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AsthmaRetno Ariza S Soemarwoto

Pulmologist

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An imbalance of Th1 and Th2 cells, especially Th2

cells plays an important role in the development of

allergic diseases

Th1IFN-, IL-2

Th2IL-4, 5, 13

Eliminates parasiteAllergic diseases

Eliminates microorganisms and tumors

Auto-immune disease

Transplant rejection

TcCD8+

ThCD4+

BCD19+

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Development of asthma

AsthmaAbnorma

l lung

functions

Genetic &

Environments

& Atopy

Hyper-reactiveness&viral infection

Remodeling &

Histo-pathological

changes

Allergic

rhinitis

Integrated Airway

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Atopy

Kerusakan SN Infeksi SN bawah

Alergen

Perokok pasif

Zat toksik

Persistence Inflammation

Remodeling

Asthma

Perbaikan yang

menyimpang

Risiko

Genetik

Lingkungan

Alergen

Polutan

Stress

Usia

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POTENTIAL BENEFITS

ABORTING THE ALLERGIC

MARCH THE IMMUNOLOGIC BASIS OF LOCAL ALLERGIC

REACTIONSe.g. ATOPIC DERMATITIS.

ALLERGIC RHINITIS and ASTHMA: IS ACTUALLY

A SYSTEMIC DYSREGULATION OFTHE

IMMUNE SYSTEM

ATOPIC

DERMATITIS

ALLERGIC RHINITISBRONCHIAL

ASTHMA

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Allergic reactions

Histamineother mediators

Early phase reaction

(within the first hour)

sneezingrhinorrheanasal pruritusocular pruritus

Late phase reaction

(after several hours)

nasal obstructionswollen eyestiredness, irritabilitysleep disturbance

Attract Eosinophilsand other immune cells

Mast cell

Allergens Adcock I. Clin Exp Allerg Rev 2002; 2: 85-8.

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Environment

al factorsGenetic

factors

Triggers

Viralinfections

Expose to

allergensPollutants

Allergic

inflammation

Clinical

symptoms

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Prevalence of asthma

Based on SKRT 1995 13/1000

Reseach :

In IndonesiaChild 11,5 % Adult 7,7 %

Wang et al 2001

Rhinitis 5,1%

Non rhinitis 0,75 %

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asthma triggers

Debu, asap, polusi udara

Flu

Binatang berbulu (anjing, kucing, burung), kecoa

Pollen dari pohon, rumput

Bau menyengat

Perubahan cuaca, udara yg sangat dingin

Aktivitas berat, menangis, tertawa, teriak

Aspirin atau obat lain

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How is asthma diagnosed?

Based on a physical examination,

personal history, and lung function

tests

Typical asthma symptoms such as

wheezing or coughing,

the personal historyallergies or a

familial tendency towards asthma.

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intermittent

moderatepersistentmild

persistent

severepersisten

t

immunotherapy

oral or MDI bronchodilator

MDI LABA + Steroid

allergen and irritant avoidance

Treatment of asthma

MDI steroid or

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Asthma treatment

Based on severity spirometry

Allergen avoidance

Gradation of severity: Mild short acting bronchodilator

Moderate to severe bronchodilator &antiinflammation

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Spirometry

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Peak flow meter

http://www.vitalitymedical.com/vitalitymedical.storefront/455c7fc1004c182e2719424d362305fc/Product/View/HDN755_ea

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Nebulizer

http://www.vitalitymedical.com/isroot/Stores/VitalityMedical/picxl/DEV5650D.jpg

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To use M D I

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