5.4 Immunology of COPD
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Describe the evidence that COPD may involve activation of the immune system.
- Oxidative stress due to activated neutrophils and macrophages
- Apoptosis of endothelial and epithelial cells
- Viral infections
- T cell (CD8+) mediated inflammation
- (T cells activated by antigens released during smoking induced injury or by auto-antigens)
Explain the role of the innate host defense mechanisms in initiating COPD.
Danger hypothesis - innate immune system is activated by so-called danger signals released by cells and tissues being damaged either by microbial infections or by irritants like smoke
Describe the components of the adaptive immune system thought to be involved in COPD.
- CD8+ cytotoxic T cell is predominant cell in the airways and lung parenchyma in COPD
- Epithelial and endothelial cells undergo apoptosis or necrosis
- CD4+ T cells activated - most become Th1 cells; some Th2 cells stimulate B cells
List the evidence supporting an autoimmune process being responsible for ongoing COPD
- Increased numbers of B and T cells in lungs
- Presence of serum antibodies to elastin
- Ability of T cells to produce IFN-y and IL-10 in response to elastin
- Response of T cells can be blocked by antibodies to HLA II molecules
- Presence of IgG anti-epithelial and anti-endothelial antibodies in lungs from COPD patients
Differentiate the underlying mechanism responsible for COPD from that responsible for allergic asthma.
- Asthma - inflammation, inciting antigens, helper T cells, cytokines, effector
- COPD - inflammation, inciting antigens, helper T cells, cytokines, effector
Which cytokine is responsible for differentiation of Th2 cells?
Which cytokine is responsible for differentiation of Th1 cells?
What is IL-6?
Which are inflammatory cytokines?
IL-1 and IL-6
What is IL-10?
Which T cell helps B cells make IgE?
Which T cells help B cells make IgG?
Activation of the innate host defense mechanisms requires recognition of ____ by _____
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