新光吴火狮纪念医院胸腔内科课件

AC GsGs ATPcAMP Protein kinase A activation 2-Agonist KCa activation PI hydrolysis Na+/Ca 2+ exchange Na+/K+ ATPase MLCK Blocked by charybdotoxin iberiotoxin Maxi-K channel KCa 2 -AR Cell membrane K+ ( intracellular iCa) Beta-2 Agonists Airway smooth muscle Mast cellEosinophil Cholinergic nerve Acetylcholine Histamine LTD4 Microvascular leak Agonist Receptor Adenyl cyclase Agonist Receptor Adenyl cyclase PDE3,4PDE5 ATPcAMPAMPGMPcGMPGTP PKAPKG Inflammatory cell inhibitionBronchodilatation Theophylline Theophylline leak Migration of lymphocytes? Airway smooth muscle Mediators (PDE ) T-lymphocyte Mast cell Macrophage Neuropeptides (PDE ) Mediators Cytokines (PDE ) Numbers Trafficking? Cytokines? Bronchodilation (PDE ) Mediators (PDE ) Eosinophil Endothelial cell Bone marrow Effects ? Sensory nerve Diaphragm Strength CNS ACh ACh Inflammatory cell Airway epithelium Irritant receptors Parasympathetic nerve Parasympathetic ganglion ACh Vagus nerve Anticholinergics Airway irritants, mediators Submucosal gland Nuclear membrane phospholipids Arachidonic acid Prostaglandins Thromboxane LTA4 LTC4 LTB4 LTD4 LTE4 Cyclo-oxygenase5-Lipoxygenase 5-LO inhibitors Zileuton LT- antagonists Slow reacting substanceSlow reacting substance of anaphylaxis (SRS-A)of anaphylaxis (SRS-A) Eosinophils, Mast cells Role of CysLTs in asthma LTD4 Blood flow Vascular permeability LTD4 Venopermeability extravasation Edema eosinophil infiltration LTC4 & LTD4 Dose dependent contractile of peripheral and central airways LTC4 & LTD4 Dose dependent