Neuromental factors The inhibitory system of NaNC is the major nervous system that relaxes the smooth muscle of the airway Substance p, the transmitter of the stimulative nervous system of nanc. is present in the class c chemosensitive afferent fibers of the vagus. when the class c afferent nerve ending is exposed due to injury of the airway, local lesion might be aggravated. Abrupt change of emotion might induce asthma attack especially in those with refractory asthma
Neuromental factors The inhibitory system of NANC is the major nervous system that relaxes the smooth muscle of the airway. Substance P, the transmitter of the stimulative nervous system of NANC, is present in the class C chemosensitive afferent fibers of the vagus.when the class C afferent nerve ending is exposed due to injury of the airway, local lesion might be aggravated. Abrupt change of emotion might induce asthma attack, especially in those with refractory asthma
Endocrine factors Asthma disappears in puberty in some patients, aggravated in menstruation period, during pregnancy, and when there is hyperthyroidism
Endocrine factors Asthma disappears in puberty in some patients; aggravated in menstruation period , during pregnancy, and when there is hyperthyroidism
Pathogenic mechanism E. mast cell smooth muscle contraction of the bronchiole allergen gen immediate asthma reaction AAI ventilation disorder PAF ECF airway obstruction by exudation Late asthma reaction Lts microvascular transudation ( LAR congestion and edema of the mucosa BHR PGS injury and exfoliation of the epithelial cells exposure of nerve ending neuropeptide, substance P inflammatory cells macrophage, eosinophils and neutrophils
Pathogenic mechanism • IgE、mast cell smooth muscle contraction of the bronchiole allergen allergen histamine、ECF immediate asthma reaction • • AAI ventilation disorder • • • PAF • ECF airway obstruction by exudation • Late asthma • reaction LTS microvascular transudation • （LAR） congestion and edema of the mucosa • BHR • PGS • injury and exfoliation of the epithelial cells • exposure of nerve ending neuropeptide、substance P • inflammatory cells • （macrophage、eosinophils and neutrophils） •
Hyper-reactivity of the airway Bronchial reactivity refers to the contractive reaction of the airway to various stimuli including those chemical, physical or pharmacologic in nature. Airway hyper-reactivity(AHR) is defined as the excessive bronchial contraction in response to the stumuli which do not elicit response or only cause minor response under normal conditions ahR is one of the important characteristics of asthma, whilie airway imflammation is one of the most important mechanisms that contribute to ahr
Hyper-reactivity of the airway • Bronchial reactivity refers to the contractive reaction of the airway to various stimuli including those chemical, physical or pharmacologic in nature. Airway hyper-reactivity (AHR) is defined as the excessive bronchial contraction in response to the stumuli which do not elicit response or only cause minor response under normal conditions. AHR is one of the important characteristics of asthma, whilie airway imflammation is one of the most important mechanisms that contribute to AHR
Pathology The basic pathology of bronchial asthma includes imflammation and remodeling of the airway. The basic pathological change of the inflammation includes filtration of mast cells, macrophages, eosinophils lymphocytes and neutrophils: edema of the submucosa increase of the permeability of the microvasculature retention of the secretion within the bronchioles, spasm of the bronchial smooth muscle. detachment of the cilated epithelium, exposure of the basal membrane, poliferation of goblet cells and increase of bronchial secretion, which contribute to form the chronic剥脱性 eosinophilic bronchitis
Pathology • The basic pathology of bronchial asthma includes imflammation and remodeling of the airway. • The basic pathological change of the inflammmation includes infiltration of mast cells, macrophages, eosinophils, lymphocytes and neutrophils; edema of the submucosa, increase of the permeability of the microvasculature, retention of the secretion within the bronchioles, spasm of the bronchial smooth muscle, detachment of the cilated epithelium, exposure of the basal membrane, poliferation of goblet cells and increase of bronchial secretion, which contribute to form the chronic剥脱性eosinophilic bronchitis