Lymphoid Interstitial Pneumonia

Swigris, Jeffrey J.; Berry, Gerald J.; Raffin, Thomas A.; Kuschner, Ware G.

doi:10.1378/chest.122.6.2150

Cited by 278 publications

(263 citation statements)

References 92 publications

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“…In more progressed stages, prominent perivascular and peribronchial lymphoid follicles, consisting of central T cells with peripheral B cells, are present; these cells and patterns are also found in SPC-HA3CL4 mice. The mouse model also shares with LIP the features of compression of the airways by hyperplastic lymphoid tissue, which leads to reduced ventilation capacity and impaired lung function, and lymphocytosis in BALF (9,10). In this context, the basic mechanisms underlying maintenance and loss of self-tolerance will be of prime interest because it remains largely unclear why ∼50% of LIP patients experience a favorable outcome with stabilization or resolution of lung lesions, whereas in other patients the disease progresses inexorably and takes a lethal course within 5 y of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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CD4+CD25+Foxp3+ Regulatory T Cells Are Dispensable for Controlling CD8+ T Cell-Mediated Lung Inflammation

Tosiek

Gruber

Bader

et al. 2011

The Journal of Immunology

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Every person harbors a population of potentially self-reactive lymphocytes controlled by tightly balanced tolerance mechanisms. Failures in this balance evoke immune activation and autoimmunity. In this study, we investigated the contribution of self-reactive CD8+ T lymphocytes to chronic pulmonary inflammation and a possible role for naturally occurring CD4+CD25+Foxp3+ regulatory T cells (nTregs) in counterbalancing this process. Using a transgenic murine model for autoimmune-mediated lung disease, we demonstrated that despite pulmonary inflammation, lung-specific CD8+ T cells can reside quiescently in close proximity to self-antigen. Whereas self-reactive CD8+ T cells in the inflamed lung and lung-draining lymph nodes downregulated the expression of effector molecules, those located in the spleen appeared to be partly Ag-experienced and displayed a memory-like phenotype. Because ex vivo-reisolated self-reactive CD8+ T cells were very well capable of responding to the Ag in vitro, we investigated a possible contribution of nTregs to the immune control over autoaggressive CD8+ T cells in the lung. Notably, CD8+ T cell tolerance established in the lung depends only partially on the function of nTregs, because self-reactive CD8+ T cells underwent only biased activation and did not acquire effector function after nTreg depletion. However, although transient ablation of nTregs did not expand the population of self-reactive CD8+ T cells or exacerbate the disease, it provoked rapid accumulation of activated CD103+CD62Llo Tregs in bronchial lymph nodes, a finding suggesting an adaptive phenotypic switch in the nTreg population that acts in concert with other yet-undefined mechanisms to prevent the detrimental activation of self-reactive CD8+ T cells.

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Section: Discussionmentioning

confidence: 99%

“…Of note, LIP develops in, on average, 50% of HIV-positive children. In adults, LIP is postulated to be of autoimmune origin; in children, it may be of an indirect viral cause (9,10). However, the pathogenesis of LIP remains poorly understood and requires further study.…”

mentioning

confidence: 99%

CD4+CD25+Foxp3+ Regulatory T Cells Are Dispensable for Controlling CD8+ T Cell-Mediated Lung Inflammation

Tosiek

Gruber

Bader

et al. 2011

The Journal of Immunology

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“…1 LiP is characterized by a diffuse lymphocytic infiltrate with lymphoid hyperplasia around the enlarging airways. this may range from small benign lymphoid aggregates to high degree lymphoma in 5% of cases.…”

Section: Introductionmentioning

confidence: 99%

“…this may range from small benign lymphoid aggregates to high degree lymphoma in 5% of cases. [1][2][3] Death results in approximately 33% to 50% of patients in nearly five years after the diagnosis. 2 Acute cor pulmonale is a clinical syndrome characterized by signs of right heart failure (right ventricular hypertrophy) of sudden onset and results from the abrupt increase of pulmonary vascular resistance due to diseases that affect the function and/or the structure of the lung, of which pulmonary embolism is the most common cause.…”

Section: Introductionmentioning

confidence: 99%

“…LiP is very common in children with AiDs and in women with sjögren's syndrome, an autoimmune disease. [1][2][3]8 the commonly affected age-group is children over two years. the common findings are digital clubbing, enlarged parotids, lymphadenopathy, hepatosplenomegaly, and chronic radiographic changes of diffuse infiltrate type with hypoxia and hypergammaglobulinemia.…”

Section: Introductionmentioning

confidence: 99%

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Acute cor pulmonale due to lymphocytic interstitial pneumonia in a child with AIDS

Moreira-Silva¹,

Moreno²,

Dazzi³

et al. 2012

Braz J Infect Dis

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Case presentation: A five-year-old male, infected by human immunodeficiency virus (HiV), was admitted at the division of infectious diseases of this hospital with cough, tachydyspnea, fever, and breathing difficulty. computed tomography scan showed ground-glass opacities, cystic lesions, and bronchiectasis. the patient had nasal flaring, intercostal and subcostal retractions, and keeled chest. Abdomen was depressible; liver was 3 cm from the right-costal border, while spleen was 6 cm from the left-costal border.Echocardiogram examinations showed signs of acute cor pulmonale characterized by pulmonary hypertension and increased right-heart chamber dimensions.Diagnostics outcome: Acquired immunodeficiency syndrome (AiDs)-b3, lymphocytic interstitial pneumonia (LiP), and acute cor pulmonale. regressions of pulmonary hypertension and of right-heart chamber were observed after 30 days of highly active antiretroviral therapy (HAArt) and chloroquine therapy. Conclusion:AiDs should be considered in children with recurrent pneumonia that is mostly associated with LiP rather than cystic fibrosis.

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An unusual case of persistent consolidation: Idiopathic lymphoid interstitial pneumonia

Caterson,

Kim,

Zaborowski

et al. 2024

Respirology Case Reports

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Lymphocytic interstitial pneumonia (LIP) is a rare but largely benign interstitial lung disease, most frequently associated with HIV and autoimmune conditions. It is infrequently found to be an idiopathic condition. Diagnosis is complex and can require numerous invasive tests as evidenced in the case presented. The diagnosis is made from a combination of clinical, radiological, and histological features but the unusual radiological and clinical features meant diagnosis in our case required surgical biopsy. There is minimal evidence around best treatment although largely involves targeting the underlying cause. There is a small risk of transformation to lymphoma and fibrosis. Immunosuppression with steroids is the most common therapeutic strategy however in our case the radiographic changes spontaneously resolved. We present a case of an immunocompetent male presenting with significant radiological and histopathological findings of LIP, without significant symptomatology, that spontaneously resolved without intervention suggesting a monitoring approach may be a valid management strategy.

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Lymphoid Interstitial Pneumonia

Cited by 278 publications

References 92 publications

CD4+CD25+Foxp3+ Regulatory T Cells Are Dispensable for Controlling CD8+ T Cell-Mediated Lung Inflammation

CD4+CD25+Foxp3+ Regulatory T Cells Are Dispensable for Controlling CD8+ T Cell-Mediated Lung Inflammation

Acute cor pulmonale due to lymphocytic interstitial pneumonia in a child with AIDS

An unusual case of persistent consolidation: Idiopathic lymphoid interstitial pneumonia

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