Epithelial cells are held together by tight junctions, which effectively form a seal against the external environment. The internal epithelia are known as mucosal epithelia because they secrete a viscous fluid called mucus, which contains many glycoproteins called mucins. Mucus has a number of protective functions. Microorganisms coated in mucus may be prevented from adhering to the epithelium, and in the respiratory tract, microorganisms can be expelled in the outward flow of mucus driven by the beating of cilia on the mucosal epithelium (Fig. 2.7). The importance of mucus flow in clearing infection is illustrated by people with the inherited disease cystic fibrosis, in which the mucus becomes abnormally thick and dehydrated due to defects in a gene, CFTR, encoding a chloride channel in the epithelium. Such individuals frequently develop lung infections caused by bacteria that colonize the epithelial surface but do not cross it (see Fig. 2.7). In the gut, peristalsis is an important mechanism for keeping both food and infectious agents moving through the body. Failure of peristalsis is typically accompanied by the overgrowth of pathogenic bacteria within the lumen of the gut.
Fig. 2.5 Many barriers prevent pathogens from crossing epithelia and colonizing tissues. Surface epithelia provide mechanical, chemical, and microbiological barriers to infection.
Skin Gut Lungs Eyes/nose/oral cavity Mechanical Epithelial cells joined by tight junctions Longitudinal fow of air or fuid Longitudinal fow of air or fuid Normal microbiota Movement of mucus by cilia Fatty acids Low pH Pulmonary surfactant Enzymes (pepsin) Enzymes in tears and saliva (lysozyme) Microbiological Chemical ˜-defensins Lamellar bodies Cathelicidin Histatins ˜-defensins °-defensins Cathelicidin Tears Nasal cilia °-defensins (cryptdins) RegIII (lecticidins) Cathelicidin
Anatomic barriers and initial chemical defenses.
Fig. 2.6 Epithelia form specialized physical and chemical barriers that provide innate defenses in different locations. Top panel: the epidermis has multiple layers of keratinocytes in different stages of differentiation arising from the basal layer of stem cells. Differentiated keratinocytes in the stratum spinosum produce β-defensins and cathelicidins, which are incorporated into secretory organelles called lamellar bodies (yellow) and secreted into the intercellular space to form a waterproof lipid layer (the stratum corneum) containing antimicrobial activity. Center panel: in the lung, the airways are lined by ciliated epithelium. Beating of the cilia moves a continuous stream of mucus (green) secreted by goblet cells outward, trapping and ejecting potential pathogens. Type II pneumocytes in the lung alveoli (not shown) also produce and secrete antimicrobial defensins. Bottom panel: in the intestine, Paneth cells—specialized cells deep in the epithelial crypts— produce several kinds of antimicrobial proteins: α-defensins (cryptdins) and the antimicrobial lectin RegIII.
Most healthy epithelial surfaces are also associated with a large population of normally nonpathogenic bacteria, known as commensal bacteria or the microbiota, that help keep pathogens at bay. The microbiota can also make antimicrobial substances, such as the lactic acid produced by vaginal lactobacilli, some strains of which also produce antimicrobial peptides (bacteriocins). Commensal microorganisms also induce responses that help to strengthen the barrier functions of epithelia by stimulating the epithelial cells to produce
Lung of patient with cystic fbrosis Ciliated respiratory epithelium is covered by a layer of mucus Mucus Cilia Epithelium