By Kian Fan Chung; Andrew Bush
ISBN-10: 034076287X
ISBN-13: 9780340762875
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Example text
It consists of an initial phase of asthma associated with a very marked blood eosinophilia and eosinophilic vasculitis. This gives rise to pulmonary infiltrates, myocarditis, myositis, neuritis, skin nodules and rashes, and glomerulonephritis. The condition usually responds rapidly to corticosteroids, although the recommended treatment is cyclophosphamide and corticosteroids. Recently, several cases of Churg-Strauss syndrome have been diagnosed in asthmatic patients given the leukotriene antagonists, zafirlukast or montelukast.
Efforts are being made to make a systematic identification of these genes throughout the genome, but this has shown the complexity of genetic susceptibility interacting with several environmental factors, which could explain the variable phenotypic features of asthma across the population. Asthma is a polygenic disease that represents a complex interaction between predisposing factors that increase the susceptibility and causal factors that induce an asthma response. For example, some of the genetic factors underlying the atopic state have been identified, and once the airways have been sensitized, exposure to causal factors, such as inhaled allergens, can induce an episode of bronchoconstriction.
Eosinophil cationic protein or eosinophil peroxidase) or neutrophil-derived proteins (such as neutrophil myeloperoxidase or elastase). Cell counts of induced sputum from normal individuals show predominance of macrophages and neutrophils, with only the occasional eosinophil, lymphocyte and epithelial cells. 9), while, in the fluid phase, increased concentrations of eosinophilic proteins, such as eosinophil cationic protein (ECP) and eosinophil peroxidase, in addition to markers of increased microvascular permeability such as albumin and fibrinogen, have been measured.
Clinicians' guide to asthma by Kian Fan Chung; Andrew Bush
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