A detailed medical flowchart showing the pathophysiology of asthma. The flowchart should flow top to bottom with clear arrows and boxes. Include these steps in order: 1. TRIGGERS box at top (Allergens / Environmental antigens, Exercise, Stress, Respiratory infections, Cold air, Pollutants/Diesel fumes, Ozone/Nitrates) 2. Arrow down to: Antigen Presentation & Sensitization (Dendritic cells process antigen → T-helper 2 (Th2) cell activation) 3. Arrow down to: IgE Production (B-cells stimulated by IL-4/IL-13 → IgE synthesis → IgE binds to mast cells) 4. Arrow down to: EARLY PHASE REACTION (0–30 min) box with: - Mast cell degranulation (IgE-mediated) - Release of: Histamine, Chemotactic factors, Proteolytic enzymes, Heparin, Leukotrienes (LTC4, LTD4), Prostaglandins - Result: Smooth muscle bronchoconstriction, Mucus hypersecretion, Vascular permeability ↑ 5. Arrow down to: LATE PHASE REACTION (2–8 hrs) box with: - Recruitment of: Eosinophils, Neutrophils, Mononuclear cells, Basophils - Release of: Cytokines (IL-3 to IL-6, TNF-α, IFN-γ), Vasoactive factors, Arachidonic acid metabolites, Major basic protein (MBP) - Activation of epithelial & endothelial cells 6. Arrow down to: THREE MECHANISMS OF AIRFLOW OBSTRUCTION box: - Bronchoconstriction (smooth muscle contraction) - Mucosal edema (vascular leak + inflammatory infiltrate) - Mucus plug formation 7. Arrow down to: AIRWAY HYPERRESPONSIVENESS box: - Increased sensitivity to triggers - Amplified inflammatory response 8. Arrow down to: CHRONIC INFLAMMATION & AIRWAY REMODELING box (if untreated): - Goblet cell hyperplasia - Smooth muscle hypertrophy - Subepithelial fibrosis - Basement membrane thickening - Angiogenesis 9. Arrow down to: CLINICAL MANIFESTATIONS box at bottom: Wheezing, Dyspnea, Chest tightness, Cough, ↓ FEV1, ↓ FEV1/FVC ratio Use a clean clinical white background, blue and red color scheme for the boxes, with clear bold text labels. Title at top: "PATHOPHYSIOLOGY OF ASTHMA". Make the chart professional and educational quality suitable for medical students.