ABSTRACT
I. Introduction Although significant progress has been made in our understanding of Pneumocystis pneumonia (PcP), the exact mechanisms of the associated lung injury remain largely undetermined. The lack of a reliable culture system for this organism has hampered the identification and characterization of Pneumocystis-specific gene products that are directly involved in damaging the lung. However, more efficient identification and greater understanding of the Pneumocystis gene products that contribute to lung injury should be facilitated by the ongoing Pneumocystis Genome Project. In addition, there are several good animal models of infection that closely emulate the pathological process observed in humans with PcP. These models have been employed successfully to acquire valuable information about the host-parasite interaction as well as the lung injury and respiratory impairment resulting from that interaction. This chapter discusses important observations made in patients with PcP, as well as direct experimental data obtained from controlled animal studies, that have contributed to relevant discoveries related to the lung injury associated with Pneumocystis pneumonia. Together, these clinical and experimental findings have helped explain the clinical features observed in patients with PcP, and have aided in the clinical treatment of this syndrome.
