Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?

Thomas HügleDepartment of Rheumatology, Felix-Platter-Spital, University of Basel, Basel, SwitzerlandAbstract: Interstitial lung disease (ILD) and lung fibrosis are characterized by different grades of fibrosis and inflammation. Persistent low-grade inflammation is believed to play a ma...

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Main Author: Thomas Hügle
Format: Article
Language:English
Published: Dove Medical Press 2011-02-01
Series:Journal of Inflammation Research
Online Access:http://www.dovepress.com/immunology-of-fibrotic-lung-disease-managing-infections-whilst-prevent-a6209
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author Thomas Hügle
author_facet Thomas Hügle
author_sort Thomas Hügle
collection DOAJ
description Thomas HügleDepartment of Rheumatology, Felix-Platter-Spital, University of Basel, Basel, SwitzerlandAbstract: Interstitial lung disease (ILD) and lung fibrosis are characterized by different grades of fibrosis and inflammation. Persistent low-grade inflammation is believed to play a major pathogenic role, leading to an imbalance of cytokines, growth factors, and tissue proteinases. Recruited monocytes and macrophages play a pivotal role through their cytokine expression and possibly differentiation into fibrocytes, pericytes, or myofibroblasts. Atypical bacterial infections can cause ILD, although not usually in the form of usual interstitial pneumonia. On the other hand, bacterial colonization is frequently encountered in patients with chronic fibrotic lung disorders, and patients regularly undergo antibacterial treatment. As demonstrated in patients with diffuse panbronchiolitis and other chronic respiratory disorders, treatment with macrolides can be beneficial. This is partly explained by their antimicrobial effects but, for macrolides, immunomodulatory properties have been identified which might also be beneficial in patients with ILD or lung fibrosis. This article reviews the immunology of lung fibrogenesis and putative implications of macrolides for reinstallation of tolerance.Keywords: lung fibrosis, inflammation, pneumonia
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spelling doaj.art-69247a08a1454f35987cc8202fa1a0422022-12-21T19:24:29ZengDove Medical PressJournal of Inflammation Research1178-70312011-02-012011default2127Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?Thomas HügleThomas HügleDepartment of Rheumatology, Felix-Platter-Spital, University of Basel, Basel, SwitzerlandAbstract: Interstitial lung disease (ILD) and lung fibrosis are characterized by different grades of fibrosis and inflammation. Persistent low-grade inflammation is believed to play a major pathogenic role, leading to an imbalance of cytokines, growth factors, and tissue proteinases. Recruited monocytes and macrophages play a pivotal role through their cytokine expression and possibly differentiation into fibrocytes, pericytes, or myofibroblasts. Atypical bacterial infections can cause ILD, although not usually in the form of usual interstitial pneumonia. On the other hand, bacterial colonization is frequently encountered in patients with chronic fibrotic lung disorders, and patients regularly undergo antibacterial treatment. As demonstrated in patients with diffuse panbronchiolitis and other chronic respiratory disorders, treatment with macrolides can be beneficial. This is partly explained by their antimicrobial effects but, for macrolides, immunomodulatory properties have been identified which might also be beneficial in patients with ILD or lung fibrosis. This article reviews the immunology of lung fibrogenesis and putative implications of macrolides for reinstallation of tolerance.Keywords: lung fibrosis, inflammation, pneumoniahttp://www.dovepress.com/immunology-of-fibrotic-lung-disease-managing-infections-whilst-prevent-a6209
spellingShingle Thomas Hügle
Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
Journal of Inflammation Research
title Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
title_full Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
title_fullStr Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
title_full_unstemmed Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
title_short Immunology of fibrotic lung disease: managing infections whilst preventing autoimmunity?
title_sort immunology of fibrotic lung disease managing infections whilst preventing autoimmunity
url http://www.dovepress.com/immunology-of-fibrotic-lung-disease-managing-infections-whilst-prevent-a6209
work_keys_str_mv AT thomashampuumlgle immunologyoffibroticlungdiseasemanaginginfectionswhilstpreventingautoimmunity