Asthma inflammation and cancer


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  • Asthma inflammation and cancer

    1. 1. Asthma inflammation and cancer Eman abd el-raouf ahmed Immunology department Medical research institute
    2. 2. The content Introduction Causes Amine mediators Lipid mediators Cytokines and asthma Focus on IL-13 role Asthma and cancer pathophysiology treatment
    3. 3. What’s the relation between asthma and lung cancer?
    4. 4. introduction Asthma is a complex chronic inflammatory disease of the airways that involves the activation of many inflammatory and structural cells all of which release inflammatory mediators that result in the typical pathophysiological changes of asthma
    5. 5. A-Cellular Origin of Mediators Many inflammatory cells are recruited to asthmatic airways or are activated in situ. These include mast cells, macrophages, eosinophils, T lymphocytes, dendritic cells, basophils, neutrophils, and platelets. Indeed, these cells may become the major sources of inflammatory mediators in the airway, and this may explain how asthmatic inflammation persists even in the absence of activating stimuli.
    6. 6. B. Synthesis and Metabolism Many of the key enzymes have now been cloned; in several cases, specific inhibitors have been developed that may have useful therapeutic effects. 5-Lipoxygenase (5-LO)b inhibitors, which inhibit the synthesis of leukotrienes (LTs), have already been shown to have beneficial effects in the control of clinical asthma and are now available for clinical use . There have been major advances in our understanding of the synthetic pathways involved in the synthesis of inflammatory mediators.
    7. 7. C-Mediator Receptors The receptor for platelet- activating factor (PAF) was the first inflammatory mediator receptor to be cloned The receptors for many inflammatory mediators have the typical seven- transmembrane domain structure that is expected for G protein-coupled receptors. Cytokine receptors signal through complex pathways, including MAP kinases and other protein kinases, that result in the activation of transcription factors. Transcription factors regulate the expression of many genes, including inflammatory genes themselves.
    8. 8. D. Mediator Effects Inflammatory mediators produce many effects in the airways, including bronchoconstric tion, plasma exudation, mucus secretion, neural effects, and attraction and activation of inflammatory cells. there is increasing recognition that mediators may result in long-lasting structural changes in the airways that are also mediated by the release of inflammatory mediators These changes may include fibrosis resulting from the deposition of collagen, which is seen predominantl y under the epithelium even in patients with mild asthma. The airway smooth muscle layer is also thickened in asthma, and this is likely the result of increases in the number of smooth muscle cells (hyperplasia) and increases in their size (hypertrophy) There may be proliferation of airway vessels (angiogenesis)
    9. 9. Chronic Inflammation Although in the past much attention has been paid to acute inflammatory responses (such as bronchoconstriction, plasma exudation, and mucus hyper secretion) in asthma, it is being increasingly recognized that chronic inflammation is an important aspect of asthma This chronic inflammation may result in structural changes in the airway, such as fibrosis (particularly under the epithelium), increased thickness of the airway smooth muscle layer (hyperplasia and hypertrophy), hyperplasia of mucus-secreting cells, and new vessel formation (angiogenesis). Some of these changes may be irreversible, leading to fixed narrowing of the airways.
    10. 10. Transcription Factors Transcription factors are DNA- binding proteins that regulate the expression of inflammatory genes, including enzymes involved in the synthesis of inflammatory mediators and protein and peptide mediators. Transcription factors therefore play a critical role in the expression of inflammatory proteins in asthma, because many of these proteins are regulated at a transcriptional level These transcription factors include nuclear factor-κB (NF-κB) and activator protein-1 (AP-1), which are universal transcription factors that are involved in the expression of multiple inflammatory and immune genes and may play a key role in amplifying the inflammatory response. Other transcription factors, such as nuclear factor of activated T cells (NF-AT), are more specific and regulate the expression of a restricted set of genes in particular types of cell; NF-AT regulates the expression of interleukin (IL)-2 and IL-5 in T lymphocytes.
    11. 11. Amine mediators Histamine [2-(4-imidazole)ethylamine] was the first mediator implicated in the pathophysiological changes of asthma Histamine increases the concentration of inositol-1,4,5-trisphosphate (IP3) in airway smooth muscle, although the magnitude of the increase is less than with cholinergic agonists, which may reflect lower receptor density . Bronchoconstriction was one of the first recognized effects of histamine. Inhaled or intravenously administered histamine causes bronchoconstriction. Asthmatic patients are more sensitive to the bronchoconstriction effects of inhaled and intravenously administered histamine than are normal individuals
    12. 12. Role of histamine: Histamine may also have effects on inflammatory cells, and it has been found to influence the release of cytokines and inflammatory mediators from a variety of inflammatory and immune cells Histamine is a selective chemoattractant for eosinophils
    13. 13. Role in asthma Measurement of histamine in the circulation is complicated by the spontaneous release from basophils, and measurement of stable metabolites in the urine may not reflect release from mast cells in the airways. It is possible that basophils from patients with asthma may be more “leaky” and that this may contribute to the higher concentrations measured in asthmatic patients.
    14. 14. Lipid-Derived Mediators Prostanoids Prostanoids include PGs and thromboxane (Tx), which are generated from arachidonic acid, COX-1 is constitutive and is responsible for basal release of prostanoids, whereas COX-2 is inducible by inflammatory stimuli, such as endotoxin and proinflammatory cytokines
    15. 15. Cytokines and asthma
    16. 16. Lung inflammation: Inflammation is an essential component of many lung diseases, including asthma, COPD, lung cancer, and granulomatous lung diseases.
    17. 17. Asthma and cancer
    18. 18. Asthma and lung cancer The researchers found asthmatics were affected by lung cancer more frequently than the general population - the cancers registered over the course of the study exceeded the anticipated level by 58%. Bronchial inflammation generates free radicals, and there is evidence that the antioxidant levels in the respiratory tract lining of asthmatics are reduced. As free radicals have the potential to cause genetic damage, they may be linked to the development of tumours
    19. 19. References: n_allergy/hives_or_urticaria/ lt=&type=&cond=asthma&intr=&outc=&lead=&spons=&id=&state1 =&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&rcv_ s=&rcv_e=&lup_s=&lup_e cytokines/ immunology.aspx
    20. 20. 1081120613cience/article/pii/S 006467
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