PEDIATRICS Vol. 72 No. 1 July 1983, pp. 1-15
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Lung Defenses Against Infection: A Clinical Correlation

Shirley Murphy MD1 and Alfred L. Florman MD1

1 From the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque

The current state of knowledge of lung defenses has been reviewed. First, mechanical factors such as aerodynamic filtration and mucociliary transport were considered. Then, in general terms, the contributions of alveolar macrophages, neutrophils, lymphocytes, and immunoglobulins, and the roles of complement, antiproteases, lysozyme, and fibronectin were examined. Interactions between these components may regulate their effect. Finally, the responses to five specific micro-organisms were reviewed to illustrate different aspects of the lung's defenses. Streptococcus pneumoniae was selected as a representative extracellular bacterial pathogen, Mycobacterium tuberculosis as an intracellular bacterial pathogen, Mycoplasma pneumoniae because it elicits significant humoral and cell-mediated immunity, respiratory syncytial virus as an example of a local viral pathogen, and measles as a viral pathogen that causes generalized disease. It was shown that these responses may not always be beneficial for the host. For each of the five infections, recommendations for improving the outcome were made.

Key Words: lung • immunology • respiratory infections • bacterial pneumonitis • viral pneumonitis

Accepted on October 15, 1982




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