Role of innate immune cells and their products in lung immunopathology

The lung, with its enormous surface area, is literally ‘bathed in a sea’ of potential toxins that include pathogenic microorganisms, allergens, and pollutants. To preserve homeostasis and protect itself from injury, the lung has evolved intricate defense systems that guard it from these injurious agents. This chapter will focus on the innate component of the immune system that represents the first line of defense against microbial pathogens and pollutants. The innate immune system of the lung is diverse and includes structural cells such as epithelial cells and fibroblasts as well as itinerant leukocytes such as neutrophils, monocytes, and macrophages. Dendritic cells and mast cells, although of hematopoietic origin, are resident in the lung and help sense and orchestrate immune responses in the lung. Cells of the innate immune system secrete various soluble factors that are directly or indirectly microbicidal and/or modulate the inflammatory response. Among these soluble factors, proteinases and anti-proteinases factor prominently and exert both physiological and pathological effects on the function of diverse cell types in the lung. In concert with the adaptive immune system, the innate immune system of the lung is highly effective in combating invading microbial pathogens as evidenced by the rarity with which healthy humans succumb to lung infections.