Acute exacerbations in COPD and their control with oral immunization with non-typeable haemophilus influenzae.

Frontiers in Immunology
Robert L Clancy, Margaret Dunkley

Abstract

Chronic obstructive pulmonary disease (COPD) a term based on the demonstration of irreversible airways obstruction, introduced to unify a range of chronic progressive diseases of the airways consequent upon inhalation of toxins. While disease is initiated and progressed by inhaled toxins, an additional pathway of damage has emerged, with particular relevance to acute exacerbations. Exacerbations of disease due to an increase in the level of intrabronchial inflammation have taken on a new significance as their role in determining both acute and chronic outcomes is better understood. This "second pathway" of disease is a consequence of bacterial colonization of damaged airways. Although bacteria have been linked to acute episodes in COPD over 50 years, only recently has quality data on antibiotic usage and the detection of "exacerbation isolates" of non-typeable Haemophilus influenzae (NTHi) provided strong argument in support of a pathogenic role. Yet a poor correlation between detection of colonizing bacteria and clinical status remained a concern in attempts to explain a role for bacteria in a classical infection model. This presentation discusses a hypothesis that acute exacerbations reflect a T cell-dependent hypersensitivit...Continue Reading

Citations

Dec 9, 2014·Human Vaccines & Immunotherapeutics·Keith GrimwoodAllan W Cripps
Mar 1, 2012·Current Opinion in Pharmacology·Mario CazzolaM Gabriella Matera
Oct 27, 2016·Critical Reviews in Microbiology·Yang HeJunshuai Wang
May 26, 2017·Critical Reviews in Microbiology·Krishna Bajee SriramAllan W Cripps
Jul 19, 2014·The European Respiratory Journal·Mathieu C MorissetteMartin R Stämpfli
Mar 1, 2012·Internal Medicine Journal·R L Clancy
Jan 21, 2014·Current Opinion in Pulmonary Medicine·Mir M Alikhan, F Eun-Hyung Lee
Feb 26, 2019·Frontiers in Immunology·Mohib UddinFrauke Pedersen
Oct 13, 2020·Frontiers in Medicine·Keshav Raj PaudelPhilip M Hansbro
Jul 6, 2020·Respiratory Research·Jing ZhangJingtong Zheng
Jul 21, 2011·The Medical Journal of Australia·Robert L Clancy, Margaret Dunkley
Mar 9, 2021·Frontiers in Immunology·Juliana Ochoa-GrullónSilvia Sánchez-Ramón

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Methods Mentioned

BETA
lavage
biopsy
biopsies

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