Mechanisms of defence in the lung: Lessons from Pneumocystis carinii pneumonia

Robert Vassallo, Charles F. Thomas, Zvezdana Vuk-Pavlovic, Andrew H. Limper

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Pneumocystis carinii continues to represent an important complication of individuals with compromised immunity. P. carinii interacts with immune and non-immune cells in the lung and mediates lung injury through a variety of mechanisms. CD4+ T lymphocytes are the cornerstone in defence against P. carinii. Recent studies indicate that alveolar macrophages provide essential functions that significantly enhance clearance of P. carinii infection. P. carinii also attaches to alveolar epithelial cells, causing inhibition of epithelial growth and replication. In addition to cellular interactions, P. carinii organisms bind to a variety of host adhesive proteins present in the lower respiratory tract. Binding of these proteins to P. carinii modulates host cell recognition and immune responses to the parasite. During the course of P. carinii pneumonia, several inflammatory mediators are produced in the lung. Although necessary for control of infection, exuberant inflammatory responses also predispose the host to the development of acute lung injury. Thus, host defences against P. carinii depend on complex interactions between immune and non-immune cells as well as several mediators that facilitate host recognition and eventual elimination of infection. Understanding these complex processes may enable development of novel therapeutic approaches for management of this important infection.

Original languageEnglish (US)
Pages (from-to)130-139
Number of pages10
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Volume17
Issue number2
StatePublished - Jun 1 2000

Keywords

  • AIDS
  • Alveolar macrophage
  • Cytokines
  • Lung defences
  • Lymphocytes
  • Pneumocystis carinii
  • Surfactant proteins

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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