08301016030
• ???

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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

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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

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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?

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Anatomy of Asthma
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Triggers of Asthma

• Dust
• Pollen
• Cockroaches
• Cold air
• Smoke
• Animal dander, skin, dried saliva, hair

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Mast Cells and Plasma Cells
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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

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Mast Cell Degranulation
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Steroid effects of the lung

• Leukotriene promotes contraction of smooth muscle
  of the bronchioles
• Histamine increases vascular permeability,
  causing capillary leakage and edema

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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

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Hereditary factors for Asthma

• Study done in Arizona involving 344 families

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Environmental factors for Asthma
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Genes related to Asthma

• Multifactorial
• 25 genes more commonly associated with asthma
• Related to immune system or inflammation
• Studies are inconsistent

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Environmental factors in Asthma

• Tobacco smoke
• Air pollutants
• Caesarean sections
• Psychological stress modulates immune system
• Hygiene hypothesis

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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

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Eczema- inflammation of epidermis

• Redness
• Crusting
• Flaking
• Blistering
• Cracking
• Oozing
• Bleeding
• Edema

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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

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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

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Filaggrin gene

• Linked Asthma, Eczema, Hay Fever
• Location 1q21.3
• Function
• Bundles keratin intermediate filaments
• Promotes disulfide-bond formation among
  theintermediate filaments mammalian epidermis

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Treatment of Eczema

• Moisturizer to fight dry skin
• Steroid cream to repress immune system and reduce
  swelling

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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

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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

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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

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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

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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

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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-a
  nd-eczema/
• http//www.thetech.org/genetics/ask.php?id161
• http//www.blisstree.com/articles/filaggrin-gene-a
  nd-eczema/
• http//news.bbc.co.uk/2/hi/health/8055038.stm
• http//www.news-medical.net/news/2009/05/18/Resear
  chers-look-at-eczema-asthma-link.aspx

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Questions?

• Comments?