TY - JOUR
T1 - Lymphoid follicles in (very) severe COPD
T2 - beneficial or harmful?
AU - Brusselle, G. G.
AU - Demoor, T.
AU - Bracke, K. R.
AU - Brandsma, C-A.
AU - Timens, W.
PY - 2009/7
Y1 - 2009/7
N2 - Inflammation is a main pathogenetic factor in the development and progression of chronic obstructive pulmonary disease (COPD) Recently, it has become clear that not only the innate, but also the specific immune response plays a role. A striking finding, in particular in lungs of patients with severe COPD, often with a predominant emphysema phenotype, is the presence of B-cell follicles. As seen in other tissues, these follicles are the result of lymphoid neogenesis. The finding of oligoclonality in B-cell follicles in COPD suggests that they play a role in local antigen specific immune responses. To date, it is not known which antigens may be involved; microbial antigens, cigarette smoke-derived antigens and antigens from extracellular matrix breakdown products have been suggested. Consequently, the pathogenetic role of this follicular B-cell response is not yet clear. It might be protective against microbial colonisation and infection of the lower respiratory tract and, therefore, beneficial, or it could be of a more harmful (autoimmune) nature, directed against lung tissue components. It is necessary to determine the specific antigen(s) and to explore the exact role of the COPD related B-cell response in order to include modulation of this response and develop therapeutic options.
AB - Inflammation is a main pathogenetic factor in the development and progression of chronic obstructive pulmonary disease (COPD) Recently, it has become clear that not only the innate, but also the specific immune response plays a role. A striking finding, in particular in lungs of patients with severe COPD, often with a predominant emphysema phenotype, is the presence of B-cell follicles. As seen in other tissues, these follicles are the result of lymphoid neogenesis. The finding of oligoclonality in B-cell follicles in COPD suggests that they play a role in local antigen specific immune responses. To date, it is not known which antigens may be involved; microbial antigens, cigarette smoke-derived antigens and antigens from extracellular matrix breakdown products have been suggested. Consequently, the pathogenetic role of this follicular B-cell response is not yet clear. It might be protective against microbial colonisation and infection of the lower respiratory tract and, therefore, beneficial, or it could be of a more harmful (autoimmune) nature, directed against lung tissue components. It is necessary to determine the specific antigen(s) and to explore the exact role of the COPD related B-cell response in order to include modulation of this response and develop therapeutic options.
KW - Chronic obstructive pulmonary disease
KW - immune response
KW - inflammatory response
KW - lymphocytes
KW - review
KW - OBSTRUCTIVE PULMONARY-DISEASE
KW - SMOKE-INDUCED EMPHYSEMA
KW - LUNG-VOLUME-REDUCTION
KW - NON-HODGKINS-LYMPHOMA
KW - CIGARETTE-SMOKE
KW - B-CELLS
KW - HAEMOPHILUS-INFLUENZAE
KW - RHEUMATOID-ARTHRITIS
KW - AIRWAY INFLAMMATION
KW - PERIPHERAL AIRWAYS
U2 - 10.1183/09031936.00150208
DO - 10.1183/09031936.00150208
M3 - Review article
SN - 0903-1936
VL - 34
SP - 219
EP - 230
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 1
ER -