Immunology of Interstitial Lung Disease, Michels, Lec Flashcards
What are the lung defenses of upper airways and bronchi
anatomic barriers, cough, mucociliary apparatus, airway epithelium
secretory IgA
dendritic cells, lymphocytes and Neutrophils
host defenses in alveolar spaces
alveolar macrophages
Ig, opsonins, surfactants
lymophocyte-mediated immunity
Neutrophils and eosinophils
What are the immune cells in pulmonary immune system
dendritic cells, alveolar macrophages RBC, lymph node dendritic cell T cells, B cells, memory T cells virus specific B cell
What is BALT and GALT
bronchial assoc lymphoid tissue
gut associate lymphoid tissue
what do macrophages look like in smoker lung
carbon in the macrophages
what does BAL look like in sarcoidosis
increased # lymphocytes, CD4 alveolitis
beaded looking cell sin BAL is indicative of what
asbestosis
Wha ttype cells will you see on BAL of scleroderma patient
neutrophils and eos
What type interstitial lung disease are corticosteroids not indicated
idiopathic pulmonary fibrosis
nonspecific interstitial pneumonia has good or poor response to corticosteroids
favorable
What events lead to development of interstitial pulmonary fibrosis
vasodialtion, coagulation, oxidative stress, vascualr remodeling
TGF-beta!!!! from alveolar macrophages
TNF alpha
PDGF
What is protective against radiation induced lung fibrosis
ACEI
what is evidence for cellular and humoral immunity in IPF
CD4 T cells
biased T cell R Vbeta
presence of autoAb in some studies
lymphoid neogenesis without organization
What are the genetic contributions for pulmonary fibrosis and lung cancer
defects in surfactant protein A2
genetic mutation related to familial interstitial ung disease
surfactant protein C gene
mutation in familities with idiopathic pulmonary fibrosis
telomerase mutations
mutation with pulmonary fibrosis
MUC58 promoter polymorphism
how does systemic sarcoidosis affect lungs
interstitial pneumonitis and granulmatous formation progress to fibrosis
damage alveolar and bronchial tissue and vascular surface area
What proteins are involved in inflammatory response in sarcoidosis
TNF alpha
IL7
MMP-12
what can cause progression to persistent granulmoatous inflammation
persitence of Ag
Failure of immune system to halt inflammatory processes
What is HS pneumonitis
group lung disease from inhalaltion of exogenous Ag molecules
Sx HS pneumonitis
transient fever, hypoxemia, myalgias, arthralgias, dyspnea, cough 2-9 hrs post exposure
Tx HS pnuemonitis
Sx resolve w/o Tx
take away exposure
What lymphocyte count suggests HS pneumonitis
> 40% with higher perentage neutrophils and degranulated macrophages
