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Semin Respir Crit Care Med 2004; 25(1): 43-52
DOI: 10.1055/s-2004-822304
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Host Defense and Bacterial Pneumonia

Kyle I. Happel1 , Gregory J. Bagby2 , Steve Nelson1 , 2
  • 1Section of Pulmonary and Critical Care Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
  • 2Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Publication History

Publication Date:
12 March 2004 (online)

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Despite advances in antibiotic therapy, bacterial pneumonia remains a significant cause of morbidity and mortality. Pulmonary host defense has both an innate component, consisting of nonspecific antimicrobial factors, as well as an acquired component, which is pathogen-specific. Defects in either arm of the immune system can have a profound impact on the other because these are highly interactive systems. From the upper airway to the respiratory alveolus, defense mechanisms are in place to maintain sterility of the lower respiratory tract. These features include anatomical barriers, nonspecific antimicrobial peptides, the mucociliary escalator, and the airway lining fluid. In the airspaces, the alveolar macrophage is the cell responsible for early pathogen clearance and subsequent initiation of the acute inflammatory response. Neutrophil recruitment and acquired immune responses are dependent on cytokine secretion by these resident tissue phagocytes. This article reviews the salient features of innate and acquired immunity against bacterial pathogens and how host factors (such as alcoholism) undermine these antibacterial defenses.

KEYWORDS

Pneumonia - host defense - cytokines - inflammation - alcohol

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Steve NelsonM.D. 

Division of Pulmonary and Critical Care Medicine, Louisiana State University Health Sciences Center

1901 Perdido St., Ste. 3205, New Orleans

LA 70112-1393

Email: snelso1@lsusc.edu

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