Professional Documents
Culture Documents
PENYAKIT ALERGI
OLEH :
..........TRIGGERED BY AN
ALLERGEN
THE TYPE OF ALLERGEN
1. House dust
mite
2. House dust
3. Human dander
4. Fungi
5. Animal dander
6. Cockroach
Allergy Can Affect Different
People in Different Ways
Itchy Eyes
Eye Symptoms
Asthma
Lung Symptoms Rash & Itching
Digestive Symptoms
PHYSICAL EXAMINATION
Allergic salute
Allergic crease
Mannerism
Mouth open/facies
adenoid
Height arched-palate
MANY Organs MAY AFFECT
ALLERGIC DISEASE
NOSE
ALLERGIC RHINITIS
EXTERNAL EAR
ATOPIC DERMATITIS
ALLERGIC CONTACT DERMATITIS
MIDLE EAR
OTITIS MEDIA WITH EFFUSION
LARYNGOPHARYNX
ACUTE SEVERE LARYNGOPHARYNGITIS
CHRONIC LARYNGOPHARYNGITIS
THE NATURAL COURSE OF ATOPIC DISEASE IN
CHILDHOOD
figure
RISK OF DEVELOPING ALLERGY BASED ON
FAMILY HISTORY
THE IMMUNOPATHOLOGICAL MARCH
(the immunological induction and expression of allergy)
Tertiary
Secondary
Tissue
Primary Chronic Hyper-
Maternal responsive- Chronic
Inflammation
Allergen ness Symptomatolog
y (e.g.Status
Exposure (Allergic
Asthmatics/
Rhinitis,
Boosting Subclinical Asthma, COPD)
Th2 Repeated Responses Atopic
Memory (MPI)
Postnatal Immune
Exposure (MPI) dermatitis)
Th1
Exposure Deviation Memory
Intrauteri Tissue
ne Th2- Deletion Reversion
Remodeling
skewed Anergy
to Th1
Unresponsiveness
Genes, Sensitization
boys
Inflammation
Primary
Secondary
Hyperreactivity
Symptoms
Tertiary
Damage
REAKSI HIPERSENSIFITAS
Syok anafilaktik
Rhinitis alergika
Urtikaria
Asma bronkiale
9
PERJALANAN REAKSI TIPE I
Stadium I : Sensitisasi
Stadium II : Aktifasi
10
Guntur, 1999
11
13
Mast cell activation and physiological effects of mast-
cell derived mediators
14
MEDIATOR REAKSI TIPE I
HISTAMIN
SEROTONIN
HEPARIN
ECF-A dan NCF - A
15
(Kuby, 2000)
Mediator Release from Mast
Cells
Allergen
2+
Ca
2+
MEMBRANE- Ca
DERIVED
MEDIATORS
PROSTAGLANDINS
LEUKOTRIENES
HISTAMINE
CHEMOTACTIC FACTORS
PLATELET ACTIVATING FACTOR
PREFORMED
MEDIATORS
Allergic Mediators Released
from Mast Cells
OTHER
SEROTONIN
(VIA PLATELETS) ALLERGIC SYMPTOMS
LEUKOTRIENES
RUNNY, OR BLOCKED NOSE
PROSTAGLANDINS
SNEEZING
HISTAMINE RED, ITCHY, WATERY EYES
(The major Allergic
mediator released
from ITCHY THROAT / EARS
the Mast Cell)
RASH
THE DEFINITON OF
ALLERGIC RHINITIS
RECENT DEFINITION
The inflammation of the mucous
of the nose which mediated by
IgE/type 1 hypersensitivity,
following allergen exposure; and
causes symptoms: nasal
congestion or obstruction, itching,
sneezing, watering/rhinorhoea
and of the nose.
BASIC CONCEPT
RECENTLY
The domination
of TH 2 function
compare to TH 1
OLD
The hypo function of T
cell suppressor compare
to T cell helper.
THE CHANGES IN THE
NOSE MUCOSA
Sensitization stage
Activation stage
Effector stage:
Rapid phase reaction
Late phase reaction
Hyperresponsive
condition
D. Patogenesis Rinitis Alergi
Melepas
BANYAK SEL : MEDIATOR
SEL MAST Histamin
EOSINOFIL PDG 2, LTc 4
NETROFIL OBSTRUKSI
EPITHELIAL LIMFOSIT TNF, PAF, DIFUS
SHEDDING EPITEL Eo chemo F. SALURAN
GM-CSF
NAFAS
ALLERGEN EXPOSURE
ARACHIDONIC ACID
CHEMOTACTIC PAF HISTAMINE CYCLOXYGENASE LIPOXYGENASE
FACTORS
PROSTAGLANDIN LEUKOTRIENES
SYMPTOMS
SYMPTOMSOF
OFASTHMA
ASTHMA
PATHOGENESIS OF ASTHMA
antigen
Nave T-lymphocyte
IL-12 [-]
Th-O
Th-O
Th-1
Th-1response
response Ig E Mast Cell Basophils Eosinophil
IFN, lymphotoxin, IL-2
Mediators of inflammation
Cell
Cellmediated
mediatedimmunity
immunity Histamine,
Histamine,prostaglandins,
prostaglandins,
And
And Leukotrienes,
Leukotrienes,enzymes
enzymes
Neutrophilic
Neutrophilicinflammation
inflammation
Bronchial
Bronchial Hyperresponsiveness
Hyperresponsiveness
Asthma
AsthmaSymptoms
Symptoms Airway
Airway Obstruction
Obstruction
C. Eosinofil dan Reaksi Inflamasi Alergi
Pharmacotherapy Immunotherapy
Safe
Effective
Easy administration
Costs Effective
Specialist prescription
May alter the natural
course of the disease
Patient education
always indicated
Optional therapy:
Other medications and/or surgery for complications
or
Treatment combination of both approaches