Goljan error?

[maverick_pkg]

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Hi
Goljan in his lectures mentions that corticosteroids decrease eosinophil levels and thats why they are used in type 1 hypersensitivity reactions.
later on in the same chapter he says that eosinophils are attracted in type 1 hypersensitivity by eosinophil chemotactic factor released by mast cell degranulation, and that they have histaminase activity and also have aryl sulfatase which opposes leukotriene's actions (bronchoconstriction). Thus going by this statement one would assume that eosinophils are good for us in type 1 HS eg asthma.
Then why give corticosteroids and decrease eosinophil levels?

 

[Idiopathic]

I think the goal of giving corticosteroids is to reduce the overall immune response, not to focus on eosinophils. Also, the prevention of the asthma 'attack' is of utmost importance. By the time arylsulfatase and histaminase are available, the acute reactants have done their damage, I believe. What benefit eosinophils provide here is simply a clean-up effect.

 

[BrooklynDO]

steroids take a long time to be effective... you are giving them in any acute attack simply to try to prevent later recurrance (hours) and to possibly reduce the time of the current attack.
eg. angioedema : give a "horse dose" of benadryl and then give some corticosteriods...unless there is a reason not to give the steroids... therefore they are optional in the acute setting and not really involved in treating the acute reaction...
also...half of medicine is "we do it coz it works, and let the Phd's figure out why"

 

[maverick_pkg]

steroids take a long time to be effective... you are giving them in any acute attack simply to try to prevent later recurrance (hours) and to possibly reduce the time of the current attack.
eg. angioedema : give a "horse dose" of benadryl and then give some corticosteriods...unless there is a reason not to give the steroids... therefore they are optional in the acute setting and not really involved in treating the acute reaction...
also...half of medicine is "we do it coz it works, and let the Phd's figure out why"

haha.. think u r right. the phd bit was gr8