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Immunity May 2023The recent revolution in tissue-resident macrophage biology has resulted largely from murine studies performed in C57BL/6 mice. Here, using both C57BL/6 and BALB/c mice,...
The recent revolution in tissue-resident macrophage biology has resulted largely from murine studies performed in C57BL/6 mice. Here, using both C57BL/6 and BALB/c mice, we analyze immune cells in the pleural cavity. Unlike C57BL/6 mice, naive tissue-resident large-cavity macrophages (LCMs) of BALB/c mice failed to fully implement the tissue-residency program. Following infection with a pleural-dwelling nematode, these pre-existing differences were accentuated with LCM expansion occurring in C57BL/6, but not in BALB/c mice. While infection drove monocyte recruitment in both strains, only in C57BL/6 mice were monocytes able to efficiently integrate into the resident pool. Monocyte-to-macrophage conversion required both T cells and interleukin-4 receptor alpha (IL-4Rα) signaling. The transition to tissue residency altered macrophage function, and GATA6 tissue-resident macrophages were required for host resistance to nematode infection. Therefore, during tissue nematode infection, T helper 2 (Th2) cells control the differentiation pathway of resident macrophages, which determines infection outcome.
Topics: Mice; Animals; Filarioidea; Filariasis; Th2 Cells; Monocytes; Pleural Cavity; Mice, Inbred C57BL; Macrophages; Nematode Infections; Cell Differentiation; Mice, Inbred BALB C
PubMed: 36948193
DOI: 10.1016/j.immuni.2023.02.016 -
Expert Review of Respiratory Medicine Oct 2022Pleural infection causes significant morbidity and mortality. An important aspect in the treatment of pleural infection is the pharmacokinetics of antibiotics, an area... (Review)
Review
INTRODUCTION
Pleural infection causes significant morbidity and mortality. An important aspect in the treatment of pleural infection is the pharmacokinetics of antibiotics, an area often neglected.
AREAS COVERED
Pathophysiology of pleural infection and the importance of antibiotic therapy in the treatment of pleural infection are discussed. After reviewing all available literature on pharmacokinetics of antibiotics for pleural infection, the scarcity of data and knowledge gaps are highlighted.
EXPERT OPINION
This review aims to heighten awareness of the limited pharmacokinetic data of commonly used antibiotics for pleural infection. It serves to remind clinicians that choice of antibiotics for pleural infection should be based not only on bacterial sensitivity but also adequate delivery of antibiotics to the infected pleural cavity. Antibiotic pharmacokinetics may vary with agents used, pleural thickness and individual characteristics. Consideration must be given to insufficient pleural delivery of systemic antibiotics in patients lacking clinical improvement. Pleural infection research has disproportionately focused on fluid drainage. Optimizing delivery of effective antibiotic therapy to the pleural cavity must be regarded a key priority to progress clinical care. Large comprehensive cohort studies on pharmacokinetic variability are the essential next step. The possibility of intrapleural administration is also an area that warrants additional research.
Topics: Humans; Fibrinolytic Agents; Anti-Bacterial Agents; Drainage; Pleural Diseases; Communicable Diseases; Pleural Effusion
PubMed: 36377497
DOI: 10.1080/17476348.2022.2147508 -
Pediatric Radiology Nov 2021In addition to radiography, ultrasound (US) has long proved to be a valuable imaging modality to evaluate the pediatric lung and pleural cavity. Its many inherent... (Review)
Review
In addition to radiography, ultrasound (US) has long proved to be a valuable imaging modality to evaluate the pediatric lung and pleural cavity. Its many inherent advantages, including real-time performance, high spatial resolution, lack of ionizing radiation and lack of need for sedation make it preferable over other imaging modalities such as CT. Since the introduction of ultrasound contrast agents (UCAs), contrast-enhanced ultrasound (CEUS) has become a valuable complementary US technique, with many well-established uses in adults and evolving uses in children. Lung CEUS applications are still not licensed and are performed off-label, although the added value of CEUS in certain clinical scenarios is increasingly reported. The limited evidence of CEUS in the evaluation of pediatric lungs focuses primarily on community-acquired pneumonia and its complications. In this clinical setting, CEUS is used to confidently and accurately diagnose necrotizing pneumonia and to delineate pleural effusions and empyema. In addition to intravenous use, UCAs can be administered directly into the pleural cavity through chest catheters to improve visualization of loculations within a complex pleural effusion, which might necessitate fibrinolytic therapy. The purpose of this paper is to present the current experience on pediatric lung CEUS and to suggest potential additional uses that can be derived from adult studies.
Topics: Adult; Child; Contrast Media; Humans; Lung; Pleural Effusion; Pneumonia; Ultrasonography
PubMed: 33978798
DOI: 10.1007/s00247-020-04914-8 -
Journal of Thoracic Disease Feb 2015The pleural cavity is the potential space between the two pleurae (visceral and parietal) of the lungs. The pleurae are serous membranes which fold back onto themselves... (Review)
Review
The pleural cavity is the potential space between the two pleurae (visceral and parietal) of the lungs. The pleurae are serous membranes which fold back onto themselves to form a two-layered membranous structure. The thin space between the two pleural layers is known as the pleural cavity and normally contains a small amount of pleural fluid. There are two layers; the outer pleura (parietal pleura) is attached to the chest wall and the inner pleura (visceral pleura) covers the lungs and adjoining structures, via blood vessels, bronchi and nerves. The parietal pleurae are highly sensitive to pain, while the visceral pleura are not, due to its lack of sensory innervation. In the current review we will present the anatomy of the pleural space.
PubMed: 25774304
DOI: 10.3978/j.issn.2072-1439.2015.01.48 -
World Journal of Clinical Cases Jun 2022Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones. Pleural involvement in...
Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones. Pleural involvement in cryptococcal infections can manifest with or without pleural effusion. The presence of in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection, which is commonly determined by pleural biopsy, fluid culture, and/or detection of cryptococcal antigen in the pleura or pleural fluid.
PubMed: 35812673
DOI: 10.12998/wjcc.v10.i16.5510 -
Journal of Thoracic Disease Sep 2017A thorough understanding of intrathoracic anatomy enables the interventional bronchoscopist to perform procedures efficaciously. The review of the anatomy of the... (Review)
Review
A thorough understanding of intrathoracic anatomy enables the interventional bronchoscopist to perform procedures efficaciously. The review of the anatomy of the thoracic cavity focuses first on the trachea and the relationship of the airway with surrounding structures, knowledge important for the safe conduct of bronchoscopic procedures. We then describe the anatomy of the pleural cavity relevant to the practitioner performing pleuroscopy.
PubMed: 29214069
DOI: 10.21037/jtd.2017.08.116 -
JAMA Aug 2019
Topics: Chest Tubes; Drainage; Humans; Pleural Cavity; Pleural Diseases
PubMed: 31454047
DOI: 10.1001/jama.2019.8842