Surviving Deadly Lung Infections: Innate Host Tolerance Mechanisms in the Pulmonary System.
Surviving Deadly Lung Infections: Innate Host Tolerance Mechanisms in the Pulmonary System.
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DOI：
10.3389/fimmu.2018.01421
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发表时间：
2018
影响因子：
7.3
通讯作者：
Jamieson AM
中科院分区：
文献类型：
--
作者：
Crane MJ;Lee KM;FitzGerald ES;Jamieson AM
许多关于传染病的研究侧重于通过使用抗微生物药物、免疫反应或两者结合来清除病原体。病原体的快速清除允许快速恢复到健康状态并增加生存。针对病原体的抗感染方法具有固有的局限性，包括其病原体特异性、可能产生抗微生物药物耐药性以及疫苗效力差等。在感染中存活的另一种方法是耐受疾病状态中发生的体内平衡变化，这一过程被称为宿主耐受或恢复力，与病原体负担无关。感染期间体内平衡的改变是多种多样的，包括组织损伤、炎症增加、代谢变化、温度变化和呼吸变化。鉴于其重要性和敏感性，肺是了解宿主对传染病耐受性的良好系统。肺炎是全世界五岁以下儿童死亡的主要原因。其中一个原因是，当肺系统发生巨大变化时，它会极大地影响患者的整体健康和生存。在感染期间，靶向参与维持肺宿主耐受性的宿主途径可能提供一种可广泛适用于各种病理的替代治疗途径。在这篇综述中，我们将总结最近关于宿主肺部感染耐受性的研究结果。我们将重点关注先天免疫反应在耐受中的作用，以及最初的病毒性肺部感染如何改变白细胞、上皮和内皮细胞对随后细菌感染的耐受机制。通过了解肺部的耐受性机制，我们可以更好地解决致命肺部感染的治疗方案。
Much research on infectious diseases focuses on clearing the pathogen through the use of antimicrobial drugs, the immune response, or a combination of both. Rapid clearance of pathogens allows for a quick return to a healthy state and increased survival. Pathogen-targeted approaches to combating infection have inherent limitations, including their pathogen-specific nature, the potential for antimicrobial resistance, and poor vaccine efficacy, among others. Another way to survive an infection is to tolerate the alterations to homeostasis that occur during a disease state through a process called host tolerance or resilience, which is independent from pathogen burden. Alterations in homeostasis during infection are numerous and include tissue damage, increased inflammation, metabolic changes, temperature changes, and changes in respiration. Given its importance and sensitivity, the lung is a good system for understanding host tolerance to infectious disease. Pneumonia is the leading cause of death for children under five worldwide. One reason for this is because when the pulmonary system is altered dramatically it greatly impacts the overall health and survival of a patient. Targeting host pathways involved in maintenance of pulmonary host tolerance during infection could provide an alternative therapeutic avenue that may be broadly applicable across a variety of pathologies. In this review, we will summarize recent findings on tolerance to host lung infection. We will focus on the involvement of innate immune responses in tolerance and how an initial viral lung infection may alter tolerance mechanisms in leukocytic, epithelial, and endothelial compartments to a subsequent bacterial infection. By understanding tolerance mechanisms in the lung we can better address treatment options for deadly pulmonary infections.
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影响因子：
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