What is the clinical relevance of different lung compartments?

被引:25
作者
Tschernig T. [1 ]
Pabst R. [1 ]
机构
[1] Department of Functional and Applied Anatomy, Medical School of Hannover, 30625 Hannover
关键词
Sarcoidosis; Drain Lymph Node; Bronchial Mucosa; Lung Compartment; Bronchial Circulation;
D O I
10.1186/1471-2466-9-39
中图分类号
学科分类号
摘要
The lung consists of at least seven compartments with relevance to immune reactions. Compartment 1 the bronchoalveolar lavage (BAL), which represents the cells of the bronchoalveolar space: From a diagnostic point of view the bronchoalveolar space is the most important because it is easily accessible in laboratory animals, as well as in patients, using BAL. Although this technique has been used for several decades it is still unclear to what extent the BAL represents changes in other lung compartments. Compartment 2 bronchus-associated lymphoid tissue (BALT): In the healthy, BALT can be found only in childhood. The role of BALT in the development of the mucosal immunity of the pulmonary surfaces has not yet been resolved. However, it might be an important tool for inhalative vaccination strategies. Compartment 3 conducting airway mucosa: A third compartment is the bronchial epithelium and the submucosa, which both contain a distinct pool of leukocytes (e.g. intraepithelial lymphocytes, IEL). This again is also accessible via bronchoscopy. Compartment 4 draining lymph nodes/Compartment 5 lung parenchyma: Transbronchial biopsies are more difficult to perform but provide access to two additional compartments lymph nodes with the draining lymphatics and lung parenchyma, which roughly means "interstitial" lung tissue. Compartment 6 the intravascular leukocyte pool: The intravascular compartment lies between the systemic circulation and inflamed lung compartments. Compartment 7 periarterial space: Finally, there is a unique, lung-specific space around the pulmonary arteries which contains blood and lymph capillaries. There are indications that this "periarterial space" may be involved in the pulmonary host defense. All these compartments are connected but the functional network is not yet fully understood. A better knowledge of the complex interactions could improve diagnosis and therapy, or enable preventive approaches of local immunization. © 2009 Tschernig and Pabst; licensee BioMed Central Ltd.
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共 18 条
[1]  
Pabst R., Tschernig T., Lymphocytes in the lung: An often neglected cell. Numbers, characterization and compartmentalization, Anat Embryol, 192, pp. 293-299, (1995)
[2]  
Pabst R., Tschernig T., Lymphocyte dynamics: Caution in interpreting BAL numbers, Thorax, 52, pp. 1078-1080, (1997)
[3]  
Meyer K.C., Bronchoalveolar lavage as a diagnostic tool, Semin Respir Crit Care Med, 28, pp. 546-560, (2007)
[4]  
Lehmann C., Wilkening A., Leiber D., Markus A., Krug N., Pabst R., Tschernig T., Lymphocytes in the bronchoalveolar space reenter the lung tissue by means of the alveolar epithelium, migrate to regional lymph nodes, and subsequently rejoin the systemic immune system, Anat Rec, 264, pp. 229-236, (2001)
[5]  
Tschernig T., Kleemann W.J., Pabst R., Bronchus-associated lymphoid tissue (BALT) in the lungs of children who had died from sudden infant death syndrome and other causes, Thorax, 50, pp. 658-660, (1995)
[6]  
Tschernig T., Pabst R., Bronchus-associated lymphoid tissue (BALT) is not present in the normal adult lung but in different diseases, Pathobiology, 68, pp. 1-8, (2000)
[7]  
Brandtzaeg P., Pabst R., Let's go mucosal: Communication on slippery ground, Trends Immunol, 25, pp. 570-577, (2004)
[8]  
Pabst R., Durak D., Roos A., Luhrmann A., Tschernig T., TLR2/6 stimulation of the rat lung: Effects on lymphocyte subsets, natural killer cells and dendritic cells in different parts of the air-conducting compartments and at different ages, Immunology, 126, pp. 132-139, (2009)
[9]  
Synek M., Beasley R., Frew A.J., Goulding D., Holloway L., Lampe F.C., Roche W.R., Holgate S.T., Cellular infiltration of the airways in asthma of varying severity, Am J Respir Crit Care Med, 154, pp. 224-230, (1996)
[10]  
Tschernig T., de Vries V.C., Debertin A.S., Braun A., Walles T., Traub F., Pabst R., Density of dendritic cells in the human tracheal mucosa is age dependent and site specific, Thorax, 61, pp. 986-991, (2006)