Bacterial pneumonia future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz
Overview
Due to increasing antibiotic resistance and emerging organisms, it is important that the approaches to diagnosing pneumonia continue to be developed. Currently, the host factors predisposing one to pneumonia are being studied in detail.[1] These include:
- Host susceptibility
- Host response to infection
- Host consequences
Host susceptibility
Factors that determine host susceptibility include age, genetic factors, exposures, chronic diseases and acute conditions that allow pneumonia to develop.
- Age: increased susceptibility to pneumonia and related mortality is increased at the extremes of age; in pediatric and geriatric populations
- Genetic factors: a few links to gene variants have emerged and studying them further may help determine ways to prevent the occurrence of pneumonia. Through meta-analysis studied, potentially interesting gene variants have been found in NGR1 (P = 6.3 × 10-8), PAK6 (P = 3.3 × 10-7), and near MATN1 (P = 2.8 × 10-7).[2] Variants have also been studied in the FER gene that may reduce sepsis realted death in cases of pneumonia.[3]
- Exposures: cigarette smoke, alcohol abuse and air pollution can greatly exacerbate pneumonia and promote the development of disease
- Chronic diseases: chronic diseases predispose to pneumonia due to structural changes that develop over time. These include COPD, diabetes, cancer and obesity, among others.
- Acute conditions
Host response to infection
Factors that affect host response include a hosts immune resistance and repair mechanisms.
- Immune resistance: Microbes enter the respiratory system and are encountered by epithelial cells, macrophages and dendritic cells. The response provided by these cells can help determine the progression and outcome of the disease. The function of B and T cells, NF-κB and cytokines in preventing pneumonia and contributing to immunity are being further studied.[4][5]
- Repair mechanisms:
Host consequences
Host consequences refer to development of complications and exacerbation of existing chronic conditions.
- Development of complications:
- Exacerbation of existing chronic conditions:
References
- ↑ 1.0 1.1 1.2 1.3 Dela Cruz CS, Wunderink RG, Christiani DC, Cormier SA, Crothers K, Doerschuk CM; et al. (2018). "Future Research Directions in Pneumonia. NHLBI Working Group Report". Am J Respir Crit Care Med. 198 (2): 256–263. doi:10.1164/rccm.201801-0139WS. PMC 6058989. PMID 29546996.
- ↑ Hayden LP, Cho MH, McDonald MN, Crapo JD, Beaty TH, Silverman EK; et al. (2017). "Susceptibility to Childhood Pneumonia: A Genome-Wide Analysis". Am J Respir Cell Mol Biol. 56 (1): 20–28. doi:10.1165/rcmb.2016-0101OC. PMC 5248961. PMID 27508494.
- ↑ Rautanen A, Mills TC, Gordon AC, Hutton P, Steffens M, Nuamah R; et al. (2015). "Genome-wide association study of survival from sepsis due to pneumonia: an observational cohort study". Lancet Respir Med. 3 (1): 53–60. doi:10.1016/S2213-2600(14)70290-5. PMC 4314768. PMID 25533491.
- ↑ Quinton LJ, Walkey AJ, Mizgerd JP (2018). "Integrative Physiology of Pneumonia". Physiol Rev. 98 (3): 1417–1464. doi:10.1152/physrev.00032.2017. PMC 6088146. PMID 29767563.
- ↑ Quinton LJ, Mizgerd JP (2015). "Dynamics of lung defense in pneumonia: resistance, resilience, and remodeling". Annu Rev Physiol. 77: 407–30. doi:10.1146/annurev-physiol-021014-071937. PMC 4366440. PMID 25148693.