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Pneumologie 2002; 56(10): 621-630
DOI: 10.1055/s-2002-34611
Serie: Seltene Lungenerkrankungen (3)
© Georg Thieme Verlag Stuttgart · New York

Idiopathische eosinophile Pneumonien

Idiopathic Eosinophilic PneumoniasD.  Kirsten1
  • 1Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Großhansdorf
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Publikationsverlauf

Publikationsdatum:
09. Oktober 2002 (online)

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Einleitung

Innerhalb der interstitiellen Lungenerkrankungen stellen die idiopathischen eosinophilen Pneumonien Entitäten dar, deren diagnostisches Hauptmerkmal die Vermehrung eosinophiler Granulozyten ist.

In einer Reihe entzündlicher, parasitärer und auch neoplastischer Prozesse wird jeweils eine Vermehrung dieser Zellelemente beobachtet. Wie die eosinophilen Zellen in den jeweils pathogenetischen Prozess einbezogen sind, ob fördernd oder bremsend, ist bislang weitgehend unbekannt.

Auch der eosinophile Granulozyt (so genannt wegen seiner eosinophil anzufärbenden Granula) ist von den Knochenmarkstammzellen abgeleitet. Er besitzt zwei Arten von Granula. In den größeren Granula ist unter anderem das kationische Protein enthalten. Die schmaleren Granula sind von amorpher Natur und enthalten Sulfatasen und Phosphatasen [11]. Unter dem Einfluss von Interleukin-5 und Wachstumsfaktoren gelangt der Eosinophile in die Blutbahn, um sie 24 Stunden später in Richtung Gewebe wieder zu verlassen. Die eosinophilen Zellen prozessieren inflammatorische Mediatoren [46] [60] und enzymatische Proteine und geben sie in das umgebende Gewebe ab [9]. Dabei kommt es unter Einfluss der T-Helferzellen zu Interaktionen mit Mastzellen, Makrophagen, Thrombozyten, Fibroblasten und auch Endothelzellen (Abb. [1]).

Abb. 1 Elektronenmikroskopische Aufnahme eines eosinophilen Granulozyts von Prof. Dr. K. F. Rabe, Leiden/NL freundlicherweise zur Verfügung gestellt.

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Bereits publizierte Beiträge zu dieser Serie:

  1. Pulmonale Lymphangioleiomyomatose. Pneumologie 2002; 56: 309 - 315

  2. Alveolarproteinose. Pneumologie. 2002; 56: 448 - 456

Prof. Dr. med. D. Kirsten

Krankenhaus Großhansdorf · Zentrum für Pneumologie und Thoraxchirurgie

Wöhrendamm 80

22927 Großhansdorf