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am rev respir dis [journal]
- Adult criteria for obstructive apnea do not identify children with serious obstruction. [Comment, Letter]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 1):1697.
- Cell adhesion molecules and the bronchial epithelium. [Journal Article]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S79-82.
The bronchial epithelium is the major barrier between the host and the provoking antigens in bronchial asthma. Recent studies have indicated that the epithelium is a truly stratified structure, with the superficial columnar cells depending on the underlying basal cells for anchorage. Only columnar cells are shed into bronchial lavage fluid. The epithelium is more fragile in asthma and more cells are lost in clusters. Desmosomes appear to be the major structural adhesion mechanism at the plane of cleavage between the columnar cells and the basal cells. The alpha 6- and beta 4-integrins, which contribute to hemidesmosomes and anchor cells to the underlying basement membrane, are expressed solely by basal cells. The apical aspects of the columnar cells are sealed by tight and intermediate junctions. There is constitutive expression of ICAM-1 and E-selectin in the vasculature of the bronchial mucosa, and ICAM is also present within the epithelium. These findings indicate that the bronchial epithelium is a complex structure that, as a mucosal surface, has constitutive expression of inflammatory cell adhesion molecules to serve normal leukocyte traffic.
- Adhesion molecules and cytokine production. [Journal Article, Research Support, Non-U.S. Gov't, Review]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S70-4.
The exchange of cross-talks between cells relies on soluble factors or direct cell-cell contact. Soluble factors increase the expression of cell surface molecules that activate adjacent cells by direct contact to produce cytokines. In the lung, dendritic cells are potent inducers of T-cell proliferation, and the interaction between the two leads to the production of high amounts of TNF alpha and TNF beta. Of the molecules involved in these biologic functions, LFA-3, CD11c, and the combination of beta 1 and beta 2 integrins are the most efficient. However, blocking TNF alpha or TNF beta production does not affect the alloreaction. The interaction between activated T cells and monocytes resulted in a large production of IL-1 beta. In this reaction, CD69, CD2, and the beta 2 integrins (CD11a, b, c, and CD18) and also other molecules such as a 25- to 35-kD glycoprotein play an important part. Finally, interaction between monocytes and fibroblasts leads to the production of large amounts of collagenase and PGE2 by fibroblasts. Cell-associated IL-1, particularly IL-1 alpha and membrane-bound TNF alpha, can also play a crucial role in the process of cell-cell interaction. This interaction may be controlled by inhibitors to IL-1 and TNF.
- Molecular mechanisms mediating lymphocyte recirculation, inflammation, and metastasis formation. [Journal Article, Review]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S65-9.
A multitude of glycoproteins expressed in cellular membranes have been identified by monoclonal antibodies. Besides mediating transient cell/cell contacts, these molecules unequivocally function as receptor structures capable of transmitting signals for cell growth and differentiation. They are the central determinators of local immune responses, and they allow an adjustment of the recirculating immunocompetent cells to their respective local microenvironments. Given that receptor/ligand interactions are characteristic of particular in vivo sites, knowledge of structural and functional features of adhesion receptors can provide new prospects for a more targeted clinical immune intervention.
- Mechanisms of neutrophil and eosinophil accumulation in vivo. [Journal Article, Research Support, Non-U.S. Gov't, Review]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S60-4.
The accumulation of leukocytes into tissues is a characteristic feature of inflammatory reactions. This process is triggered by chemical signals generated in a tissue in response to an inflammatory stimulus e.g., invading microbes, other foreign organisms, allergens, or damaged tissue cells. The mechanisms involved in neutrophil and eosinophil accumulation in vivo are complex and dependent on an initial interaction between the leukocytes and the microvascular endothelial cells. This response is regulated by the coordinated expression and/or activation of leukocyte and endothelial cell adhesion molecules. The precise mechanisms that control the selective accumulation of eosinophils, as opposed to neutrophils, in certain inflammatory reactions (e.g., in IgE-mediated allergic reactions) remain unclear. This may be explained partly by the generation of eosinophil-specific inflammatory mediators and activation of selective adhesion pathways such as the VLA-4/VCAM-1 interaction. Although the neutrophil and eosinophil have distinct roles in host defense, they have been implicated in the pathogenesis of a number of inflammatory disorders. Thus, a better understanding of the events mediating and regulating neutrophil and eosinophil accumulation in vivo will be of considerable value in the development of therapeutic strategies for inflammatory disease states.
- Identification and characterization of novel airway epithelial integrins. [Journal Article, Research Support, U.S. Gov't, P.H.S.]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S38-42.
Integrins are heterodimeric glycoproteins that mediate cell-to-matrix and some cell-to-cell interactions. Recent evidence underscores the important roles of these receptors in signaling machines that transduce positional information into complex changes in cell behavior. As such, integrins have been shown to play critical roles in cell growth, differentiation, and migration. Most cells express multiple members of this family, but the integrin repertoire of any given cell appears to be highly tissue- and cell-type-specific. We have used the homology-based polymerase chain reaction to identify known and novel integrin subunits in airway epithelial cells. With this technique we have identified three novel integrin subunits that participate in the formation of at least four novel integrin heterodimers. The best characterized of these, alpha v beta 6, is a receptor for the extracellular matrix protein fibronectin, and appears to be expressed only in terminally differentiated mucosal epithelial cells. The novel alpha subunit, alpha 9, forms a heterodimer with the known beta subunit, beta 1, in some epithelial cell lines. Elucidatation of the specific roles these receptors play in airway health and disease will likely provide unique insights into both the biology of integrins and the biology of the airway epithelium.
- Adhesion molecules in the lung. An overview. [Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Review]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 2):S31-7.
Several distinct cell adhesion molecule families have recently been identified and found to be important in the inflammatory response and for epithelial and endothelial homeostasis. The integrin family of adhesion molecules functions in both cell-matrix and cell-cell interactions, whereas the cadherins serve as important cell-cell receptors for maintenance of epithelial integrity. The leukocyte integrins, selectins, members of the immunoglobulin supergene family, and specific carbohydrates mediate adhesive interactions between leukocytes and endothelial cells. The mechanisms of leukocyte-epithelial adhesion are less well understood, but integrins and members of the immunoglobulin supergene family are also involved. The role of these molecules in pulmonary structure and inflammation is currently being actively explored. Further knowledge of these interactions, and the interplay of adhesion molecules, cytokines, and chemoattractants is likely to lead to novel therapeutic modalities in inflammatory diseases of the airway and lung parenchyma. In this overview, the families of adhesion molecules will be summarized, and their relevance for pulmonary structure and inflammation will be discussed.
- Resection of pulmonary metastases. [Journal Article, Review]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 1):1691-6.
- T-lymphocytes with gamma delta+ V delta 2+ antigen receptors are present in increased proportions in a fraction of patients with tuberculosis or with sarcoidosis. [Journal Article]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 1):1685-90.
T-lymphocytes with T-cell antigen receptor (TCR) comprising a gamma chain and a delta chain (gamma delta+ T cells) are believed to be involved in the immune reaction to mycobacterial antigens, and they have been found in increased proportions in sarcoid patients. We evaluated the proportions of gamma delta+ T-lymphocytes and of two major gamma delta+ subpopulations, the V delta 1+ and the V delta 2+ T-cell subsets, in 10 normal blood donors, in 15 patients with tuberculosis (TB), seven of whom had pleural effusion (PE), and in 12 patients with pulmonary sarcoidosis (PS), nine of whom underwent bronchoalveolar lavage (BAL). T-cell subsets were evaluated in peripheral blood (PBL) of all subjects and in PE from patients with TB and in BAL from patients with PS. Compared with normal blood donors, patients with TB had increased proportions of PBL CD3+ gamma delta+ T cells (6 +/- 1% versus 14 +/- 3% of CD3+ T cells, p < 0.05) because of the presence of four patients who had an increase (respectively, 18.3, 22.0, 24.2, and 35.4% of CD3+ T cells) of gamma delta+ T cells. In patients with TB and PE, gamma delta+ T cells were 7.9 +/- 2.7%, a value not different from that in the tubercular PBL and in normal PBL. Although patients with PS had proportions of PBL gamma delta+ T cells (9.2 +/- 3.4%) similar to those in normal PBL, two patients had increased (35 and 31%) PBL gamma delta+ T-lymphocytes.(
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- The effects of inhaled interferon gamma in normal human airways. [Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.]
- Am Rev Respir Dis 1993 Dec; 148(6 Pt 1):1677-82.
Recent studies suggest that cytokines such as recombinant interferon-gamma (rIFN-gamma) may play a role in the treatment of certain respiratory conditions associated with infection and inflammation. This study was designed to determine if rIFN-gamma could be delivered effectively in a group of normal human volunteers. The effectiveness of the inhaled delivery system was demonstrated by the recovery of free IFN-gamma in bronchoalveolar lavage (BAL) fluid and macrophage (M phi) expression of IP-10, an IFN-gamma-inducible molecule, after therapy but not at baseline. IL-1 beta, but not IL-8, gene transcripts also showed evidence for up-regulation after rIFN-gamma therapy. Compared with baseline, inhaled rIFN-gamma did not significantly alter clinical symptom scores, spirometry, morning peak expiratory flow rate (PEFR), or the response to methacholine. Of interest, the evening PEFR increased significantly (p = 0.02), from 568 +/- 36 L/min at baseline to 584 +/- 33 L/min after inhaled rIFN-gamma. Although there was no significant change in total white cell count in BAL fluid, the cellular composition did demonstrate a significant decrease in percentage of alveolar M phi (p = 0.02) and an increase in percentage of lymphocytes (p = 0.02) after rIFN-gamma. There were no histologic differences seen in bronchial biopsy specimens, and there was no evidence for up-regulation of ICAM-1 or HLA-DR expression after rIFN-gamma. We conclude that, in normal persons, rIFN-gamma can be effectively delivered by inhalation. Future trials using inhaled rIFN-gamma appear to be warranted for certain pulmonary diseases.