Published ahead of print on November 30, 2006, doi:10.1164/rccm.200606-777PP Am. J. Respir. Crit. Care Med., Volume 175, Number 4, February 2007, 306-311 A more recent version of this article appeared on February 15, 2007
Submitted on June 12, 2006 Pulmonary Perspective: Targeting the Networks that Underpin Contiguous Immunity in Asthma and COPDIan Sabroe1*,1 School of Medicine and Biological Sciences, Academic Unit of Respiratory Medicine, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom, 2 School of Medicine and Biological Sciences, Academic Unit of Infectious Diseases, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom, 3 School of Medicine, Allergy and Inflammation Research, Division of Infection, Inflammation and Repair, University of Southampton, Southampton General Hospital, Southampton, United Kingdom * To whom correspondence should be addressed. E-mail: i.sabroe{at}sheffield.ac.uk.
Recent advances in the field of innate immunity have driven an important reappraisal of the role of these processes in airways disease. Various strands of evidence indicate that resident cells such as macrophages and epithelial cells have central importance in the initiation of inflammation. Macrophage activation has the potential to regulate not just typical aspects of innate immunity, but also, via a variety of intricate cell:cell networks, adaptive responses and responses characterised by Th2-type cytokine production. In turn, such adaptive immune processes modify the phenotype and function of the innate immune system. Cooperative responses between monocytic cells and tissue cells are likely to be crucial to the generation of effective inflammatory responses, and a realisation of the importance of these networks is providing a new way of identifying anti-inflammatory therapies. Importantly, the repeated cycles of allergic and non-allergic inflammation that comprise chronic human airway disease are not necessarily well-described by current terminology, and we propose and describe a concept of contiguous immunity, in which continual bidirectional crosstalk between innate and adaptive immunity describes disease processes more accurately. Key words: Asthma, COPD, innate immunity, inflammation, macrophages
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