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Micrograph showing hemosiderin-laden alveolar macrophages, as seen in a pulmonary hemorrhage. H&E stain. An alveolar macrophage, pulmonary macrophage, (or dust cell) is a type of macrophage, a professional phagocyte, found in the airways and at the level of the alveoli in the lungs, but separated from their walls. [1]
[2] [9] Lipid-laden alveolar macrophages have been reported in cases of vaping-associated pulmonary injury. [10] [1] [11] The lipid-laden macrophage index (LLMI) can be calculated by counting 100 macrophages in a BAL specimen treated with a lipid stain and scoring each macrophage from 0 to 4 based on the amount of lipids present in the cell.
The cells are primarily monocytes and macrophages, and they accumulate in lymph nodes and the spleen. The Kupffer cells of the liver and tissue histiocytes are also part of the MPS. The mononuclear phagocyte system and the monocyte macrophage system refer to two different entities, often mistakenly understood as one.
CCL20 is produced by mucosa and skin by activated epithelial cells and attracts Th17 cells to the site of inflammation. It is also produced by Th17 cells themselves. [14] It further attracts activated B cells, memory T cells and immature dendritic cells and has part in migration of these cells in secondary lymphoid organs.
The short-term exposure attracts macrophages and neutrophils to the lung with a 4-fold increase in cellularity. [ 4 ] [ 2 ] Short duration also biases polarization towards M1 phenotype. The number of immune cells however will be normalized in 6 months, demonstrating the shift in signaling direction.
A siderophage is a hemosiderin-containing macrophage. Heart failure cells are siderophages generated in the alveoli of the lungs of people with left heart failure or chronic pulmonary edema, when the high pulmonary blood pressure causes red blood cells to pass through the vascular wall. [1] Siderophages are not specific of heart failure.
Mucociliary clearance (MCC), mucociliary transport, or the mucociliary escalator describes the self-clearing mechanism of the airways in the respiratory system. [1] It is one of the two protective processes for the lungs in removing inhaled particles including pathogens before they can reach the delicate tissue of the lungs.
Pulmonary surfactant thus greatly reduces surface tension, increasing compliance allowing the lung to inflate much more easily, thereby reducing the work of breathing. It reduces the pressure difference needed to allow the lung to inflate. The lung's compliance, and ventilation decrease when lung tissue becomes diseased and fibrotic. [3]