免疫学
炎症
免疫系统
先天免疫系统
自身免疫
医学
慢性阻塞性肺病
先天性淋巴细胞
获得性免疫系统
精神科
作者
Guy Brusselle,Guy Joos,Ken R. Bracke
出处
期刊:The Lancet
[Elsevier]
日期:2011-09-01
卷期号:378 (9795): 1015-1026
被引量:666
标识
DOI:10.1016/s0140-6736(11)60988-4
摘要
Chronic obstructive pulmonary disease (COPD) is a heterogeneous syndrome associated with abnormal infl ammatory immune responses of the lung to noxious particles and gases.Cigarette smoke activates innate immune cells such as epithelial cells and macrophages by triggering pattern recognition receptors, either directly or indirectly via the release of damage-associated molecular patterns from stressed or dying cells.Activated dendritic cells induce adaptive immune responses encompassing T helper (Th1 and Th17) CD4+ T cells, CD8+ cytotoxicity, and B-cell responses, which lead to the development of lymphoid follicles on chronic infl ammation.Viral and bacterial infections not only cause acute exacerbations of COPD, but also amplify and perpetuate chronic infl ammation in stable COPD via pathogen-associated molecular patterns.We discuss the role of autoimmunity (autoantibodies), remodelling, extracellular matrix-derived fragments, impaired innate lung defences, oxidative stress, hypoxia, and dysregulation of microRNAs in the persistence of the pulmonary infl ammation despite smoking cessation.
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