Clinical questions to be addressed:
Treatment for the Severe Asthmatic Patient
This lecture outlines two potentially novel approaches still in early stages of development. Bronchial thermoplasty is a procedure by which an expandable thermal "basket" can be inserted into the airways of asthma patients. A second new line of treatment examines the potential role of inter- and extracellular phospholipases (phospholipase A2), which regulate the inflammatory responses in the lung.
Reversible Airway Obstruction
Asthma has long been associated with reversible airway obstruction. We now recognize that asthma is a chronic inflammatory disorder affecting the lungs that can lead to persistent changes in the pulmonary parenchyma known as remodeling. Recent studies have demonstrated that a family of enzymes, the matrix metalloproteinases, can be activated during inflammatory diseases such as asthma, resulting in breakdown of the extracellular matrix. A secondary host response to this activity is the deposition of various types of collagen, resulting in significant changes in various pulmonary functions. This presentation will discuss how matrix metalloproteinases can be activated and what measures may be taken prophylactically to avoid pathologic remodeling of normal lung tissue.