Immunopathogenesis of Pneumocystis carinii pneumonia.
Pneumocystis carinii pneumonia (PCP) is a life-threatening infection that occurs in immunocompromised individuals, particularly those with advanced human immunodeficiency virus (HIV) infection. Interestingly, morbidity and mortality is related to the underlying cause of immunosuppression, with AIDS patients faring better than oncology patients for example. In addition, the prognosis of PCP has been correlated with markers of inflammation rather than with organism numbers. There is now increasing evidence that lung damage occurring during PCP is a result of the type and extent of the host inflammatory response to P. carinii rather than a result of direct damage by the organism. This review will discuss the experimental and clinical data demonstrating how the host-mediated inflammatory response to infection with P. carinii determines the ultimate outcome of PCP. A better understanding of the pathophysiology of PCP should lead to the development of improved therapies for the treatment of PCP.
Gigliotti
Francis
F
University of Rochester School of Medicine & Dentistry, 601 Elmwood Avenue, Box 690, Rochester, NY 14642, USA. francis_gigliotti@urmc.rochester.edu
Wright
Terry W
TW
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000382:microbiology; D000818:Animals; D016207:Cytokines / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D016867:Immunocompromised Host; D007223:Infant; D007249:Inflammation; D008170:Lung Compliance; D016676:Macrophages, Alveolar / Q000502:physiology; D008322:Mammals / Q000382:microbiology; D051379:Mice; D016513:Mice, SCID; D009504:Neutrophils / Q000276:immunology; D016720:Pneumocystis Infections / Q000382:microbiology / Q000662:veterinary; D045363:Pneumocystis carinii / Q000145:classification / Q000472:pathogenicity; D011020:Pneumonia, Pneumocystis / Q000276:immunology* / Q000382:microbiology; D011663:Pulmonary Surfactants / Q000378:metabolism; D015398:Signal Transduction; D013045:Species Specificity; D016176:T-Lymphocyte Subsets / Q000276:immunology
D016207:Cytokines; D011663:Pulmonary Surfactants