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Hi,

Does anyone know much about the mechanism for asthma? I suffered from

exercise induced asthma since I was a kid, but it seems to be gone since

my transplant. I don't know whether to attribute it to the immune

suppression, my generally improved health, or something else. It is

nice to be able to exercise without gasping for breath though!

Speaking of exercise, I'm going to be doing this triathlon this coming

Sunday. It turns out that I'm not going to be doing the entire thing

myself. After the bout with CMV I got a little nervous about

infections, and asked Dr. Raiford if it was a good idea to be swimming

in lake water, and he said I should wait 'till a year post transplant.

So I'm doing the biking as a part of a team. My brother is swimming,

and my sister is running.

The CMV also threw a monkey wrench into my plans to make this a fund

raiser. It hit me about the time I was getting started with the fund

raising, and not only laid me up in bed, but cast doubt on whether I'd

be able to do the tri at all. Once I got well, and rearranged my plans

it was really too late to get any major fund raising done. So, I'm

considering this to be a trial run for next year. Hopefully I'll be

able to do it solo next year, and have all the fund raising in place

well before the race!

I'll let you all know how it goes!

athan

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My bet would be on immune suppression. For me EIA was easily controlled with a

low dose of prednisone, steroid inhalers or even some non-steroid inhalers

(Intal) and NO fast acting inhalers. Now, I just take Singulair (leukotriene

inhibitor), which I highly recommend - no side effects and 1 tiny pill/day. It

basically " ties up " the molecule that triggers asthma and prevents it.

I definitely agree with your last statement!

Arne

---- athan wrote:

=============

Hi,

Does anyone know much about the mechanism for asthma? I suffered from

exercise induced asthma since I was a kid, but it seems to be gone since

my transplant. I don't know whether to attribute it to the immune

suppression, my generally improved health, or something else. It is

nice to be able to exercise without gasping for breath though!

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Good luck to you and your teammates/family! It is so wonderful that you are participating in the triathlon.

Enjoy. My husband came out to watch me finish a 10 K race a couple years ago. I was already done, but he saw a neighbor finishing the 1/2 marathon - said she looked miserable. Since then, my first and foremost goal is to enjoy - and to look like it as I cross the finish line! The time may be slower, but finishing and "looking at least pretty good" is the goal.

Take care.

Joanne H

(, Ca., mom of , 17, UC/PSC 2-06)

-----Original Message-----From: [mailto: ]On Behalf Of athan Sent: Wednesday, October 03, 2007 2:42 AMTo: Subject: Asthma

Hi,Does anyone know much about the mechanism for asthma? I suffered from exercise induced asthma since I was a kid, but it seems to be gone since my transplant. I don't know whether to attribute it to the immune suppression, my generally improved health, or something else. It is nice to be able to exercise without gasping for breath though! Speaking of exercise, I'm going to be doing this triathlon this coming Sunday. It turns out that I'm not going to be doing the entire thing myself. After the bout with CMV I got a little nervous about infections, and asked Dr. Raiford if it was a good idea to be swimming in lake water, and he said I should wait 'till a year post transplant. So I'm doing the biking as a part of a team. My brother is swimming, and my sister is running. The CMV also threw a monkey wrench into my plans to make this a fund raiser. It hit me about the time I was getting started with the fund raising, and not only laid me up in bed, but cast doubt on whether I'd be able to do the tri at all. Once I got well, and rearranged my plans it was really too late to get any major fund raising done. So, I'm considering this to be a trial run for next year. Hopefully I'll be able to do it solo next year, and have all the fund raising in place well before the race!I'll let you all know how it goes!athan

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> Does anyone know much about the mechanism for asthma?

Hi athan;

The mechanism for asthma seems to involve T cells that get stimulated

by antigens (presented to them by antigen presenting cells) in the

airways. The stimulated T cells then produce pro-inflammatory

cytokines that can initiate and perpetuate airway inflammation. The

synthesis of the pro-inflammatory cytokines by the T cells involves

changes of gene expression, mediated by transcription factors.

Glucocorticoids seem to be the most effective therapy in the control

of the inflammatory processes in asthma and they probably function by

inhibiting the transcription factors that regulate the increases in

gene expression that contribute to the disease.

A lot of recent research is focused on the newly discovered Th17

cells, as described in this recent review:

An Update on Transcription Factors in Asthma

Erwin W. Gelfand, MD

http://www.medscape.com/viewarticle/555296

I'm very interested in these Th17 cells in relation to inflammatory

bowel disease.

Best regards,

Dave

(father of (23); PSC 07/03; UC 08/03)

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Hi athan,

I see that Dave R. gave you a very interesting and elegant scientific

description of how the mechanics of asthma. Thanks, Dave. I have

asthma, too, and have had exercise-induced asthma in past years.

(Skiing at high altitudes was fun.....not!) I worked in a

pediatrician's office for about a year many years ago and learned more

about the physical manifestations of asthma and how to treat it. My

understanding of it is that it is an autoimmune disorder because it

shows up somewhat like the bile ducts in PSC -- the airway constricts

the muscles on the outside while the mucous membranes on the inside

become inflamed. Therefore, the closing airway and inability to get

much air in or out. I was evaluated at National Jewish through one of

their ongoing free studies, too.

I, too, have had changes in different ailments since I was diagnosed

with PSC. I don't get migraines anymore; but that was a result of

trying to get off as many medications as possible then and I quit

using the estrogen patch as part of menopausaul hormone replacement

therapy and a way to slow down the migraines. However, it turns out

(and I found this out by mere chance) that the estrogen itself was

causing the migraines. The asthma is still with me but not even close

to the severity of it 15 years ago. And again, it was another cause (a

lot of diet adjustments). But I don't use any inhalers on a regular

basis anymore.

I haven't had a transplant, but then you have AND you have also worked

yourself into prime physical condition (I know you're a little off

right now, but still doing a leg of the triathlon -- amazing!) and

that can put asthma in the background, too. Do you ever wheeze? Dry

air? Smog? Anything else triggering? I have been told that I do have a

reactive airway and always will, and I do better with general

anesthesia when I'm given a breathing treatment before they begin. So,

I'm curious what they (the docs, nurses) say to you about your airway

now.

Best of luck to you in the triathlon this weekend. I am very proud of

it and brag about you (not by name or anything) to my friends --

" there's this guy on my online support group and he had a transplant

and is participating in a triathlon....same year for both! "

Buena suerte!

Dana

PSC dx 2-1-06

Asthma

Posted by: " athan " thegeorges2@... thegeorges2

Date: Wed Oct 3, 2007 3:24 am ((PDT))

Hi,

Does anyone know much about the mechanism for asthma? I suffered from

exercise induced asthma since I was a kid, but it seems to be gone since

my transplant. I don't know whether to attribute it to the immune

suppression, my generally improved health, or something else. It is

nice to be able to exercise without gasping for breath though!

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Hey athan

Congrats on doing the Tri fundraiser. I completed a cycling fundraiser

this summer so I can relate to the amount of effort required both to

completing it and doing the fundraising as well.

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