Health Observance

World Pneumonia Day 2020

Nicole Lynn
November 12, 2020

Pneumonia is incredibly common. In 2019 alone, 2.5 million lives worldwide were lost to this infectious disease, over half of which were children. On Nov. 12, 2009, a coalition of global health leaders established World Pneumonia Day to raise awareness, promote pharmaceutical intervention, and generate action to combat pneumonia across the globe. Today, the American Society for Biochemistry and Molecular Biology joins in this effort by explaining this illness and the risks it poses. We also highlight new research by scientists working combat it.

What is pneumonia?

Pneumonia is a potentially serious infection affecting one or both lungs, resulting in inflammation and the buildup of pus and/or fluids in the air sacs, known as alveoli, where gas exchange occurs.

Pneumonia manifests as a mild to severe illness, ranging from moderate flulike symptoms to sepsis, respiratory failure and even death. The range of illness often depends on age, cause of infection, and one’s general health at the time of infection.

While an assortment of germs cause pneumonia, Streptococcus pneumoniae, a resident bacteria of the respiratory tract, is the most common form. Among adults, the influenza virus (the flu) is the traditional cause of viral pneumonia, while the respiratory syncytial virus (RSV) is the leading cause of viral pneumonia in children. Similarly, certain soil-dwelling fungi also promote pneumonia in individuals. For the immunocompromised, or those with chronic health conditions, fungal pneumonia is most common.

Lastly, with the onslaught of the recent pandemic, SARS-COV-2 (the virus that causes COVID-19) is also contributing to increasing cases of pneumonia worldwide.

Research highlight: Pneumonia and bacterial signaling

The pathogen S. pneumoniae is the leading cause of bacterial pneumonia. When the immune system is compromised, this pathogen can transmigrate from the sinuses to the lung’s alveolar cells, causing pulmonary infection. In the Journal of Biological Chemistry, Olotu et al. investigated the mechanisms by which S. pneumonia affects cellular integrity. Specifically, this group was interested in the effects of S. pneumoniae on purinergic signaling, a type of cellular communication that is important for maintaining healthy alveolar cells. The results of this study revealed that S. pneumonia directly inhibits this signaling pathway, therefore reducing overall alveolar cellular function and integrity. This study presents exciting and complex host–pathogen interactions that can impact pneumonia progression.

Research highlight: Pneumonia bacteria rely on their hosts

Fatty acids are the building blocks of fat; in bacteria, fatty acids are used to construct their cell membrane (outer coating). A recent study in JBC by Gullett et al. probes the mechanisms by which the bacteria S. pneumoniae responds to external, host-derived fatty acids. This group discovered that S. pneumoniae build their cellular membrane almost exclusively from these external, host-derived fatty acids. For this to occur, S. pneumoniae suppress the genes required for traditional bacterial fatty acid production. This research group also discovered that S. pneumoniae encodes multiple fatty acid–binding proteins, allowing for host-derived fatty acid construction. Two of these fatty acid–binding proteins were highly similar to those observed in a related bacteria Staphylococcus aureus. Insights in this study can inform on novel therapeutic targets for future treatment against S. pneumoniae infection.

Transmission

Pneumonia transmission manifests through multiple means. According to the Centers for Disease Control and Prevention, the spread of pneumonia can occur in a community-acquired or healthcare-associated fashion, meaning transmission can take place outside the hospital (in the community setting) or after time spent in a healthcare facility, respectively.

Patients who undergo ventilation receive oxygen externally through a tube placed either down their nose or mouth or directly into the trachea (windpipe). In the hospital setting, ventilator-associated pneumonia (VAP) can develop when a patient requires mechanical assistance. While this procedure is effective and life-saving, the presence of a foreign device can introduce germs and cause infection. VAP occurs when these germs enter a patient’s lungs through the ventilation equipment, promoting pneumatic infection.

Hospitals combat VAP through enhanced hygiene protocols and reducing the amount of time spent on the ventilator, for example: frequent cleaning of the patient’s mouth, hand washing before and after touching the patient or ventilator tubes and daily checks on the patient’s ability to breathe independently.

Smoking greatly increases a person’s risk of contracting VAP. Good oral and personal hygiene reduce the risk.

Research highlight: Ventilator-associated pneumonia

Bronchioalveolar lavage, or the insertion of an endoscope into the lungs for sample collection, is the predominant method for diagnosing ventilator-associated pneumonia (VAP). Alternatively, endotracheal aspirates are a less invasive, taking samples from the upper respiratory tract (e.g. sinuses and windpipe). In a recent study in the journal Molecular & Cellular Proteomics, Pathak et al. are the first to characterize the proteome and metabolome in endotracheal aspirates from patients diagnosed with VAP. This study revealed samples from patients with VAP contain metabolites indicative of the host response to VAP, in addition to detectable pathogen peptides. The broader impacts of this study include improvements to early diagnostic methods and treatment for those suffering with ventilator-associated pneumonia.

Diagnosis and treatment

The symptoms of pneumonia can vary from mild to severe, therefore initial diagnosis can be difficult. Often, physicians will perform a physical exam, followed by diagnostics such as blood tests or mucus samples to confirm infection and determine the source pathogen.

Another diagnostic tool that physicians use is the chest X-ray; the X-ray provides a picture of your lungs, showing sites of inflammation or fluid buildup. In the hospital setting, patients may also undergo a CT scan, which can give a clearer, in-depth view of the lungs and any potential complications.

Once you are diagnosed with pneumonia, your physician will determine a treatment plan; often, this depends on the infectious agent (bacteria, virus or fungi). In the case of bacterial pneumonia, antibiotics are often prescribed. It is important to note that completing the course of antibiotic medication is vital to recovery; stopping medication early can lead to reinfection or the onset of antibiotic resistance. Viral pneumonia often requires an alternate course of treatment, usually in the form of antiviral medications. Similarly, fungal pneumonia infections are treated with antifungal drugs, of which often require administration over several weeks.

Prevention

Pneumonia can affect people of all ages, but there are simple measures you can take to prevent pneumatic infection, such as keeping your vaccinations up to date. According to the CDC, routine vaccinations can lower your risk for pneumonia by reducing the risk of infection by other pneumonia-causing pathogens.

Currently, two pneumonia-specific vaccines are available in the United States and are recommended for different age groups; these include the pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23).

While vaccines cannot prevent all cases of pneumonia, research demonstrates the pneumococcal vaccines exhibit considerable protection in infants, adults and the elderly against invasive and pneumococcal pneumonia.

Aside from vaccinations, adopting and maintaining a healthy lifestyle can also reduce your risk of contracting pneumonia. Maintaining a healthy diet, exercising and getting an adequate amount of sleep all help to reduce the risk of respiratory illness.

For those living with lung disease, the American Lung Association encourages regular exercise, defined as 30 minutes per day, five days a week, to increase lung strength. Physical activity of this kind also reduces the risk of serious illness, such as lung cancer.

While aerobic exercise is beneficial for muscle and lung strength, relaxing breathing exercises enhance lung capacity and function. For individuals suffering with breathing conditions such as asthma or chronic obstructive pulmonary disease, five to 10 minutes a day of exercises, such as diaphragmatic or pursed-lip breathing, have shown to increase lung capacity and efficiency.

Nicole Lynn

Nicole Lynn is a graduate student at the University of California, Los Angeles, in the chemistry and biochemistry department.

Join the ASBMB Today mailing list

Sign up to get updates on articles, interviews and events.

Latest in Science

Science highlights or most popular articles

Sphingolipids show potential as biomarkers for multiple sclerosis
Journal News

Sphingolipids show potential as biomarkers for multiple sclerosis

December 01, 2020

Maria Podbielska and colleagues at the Hirszfeld Institute write in the Journal of Lipid Research about their finding that ceramide levels vary in active and inactive MS lesions in the nervous system.

World AIDS Day 2020
Health Observance

World AIDS Day 2020

December 01, 2020

Despite decades of research and amazing scientific advancements, HIV remains a global threat.

Will the coronavirus evolve to be less deadly?
News

Will the coronavirus evolve to be less deadly?

November 29, 2020

All pandemics eventually run their course. But history and science suggest many possible pathways. How might COVID-19 end?

Uncovering details of molecular Ferris wheels inside cell structures
News

Uncovering details of molecular Ferris wheels inside cell structures

November 28, 2020

Simulations on the nation’s fastest supercomputer confirm details of a molecular mechanism that cell organelles use to regulate the pH of their environment.

The NIH is turning the human reference genome into a pangenome
News

The NIH is turning the human reference genome into a pangenome

November 26, 2020

In 2000, the human genome was announced as completed. But it was filled with gaps, and did not represent humanity’s genetic diversity. Read and watch a short film about recent updates.

From the journals: MCP
Journal News

From the journals: MCP

November 25, 2020

A destructive disease can lurk in a citrus plant’s vascular system. Misfolded proteins offer a key to inflammation in liver disease. And proteomic studies provide clues about signaling linked to neurological disorders.