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Terada Y, Li W, Shepherd HM, Takahashi T, Yokoyama Y, Bery AI, Mineura K, Bai YZ, Ritter JH, Hachem RR, Bharat A, Lavine KJ, Nava RG, Puri V, Krupnick AS, Gelman AE, Reed HO, Wong BW, Kreisel D. Smoking exposure-induced bronchus-associated lymphoid tissue in donor lungs does not prevent tolerance induction after transplantation. Am J Transplant 2024; 24:280-292. [PMID: 37619922 PMCID: PMC11088405 DOI: 10.1016/j.ajt.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
The presence of bronchus-associated lymphoid tissue (BALT) in donor lungs has been suggested to accelerate graft rejection after lung transplantation. Although chronic smoke exposure can induce BALT formation, the impact of donor cigarette use on alloimmune responses after lung transplantation is not well understood. Here, we show that smoking-induced BALT in mouse donor lungs contains Foxp3+ T cells and undergoes dynamic restructuring after transplantation, including recruitment of recipient-derived leukocytes to areas of pre-existing lymphoid follicles and replacement of graft-resident donor cells. Our findings from mouse and human lung transplant data support the notion that a donor's smoking history does not predispose to acute cellular rejection or prevent the establishment of allograft acceptance with comparable outcomes to nonsmoking donors. Thus, our work indicates that BALT in donor lungs is plastic in nature and may have important implications for modulating proinflammatory or tolerogenic immune responses following transplantation.
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Affiliation(s)
- Yuriko Terada
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Wenjun Li
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hailey M Shepherd
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tsuyoshi Takahashi
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Yuhei Yokoyama
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Amit I Bery
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katsutaka Mineura
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Yun Zhu Bai
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jon H Ritter
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ramsey R Hachem
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ankit Bharat
- Department of Surgery, Northwestern University, Chicago, Illinois, USA
| | - Kory J Lavine
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ruben G Nava
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Varun Puri
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Andrew E Gelman
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Brian W Wong
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Daniel Kreisel
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
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2
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Zhen CJ, Zhang P, Bai WW, Song YZ, Liang JL, Qiao XY, Zhou ZG. Mucosa-associated lymphoid tissue lymphoma of the trachea treated with radiotherapy: A case report. World J Clin Cases 2023; 11:1607-1614. [PMID: 36926401 PMCID: PMC10011992 DOI: 10.12998/wjcc.v11.i7.1607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/04/2023] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma originates in the marginal zone of lymphoid tissue. lung is one of the most frequent non-gastrointestinal organs involved, here known as bronchus-associated lymphoid tissue (BALT) lymphoma. BALT lymphoma of unknown etiology, and most patients are asymptomatic. The treatment of BALT lymphoma is controversial.
CASE SUMMARY A 55-year-old man admitted to hospital had a three-month history of progressively coughing up yellow sputum, chest stuffiness, and shortness of breath. Fiberoptic bronchoscopy revealed mucosal visible beaded bumps 4 cm from the tracheal carina at 9 o 'clock and 3 o 'clock, the right main bronchus, and the right upper lobe bronchus. Biopsy specimens showed MALT lymphoma. Computed tomography virtual bronchoscopy (CTVB) showed uneven main bronchial wall thickening and multiple nodular protrusion. BALT lymphoma stage IE was diagnosed after a staging examination. We treated the patient with radiotherapy (RT) alone. A total dose of 30.6 Gy/17 f/25 d was given. The patient had no obvious adverse reactions during RT. The CTVB was repeated after RT and showed that the right side of the trachea was slightly thickened. CTVB was repeated 1.5 mo after RT and again showed that the right side of the trachea was slightly thickened. Annual CTVB showed no signs of recurrence. The patient now has no symptoms.
CONCLUSION BALT lymphoma is an uncommon disease and shows good prognosis. The treatment of BALT lymphoma is controversial. In recent years, less invasive diagnostic and therapeutic approaches have been emerging. RT was effective and safe in our case. The use of CTVB could provide a noninvasive, repeatable, and accurate method in diagnosis and follow-up.
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Affiliation(s)
- Chan-Jun Zhen
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Ping Zhang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Wen-Wen Bai
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Yu-Zhi Song
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Jun-Li Liang
- Nursing Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Xue-Ying Qiao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhi-Guo Zhou
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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3
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Role of tertiary lymphoid organs in the regulation of immune responses in the periphery. Cell Mol Life Sci 2022; 79:359. [PMID: 35689679 PMCID: PMC9188279 DOI: 10.1007/s00018-022-04388-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/28/2022] [Accepted: 05/20/2022] [Indexed: 12/12/2022]
Abstract
Tertiary lymphoid organs (TLOs) are collections of immune cells resembling secondary lymphoid organs (SLOs) that form in peripheral, non-lymphoid tissues in response to local chronic inflammation. While their formation mimics embryologic lymphoid organogenesis, TLOs form after birth at ectopic sites in response to local inflammation resulting in their ability to mount diverse immune responses. The structure of TLOs can vary from clusters of B and T lymphocytes to highly organized structures with B and T lymphocyte compartments, germinal centers, and lymphatic vessels (LVs) and high endothelial venules (HEVs), allowing them to generate robust immune responses at sites of tissue injury. Although our understanding of the formation and function of these structures has improved greatly over the last 30 years, their role as mediators of protective or pathologic immune responses in certain chronic inflammatory diseases remains enigmatic and may differ based on the local tissue microenvironment in which they form. In this review, we highlight the role of TLOs in the regulation of immune responses in chronic infection, chronic inflammatory and autoimmune diseases, cancer, and solid organ transplantation.
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4
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Ohm-Laursen L, Meng H, Hoehn KB, Nouri N, Jiang Y, Clouser C, Johnstone TG, Hause R, Sandhar BS, Upton NEG, Chevretton EB, Lakhani R, Corrigan CJ, Kleinstein SH, Gould HJ. B Cell Mobilization, Dissemination, Fine Tuning of Local Antigen Specificity and Isotype Selection in Asthma. Front Immunol 2021; 12:702074. [PMID: 34721376 PMCID: PMC8552043 DOI: 10.3389/fimmu.2021.702074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022] Open
Abstract
In order to better understand how the immune system interacts with environmental triggers to produce organ-specific disease, we here address the hypothesis that B and plasma cells are free to migrate through the mucosal surfaces of the upper and lower respiratory tracts, and that their total antibody repertoire is modified in a common respiratory tract disease, in this case atopic asthma. Using Adaptive Immune Receptor Repertoire sequencing (AIRR-seq) we have catalogued the antibody repertoires of B cell clones retrieved near contemporaneously from multiple sites in the upper and lower respiratory tract mucosa of adult volunteers with atopic asthma and non-atopic controls and traced their migration. We show that the lower and upper respiratory tracts are immunologically connected, with trafficking of B cells directionally biased from the upper to the lower respiratory tract and points of selection when migrating from the nasal mucosa and into the bronchial mucosa. The repertoires are characterized by both IgD-only B cells and others undergoing class switch recombination, with restriction of the antibody repertoire distinct in asthmatics compared with controls. We conclude that B cells and plasma cells migrate freely throughout the respiratory tract and exhibit distinct antibody repertoires in health and disease.
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Affiliation(s)
- Line Ohm-Laursen
- Randall Centre for Cell and Molecular Biophysics and School of Basic and Medical Biosciences, King’s College London, London, United Kingdom
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Hailong Meng
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
| | - Kenneth B. Hoehn
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
| | - Nima Nouri
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Yue Jiang
- Bristol Myers Squibb, Seattle, WA, United States
| | | | | | - Ron Hause
- Bristol Myers Squibb, Seattle, WA, United States
| | - Balraj S. Sandhar
- Randall Centre for Cell and Molecular Biophysics and School of Basic and Medical Biosciences, King’s College London, London, United Kingdom
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Nadine E. G. Upton
- Randall Centre for Cell and Molecular Biophysics and School of Basic and Medical Biosciences, King’s College London, London, United Kingdom
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Elfy B. Chevretton
- Department of Ear, Nose and Throat (ENT) Services, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Raj Lakhani
- Department of Ear, Nose and Throat (ENT) Services, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Chris J. Corrigan
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
- Department of Respiratory Medicine and Allergy and School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Steven H. Kleinstein
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
- Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, United States
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, United States
| | - Hannah J. Gould
- Randall Centre for Cell and Molecular Biophysics and School of Basic and Medical Biosciences, King’s College London, London, United Kingdom
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
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5
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Panitz N, Gerhardt K, Becker C, Schleife H, Bach E, Opitz S, Schaudinn A, Platzbecker U, Kayser S. Two rare cases of bronchus-associated lymphoid tissue lymphoma successfully treated with rituximab-bendamustine. Clin Case Rep 2021; 9:e04557. [PMID: 34401153 PMCID: PMC8346601 DOI: 10.1002/ccr3.4557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/20/2021] [Indexed: 11/10/2022] Open
Abstract
BALT lymphoma is a rare B-NHL with a favorable prognosis. We here report on two patients with nonspecific symptoms: one showed as major symptom severe thrombocytopenia and the other dyspnea and dry cough, thereby suggesting an inflammatory focus in the lungs. There is no standard of care established yet. Both patients were successfully treated with rituximab and bendamustine. Thus, combined immunochemotherapy should be considered as first-line therapy as in other MALT lymphomas, if the treatment/eradication of an underlying chronic inflammatory disorder/trigger factor can be excluded.
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Affiliation(s)
- Nydia Panitz
- Medical Clinic and Policlinic IHematology and Cellular TherapyUniversity Hospital LeipzigLeipzigGermany
| | - Kristin Gerhardt
- Medical Clinic and Policlinic IHematology and Cellular TherapyUniversity Hospital LeipzigLeipzigGermany
| | | | | | - Enrica Bach
- Medical Clinic and Policlinic IHematology and Cellular TherapyUniversity Hospital LeipzigLeipzigGermany
| | - Sabine Opitz
- Department of DiagnosticsInstitute of PathologyUniversity Hospital LeipzigLeipzigGermany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional RadiologyUniversity of LeipzigLeipzigGermany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic IHematology and Cellular TherapyUniversity Hospital LeipzigLeipzigGermany
| | - Sabine Kayser
- Medical Clinic and Policlinic IHematology and Cellular TherapyUniversity Hospital LeipzigLeipzigGermany
- NCT Trial CenterNational Center of Tumor DiseasesGerman Cancer Research Center (DKFZ)HeidelbergGermany
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6
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Walters EH, Shukla SD, Mahmood MQ, Ward C. Fully integrating pathophysiological insights in COPD: an updated working disease model to broaden therapeutic vision. Eur Respir Rev 2021; 30:200364. [PMID: 34039673 PMCID: PMC9488955 DOI: 10.1183/16000617.0364-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/18/2021] [Indexed: 12/17/2022] Open
Abstract
Our starting point is that relatively new findings into the pathogenesis and pathophysiology of airway disease in smokers that lead to chronic obstructive pulmonary disease (COPD) need to be reassessed as a whole and integrated into "mainstream" thinking along with traditional concepts which have stood the test of time. Such a refining of the accepted disease paradigm is urgently needed as thinking on therapeutic targets is currently under active reconsideration. We feel that generalised airway wall "inflammation" is unduly over-emphasised, and highlight the patchy and variable nature of the pathology (with the core being airway remodelling). In addition, we present evidence for airway wall disease in smokers/COPD as including a hypocellular, hypovascular, destructive, fibrotic pathology, with a likely spectrum of epithelial-mesenchymal transition states as significant drivers of this remodelling. Furthermore, we present data from a number of research modalities and integrate this with the aetiology of lung cancer, the role of chronic airway luminal colonisation/infection by a specific group of "respiratory" bacteria in smokers (which results in luminal inflammation) and the central role for oxidative stress on the epithelium. We suggest translation of these insights into more focus on asymptomatic smokers and early COPD, with the potential for fresh preventive and therapeutic approaches.
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Affiliation(s)
- E Haydn Walters
- School of Medicine and Menzies Institute, University of Tasmania, Hobart, Australia
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Malik Q Mahmood
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Chris Ward
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Medical School, Newcastle University, UK
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7
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Curtis JL. Wouldn't you like to know: are tertiary lymphoid structures necessary for lung defence? Eur Respir J 2021; 57:57/4/2004352. [PMID: 33858851 DOI: 10.1183/13993003.04352-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 12/08/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Jeffrey L Curtis
- Medical Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA .,Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, USA.,Dept of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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8
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Lat T, Sanchez JF, McGraw MK, Hodjat P, White HD, Boethel CD. Decision-making in diagnosis of bronchus-associated lymphoid tissue lymphoma. Proc (Bayl Univ Med Cent) 2021; 34:451-455. [PMID: 34219924 DOI: 10.1080/08998280.2021.1889275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Bronchus-associated lymphoid tissue (BALT) lymphomas of the lung are uncommon, and diagnosis is often delayed due to the indolent clinical course. Often, adequate samples are difficult to obtain by bronchoscopy with transbronchial biopsy alone. This retrospective study reviewed the diagnosis and treatment of BALT lymphoma cases at our institution over the course of 19 years. Most patients were white, women, and >50 years old; the mean Charlson Comorbidity Index at the time of diagnosis was 6. Seven of 12 patients presented with solitary nodules or multiple nodules. For six cases, initial modalities were nondiagnostic; four subsequently underwent surgical biopsy, one underwent computed tomography-guided biopsy, and one underwent navigational bronchoscopy for final diagnosis of BALT lymphoma. Ultimately, 55% of cases were diagnosed with nonsurgical biopsy. One patient suffered a pneumothorax related to the initial diagnostic attempt. Ten patients received chemotherapy, radiation, and/or surgery, and 11 of the 12 are still alive. Our data confirm the previously described indolent behavior of BALT lymphomas and the challenges related to diagnosis. While previous studies have suggested surgical biopsy as the primary modality for obtaining histopathology, navigational bronchoscopy could serve as a safer alternative.
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Affiliation(s)
- Tasnim Lat
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Juan F Sanchez
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Meghan K McGraw
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Parsa Hodjat
- Department of Pathology, Baylor Scott & White Health, Temple, Texas
| | - Heath D White
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Carl D Boethel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
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9
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Wu BG, Kapoor B, Cummings KJ, Stanton ML, Nett RJ, Kreiss K, Abraham JL, Colby TV, Franko AD, Green FHY, Sanyal S, Clemente JC, Gao Z, Coffre M, Meyn P, Heguy A, Li Y, Sulaiman I, Borbet TC, Koralov SB, Tallaksen RJ, Wendland D, Bachelder VD, Boylstein RJ, Park JH, Cox-Ganser JM, Virji MA, Crawford JA, Edwards NT, Veillette M, Duchaine C, Warren K, Lundeen S, Blaser MJ, Segal LN. Evidence for Environmental-Human Microbiota Transfer at a Manufacturing Facility with Novel Work-related Respiratory Disease. Am J Respir Crit Care Med 2021; 202:1678-1688. [PMID: 32673495 DOI: 10.1164/rccm.202001-0197oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rationale: Workers' exposure to metalworking fluid (MWF) has been associated with respiratory disease.Objectives: As part of a public health investigation of a manufacturing facility, we performed a cross-sectional study using paired environmental and human sampling to evaluate the cross-pollination of microbes between the environment and the host and possible effects on lung pathology present among workers.Methods: Workplace environmental microbiota were evaluated in air and MWF samples. Human microbiota were evaluated in lung tissue samples from workers with respiratory symptoms found to have lymphocytic bronchiolitis and alveolar ductitis with B-cell follicles and emphysema, in lung tissue samples from control subjects, and in skin, nasal, and oral samples from 302 workers from different areas of the facility. In vitro effects of MWF exposure on murine B cells were assessed.Measurements and Main Results: An increased similarity of microbial composition was found between MWF samples and lung tissue samples of case workers compared with control subjects. Among workers in different locations within the facility, those that worked in the machine shop area had skin, nasal, and oral microbiota more closely related to the microbiota present in the MWF samples. Lung samples from four index cases and skin and nasal samples from workers in the machine shop area were enriched with Pseudomonas, the dominant taxa in MWF. Exposure to used MWF stimulated murine B-cell proliferation in vitro, a hallmark cell subtype found in the pathology of index cases.Conclusions: Evaluation of a manufacturing facility with a cluster of workers with respiratory disease supports cross-pollination of microbes from MWF to humans and suggests the potential for exposure to these microbes to be a health hazard.
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Affiliation(s)
| | | | - Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Randall J Nett
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Kathleen Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Jerrold L Abraham
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Thomas V Colby
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona
| | - Angela D Franko
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francis H Y Green
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Soma Sanyal
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Jose C Clemente
- Icahn Institute for Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zhan Gao
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey
| | - Maryaline Coffre
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Peter Meyn
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Adriana Heguy
- Department of Pathology, New York University School of Medicine, New York, New York
| | | | | | | | - Sergei B Koralov
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Robert J Tallaksen
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | | | | | - Randy J Boylstein
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Judith A Crawford
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Nicole T Edwards
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Marc Veillette
- Department of Biochemistry, Microbiology and Bioinformatics, Laval University, Quebec, Canada
| | - Caroline Duchaine
- Department of Biochemistry, Microbiology and Bioinformatics, Laval University, Quebec, Canada
| | - Krista Warren
- St. Luke's Department of Pathology, St. Luke's Hospital, Duluth, Minnesota; and
| | - Sarah Lundeen
- St. Luke's Department of Pathology, St. Luke's Hospital, Duluth, Minnesota; and
| | - Martin J Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey
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10
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Booth JS, Toapanta FR. B and T Cell Immunity in Tissues and Across the Ages. Vaccines (Basel) 2021; 9:vaccines9010024. [PMID: 33419014 PMCID: PMC7825307 DOI: 10.3390/vaccines9010024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/23/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023] Open
Abstract
B and T cells are key components of the adaptive immune system and coordinate multiple facets of immunity including responses to infection, vaccines, allergens, and the environment. In humans, B- and T-cell immunity has been determined using primarily peripheral blood specimens. Conversely, human tissues have scarcely been studied but they host multiple adaptive immune cells capable of mounting immune responses to pathogens and participate in tissue homeostasis. Mucosal tissues, such as the intestines and respiratory track, are constantly bombarded by foreign antigens and contain tissue-resident memory T (TRM) cells that exhibit superior protective capacity to pathogens. Also, tissue-resident memory B (BRM) cells have been identified in mice but whether humans have a similar population remains to be confirmed. Moreover, the immune system evolves throughout the lifespan of humans and undergoes multiple changes in its immunobiology. Recent studies have shown that age-related changes in tissues are not necessarily reflected in peripheral blood specimens, highlighting the importance of tissue localization and subset delineation as essential determinants of functional B and T cells at different life stages. This review describes our current knowledge of the main B- and T-cell subsets in peripheral blood and tissues across age groups.
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Affiliation(s)
- Jayaum S. Booth
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21075, USA;
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Franklin R. Toapanta
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21075, USA;
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Correspondence:
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11
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Ghosh S, Mehta AC, Abuquyyas S, Raju S, Farver C. Primary lung neoplasms presenting as multiple synchronous lung nodules. Eur Respir Rev 2020; 29:29/157/190142. [PMID: 32878970 DOI: 10.1183/16000617.0142-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/08/2020] [Indexed: 12/26/2022] Open
Abstract
Multiple synchronous lung nodules are frequently encountered on computed tomography (CT) scanning of the chest and are most commonly either non-neoplastic or metastases from a known primary malignancy. The finding may initiate a search for primary malignancy elsewhere in the body. An exception to this rule, however, is a class of rare primary lung neoplasms that originate from epithelial (pneumocytes and neuroendocrine), mesenchymal (vascular and meningothelial) and lymphoid tissues of the lung. While these rare neoplasms also present as multiple synchronous unilateral or bilateral lung nodules on chest CT, they are often overlooked in favour of more common causes of multiple lung nodules. The correct diagnosis may be suggested by a multidisciplinary team and established on biopsy, performed either as part of routine diagnostic work-up or staging for malignancy. In this review, we discuss clinical presentations, imaging features, pathology findings and subsequent management of these rare primary neoplasms of the lung.
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Affiliation(s)
- Subha Ghosh
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sami Abuquyyas
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shine Raju
- Pulmonary, Critical Care and Sleep Medicine, University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Carol Farver
- Dept of Pathology, Cleveland Clinic, Cleveland, OH, USA
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12
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Freeman CM, Curtis JL. It's Complicated: Lung Dendritic Cells in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2020; 202:479-481. [PMID: 32286855 PMCID: PMC7427380 DOI: 10.1164/rccm.202004-0899ed] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Christine M Freeman
- Research ServiceVeterans Affairs Ann Arbor Healthcare SystemAnn Arbor, Michigan
- Department of Internal MedicineMichigan MedicineAnn Arbor, Michigan
- Graduate Program in ImmunologyUniversity of MichiganAnn Arbor, Michiganand
| | - Jeffrey L Curtis
- Department of Internal MedicineMichigan MedicineAnn Arbor, Michigan
- Graduate Program in ImmunologyUniversity of MichiganAnn Arbor, Michiganand
- Medical ServiceVA Ann Arbor Healthcare SystemAnn Arbor, Michigan
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13
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Kumar V. Pulmonary Innate Immune Response Determines the Outcome of Inflammation During Pneumonia and Sepsis-Associated Acute Lung Injury. Front Immunol 2020; 11:1722. [PMID: 32849610 PMCID: PMC7417316 DOI: 10.3389/fimmu.2020.01722] [Citation(s) in RCA: 273] [Impact Index Per Article: 68.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022] Open
Abstract
The lung is a primary organ for gas exchange in mammals that represents the largest epithelial surface in direct contact with the external environment. It also serves as a crucial immune organ, which harbors both innate and adaptive immune cells to induce a potent immune response. Due to its direct contact with the outer environment, the lung serves as a primary target organ for many airborne pathogens, toxicants (aerosols), and allergens causing pneumonia, acute respiratory distress syndrome (ARDS), and acute lung injury or inflammation (ALI). The current review describes the immunological mechanisms responsible for bacterial pneumonia and sepsis-induced ALI. It highlights the immunological differences for the severity of bacterial sepsis-induced ALI as compared to the pneumonia-associated ALI. The immune-based differences between the Gram-positive and Gram-negative bacteria-induced pneumonia show different mechanisms to induce ALI. The role of pulmonary epithelial cells (PECs), alveolar macrophages (AMs), innate lymphoid cells (ILCs), and different pattern-recognition receptors (PRRs, including Toll-like receptors (TLRs) and inflammasome proteins) in neutrophil infiltration and ALI induction have been described during pneumonia and sepsis-induced ALI. Also, the resolution of inflammation is frequently observed during ALI associated with pneumonia, whereas sepsis-associated ALI lacks it. Hence, the review mainly describes the different immune mechanisms responsible for pneumonia and sepsis-induced ALI. The differences in immune response depending on the causal pathogen (Gram-positive or Gram-negative bacteria) associated pneumonia or sepsis-induced ALI should be taken in mind specific immune-based therapeutics.
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Affiliation(s)
- Vijay Kumar
- Children's Health Queensland Clinical Unit, Faculty of Medicine, School of Clinical Medicine, Mater Research, University of Queensland, Brisbane, QLD, Australia.,Faculty of Medicine, School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
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14
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Kelemen K, Rimsza LM, Craig FE. Primary Pulmonary B-cell Lymphoma. Semin Diagn Pathol 2020; 37:259-267. [PMID: 32444246 DOI: 10.1053/j.semdp.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/22/2020] [Accepted: 04/09/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Katalin Kelemen
- Mayo Clinic Arizona, Division of Hematopathology, Department of Laboratory Medicine and Pathology, Phoenix, Arizona.
| | - Lisa M Rimsza
- Mayo Clinic Arizona, Division of Hematopathology, Department of Laboratory Medicine and Pathology, Phoenix, Arizona
| | - Fiona E Craig
- Mayo Clinic Arizona, Division of Hematopathology, Department of Laboratory Medicine and Pathology, Phoenix, Arizona
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15
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Malinina A, Dikeman D, Westbrook R, Moats M, Gidner S, Poonyagariyagorn H, Walston J, Neptune ER. IL10 deficiency promotes alveolar enlargement and lymphoid dysmorphogenesis in the aged murine lung. Aging Cell 2020; 19:e13130. [PMID: 32170906 PMCID: PMC7189990 DOI: 10.1111/acel.13130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/22/2019] [Accepted: 02/04/2020] [Indexed: 12/13/2022] Open
Abstract
The connection between aging-related immune dysfunction and the lung manifestations of aging is poorly understood. A detailed characterization of the aging IL10-deficient murine lung, a model of accelerated aging and frailty, reconciles features of both immunosenescence and lung aging in a coherent model. Airspace enlargement developed in the middle-aged (12 months old) and aged (20-22 months old) IL10-deficient lung punctuated by an expansion of macrophages and alveolar cell apoptosis. Compared to wild-type (WT) controls, the IL10-deficient lungs from young (4-month-old) mice showed increased oxidative stress which was enhanced in both genotypes by aging. Active caspase 3 staining was increased in the alveolar epithelial cells of aged WT and mutant lungs but was greater in the IL10-deficient milieu. Lung macrophages were increased in the aged IL10-deficient lungs with exuberant expression of MMP12. IL10 treatment of naïve and M2-polarized bone marrow-derived WT macrophages reduced MMP12 expression. Conditioned media studies demonstrated the secretome of aged mutant macrophages harbors reduced AECII prosurvival factors, specifically keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF), promotes cell death, and reduces survival of primary alveolar epithelial cells. Compared to WT controls, aged IL10-deficient mice have increased parenchymal lymphoid collections comprised of a reduced number of apoptotic cells and B cells. We establish that IL10 is a key modulator of airspace homeostasis and lymphoid morphogenesis in the aging lung enabling macrophage-mediated alveolar epithelial cell survival and B-cell survival within tertiary lymphoid structures.
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Affiliation(s)
- Alla Malinina
- Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | - Dustin Dikeman
- Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | - Reyhan Westbrook
- Division of Geriatrics Johns Hopkins School of Medicine Baltimore MD USA
| | - Michelle Moats
- Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
- Departments of Biology and Chemistry and Biochemistry Florida International University Miami FL USA
| | - Sarah Gidner
- Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | | | - Jeremy Walston
- Division of Geriatrics Johns Hopkins School of Medicine Baltimore MD USA
| | - Enid R. Neptune
- Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
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16
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Anatomical Uniqueness of the Mucosal Immune System (GALT, NALT, iBALT) for the Induction and Regulation of Mucosal Immunity and Tolerance. MUCOSAL VACCINES 2020. [PMCID: PMC7149644 DOI: 10.1016/b978-0-12-811924-2.00002-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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17
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The prognostic significance of tumor-infiltrating lymphocytes assessment with hematoxylin and eosin sections in resected primary lung adenocarcinoma. PLoS One 2019; 14:e0224430. [PMID: 31743333 PMCID: PMC6863614 DOI: 10.1371/journal.pone.0224430] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 10/15/2019] [Indexed: 01/02/2023] Open
Abstract
The prognostic significance of tumor-infiltrating lymphocytes has been determined in cancers of the lung, colon and breast, though there is no standardized method for using this prognostic indicator for lung cancer. We applied a modified version of the method proposed by the International Immuno-Oncology Biomarkers Working Group to primary lung adenocarcinoma, which uses histologic findings of hematoxylin and eosin sections. The study included a total cohort of 146 lung adenocarcinoma patients who underwent lobectomy with lymph node dissection at two hospitals between 2008 and 2012. The full-face sections of hematoxylin and eosin-stained slides were reviewed, and we evaluated the level of tumor-infiltrating lymphocytes as a percentage of the area occupied out of the total intra-tumoral stromal area. Histopathologic factors include histologic grade, necrosis, extracellular mucin, lymphovascular invasion, lymph node metastasis, level of tumor infiltrating lymphocytes, tertiary lymphoid structures around the tumor, and the presence of a germinal center in tertiary lymphoid structures. The high level of tumor-infiltrating lymphocytes was found to be significantly correlated with the histologic grade (p = 0.023), necrosis (p = 0.042), abundance of tertiary lymphoid structures(p<0.001) and presence of a germinal center in tertiary lymphoid structures (p = 0.004). A high level of tumor-infiltrating lymphocytes was associated with better progression-free survival (p = 0.011) as well as overall survival (p = 0.049). On multivariable analysis, high tumor-infiltrating lymphocyte levels were a good independent prognostic factor for progression-free survival (Hazard ratio: 0.389, 95% confidence interval: 0.161–0.941, p = 0.036). Histologic evaluation of tumor-infiltrating lymphocytes level in lung adenocarcinoma with H&E sections therefore has prognostic value in routine surgical pathology.
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18
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Snyder ME, Farber DL. Human lung tissue resident memory T cells in health and disease. Curr Opin Immunol 2019; 59:101-108. [PMID: 31265968 DOI: 10.1016/j.coi.2019.05.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/28/2019] [Indexed: 12/21/2022]
Abstract
The human lung contains a heterogeneous population of immune cells which mediate protective responses, maintain tissue homeostasis, but can also promote immunopathology in disease. The majority of T cells in the human lung are tissue resident memory T cells (TRM) which have been shown in mouse models to provide vital roles in the protection against multiple respiratory pathogens, and contribute to heterosubtypic protection in the context of vaccination. In this review, we will discuss recent studies in humans identifying lung TRM, their role in maintaining tissue homeostasis, and emerging evidence implicating TRM in anti-tumor immunity and immune surveillance as well as their potential for immunopathology in chronic airway inflammation.
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Affiliation(s)
- Mark E Snyder
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care at University of Pittsburgh, Pittsburgh, PA 15213, United States; Department of Immunology at University of Pittsburgh, Pittsburgh, PA 15213, United States; Starzl Transplantation Institute at University of Pittsburgh, Pittsburgh, PA 15213, United States
| | - Donna L Farber
- Department of Surgery at Columbia University Medical Center, New York, NY 10032, United States; Columbia Center for Translational Immunology at Columbia University Medical Center, New York, NY 10032, United States; Department of Microbiology and Immunology at Columbia University Medical Center, New York, NY 10032, United States.
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19
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Abstract
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is the most common primary pulmonary lymphoma. There are limited studies on imaging features of pulmonary MALT lymphoma. We present the computed tomography (CT) manifestations of pulmonary MALT lymphoma and the correlation between CT manifestations and clinical characteristics. Patients (n = 53) with histologically confirmed pulmonary MALT lymphoma who underwent chest CT scanning were retrospectively analyzed. Evaluated findings included distribution of pulmonary lesions, morphological pattern of appearance, contrast enhancement features, size, presence of thoracic lymphadenopathy, and secondary associated features. Pulmonary MALT lymphoma was observed in multiple (79%) and bilateral (66%) disease with random distribution (≥70%) of pulmonary lesions. The most frequent morphological pattern was consolidation (n = 33, 62%), followed by nodule (n = 23, 43%) and mass (n = 11, 21%). Common associated features were air bronchograms and bronchiectasis, especially cystic bronchiectasis and angiogram sign. Asymptomatic patients had less consolidation and bronchiectasis than did symptomatic patients. Cystic bronchiectasis was only observed in the symptomatic group. In conclusion, pulmonary MALT lymphoma manifests as diverse patterns on CT scans. Consolidation combined with cystic bronchiectasis was a characteristic late sign, which may assist in differential diagnosis. High-resolution CT images and multiplanar reconstruction techniques are helpful for accurately determining imaging manifestations.
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20
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He W, Zhang W, Cheng C, Li J, Wu X, Li M, Chen Z, Wang W. The distributive and structural characteristics of bronchus-associated lymphoid tissue (BALT) in Bactrian camels ( Camelus bactrianus). PeerJ 2019; 7:e6571. [PMID: 30881767 PMCID: PMC6417404 DOI: 10.7717/peerj.6571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/04/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Bronchus-associated lymphoid tissue (BALT), distributed in the bronchial mucosa, plays a critical role in maintaining the mucosal immune homeostasis of the lower respiratory tract. The bronchial tree is a functional structure for gas exchange with the outside environment and maintains basic lung morphology. METHODS To explore the structural and distributive characteristics of BALT in Bactrian camels, twelve healthy adult Bactrian camels were divided into two groups (six in each group). The lungs, bronchial tree and BALT were observed and analysed systematically through anatomical and histological methods. RESULTS The results showed that Bactrian camel lungs were constituted by the left cranial lobe, left caudal lobe, right cranial lobe, right caudal lobe and accessory lobe, but lacked the middle lobe. The cranial lobe was narrow and small, the caudal lobe was extremely developed (almost four times the cranial lobe in size), and the accessory lobe was smaller than the cranial lobe; the bronchial tree, an unequal dichotomy with a tracheobronchial branch, was composed of dorsal, ventral, lateral and medial bronchiole systems. Isolated lymphoid follicles (the chief type) and aggregates of lymphoid follicles revealed two types of BALT, and germinal centres, follicle-associated epithelium and high endothelial venules could be observed in some well-developed BALT. Additionally, BALT was scattered along the bronchial tree in the entire lung, and the density increased from the trachea to the lower graded branches (densest in the bronchioles) and then decreased, with the occasional location around respiratory bronchioles or among the pulmonary mesenchyme. In the conducting portion, BALT was primarily located in the mucosa lamina propria but was also found in the submucosa, under the muscular layer, and around the submucosal glands and cartilage. CONCLUSION The results demonstrated that the lung morphology of Bactrian camels was similar to that of horses, but the bronchial branches were more closely related to those of ruminants. These characteristics were in accordance with the morphological and structural variation regularity of lungs with species evolution. BALT was mainly scattered in the conducting portion, and bronchioles, as the final "checkpoint" in the surveillance, capture and recognition of antigens before pulmonary exchange, were the pivotal locational position of BALT. However, BALT at different depths of the bronchial wall of the conducting portion might be at different developmental stages. Our study provided evidence for further insight into the mucosal immunomodulatory mechanism of BALT in the respiratory system of Bactrian camels.
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Affiliation(s)
- Wanhong He
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Wangdong Zhang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Cuicui Cheng
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Jianfei Li
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Xiuping Wu
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Min Li
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Zhihua Chen
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Wenhui Wang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
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21
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McKleroy W, Lyn-Kew K. 500 Million Alveoli from 30,000 Feet: A Brief Primer on Lung Anatomy. Methods Mol Biol 2019; 1809:3-15. [PMID: 29987778 DOI: 10.1007/978-1-4939-8570-8_1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The lungs are a complex organ that fulfill multiple life-sustaining roles including transfer of oxygen and carbon dioxide between the ambient environment and the bloodstream, host defense, and immune homeostasis. As in any biological system, an understanding of the underlying anatomy is prerequisite for successful experimental design and appropriate interpretation of data, regardless of the precise experimental model or procedure in use. This chapter provides an overview of human lung anatomy focused on the airways, the ultrastructure or parenchyma of the lung, the pulmonary vasculature, the innervation of the lungs, and the pulmonary lymphatic system. We will also discuss notable anatomic differences between mouse and human lungs.
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Affiliation(s)
- William McKleroy
- Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, CO, USA.,Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kenneth Lyn-Kew
- Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, CO, USA.
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22
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Kalinkovich A, Gabdulina G, Livshits G. Autoimmunity, inflammation, and dysbiosis mutually govern the transition from the preclinical to the clinical stage of rheumatoid arthritis. Immunol Res 2018; 66:696-709. [DOI: 10.1007/s12026-018-9048-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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23
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Possebon L, Costa SS, Souza HR, Azevedo LR, Sant'Ana M, Iyomasa-Pilon MM, Oliani SM, Girol AP. Mimetic peptide AC2-26 of annexin A1 as a potential therapeutic agent to treat COPD. Int Immunopharmacol 2018; 63:270-281. [DOI: 10.1016/j.intimp.2018.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 12/27/2022]
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24
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Sigaux J, Biton J, André E, Semerano L, Boissier MC. Air pollution as a determinant of rheumatoid arthritis. Joint Bone Spine 2018. [PMID: 29524589 DOI: 10.1016/j.jbspin.2018.03.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Pollution has long been incriminated in many cardiovascular and respiratory diseases. More recently, studies evaluated the potential role for particulate pollutants in autoimmune diseases, including rheumatoid arthritis (RA). The incidence of RA was found to be higher in urban areas. Living near air pollution emitters was associated with higher risks of developing RA and of producing RA-specific autoantibodies. Nevertheless, no strong epidemiological evidence exists to link one or more specific air pollution particles to RA. The presence in the bronchi of lymphoid satellite islands (inducible bronchus-associated lymphoid tissue, iBALT) is strongly associated with both inflammatory lung disease and RA-associated lung disease. Diesel exhaust particles can stimulate iBALT formation. The induction by air pollution of an inflammatory environment with high citrullination levels in the lung may induce iBALT formation, thereby causing a transition toward a more specific immune response via the production of anti-citrullinated peptide antibodies. Air pollution not only triggers innate immune responses at the molecular level, increasing the levels of proinflammatory cytokines and reactive oxygen species, but is also involved in adaptive immune responses. Thus, via the aryl hydrocarbon receptor (AHR), diesel exhaust particles can trigger a T-cell switch to the Th17 profile. Finally, in the murine collagen-induced arthritis model, animals whose lymphocytes lack the AHR develop milder arthritis.
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Affiliation(s)
- Johanna Sigaux
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France.
| | - Jérôme Biton
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - Emma André
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| | - Luca Semerano
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| | - Marie-Christophe Boissier
- Inserm UMR 1125, 74, rue Marcel-Cachin, 93017 Bobigny, France; Sorbonne Paris Cité, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny, France; Service de rhumatologie, Groupe hospitalier Avicenne-Jean-Verdier-René-Muret, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
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25
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Kargi A, Gürel D, Akkoclu A, Sanli A, Yilmaz E. Primary Pulmonary Extranodal Marginal Zone Lymphoma/Low Grade B-cell Lymphoma of MALT Type Combined with Well-Differentiated Adenocarcinoma. TUMORI JOURNAL 2018; 96:168-71. [DOI: 10.1177/030089161009600129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We describe a rare case of extranodal marginal zone/low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) combined with areas of well-differentiated adenocarcinoma. In addition, the MALT lymphoma was synchronously systemic, with involvement of the lung, stomach and duodenum.
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Affiliation(s)
- Aydanur Kargi
- Department of Pathology, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Duygu Gürel
- Department of Pathology, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Atilla Akkoclu
- Department of Chest Diseases, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Aydin Sanli
- Department of Thoracic Surgery, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Erkan Yilmaz
- Department of Radiology, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
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26
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Murphy D, Hutchinson D. Is Male Rheumatoid Arthritis an Occupational Disease? A Review. Open Rheumatol J 2017; 11:88-105. [PMID: 28932330 PMCID: PMC5585464 DOI: 10.2174/1874312901711010088] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/21/2017] [Accepted: 07/09/2017] [Indexed: 11/24/2022] Open
Abstract
Background: Rheumatoid arthritis (RA) is a systemic, inflammatory disease with an estimated global prevalence of 0.3–1.0%. An unexplained association exists between low formal education and the development of RA independent of smoking. It is established that RA is initiated in the lungs and that various occupations associated with dust, fume and metal inhalation can increase the risk of RA development. Objective: The objective of this review is to evaluate published clinical reports related to occupations associated with RA development. We highlight the concept of a “double-hit” phenomenon involving adsorption of toxic metals from cigarette smoke by dust residing in the lung as a result of various work exposures. We discuss the relevant pathophysiological consequences of these inhalational exposures in relation to RA associated autoantibody production. Method: A thorough literature search was performed using available databases including Pubmed, Embase, and Cochrane database to cover all relative reports, using combinations of keywords: rheumatoid arthritis, rheumatoid factor, anti-citrullinated peptide antibody silica, dust, fumes, metals, cadmium, cigarette smoking, asbestos, mining, bronchial associated lymphoid tissue, heat shock protein 70, and adsorption. Conclusion: We postulate that the inhalation of dust, metals and fumes is a significant trigger factor for RA development in male patients and that male RA should be considered an occupational disease. To the best of our knowledge, this is the first review of occupations as a risk factor for RA in relation to the potential underlying pathophysiology.
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Affiliation(s)
- Dan Murphy
- Rheumatology Department, Royal Cornwall Hospital, Truro, Cornwall TR1 3LH, UK.,University of Exeter Medical School, Cornwall Campus, Knowledge Spa, Truro, Cornwall, TR1 3HD, UK.,St. Austell Healthcare Group, Wheal Northey Surgery, St Austell, Cornwall, PL25 3EF, UK
| | - David Hutchinson
- Rheumatology Department, Royal Cornwall Hospital, Truro, Cornwall TR1 3LH, UK.,University of Exeter Medical School, Cornwall Campus, Knowledge Spa, Truro, Cornwall, TR1 3HD, UK
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27
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Bokor J, Danics K, Bencze E, Keller E, Szollosi Z. A single-centre review of suspected sudden infant death cases. MEDICINE, SCIENCE, AND THE LAW 2017; 57:84-90. [PMID: 28438099 DOI: 10.1177/0025802417704599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to establish the number of deaths in infants under 1 year of age that were being reported for medico-legal examination at a single large academic centre in Hungary, as well as the method of these investigations with special emphasis on histopathology, ancillary techniques and the adherence of our current practice to international recommendations. A single-centre, retrospective audit was conducted on all suspected sudden infant death cases. After the review there were eight infectious background sudden infant death syndrome (SIDS) cases, infectious respiratory tract disease in 14 cases, cardiac septal tumour in one case, and hepatic, possibly metabolic, disorder in one case. Our study has highlighted that even in a single institution there is a huge heterogeneity of approaches which needs standardisation. A reclassification of infant cases according to the San Diego definition resulted in a decreased number of SIDS cases in our material. The San Diego definition and related international recommendations were found to be practical and the classification provides a guide to the standardisation of current practice.
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Affiliation(s)
- Janos Bokor
- 1 Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Krisztina Danics
- 1 Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Bencze
- 2 Department of Cellular Pathology, BAZ County Hospital, Miskolc, Hungary
| | - Eva Keller
- 1 Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltan Szollosi
- 1 Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
- 2 Department of Cellular Pathology, BAZ County Hospital, Miskolc, Hungary
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28
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Yadava K, Bollyky P, Lawson MA. The formation and function of tertiary lymphoid follicles in chronic pulmonary inflammation. Immunology 2016; 149:262-269. [PMID: 27441396 PMCID: PMC5046054 DOI: 10.1111/imm.12649] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 12/13/2022] Open
Abstract
Tertiary lymphoid follicles (TLFs) can develop in the respiratory tract in response to infections or chronic inflammation. However, their functional relevance remains unclear because they are implicated in both protective and pathological responses. In contrast to homeostatic conditions, external antigens and damage to the lung tissue may drive TLF formation in inflamed lungs, and once established, the presence of pulmonary TLFs may signal the progression of chronic lung disease. This novel concept will be discussed in light of recent work in chronic obstructive pulmonary disease and how changes in the pulmonary microbiota may drive and direct TLF formation and function. We will also discuss the cellularity of TLFs at the pulmonary mucosa, with emphasis on the potential roles of lymphoid tissue inducer cells, and B- and T-cell aggregates, and will examine the function of key chemokines and cytokines including CXCL13 and interleukin-17, in the formation and maintenance of pulmonary TLFs.
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Affiliation(s)
- Koshika Yadava
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Paul Bollyky
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Sirajuddin A, Raparia K, Lewis VA, Franks TJ, Dhand S, Galvin JR, White CS. Primary Pulmonary Lymphoid Lesions: Radiologic and Pathologic Findings. Radiographics 2016; 36:53-70. [PMID: 26761531 DOI: 10.1148/rg.2016140339] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The pulmonary lymphoid system is complex and is composed of two compartments: the pulmonary lymphatics and the bronchus-associated lymphoid tissue (BALT). Additional important cells that function in the pulmonary lymphoid system include dendritic cells, Langherhans cells, macrophages, and plasma cells. An appreciation of the normal lymphoid anatomy of the lung as well as its immunology is helpful in understanding the radiologic and pathologic findings of the primary pulmonary lymphoid lesions. Primary lymphoid lesions of the lung arise from the BALT and are uncommon. However, they are increasingly recognized within the growing number of posttransplant patients as well as other patients who are receiving immunosuppressive therapies. Primary lymphoid lesions encompass a wide range of benign and malignant lesions. Benign lymphoid lesions of the lung include reactive lymphoid hyperplasia, follicular bronchiolitis, lymphoid interstitial pneumonia, and nodular lymphoid hyperplasia. Malignant lymphoid lesions of the lung include low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), other non-Hodgkin lymphomas, and Hodgkin lymphoma. Last, a miscellaneous group of primary lymphoid lesions includes lymphomatoid granulomatosis, posttransplant lymphoproliferative disorders, acquired immunodeficiency syndrome (AIDS)-related lymphoma, and intravascular lymphoma/lymphomatosis. These lesions are best evaluated with multidetector chest computed tomography. The radiologic findings of the primary lymphoid lesions are often nonspecific and are best interpreted in correlation with clinical data and pathologic findings. The purpose of this article is to review pulmonary lymphoid anatomy as well as the most common primary pulmonary lymphoid disorders.
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Affiliation(s)
- Arlene Sirajuddin
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Kirtee Raparia
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Vanessa A Lewis
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Teri J Franks
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Sabeen Dhand
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Jeffrey R Galvin
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Charles S White
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
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Wiesner DL, Smith KD, Kotov DI, Nielsen JN, Bohjanen PR, Nielsen K. Regulatory T Cell Induction and Retention in the Lungs Drives Suppression of Detrimental Type 2 Th Cells During Pulmonary Cryptococcal Infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2016; 196:365-74. [PMID: 26590316 PMCID: PMC4685009 DOI: 10.4049/jimmunol.1501871] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/26/2015] [Indexed: 12/18/2022]
Abstract
Lethal disease caused by the fungus Cryptococcus neoformans is a consequence of the combined failure to control pulmonary fungal replication and immunopathology caused by induced type 2 Th2 cell responses in animal models. In order to gain insights into immune regulatory networks, we examined the role of regulatory T (Treg) cells in suppression of Th2 cells using a mouse model of experimental cryptococcosis. Upon pulmonary infection with Cryptococcus, Treg cells accumulated in the lung parenchyma independently of priming in the draining lymph node. Using peptide-MHC class II molecules to identify Cryptococcus-specific Treg cells combined with genetic fate-mapping, we noted that a majority of the Treg cells found in the lungs were induced during the infection. Additionally, we found that Treg cells used the transcription factor, IFN regulatory factor 4, to dampen harmful Th2 cell responses, as well as mediate chemokine retention of Treg cells in the lungs. Taken together, induction and IFN regulatory factor 4-dependent localization of Treg cells in the lungs allow Treg cells to suppress the deleterious effects of Th2 cells during cryptococcal infection.
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Affiliation(s)
- Darin L Wiesner
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455
| | - Kyle D Smith
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455
| | - Dmitri I Kotov
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455; Center for Immunology, University of Minnesota, Minneapolis, MN 55455
| | - Judith N Nielsen
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599; and
| | - Paul R Bohjanen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455; Center for Immunology, University of Minnesota, Minneapolis, MN 55455; Center for Infectious Diseases and Translational Research, University of Minnesota, Minneapolis, MN 55455
| | - Kirsten Nielsen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455; Center for Infectious Diseases and Translational Research, University of Minnesota, Minneapolis, MN 55455
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Goossens PL, Tournier JN. Crossing of the epithelial barriers by Bacillus anthracis: the Known and the Unknown. Front Microbiol 2015; 6:1122. [PMID: 26500645 PMCID: PMC4598578 DOI: 10.3389/fmicb.2015.01122] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/28/2015] [Indexed: 12/15/2022] Open
Abstract
Anthrax, caused by Bacillus anthracis, a Gram-positive spore-forming bacterium, is initiated by the entry of spores into the host body. There are three types of human infection: cutaneous, inhalational, and gastrointestinal. For each form, B. anthracis spores need to cross the cutaneous, respiratory or digestive epithelial barriers, respectively, as a first obligate step to establish infection. Anthrax is a toxi-infection: an association of toxemia and rapidly spreading infection progressing to septicemia. The pathogenicity of Bacillus anthracis mainly depends on two toxins and a capsule. The capsule protects bacilli from the immune system, thus promoting systemic dissemination. The toxins alter host cell signaling, thereby paralyzing the immune response of the host and perturbing the endocrine and endothelial systems. In this review, we will mainly focus on the events and mechanisms leading to crossing of the respiratory epithelial barrier, as the majority of studies have addressed inhalational infection. We will discuss the critical gaps of knowledge that need to be addressed to gain a comprehensive view of the initial steps of inhalational anthrax. We will then discuss the few data available on B. anthracis crossing the cutaneous and digestive epithelia.
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Affiliation(s)
- Pierre L Goossens
- Pathogénie des Toxi-Infections Bactériennes, Institut Pasteur , Paris, France
| | - Jean-Nicolas Tournier
- Pathogénie des Toxi-Infections Bactériennes, Institut Pasteur , Paris, France ; Unité Interactions Hôte-Agents Pathogènes, Institut de Recherche Biomédicale des Armées , Brétigny-sur-Orge, France ; Ecole du Val-de-Grâce , Paris, France
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Daffa NI, Tighe PJ, Corne JM, Fairclough LC, Todd I. Natural and disease-specific autoantibodies in chronic obstructive pulmonary disease. Clin Exp Immunol 2015; 180:155-63. [PMID: 25469980 PMCID: PMC4367103 DOI: 10.1111/cei.12565] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2014] [Indexed: 12/01/2022] Open
Abstract
Autoimmunity may contribute to the pathogenesis of chronic obstructive pulmonary disease (COPD). Studies have identified disease-specific autoantibodies (DSAAbs) in COPD patients, but natural autoantibodies (NAAbs) may also play a role. Previous studies have concentrated on circulating autoantibodies, but lung-associated autoantibodies may be most important. Our aim was to investigate NAAbs and DSAAbs in the circulation and lungs of COPD smoking (CS) patients compared to smokers (S) without airway obstruction and subjects who have never smoked (NS). Immunoglobulin (Ig)G antibodies that bind to lung tissue components were significantly lower in the circulation of CS patients than NS (with intermediate levels in S), as detected by enzyme-linked immunosorbent assay (ELISA). The levels of antibodies to collagen-1 (the major lung collagen) detected by ELISA were also reduced significantly in CS patients’ sera compared to NS. The detection of these antibodies in NS subjects indicates that they are NAAbs. The occurrence of DSAAbs in some CS patients and S subjects was indicated by high levels of serum IgG antibodies to cytokeratin-18 and collagen-5; furthermore, antibodies to collagen-5 eluted from homogenized lung tissue exposed to low pH (0·1 M glycine, pH 2·8) were raised significantly in CS compared to S and NS. Thus, this study supports a role in COPD for both NAAbs and DSAAbs.
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Affiliation(s)
- N I Daffa
- School of Life Sciences, University of Nottingham, Nottingham, UK; Medical Microbiology Department, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Faner R, Cruz T, Agusti A. Immune response in chronic obstructive pulmonary disease. Expert Rev Clin Immunol 2014; 9:821-33. [PMID: 24070046 DOI: 10.1586/1744666x.2013.828875] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a major public health problem because of its high prevalence, rising incidence and associated socio-economic cost. The inhalation of toxic particles and gases, mostly tobacco smoke, is the main risk factor for COPD. Yet, not all smokers are equally susceptible to these toxic effects and only a percentage of them develop the disease (so-called 'susceptible smokers'). This, in combination with the observation that COPD shows familial aggregation, suggests that the genetic background of the smoker is a key element in the pathogenesis of the disease. On the other hand, it is well established that 'susceptible' smokers exhibit an enhanced inflammatory response of the lung parenchyma as compared with 'resistant' smokers (i.e., those who manage to maintain lung function within the normal age range despite their habit). Importantly, in COPD patients this inflammatory response does not resolve after quitting smoking, again at variance with resistant smokers. All in all, these observations suggest that the pathogenesis of COPD may involve, in some patients, an autoimmune component which contributes to the enhanced and persistent inflammatory response that characterizes the disease. Here we: i) review briefly the pathobiology of COPD; ii) present the available scientific evidence supporting a potential role for autoimmunity in COPD; iii) propose a three-step pathogenic hypothesis in the transition from smoking to COPD; and iv) discuss potential implications for the diagnosis and treatment of this frequent, growing, devastating and costly disease.
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Affiliation(s)
- Rosa Faner
- FISIB, CIBER Enfermedades Respiratorias (CIBERES), Mallorca, Spain
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Perry E, Kelly C, Eggleton P, De Soyza A, Hutchinson D. The lung in ACPA-positive rheumatoid arthritis: an initiating site of injury? Rheumatology (Oxford) 2014; 53:1940-50. [DOI: 10.1093/rheumatology/keu195] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Shaban MM, Mohamed SA, Kamel MA. Role of autoimmunity in the pathogenesis of chronic obstructive pulmonary disease. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2014. [DOI: 10.1016/j.ejcdt.2013.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Infectious Mechanisms Regulating Susceptibility to Acute Exacerbations of COPD. SMOKING AND LUNG INFLAMMATION 2013. [PMCID: PMC7115011 DOI: 10.1007/978-1-4614-7351-0_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Acute exacerbations of COPD (AECOPD) are defined by clinical criteria, outlined in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines [1]. These include an acute increase in one or more of the following cardinal symptoms, beyond day to day variability: dyspnea, increased frequency or severity of cough and increased volume or change in character of sputum, which represent an acute increase in airway inflammation. The role of infection in the pathogenesis of COPD, acute exacerbation and disease progression has been a clinical and research question for many years, and the pendulum has swung from infection as a major cause of acute exacerbation and COPD (British Hypothesis) [2], to infection as an unrelated epiphomenon in acute exacerbation [3–5], and back again to infection as integral in the development of AECOPD and likely an important contributor to COPD progression [6–19]. Upwards of 80 % of AECOPD are driven by infectious stimuli, with 40–50 % associated with bacterial infection and 30–50 % associated with acute viral infection, with some exacerbations having dual bacterial and viral causation [20]. Much of the advancement in our understanding of the role of infection is AECOPD is due to the advancement of clinical and research tools that have allowed researchers to accurately characterize the microbial pathogens, and better understand the host-pathogen interactions (Table 1).
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Kato A, Hulse KE, Tan BK, Schleimer RP. B-lymphocyte lineage cells and the respiratory system. J Allergy Clin Immunol 2013; 131:933-57; quiz 958. [PMID: 23540615 DOI: 10.1016/j.jaci.2013.02.023] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 02/20/2013] [Accepted: 02/21/2013] [Indexed: 12/12/2022]
Abstract
Adaptive humoral immune responses in the airways are mediated by B cells and plasma cells that express highly evolved and specific receptors and produce immunoglobulins of most isotypes. In some cases, such as autoimmune diseases or inflammatory diseases caused by excessive exposure to foreign antigens, these same immune cells can cause disease by virtue of overly vigorous responses. This review discusses the generation, differentiation, signaling, activation, and recruitment pathways of B cells and plasma cells, with special emphasis on unique characteristics of subsets of these cells functioning within the respiratory system. The primary sensitization events that generate B cells responsible for effector responses throughout the airways usually occur in the upper airways, tonsils, and adenoid structures that make up the Waldeyer ring. On secondary exposure to antigen in the airways, antigen-processing dendritic cells migrate into secondary lymphoid organs, such as lymph nodes, that drain the upper and lower airways, and further B-cell expansion takes place at those sites. Antigen exposure in the upper or lower airways can also drive expansion of B-lineage cells in the airway mucosal tissue and lead to the formation of inducible lymphoid follicles or aggregates that can mediate local immunity or disease.
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Affiliation(s)
- Atsushi Kato
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Liebrechts-Akkerman G, Bovée JVMG, Wijnaendts LCD, Maes A, Nikkels PGJ, de Krijger RR. Histological findings in unclassified sudden infant death, including sudden infant death syndrome. Pediatr Dev Pathol 2013; 16:168-76. [PMID: 23331080 DOI: 10.2350/12-10-1262-oa.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Our objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports of 187 cases were available for systematic review, including brain autopsy in 135 cases. An explanation for the cause of death in 19 patients (10.2%) was found. Twelve patients had bronchopneumonia, 3 showed extensive aspiration, 2 had signs of a metabolic disorder, 1 had sepsis, and 1 had meningitis. Frequent nonspecific findings were congestion (66%), edema (47%), small hemorrhages (18%), and lymphoid aggregates (51%) in the lungs; congestion of the liver (23%); and asphyctic bleeding in the kidney (44%), adrenal gland (23%), and thymus (17%). Statistical associations were found for infection with starry sky macrophages in the thymus (P = 0.004), with calcification (P = 0.023), or with debris in the Hassal's corpuscles (P = 0.034). In this study, in 10.2% of cases the histological findings were incompatible with SIDS or USID. Furthermore, several frequent nonspecific histological findings in the thymus that point toward an infection were found.
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Le Guennec L, Pestre V, Mouthon L. [Chronic obstructive pulmonary disease: an autoimmune disease?]. Rev Mal Respir 2012; 29:557-65. [PMID: 22542413 DOI: 10.1016/j.rmr.2012.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 11/25/2011] [Indexed: 11/25/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality characterized by irreversible airflow limitation involving a reduced caliber of distal airways (less than 2mm) and alveolar destruction. Exposure to tobacco is a major risk factor for COPD, but all smokers do not develop the disease. In addition, there is continued progression of the disease several years after cessation of the exposure. To explain these phenomena, factors involving innate immunity including the release of neutrophil elastase, macrophage metalloproteases, in combination with pro-apoptotic factors, involved in the worsening of the lesions of emphysema and fibrosis of small airways have been described for many years. More recently, it has been proposed at an advanced stage of the disease that an autoimmune reaction directed mainly at elastin could participate to the pathogenesis of the disease. We here review the immunological processes and currently available data on autoimmunity in COPD.
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Affiliation(s)
- L Le Guennec
- Service de médecine interne, centre de référence pour les vascularités nécrosantes et la sclérodermie systémique, faculté de médecine Paris-Descartes, université Paris-Descartes, hôpital Cochin, AP-HP de Paris, 27 rue du Faubourg-Saint-Jacques, Paris cedex 14, France
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Lee JH, Hanaoka M, Kitaguchi Y, Kraskauskas D, Shapiro L, Voelkel NF, Taraseviciene-Stewart L. Imbalance of apoptosis and cell proliferation contributes to the development and persistence of emphysema. Lung 2012; 190:69-82. [PMID: 22015802 DOI: 10.1007/s00408-011-9326-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 09/12/2011] [Indexed: 01/13/2023]
Abstract
BACKGROUND We postulate that in adults there is an established lung structure maintenance program and that lung alveolar septal cells are undergoing both continuous apoptosis and proliferation. Whereas lung cell apoptosis has been recognized in human emphysema, little is known about cell proliferation. METHODS Using a novel rat model of emphysema, induced by intratracheal instillation of cigarette smoke extract (CSE), we investigated the dynamics of emphysematous lung destruction. Emphysematous lung destruction was determined by measuring mean linear intercept and destructive index. Lung injury and repair were assessed by immunohistochemistry and Western blot analysis for active caspase-3 and proliferating cell nuclear antigen (PCNA) after 4, 8, and 12 weeks of CSE instillations. RESULTS The emphysematous lung tissue destruction was present at 4 weeks of CSE treatment and progressed to 8 weeks. Spontaneous repair began at 12 weeks. Treatment with a peroxisome proliferator activated receptor (PPAR)α+γ agonist or granulocyte and macrophage-colony stimulating factor (GM-CSF) for 4 weeks prevented the progression of emphysematous lung destruction and decreased the number of caspase-3-positive cells. CONCLUSION Apoptosis and cell proliferation occur in this new model of emphysema. Treatment with a PPARα+γ agonist or GM-CSF can inhibit the progression of emphysematous alveolar septal destruction by decreasing alveolar cell apoptosis.
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Affiliation(s)
- Ji-Hyun Lee
- Division of Pulmonary Science and Critical Care Medicine, University of Colorado School of Medicine, Denver, CO 80262, USA.
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Aubart F, Crestani B, Nicaise-Roland P, Tubach F, Bollet C, Dawidowicz K, Quintin E, Hayem G, Palazzo E, Meyer O, Chollet-Martin S, Dieudé P. High levels of anti-cyclic citrullinated peptide autoantibodies are associated with co-occurrence of pulmonary diseases with rheumatoid arthritis. J Rheumatol 2011; 38:979-82. [PMID: 21362759 DOI: 10.3899/jrheum.101261] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate whether levels of anti-cyclic citrullinated peptide antibodies (anti-CCP2) in patients with rheumatoid arthritis (RA) are associated with the co-occurrence of lung diseases. METHODS A total of 252 RA patients were included in a cross-sectional study. Pulmonary disease was confirmed by high-resolution chest computed tomography scan. Circulating anti-CCP2 were quantified using ELISA. Multivariate logistic regression was conducted to identify independent risk factors for lung disease. RESULTS Male sex (OR 3.29, 95% CI 1.59-6.80) and high anti-CCP2 levels (OR 1.49, 95% CI 1.25-1.78) were identified as independent risk factors for lung disease in the RA population. CONCLUSION High anti-CCP2 levels are associated with lung disease in the RA population.
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Affiliation(s)
- Fleur Aubart
- Service de Rhumatologie, Hôpital Bichat Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
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Regulation of inducible BALT formation and contribution to immunity and pathology. Mucosal Immunol 2010; 3:537-44. [PMID: 20811344 DOI: 10.1038/mi.2010.52] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inducible bronchus-associated lymphoid tissue (iBALT) is an organized tertiary lymphoid structure that is not pre-programmed but develops in response to infection or under chronic inflammatory conditions. Emerging research has shown that iBALT provides a niche for T-cell priming and B-cell education to assist in the clearance of infectious agents, highlighting the prospect that iBALT may be engineered and harnessed to enhance protective immunity against respiratory pathogens. Although iBALT formation is associated with several canonical factors of secondary lymphoid organogenesis such as lymphotoxin-α and the homeostatic chemokines, CXCL13, CCL19, and CCL21, these cytokines are not mandatory for its formation, even though they influence its organization and function. Similarly, lymphoid tissue-inducer cells are not a requisite of iBALT formation. In contrast, dendritic cells are emerging as pivotal players required to form and sustain the presence of iBALT. Regulatory T cells appear to be able to attenuate the development of iBALT, although the underlying mechanisms remain ill-defined. In this review, we discuss facets unique to iBALT induction, the cellular subsets, and molecular cues that govern this process, and the contribution of this ectopic structure toward the generation of immune responses in the pulmonary compartment.
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Kuo YB, Chang CA, Wu YK, Hsieh MJ, Tsai CH, Chen KT, Chen CY, Chan EC. Identification and clinical association of anti-cytokeratin 18 autoantibody in COPD. Immunol Lett 2009; 128:131-6. [PMID: 20038439 DOI: 10.1016/j.imlet.2009.12.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 11/27/2009] [Accepted: 12/11/2009] [Indexed: 01/01/2023]
Abstract
The etiology of chronic obstructive pulmonary disease (COPD) remains unclear. A mechanism involving the autoimmune reaction in the pathogenesis of COPD has been proposed but not confirmed. The aim of this study was to investigate whether serum autoantibodies against pulmonary cellular proteins are present in COPD patients and to identify their autoantigens if possible. Samples from 50 COPD patients and 42 control subjects were studied. Circulating autoantibodies were detected by Western blot. Immunoprecipitation and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry were used to identify the autoantigens. Autoantibodies against pulmonary cellular antigens were found in the sera of COPD patients. Specifically, an autoantibody against the 45-kDa human cytokeratin 18 protein was found in 76.0% of COPD patients and 23.8% of control subjects (p<0.001). Furthermore, the cytokeratin 18 autoantibody level was positively correlated with the FEV(1) (L) (p=0.013) and FEV(1) (%pred.) (p=0.043) values observed in COPD patients. This study identified the pulmonary epithelial cytokeratin 18 protein as a COPD-associated autoantigen and found that anti-cytokeratin 18 autoantibodies were prevalent in COPD patients. Our results support the hypothesis that humoral autoimmunity may be involved in the pathogenesis of COPD.
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Affiliation(s)
- Yung-Bin Kuo
- College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
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Oh SY, Kim WS, Kim JS, Kim SJ, Kwon HC, Lee DH, Won JH, Hwang IG, Kim MK, Lee SI, Chae YS, Yang DH, Lee GW, Choi CW, Park J, Suh C, Kim HJ. Pulmonary marginal zone B-cell lymphoma of MALT type—What is a prognostic factor and which is the optimal treatment, operation, or chemotherapy?: Consortium for Improving Survival of Lymphoma (CISL) Study. Ann Hematol 2009; 89:563-8. [DOI: 10.1007/s00277-009-0875-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 11/25/2009] [Indexed: 11/29/2022]
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Kawamata N, Xu B, Nishijima H, Aoyama K, Kusumoto M, Takeuchi T, Tei C, Michie SA, Matsuyama T. Expression of endothelia and lymphocyte adhesion molecules in bronchus-associated lymphoid tissue (BALT) in adult human lung. Respir Res 2009; 10:97. [PMID: 19845971 PMCID: PMC2772857 DOI: 10.1186/1465-9921-10-97] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 10/22/2009] [Indexed: 02/02/2023] Open
Abstract
Background Bronchus-associated lymphoid tissue (BALT) is the secondary lymphoid tissue in bronchial mucosa and is involved in the development of bronchopulmonary immune responses. Although migration of lymphocytes from blood vessels into secondary lymphoid tissues is critical for the development of appropriate adaptive immunity, the endothelia and lymphocyte adhesion molecules that recruit specific subsets of lymphocytes into human BALT are not known. The aim of this study was to determine which adhesion molecules are expressed on lymphocytes and high endothelial venules (HEVs) in human BALT. Methods We immunostained frozen sections of BALT from lobectomy specimens from 17 patients with lung carcinoma with a panel of monoclonal antibodies to endothelia and lymphocyte adhesion molecules. Results Sections of BALT showed B cell follicles surrounded by T cells. Most BALT CD4+ T cells had a CD45RO+ memory phenotype. Almost all BALT B cells expressed α4 integrin and L-selectin. In contrast, 43% of BALT T cells expressed α4 integrin and 20% of BALT T cells expressed L-selectin. Almost all BALT lymphocytes expressed LFA-1. HEVs, which support the migration of lymphocytes from the bloodstream into secondary lymphoid tissues, were prominent in BALT. All HEVs expressed peripheral node addressin, most HEVs expressed vascular cell adhesion molecule-1, and no HEVs expressed mucosal addressin cell adhesion molecule-1. Conclusion Human BALT expresses endothelia and lymphocyte adhesion molecules that may be important in recruiting naive and memory/effector lymphocytes to BALT during protective and pathologic bronchopulmonary immune responses.
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Affiliation(s)
- Nakaaki Kawamata
- Departments of Immunology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
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Goossens PL. Animal models of human anthrax: the Quest for the Holy Grail. Mol Aspects Med 2009; 30:467-80. [PMID: 19665473 DOI: 10.1016/j.mam.2009.07.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 07/30/2009] [Indexed: 01/13/2023]
Abstract
Anthrax is rare among humans, few data can be collected from infected individuals and they provide a fragmentary view of the dynamics of infection and human host-pathogen interactions. Therefore, the development of animal models is necessary. Anthrax has the particularity of being a toxi-infection, a combination of infection and toxemia. The ideal animal model would explore these two different facets and mimic human disease as much as possible. In the past decades, the main effort has been focused on modelling of inhalational anthrax and the perception of specific aspects of the infection has evolved in recent years. In this review, we consider criteria which can lead to the most appropriate choice of a given animal species for modelling human anthrax. We will highlight the positive input and limitations of different models and show that they are not mutually exclusive. On the contrary, their contribution to anthrax research can be more rewarding when taken in synergy. We will also present a reappraisal of inhalational anthrax and propose reflections on key points, such as portal of entry, connections between mediastinal lymph nodes, pleura and lymphatic drainage.
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Affiliation(s)
- Pierre L Goossens
- Institut Pasteur, Toxines et Pathogénie Bactérienne, CNRS URA 2172, 28 rue du Docteur Roux, 75724 Paris cedex 15, France.
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Bánfi A, Tiszlavicz L, Székely E, Peták F, Tóth-Szüki V, Baráti L, Bari F, Novák Z. DEVELOPMENT OF BRONCHUS-ASSOCIATED LYMPHOID TISSUE HYPERPLASIA FOLLOWING LIPOPOLYSACCHARIDE-INDUCED LUNG INFLAMMATION IN RATS. Exp Lung Res 2009; 35:186-97. [DOI: 10.1080/01902140802495862] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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