James H. Shelhamer; Stewart J. Levine; Tong Wu; David B. Jacoby; Michael A. Kaliner; Stephen I. Rennard
Diseases characterized by airway inflammation, excessive airway secretion, and airway obstruction affect a substantial proportion of the population.These diseases include asthma, chronic bronchitis, bronchiectasis, and cystic fibrosis. Asthma and chronic bronchitis may affect 25 million persons in the United States. Much progress has been made in the last decade toward an understanding of the mechanisms underlying chronic airway inflammation; recent work has resulted in several new concepts of the initiation and maintenance of airway inflammation. Airway production of chemokines, cytokines, and growth factors in response to irritants, infectious agents, and inflammatory mediators may play an important role in the modulation of acute and chronic airway inflammation. Lipid mediators may be produced by resident airway cells and by inflammatory cells; production of these mediators may also be altered by inflammatory cytokines. Increased airway obstruction may be related to intercurrent viral respiratory infection and to the induction of airway inflammation and airway hyperreactivity that results from such infection. Furthermore, several models exist to explain the processes by which airway inflammation is perpetuated in diseases such as asthma and chronic bronchitis. These include neurogenic inflammation, the perpetuation of the acute inflammatory response, and cycles of airway epithelial cell-mediated and inflammatory cell-mediated recruitment and activation of inflammatory cells. An understanding of these mechanisms of airway inflammation may provide the clinician with new therapeutic approaches to the treatment of these common and chronic diseases.
AA = arachidonic acid and metabolites; NEP = neutral endopeptidase; VIP = vasoactive intestinal peptide.
GM-CSF = granulocyte macrophage colony-stimulating factor; iC3b = fragment of the third component of complement; IL-8 = interleukin-8; LTB4 = leukotriene B4.
cPLA2 = cytosolic phospholipase A ; D.C. = dendritic cell; G-CSF = granulocyte colony-stimulating factor; GM-CSF = granulocyte macrophage colony-stimulating factor; HETE = hydroxyeicosatetraenoic acid; ICAM-1 = intercellular adhesion molecule-1; IL-1 = interleukin-1; IL-6 = interleukin-6; IL-8 = interleukin-8; LPS = lipopolysaccharide; LTB4 = leukotriene B4; M = macrophage; MCP-1 = monocyte chemoattractant protein-1; PAF =platelet-activating factor; PMN = neutrophil; T.C. = T lymphocyte; TNF = tumor necrosis factor; VCAM-1 = vascular cell adhesion molecule-1.
B.C. = B lymphocyte; Eos. = eosinophil; 15 LO = 15-lipoxygenase; Hist. = histamine; IL-3 = interleukin-3; IL-4 = interleukin-4; IL-5 = interleukin-5; LCF = lymphocyte colony-stimulating factor; L.N. = lymph node; LTC4/D4 = leukotrienes C4 and D4; M.C. = mast cell; Th-2 = T lymphocyte of the T phenotype.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Shelhamer JH, Levine SJ, Wu T, Jacoby DB, Kaliner MA, Rennard SI. Airway Inflammation. Ann Intern Med. ;123:288–304. doi: 10.7326/0003-4819-123-4-199508150-00008
Download citation file:
Published: Ann Intern Med. 1995;123(4):288-304.
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use