Alcohol and the Adaptive Immune Response in the Airway: Dendritic Cell and Lymphocyte Impairments

Abstract

It is well established that alcoholics have an increased incidence of respiratory diseases. Further, chronic alcoholism predisposes for more severe disease following respiratory infections. While many studies have detailed the increase in disease severity during respiratory infections in alcoholics, much less is understood about the underlying mechanisms through which chronic alcohol consumption mediates this increase in disease severity or how alcohol alters pulmonary adaptive immune responses. It is well accepted that chronic alcohol ingestion is immunosuppressive and exerts inhibitory effects on adaptive immunity. However, these studies have largely focused on examining the immunosuppression of cell-mediated immunity in the spleen, skin, and liver. Importantly, for many pathogens the type of immune response generated in the respiratory and intestinal mucosa is distinct from that generated following intravenous, intraperitoneal, or subcutaneous exposures. Therefore, the type and extent of lesions that exist in the respiratory adaptive immune system of alcoholics and the consequences of these lesions, particularly during infections, remain in question. This chapter highlights and discusses the field’s current knowledge on chronic alcohol-induced lesions within the pulmonary dendritic cell and T cell compartments and the relationship of these lesions to increased respiratory disease.