Pulmonary Defense Mechanism_Dea Natalia_130110110190_E3/Respi

AIR CONDITIONING
mucosa of nose, nasal turbinates,
oropharynx, nasopharynx
air heated to body temperature and
humidified
OLFACTION
olfactory receptors in posterior nasal cavity
person can sniff to attempt to detect
potentially hazardous gas/dangerous
material in inspired air; the rapid shallow
inspiration brings gases into contact with
olfactory sensors without bringing them into
lung
INSPIRED PARTICLE
Filtration
1. particles > 10 m in diameter: impacting
in surface of nasal septum, turbinate,
nasopharynx; tonsils and adenoids provide
immunologic defense against biologically
active material filtered
2. particles 10-15 m in diameter: nasal hair
(vibrissae) filter
3. particles 2-10 m in diameter: impaction
or sedimentation and trapped in mucus
lining of upper airway, trachea, bronchi,
bronchioles
4. particles 2-5 m in diameter:
sedimentation by gravity in smaller
airways
5. particles 0.1-0.5 m in diameter: stay
suspended as aerosols, 80% exhaled
6. particles 0.1 m in diameter: deposited
as a result of Brownian motion due to their
bombardment by gas molecules
Removal
1. reflexes in airways
cough
sneeze
2. mucocilliary escalator
material trapped in mucus continually
moved upward toward pharynx
mucus that reach pharynx is usually
swallowed, expectorated, or removed
by blowing ones nose
DEFENSE MECHANISM OF TERMINAL
RESPIRATORY UNITS
1. Alveolar Macrophage
inhaled particles engulfed by alveolar
macrophages may be destroyed by
lysosomes
macrophages carrying non-digestible
material e.g. silica will migrate to
mucocilliary escalator via pores of Kohn
eventual removal through airway

particle-containing macrophage may

migrate from alveolar surface into septal
interstitium enter lymphatic system or
mucocilliary escalator
provide immune and inflammatory
response; secrete many enzymes,
arachidonic acid metabolites, immune
response components, growth factors,
cytokines, other mediators that modulate
the function of other cells e.g.
lymphocytes
2. Non-specific Enzymatic Destruction
lysozymes: found mainly in leukocyte,
have bactericidal properties
lactoferrin: synthesized by PMN
lymphocytes and glandular mucosal cell,
potent bacteriostatic agent
1 anti-trypsin: inactivates proteolytic
enzymes released from bacteria, dead
cells, or cells involved in lung defense
(e.g. neutrophil elastase)
interferon: potent antiviral substance
produced by macrophage and lymphocyte
complement: participates as cofactor in
antigen-antibody reaction and other
cellular defense
3. Immunologic Reactions
antibody-mediated
cell-mediated
DIFFERENCES IN PEDIATRICS
Alveolar Macrophage
alveolar macrophage from children under 2
years of age express less HLA-DR (MHC class
II cell surface receptor), are impaired with
regards to respiratory bursts, and produce
less IL-1 and TNF-alpha
Neutrophils
newborn neutrophils have diminished
capacity to undergo cellular orientation in
response to chemotactic gradient
impairment of neutrophil migratory behavior
attributed to a number of factors, inc.
decreased receptor binding sites for formylmethionyl-leucyl-phenylalanine (chemotactic
substance), reduced cell surface expression
of Mac-1 (CD11b/CD18) (macrophage-1
antigen), diminished actin polymerization
BALT (Bronchus-Associated Lymphoid
Tissue)
often observed in lung in children and
adolescents under healthy condition, likely
indicating the antigenic stimulation and
expansion of memory lymphocyte (in human
adult, BALT is not normally found in lung, but
can be found under disease conditions)