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Review
. 2008 Feb 14;358(7):716-27.
doi: 10.1056/NEJMra074111.

Acute lower respiratory tract infection

Joseph P Mizgerd  1
Affiliations
Review

Acute lower respiratory tract infection

Joseph P Mizgerd. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Neutrophils and Lung Infection
Neutrophils are effector cells of innate immunity, killing microbes using phagocytosis and neutrophil extracellular traps (NETs). Neutrophils also generate a variety of immune mediators to direct immune responses, influencing other cells of innate and adaptive immunity. Finally, neutrophils damage tissues, with products such as proteases and reactive oxygen species injuring cells and digesting matrix. TNF denotes tumor necrosis factor.
Figure 2
Figure 2. The Epithelial Interface and Lung Infection
Activation of the epithelial cells forming an interface between the air spaces and the body induces the expression of molecules recruiting neutrophils as innate immunity reinforcements. Epithelial cells recognize some microbes directly through pattern-recognition receptors (PRRs). Alveolar macrophages recognizing microbes activate epithelial cells directly and through T-cell intermediates. Invariant natural killer T (iNKT) cells recognizing microbes can also activate epithelial cells. These diverse activation pathways converge on nuclear factor κB (NF-κB) transcription factors in the epithelial cell, with RelA responsible for inducing and p50 responsible for regulating the expression of proinflammatory mediators, including neutrophil chemokines, colony-stimulating factors, and adhesion molecules. TNF denotes tumor necrosis factor.
See this image and copyright information in PMC

Comment in

  • Acute lower respiratory tract infection.
    Eisenhut M. Eisenhut M. N Engl J Med. 2008 May 29;358(22):2413-4; author reply 2414. doi: 10.1056/NEJMc080592. N Engl J Med. 2008. PMID: 18509133 No abstract available.

References

    1. Mizgerd JP. Lung infection — a public health priority. PLoS Med. 2006;3(2):e76. - PMC - PubMed
    1. Armstrong GL, Conn LA, Pinner RW. Trends in infectious disease mortality in the United States during the 20th century. JAMA. 1999;281:61–66. - PubMed
    1. Doerschuk CM. Mechanisms of leukocyte sequestration in inflamed lungs. Microcirculation. 2001;8:71–88. - PubMed
    1. Burns AR, Smith CW, Walker DC. Unique structural features that influence neutrophil emigration into the lung. Physiol Rev. 2003;83:309–336. - PubMed
    1. Metchnikoff E, editor. Immunity in infective diseases. London: Cambridge University Press; 1905. The mechanism of natural immunity against micro-organisms; pp. 175–206.

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