Intestinal Epithelial Cells as a Source of Inflammatory Cytokines and Chemokines

The intestinal epithelium has long been known to provide nonspecific defences such as mucus, lysozyme and transport of secretory immunoglobulin via the polyimmunoglobulin receptor. In the past decade, the realization emerged that enterocytes secrete molecules (cytokines) that regulate inflammation. As the focus tightened on this new role as sentinel, so has the interest in enterocyte production of cytokines with chemoattractant properties for leukocytes – the chemokines. Neutrophils are a prominent feature of the cellular infiltrate in various inflammatory diseases, and early reports indicated that epithelial cells secrete neutrophil chemoattractants. More recently, it has been shown that the cells also secrete chemokines for monocytes and lymphocytes. Some of these chemokines appear to be important in the uninflamed intestine but become increased during disease. While a great deal of knowledge has been gained regarding the circumstances leading to chemokine production by epithelial cells, the application of this understanding to the treatment of human intestinal diseases is lacking. Closing this gap is necessary to take advantage of emerging therapies aimed at blocking chemokine function

Effects of CNS Injury-Induced Immunosuppression on Pulmonary Immunity

Patients suffering from stroke, traumatic brain injury, or other forms of central nervous system (CNS) injury have an increased risk of nosocomial infections due to CNS injury-induced immunosuppression (CIDS). Immediately after CNS-injury, the response in the brain is pro-inflammatory; however, subsequently, local and systemic immunity is suppressed due to the compensatory release of immunomodulatory neurotransmitters. CIDS makes patients susceptible to contracting infections, among which pneumonia is very common and often lethal. Ventilator-acquired pneumonia has a mortality of 20–50% and poses a significant risk to vulnerable patients such as stroke survivors. The mechanisms involved in CIDS are not well understood. In this review, we consolidate the evidence for cellular processes underlying the pathogenesis of CIDS, the emerging treatments, and speculate further on the immune elements at play