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SECTION 2, DEFINITION, PATHOPHYSIOLOGY AND …

SECTION 2, definition , PATHOPHYSIOLOGY and Pathogenesis of Asthma, and Natural History of Asthma 11 August 28, 2007 SECTION 2, definition , PATHOPHYSIOLOGY AND PATHOGENESIS OF ASTHMA, AND NATURAL HISTORY OF ASTHMA KEY POINTS: definition , PATHOPHYSIOLOGY AND PATHOGENESIS OF ASTHMA, AND NATURAL HISTORY OF ASTHMA Asthma is a chronic inflammatory disorder of the airways. This feature of asthma has implications for the diagnosis, management, and potential prevention of the disease. The immunohistopathologic features of asthma include inflammatory cell infiltration: Neutrophils (especially in sudden-onset, fatal asthma exacerbations; occupational asthma, and patients who smoke) Eosinophils Lymphocytes Mast cell activation Epithelial cell injury Airway inflammation contributes to airway hyperresponsiveness, airflow limitation, respiratory symptoms, and disease chronicity.

IgE-dependent release of mediators from mast cells that includes histamine, tryptase, leukotrienes, and prostaglandins that directly contract airway smooth muscle (Busse and Lemanske 2001). Aspirin and other nonsteroidal anti-inflammatory drugs (see section 3, component 3) can also cause acute airflow obstruction in some patients, and evidence

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