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Published ahead of print on April 3, 2008, doi:10.1164/rccm.200607-1038OC

Am. J. Respir. Crit. Care Med., Volume 177, Number 12, June 2008, 1322-1330

A more recent version of this article appeared on June 15, 2008
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Submitted on July 27, 2006
Accepted on March 31, 2008

Stimulation of Lung Innate Immunity Protects Against Lethal Pneumococcal Pneumonia in Mice

Cecilia G Clement1, Scott E Evans1, Christopher M Evans2, David Hawke3, Ryuji Kobayashi3, Paul R Reynolds4, Seyed J Moghaddam1, Brenton L Scott1, Ernestina Melicoff1, Roberto Adachi5, Burton F Dickey5*, and Michael J Tuvim5

1 Department of Pulmonary Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA, 2 Center for Lung Inflammation and Infection, Institute of Biosciences and Technology, Houston, TX, USA, 3 Department of Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA, 4 Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA, 5 Department of Pulmonary Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA; Center for Lung Inflammation and Infection, Institute of Biosciences and Technology, Houston, TX, USA

* To whom correspondence should be addressed. E-mail: bdickey{at}mdanderson.org.

Rationale: The lungs are a common site of serious infection in both healthy and immunocompromised subjects, and the most likely route of delivery of a bioterror agent. Since the airway epithelium shows great structural plasticity in response to inflammatory stimuli, we hypothesized it might also show functional plasticity. Objective: To test the inducibility of lung defenses against bacterial challenge. Methods: Mice were treated with an aerosolized lysate of UV-killed non-typeable (unencapsulated) Haemophilus influenzae (NTHi), then challenged with a lethal dose of live Streptococcus pneumoniae (Spn) delivered by aerosol. Results: Treatment with the NTHi lysate induced complete protection against challenge with a lethal dose of Spn if treatment preceded challenge by 4 to 24h. Lesser levels of protection occurred at shorter (83% at 2h) and longer (83% at 48-72h) intervals between treatment and challenge. There was also some protection when treatment was given 2 h after challenge (survival increased from 14% to 57%), but not 24h after challenge. Protection did not depend on recruited neutrophils or resident mast cells and alveolar macrophages. Protection was specific to the airway route of infection, correlated in magnitude and time with rapid bacterial killing within the lungs, and was associated with increases of multiple antimicrobial polypeptides in lung lining fluid. Conclusions: We infer that protection derives from stimulation of local innate immune mechanisms, and that activated lung epithelium is the most likely cellular effector of this response. Augmentation of innate antimicrobial defenses of the lungs might have therapeutic value.


Key words: innate immunity; pneumonia; immunocompromised host; lung epithelium.







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