Imunologi ASMA

Definisi asma

Asma adalah penyakit heterogen, biasanya

ditandai dengan inflamasi kronis saluran
napas.

Asma memiliki dua fitur utama:

1. Riwayat gejala pernapasan seperti mengi, napas

pendek, dada sesak dan batuk, yang bervariasi
sepanjang waktu dan variasi dalam intensitas,
2. Expiratory airflow limitation yang bervariasi
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4883
587/)

Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (Updated 2017). Available from
www.ginaasthma.org.
Paradigma of asthma pathogenesis
Peradangan Saluran Napas
Asthma response

Early phase

Late phase
 Mediators involved in airway remodelling.

C. M. Lloyd, and D. S. Robinson Eur Respir J 2007;29:1020-

1032

©2007 by European Respiratory Society

Exposure to environmental insults can lead to
airway damage, and individuals with a genetic
predisposition to atopy and/or dysregulated or
impaired airway repair may go on to develop
sustained inflammation and tissue remodelling.
Increased activation of the epithelium leads to
signalling to inflammatory cells and also
activation of the underlying mesenchymal cells
(activated epithelial-mesenchymal trophic unit
(EMTU).
Both structural and inflammatory cell sources
of growth factors, such as those of the
transforming growth factor (TGF)-superfamily as
well as vascular endothelial growth factor (VEGF)
and interleukin (IL)-13, are thought to be
important.
Progressive structural changes include
increased numbers and size of fibroblasts and
airway smooth muscle and vascular remodelling
together with excessive and dysregulated
extracellular matrix (ECM) deposition, the balance
of which may lead to a phenotype that is
characterised by increases in airway
hyperresponsiveness (AHR) or airway obstruction.
In turn the pro-inflammatory environment
generated by chronic structural cell activation will
sustain and propagate the inflammatory response
to ongoing environmental insults.
RBM: reticular basement membrane; APC: antigen-presenting cell;