Well-Controlled Mucosal Exudation of Undiluted Plasma Proteins Serves Innate and Adaptive Immunity.

IF 4.1 4区 医学 Q2 IMMUNOLOGY
Carl Persson
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Abstract

Distinct from the pulmonary circulation, the human respiratory mucosa is supplied by highly responsive, superficial, systemic microcirculations. In the early symptomatic phase of mucosal infections, circulating peptides-proteins of all sizes are released just beneath the epithelium and will soon appear on the mucosal surface. The traditional view is that mucosal injury must be involved in this plasma exudation process. However, well-controlled human in vivo observations demonstrate that the inflammatory plasma exudation response reflects non-injurious physiologic microvascular-epithelial cooperation. Crucially, although plasma exudation brings unfiltered plasma solutes without size restriction to the mucosal surface this occurs without reducing the protective epithelial barrier against inhaled molecules. Plasma exudation starts early and increases until viral or bacterial infections resolve. Plasma exudation therefore has the potential to slow down, or even prevent, progression to pneumonia and beyond. Plasma exudation would boost efficacy of a mature adaptive immunity by delivering circulating pathogen-neutralising antibodies undiluted to infection spots in the upper airways. Early mucosal infections would thus be dampened and development of lower airway infections prevented. Inferentially, this explains how treatment with vaccines still allows upper airway infections but prevent severe respiratory disease with alveolar and pulmonary circulation injury. Plasma exudation may also contribute to real-life protection against severe influenza/Covid-19 in airway mucosal diseases that exhibit plasma exudation hyperresponsiveness. Such hyperresponsiveness is inducible indicating feasibility of finding future treatments that increase the mucosal innate and adaptive immunity. Altogether, the present synthesis of literature suggests that plasma exudation is an important component of human respiratory mucosal antimicrobial immunity.

未稀释血浆蛋白的良好控制的粘膜渗出服务于先天和适应性免疫。
与肺循环不同,人的呼吸粘膜是由高度反应的、浅表的、全身的微循环供应的。在粘膜感染的早期症状期,各种大小的循环肽蛋白在上皮下被释放,并很快出现在粘膜表面。传统观点认为,这一血浆渗出过程必然涉及粘膜损伤。然而,控制良好的人体体内观察表明,炎症性血浆渗出反应反映了非损伤的生理性微血管-上皮合作。至关重要的是,尽管血浆渗出将未经过滤的无尺寸限制的血浆溶质带到粘膜表面,但这并不会降低对吸入分子的保护性上皮屏障。血浆渗出开始较早,并增加,直到病毒或细菌感染消退。因此,血浆渗出物有可能减缓甚至预防肺炎的发展。血浆渗出可将循环中未稀释的病原体中和抗体输送到上呼吸道的感染点,从而提高成熟适应性免疫的效力。因此,早期粘膜感染将受到抑制,并防止下呼吸道感染的发展。由此推断,这解释了为什么疫苗治疗仍然会导致上呼吸道感染,但却能预防肺泡和肺循环损伤的严重呼吸道疾病。血浆渗出物也可能有助于对表现出血浆渗出物高反应性的气道粘膜疾病的严重流感/Covid-19的现实保护。这种高反应性是可诱导的,这表明未来寻找增加粘膜先天免疫和适应性免疫的治疗方法是可行的。总之,目前综合文献表明,血浆渗出液是人类呼吸道黏膜抗菌免疫的重要组成部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.70
自引率
5.40%
发文量
109
审稿时长
1 months
期刊介绍: This peer-reviewed international journal publishes original articles and reviews on all aspects of basic, translational and clinical immunology. The journal aims to provide high quality service to authors, and high quality articles for readers. The journal accepts for publication material from investigators all over the world, which makes a significant contribution to basic, translational and clinical immunology.
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