Advanced

Transepithelial exit of leucocytes: inflicting, reflecting or resolving airway inflammation?

Persson, Carl LU and Uller, Lena LU (2010) In Thorax 65. p.1111-1115
Abstract
The passage of infiltrated tissue granulocytes across airway epithelium into airway lumen is generally considered to be a pathogenic process in asthma and chronic obstructive pulmonary disease (COPD). An alternative hypothesis is proposed here-namely that the transepithelial egression of infiltrated leucocytes acts to rid diseased airway tissues of proinflammatory cells efficiently and non-injuriously. Several clinical observations previously discussed as 'unexpected' and 'puzzling' support this hypothesis. In acutely resolving allergen challenge-induced inflammation, in patients with mild asthma, airway wall eosinophils disappear without evidence of apoptosis but with evidence of a developing airway lumen eosinophilia. In the same... (More)
The passage of infiltrated tissue granulocytes across airway epithelium into airway lumen is generally considered to be a pathogenic process in asthma and chronic obstructive pulmonary disease (COPD). An alternative hypothesis is proposed here-namely that the transepithelial egression of infiltrated leucocytes acts to rid diseased airway tissues of proinflammatory cells efficiently and non-injuriously. Several clinical observations previously discussed as 'unexpected' and 'puzzling' support this hypothesis. In acutely resolving allergen challenge-induced inflammation, in patients with mild asthma, airway wall eosinophils disappear without evidence of apoptosis but with evidence of a developing airway lumen eosinophilia. In the same postchallenge resolution phase, lymphocytes, neutrophils and mast cells exhibit peak numbers in airway lumen of individuals with asthma. In severe asthma requiring intubation, clinical improvement is similarly parallelled by a marked increase over several days in airway lumen neutrophils. Increased numbers of sputum neutrophils and lymphocytes also occur as symptoms improve in COPD over several months after smoking cessation. Conversely, when the transepithelial exit of leucocytes has been inhibited in inflamed animal airways the inflammation in the airway wall has been much aggravated. Finally, transepithelial egression of numerous granulocytes and lymphocytes clearly can occur without any harm to airway epithelial barriers. The present hypothesis of 'resolution through egression' provides a novel interpretation of common airway lumen data, cautions against administration of agents that impede leucocyte egression in inflammatory airway diseases and infers new approaches in disease resolution research. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thorax
volume
65
pages
1111 - 1115
publisher
BMJ Publishing Group
external identifiers
  • wos:000284354800017
  • pmid:20688768
  • scopus:78649615151
ISSN
1468-3296
DOI
10.1136/thx.2009.133363
language
English
LU publication?
yes
id
6bdab6ca-84a5-4631-8189-03d895b9c0f4 (old id 1665541)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20688768?dopt=Abstract
date added to LUP
2010-09-02 10:54:36
date last changed
2017-01-01 07:51:05
@article{6bdab6ca-84a5-4631-8189-03d895b9c0f4,
  abstract     = {The passage of infiltrated tissue granulocytes across airway epithelium into airway lumen is generally considered to be a pathogenic process in asthma and chronic obstructive pulmonary disease (COPD). An alternative hypothesis is proposed here-namely that the transepithelial egression of infiltrated leucocytes acts to rid diseased airway tissues of proinflammatory cells efficiently and non-injuriously. Several clinical observations previously discussed as 'unexpected' and 'puzzling' support this hypothesis. In acutely resolving allergen challenge-induced inflammation, in patients with mild asthma, airway wall eosinophils disappear without evidence of apoptosis but with evidence of a developing airway lumen eosinophilia. In the same postchallenge resolution phase, lymphocytes, neutrophils and mast cells exhibit peak numbers in airway lumen of individuals with asthma. In severe asthma requiring intubation, clinical improvement is similarly parallelled by a marked increase over several days in airway lumen neutrophils. Increased numbers of sputum neutrophils and lymphocytes also occur as symptoms improve in COPD over several months after smoking cessation. Conversely, when the transepithelial exit of leucocytes has been inhibited in inflamed animal airways the inflammation in the airway wall has been much aggravated. Finally, transepithelial egression of numerous granulocytes and lymphocytes clearly can occur without any harm to airway epithelial barriers. The present hypothesis of 'resolution through egression' provides a novel interpretation of common airway lumen data, cautions against administration of agents that impede leucocyte egression in inflammatory airway diseases and infers new approaches in disease resolution research.},
  author       = {Persson, Carl and Uller, Lena},
  issn         = {1468-3296},
  language     = {eng},
  pages        = {1111--1115},
  publisher    = {BMJ Publishing Group},
  series       = {Thorax},
  title        = {Transepithelial exit of leucocytes: inflicting, reflecting or resolving airway inflammation?},
  url          = {http://dx.doi.org/10.1136/thx.2009.133363},
  volume       = {65},
  year         = {2010},
}