Fig. 1
![Principal interactions between Pneumocystis jirovecii and the respiratory tract epithelium and immune cells. DC, Dendritic cells; B-glR, β-glucan receptors; GpA, Major surface glycoprotein; IFN-gamma, interferon gamma; IL-6, interleukin 6; IL-8, interleukin 8; MCP-1, Monocyte chemoattractant protein 1; MIP -2, macrophage inflammatory protein 2; MMP-9, Matrix metalloproteinase 9; MR , Mannose receptor; NO, Nitric oxide; NF-κB, Nuclear factor kappa-light-chain-enhancer of activated B cells; ROS, Reactive oxygen species; SP-B and SP-C, Surfactant proteins B and C; TLR, toll-like receptor; TNF-alpha, tumor necrosis factor alpha. Adapted from [21].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/64721cdb215d2f6c89dbc688/j_devperiodmed.20192303.159162_fig_001.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKJXHWN4HG%2F20260109%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20260109T160618Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjENr%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaDGV1LWNlbnRyYWwtMSJHMEUCICNA63LAux2nTrico2UrC7cFigYzk34pZf7C1yw3s4YwAiEA2kZykrHv%2Bj1bSapiN168sVYD3uy%2BC4n3lQ5Zi7A9VLkqxgUIo%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FARACGgw5NjMxMzQyODk5NDAiDOcgTVvv5b8arQRiICqaBf9C3V5m6PcyH4aCgUoKp0CxJf7uBF2VvzPwnI9u9JHXJ%2Brfb%2BkKUtXIorFRHvW6DrcjKx8%2BTwH4e%2F6B6%2FGOEcuyx5VFUalxQo5ej%2BUJcnA82tB8Ubl1UejLKd%2F0c0q6IcHqYbDSrtuVHHYIEbJ5MBD6KRLKGy%2BfuZcZda5GpBLR80TPuNajBT2PFGDsaV24c9bgdKmqHrV7U0OWZPwv7ko2Le0GlfFPQYtODEAHcp9JDe38mHMD7yzcximTgsN0%2FDekyMo2SbHK4oQrEKLS8A6VWouTPJKIw4gVAebqqmsreQkGNccHzlShZqQpXTj1faG1DGK2PnPtt%2BLK%2FiYtVC8qNN%2FjNHVgigFFGIYrn6KFAdSISE7f26V4mh3LrTDilEaOdjexr5aPZHTQLgP5Lf79jRDGLnRoKt3ZO%2BkQ9nnBT1ptwUM49arJXw1wbH7K86EuaT1vUVW9KwrrX9DR1d6KjQ7qqt%2B8uWGy3rIa42kiO%2F6oklXs0tMF0RdSr6nldrjefKSxTLEczVrZ7xH5g5OYln9hLAUsPdTUWL4qLJ5mvUoZFRP739mRp2rCU5eG8NfZUsIEYbXNHVC%2BqZaNlyP%2Bt%2F30%2BN5Oz%2BMGrJgTbbz24ZhlU%2BkpcOJacdnFGHJO20qWjjUGI0WQsw1kdVHcEnuWIhGZlp%2F5A%2B9Km8Gc2kyyUv2GCIUX7svWxC0Rd1BVuqsgFG0zwdpz5OOnO7NUZUy59Bq9Iab0419fMVsAhhIuOqMKyhLv8NsCdMtS6cG%2B0crYKAJT0RBWMXUcmXXczljQJv9Umxkf9QB%2BAjN3hJtk3ovfD6OxV4Tkg8LpinZ907Vh%2BXuV8LZwlVO18zohrrhBO1Fk7L5lnnwy9kHVMrcsKzb5Rn1aSTSchjD7o4PLBjqxAUVRAovbqmTFggAsDyfrTdNmb0ntif5KuEgMAyvajn%2BTT1t2CL75Xrj9MiQv%2BmGH6NoPW88sRguDPPsoAoOzYdrxMeChoohDSLD9tusGh8z3i3YyZeEEfr8NZAgF78VwUqtt0hMKNcgZGa%2Fu%2FKePUFM5aPoT2hNllqPiDocCaKY6OnzMcvV455B%2FlqYmGlwUPzAshv1ZPZ3nkuXHfgoNkZUyh4BmowkRaq7VF20Hp9bXlw%3D%3D&X-Amz-Signature=e4279b31447b33e865b4be63fda330ff4fcdd9836b7abc2eaffe160fc626de49&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Grading of clinical symptoms in Pneumocystis pneumonia_
| Disease Exacerbation | |||
|---|---|---|---|
| Clinical feature | Mild | Moderate | Severe |
| Dyspnea | On exertion | On minimal exertion/possibly at rest | At rest |
| Oxygen saturation | SaO2 > 96% | SaO2 of 91–96% | SaO2 < 91% |
| Radiologic findings | Minimal changes on CXR | Diffuse interstitial changes on CXR | Extensive interstitial changes on CXR |
| Other | --- | Fever possible | Tachypnoea at rest, fever, cough |