Chapter 9 : Tissue Responses and Special Topics in Immunity

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This chapter explores the host response to infection, with emphasis on integrating clinical observations with those from animal studies and in vitro observations. The chapter describes the host response to infection for lung, brain, and skin, since these are the organs for which most information is available. The inflammatory response to infection has four unusual features. First, the inflammatory response can range in intensity from florid, intense granulomatous inflammation to the virtual absence of inflammatory cells. The variables responsible for differences in the magnitude and intensity of the inflammatory response include the immune status of the host and poorly defined characteristics of strains. Second, can be found in tissue as both an intracellular pathogen and an extracellular pathogen. Third, the type of inflammatory response is a function, in part, of the organ tissue where the infection occurs. Fourth, there is considerable variation in the type of effector cells found in inflammatory responses. A study compared the inflammatory response to pulmonary infection in CBA/J mice using two strains of , and strongly suggested that some of the differences observed in the human inflammatory response may be the result of unique strain differences in host inflammatory cell recruitment. In summary, the literature strongly supports the view that impairment of cell-mediated immunity is associated with enhanced susceptibility to infection.

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9

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Figure 1

Electron micrograph of -infected mouse lung tissue at day 7 of infection. The photomicrograph shows an area of lung with cryptococci filling the airspace, whereas other fungal cells are found in the intracellular space. Open arrows indicate extracellular cryptococci. Closed arrows indicate intracellular cryptococci. Most intracellular cryptococci are inside alveolar macrophages. The tissue comes from C57BL/6 mice, and the cryptococcal strain is ATCC 24067. For details of experimental infection and microscopy, see references and . Micrograph obtained at a magnification of ×3,000. Figure courtesy of Marta Feldmesser (Bronx, N.Y.).

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9
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Figure 2

Temporal inflammatory changes in three organs following intracisternal infection in rats. Rats given infection thorough the intracisternal route controlled the infection and seldom died ( ). Histopathological sections of rat brain, lung, and spleen tissue on days 7, 15, and 30 after infection with are shown. (A) Brain tissue on day 7 reveals extracellular yeast forms (arrows) within the subarachnoid space. Original magnification, ×540. (B) Lung tissue on day 7 shows cryptococci surrounded by mononuclear cells. Original magnification, ×540. Cryptococci in lung tissue presumably are a result of hematogenous dissemination from brain tissue. (C) Spleen tissue on day 7 reveals no inflammation or cryptococci. Original magnification, ×335. (D) By day 15 the brain infection has changed histopathologically such that there are increased numbers of lymphocytes and macrophages in the subarachnoid space. Original magnification, ×335. (E) In the lung on day 15, inflammation has progressed to granuloma formation. Arrows point to cryptococci within Langerhans giant cells. Original magnification, ×335. (F) Spleen tissue on day 15 reveals discrete granulomas. Original magnification, ×335. (G) By day 30, inflammation has progressed in the subarachnoid space to include a large infiltration of lymphocytes, monocytes, and epithelioid cells. By this time, several layers of lymphocytes coat the pial surface. Original magnification, ×540. (H) In the lung on day 30, the inflammatory response continues with the formation of foamy macrophages. Original magnification, ×540. (I) In spleen tissue on day 30, inflammation is resolving, paralleling the resolution of infection in other organs. The figure, courtesy of David Goldman (Bronx, N.Y.), originally appeared in reference 94 and is reproduced here with permission.

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9
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Table 1

Immunological effects associated with capsule and polysaccharide

Table references are not exhaustive. See text for more detailed discussion of effects. Additional information can be found in chapter 4 of this volume.

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9