Chest radiotherapy to achieve lung volume reduction.

Another comment refers to transepithelial elimination of neutrophils during resolution of NCAP. The interesting proposed hypothesis of inflammatory resolution through egression of leukocytes is very attractive [3]. C.G.A. Persson and L. Uller argue that elimination of leukocytes from the airways with bronchial inflammation (transepithelial egression) is a mode of resolving inflammation. This challenging interpretation is nicely presented in human and animal models in asthma and chronic obstructive pulmonary disease. However in pneumonia, the acute inflammatory response of host against microorganisms is a completely different model of airway inflammation. In pneumonia, innate responses and alveolar macrophages orchestrate the inflammatory response in lung parenchyma, and neutrophils exit the pulmonary circulation at the capillary level, that is, mainly in alveolar air spaces. Obviously, our design was not directed to evaluate the neutrophil migration across the alveolar or epithelial lining, although this topic merits attention.