The Immune Response and Its Therapeutic Modulation in a chronic pulmonary diseases

Short Communication - Research and Reports in Pulmonology (2021) Volume 2, Issue 2

Bronchiectasis (BC) is a chronic pulmonary disease with tremendous morbidity and significant mortality.

As pathogen infection has been advocated as a triggering insult in the development of BC, a central

role for the immune response in this process seems obvious. Inflammatory cells are present in both the

airways as well as the lung parenchyma, and multiple mediators of immune cells including proteases

and cytokines or their humoral products are increased locally or in the periphery. Interestingly, a defect

in the immune system or suppression of immune response during conditions such as immunodeficiency

may well predispose one to the devastating effects of BC. Thus, the outcome of an active immune response

as detrimental or protective in the pathogenesis of BC may be dependent on the state of the patient's

immunity, the severity of infection, and the magnitude of immune response. Here we reassess the

function of the innate and acquired immunity in BC, the major sites of immune response, and the nature

of the bioactive mediators. Furthermore, the potential link(s) between an ongoing immune response and

structural alterations accompanying the disease and the success of therapies that can modulate the nature

and extent of immune response in BC are elaborated upon. Bronchiectasis (BC) is clinically characterized

as irreversible dilation of the bronchi and bronchioles, leading to persistent cough, purulent sputum,

and decreased airway flow, which can be accompanied by recurrent exacerbations. Disease detection

has greatly advanced with the advent of high-resolution computed tomography (HRCT). However,

management of the disease and treatment options are not yet fully optimal, and at present there is no

disease-modifying treatment available for BC. One major reason for this suboptimal treatment of the

disease is the lack of conclusive evidence regarding the underlying cellular and molecular characteristics

of BC, especially the role of the immune response. On one hand, multiple hematopoietic cells and their

bioactive cellular and humoral products have been detected during expression and persistence of the

disease, along with a positive association between BC and a series of chronic inflammatory diseases such

as rheumatoid arthritis. On the other hand, a set of immunodeficiency disorders or subtle defects in the

generation of a normal immune response have been shown to predispose an individual to development

of BC. Although no antigen specificity has been reported in BC, increased lymphocytes have been

shown in submucosal and epithelial layers of the airway, as well as increases in specific classes of blood

immunoglobulin, which point to the notion that both innate and acquired immunities are implicated in

BC. In this report, the influence of the immune response and its secreted products are evaluated in the

context of structural modification and clinical manifestations of BC.

Author(s): Emmanuel Ameyaw,