Pulmonary disorders, including vocal cord dysfunction

The lung is a very complex immunologic organ and responds in a variety of ways to inhaled antigens, organic or inorganic materials, infectious or saprophytic agents, fumes, and irritants. There might be airways obstruction, restriction, neither, or both accompanied by inflammatory destruction of the pulmonary interstitium, alveoli, or bronchioles. This review focuses on diseases organized by their predominant immunologic responses, either innate or acquired. Pulmonary innate immune conditions include transfusion-related acute lung injury, World Trade Center cough, and acute respiratory distress syndrome. Adaptive immunity responses involve the systemic and mucosal immune systems, activated lymphocytes, cytokines, and antibodies that produce CD4+ TH1 phenotypes, such as for tuberculosis or acute forms of hypersensitivity pneumonitis, and CD4+ TH2 phenotypes, such as for asthma, Churg-Strauss syndrome, and allergic bronchopulmonary aspergillosis.