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Bácsi A, Ágics B, Pázmándi K, Kocsis B, Sándor V, Bertók L, Bruckner G, Sipka S. Radiation-Detoxified Form of Endotoxin Effectively Activates Th 1 Responses and Attenuates Ragweed-Induced Th 2-Type Airway Inflammation in Mice. Int J Mol Sci 2024; 25:1581. [PMID: 38338861 PMCID: PMC10855154 DOI: 10.3390/ijms25031581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Urbanization with reduced microbial exposure is associated with an increased burden of asthma and atopic symptoms. Conversely, environmental exposure to endotoxins in childhood can protect against the development of allergies. Our study aimed to investigate whether the renaturation of the indoor environment with aerosolized radiation-detoxified lipopolysaccharide (RD-LPS) has a preventative effect against the development of ragweed-induced Th2-type airway inflammation. To explore this, cages of six-week-old BALB/c mice were treated daily with aerosolized native LPS (N-LPS) or RD-LPS. After a 10-week treatment period, mice were sensitized and challenged with ragweed pollen extract, and inflammatory cell infiltration into the airways was observed. As dendritic cells (DCs) play a crucial role in the polarization of T-cell responses, in our in vitro experiments, the effects of N-LPS and RD-LPS were compared on human monocyte-derived DCs (moDCs). Mice in RD-LPS-rich milieu developed significantly less allergic airway inflammation than mice in N-LPS-rich or common environments. The results of our in vitro experiments demonstrate that RD-LPS-exposed moDCs have a higher Th1-polarizing capacity than moDCs exposed to N-LPS. Consequently, we suppose that the aerosolized, non-toxic RD-LPS applied in early life for the renaturation of urban indoors may be suitable for the prevention of Th2-mediated allergies in childhood.
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Affiliation(s)
- Attila Bácsi
- Department of Immunology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.B.); (B.Á.); (K.P.)
| | - Beatrix Ágics
- Department of Immunology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.B.); (B.Á.); (K.P.)
- Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, H-4032 Debrecen, Hungary
| | - Kitti Pázmándi
- Department of Immunology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (A.B.); (B.Á.); (K.P.)
| | - Béla Kocsis
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, H-7624 Pécs, Hungary;
| | - Viktor Sándor
- Institute of Bioanalysis, Medical School and Szentágothai Research Center, University of Pécs, H-7624 Pécs, Hungary;
| | - Lóránd Bertók
- National Research Directorate for Radiobiology and Radiohygiene, National Public Health Center, H-1221 Budapest, Hungary
| | - Geza Bruckner
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA;
| | - Sándor Sipka
- Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
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2
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Ulrich BJ, Kharwadkar R, Chu M, Pajulas A, Muralidharan C, Koh B, Fu Y, Gao H, Hayes TA, Zhou HM, Goplen NP, Nelson AS, Liu Y, Linnemann AK, Turner MJ, Licona-Limón P, Flavell RA, Sun J, Kaplan MH. Allergic airway recall responses require IL-9 from resident memory CD4 + T cells. Sci Immunol 2022; 7:eabg9296. [PMID: 35302861 PMCID: PMC9295820 DOI: 10.1126/sciimmunol.abg9296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Asthma is a chronic inflammatory lung disease with intermittent flares predominately mediated through memory T cells. Yet, the identity of long-term memory cells that mediate allergic recall responses is not well defined. In this report, using a mouse model of chronic allergen exposure followed by an allergen-free rest period, we characterized a subpopulation of CD4+ T cells that secreted IL-9 as an obligate effector cytokine. IL-9-secreting cells had a resident memory T cell phenotype, and blocking IL-9 during a recall challenge or deleting IL-9 from T cells significantly diminished airway inflammation and airway hyperreactivity. T cells secreted IL-9 in an allergen recall-specific manner, and secretion was amplified by IL-33. Using scRNA-seq and scATAC-seq, we defined the cellular identity of a distinct population of T cells with a proallergic cytokine pattern. Thus, in a recall model of allergic airway inflammation, IL-9 secretion from a multicytokine-producing CD4+ T cell population was required for an allergen recall response.
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Affiliation(s)
- Benjamin J Ulrich
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Rakshin Kharwadkar
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Michelle Chu
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Abigail Pajulas
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Charanya Muralidharan
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Byunghee Koh
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Pediatrics and Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Yongyao Fu
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Hongyu Gao
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Tristan A Hayes
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Pediatrics and Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Hong-Ming Zhou
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA
| | - Nick P Goplen
- Thoracic Diseases Research Unit, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Department of Immunology, Mayo Clinic College of Medicine and Science, Rochester, Rochester, MN 55902, USA
| | - Andrew S Nelson
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Pediatrics and Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Amelia K Linnemann
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Pediatrics and Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Matthew J Turner
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA
| | - Paula Licona-Limón
- Departamento de Biologia Celular y del Desarrollo, Instituto de Fisiologia Celular, Universidad Nacional Autónoma de México, Mexico City 04020, Mexico
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06510, USA
- Howard Hughes Medical Institute, Yale University, New Haven, CT 06510, USA
| | - Jie Sun
- Thoracic Diseases Research Unit, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Department of Immunology, Mayo Clinic College of Medicine and Science, Rochester, Rochester, MN 55902, USA
| | - Mark H Kaplan
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Pediatrics and Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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3
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Veerapandian R, Snyder JD, Samarasinghe AE. Influenza in Asthmatics: For Better or for Worse? Front Immunol 2018; 9:1843. [PMID: 30147697 PMCID: PMC6095982 DOI: 10.3389/fimmu.2018.01843] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/26/2018] [Indexed: 12/17/2022] Open
Abstract
Asthma and influenza are two pathologic conditions of the respiratory tract that affect millions worldwide. Influenza virus of the 2009 pandemic was highly transmissible and caused severe respiratory disease in young and middle-aged individuals. Asthma was discovered to be an underlying co-morbidity that led to hospitalizations during this influenza pandemic albeit with less severe outcomes. However, animal studies that investigated the relationship between allergic inflammation and pandemic (p)H1N1 infection, showed that while characteristics of allergic airways disease were exacerbated by this virus, governing immune responses that cause exacerbations may actually protect the host from severe outcomes associated with influenza. To better understand the relationship between asthma and severe influenza during the last pandemic, we conducted a systematic literature review of reports on hospitalized patients with asthma as a co-morbid condition during the pH1N1 season. Herein, we report that numerous other underlying conditions, such as cardiovascular, neurologic, and metabolic diseases may have been underplayed as major drivers of severe influenza during the 2009 pandemic. This review synopses, (1) asthma and influenza independently, (2) epidemiologic data surrounding asthma during the 2009 influenza pandemic, and (3) recent advances in our understanding of allergic host–pathogen interactions in the context of allergic airways disease and influenza in mouse models. Our goal is to showcase possible immunological benefits of allergic airways inflammation as countermeasures for influenza virus infections as a learning tool to discover novel pathways that can enhance our ability to hinder influenza virus replication and host pathology induced thereof.
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Affiliation(s)
- Raja Veerapandian
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Children's Foundation Research Institute, University of Tennessee Health Science Center, Memphis, TN, United States
| | - John D Snyder
- Children's Foundation Research Institute, University of Tennessee Health Science Center, Memphis, TN, United States.,College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Amali E Samarasinghe
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Children's Foundation Research Institute, University of Tennessee Health Science Center, Memphis, TN, United States
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4
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Gaillard EA, McNamara PS, Murray CS, Pavord ID, Shields MD. Blood eosinophils as a marker of likely corticosteroid response in children with preschool wheeze: time for an eosinophil guided clinical trial? Clin Exp Allergy 2016; 45:1384-95. [PMID: 25809678 DOI: 10.1111/cea.12535] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Childhood wheezing is common particularly in children under the age of 6 years and in this age group is generally referred to as preschool wheezing. Particular diagnostic and treatment uncertainties exist in these young children due to the difficulty in obtaining objective evidence of reversible airways narrowing and inflammation. A diagnosis of asthma depends on the presence of relevant clinical signs and symptoms and the demonstration of reversible airways narrowing on lung function testing, which is difficult to perform in young children. Few treatments are available and inhaled corticosteroids are the recommended preventer treatment in most international asthma guidelines. There is, however, considerable controversy about its effectiveness in children with preschool wheeze and a corticosteroid responder phenotype has not been established. These diagnostic and treatment uncertainties in conjunction with the knowledge of corticosteroid side effects, in particular the reduction of growth velocity, have resulted in a variable approach to inhaled corticosteroid prescribing by medical practitioners and a reluctance in carers to regularly administer the treatment. Identifying children who are likely responders to corticosteroid therapy would be a major benefit in the management of this condition. Eosinophils have emerged as a promising biomarker of corticosteroid responsive airways disease, and evaluation of this biomarker in sputum has successfully been employed to direct management in adults with asthma. Obtaining sputum from young children is time consuming and difficult, and it is hard to justify more invasive procedures such as a bronchoscopy in young children routinely. Recently, in children, interest has shifted to assessing the value of less invasive biomarkers of likely corticosteroid response and the biomarker 'blood eosinophils' has emerged as an attractive candidate. The aim of this review was to summarize the evidence for blood eosinophils as a predictive biomarker for corticosteroid responsive disease with a particular focus on the difficult area of preschool wheeze.
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Affiliation(s)
- E A Gaillard
- Department of Infection Immunity and Inflammation, NIHR Leicester Respiratory Biomedical Research Unit, Institute for Lung Health, University of Leicester, Leicester, Leicestershire, UK
| | - P S McNamara
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Alder Hey Children's Hospital, Liverpool, Merseyside, UK
| | - C S Murray
- Respiratory and Allergy Centre, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - I D Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - M D Shields
- Centre for Infection and Immunity, Health Sciences, Queen's University Belfast, Belfast, UK
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5
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Bharadwaj AS, Bewtra AK, Agrawal DK. Dendritic cells in allergic airway inflammation. Can J Physiol Pharmacol 2007; 85:686-99. [PMID: 17823633 DOI: 10.1139/y07-062] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dendritic cells (DCs) are primary antigen-presenting cells involved in interactions with T cells leading to the proliferation of TH1 or TH2 cell types. In asthma, predominance of TH2 cells appears to be responsible for disease pathogenesis. Differentiation of TH2 cells is driven by a variety of factors such as the expression of high levels of costimulatory molecules, the cytokine profile, and the subset of DCs. Many inflammatory cells involved in the pathogenesis of asthma either directly or indirectly modulate DC function. Traditional treatments for asthma decrease the number of airway DCs in animals as well as in patients with asthma. Immunomodulators including interleukin (IL)-10, transforming growth factor (TGF)-beta, cytosine-phosphate-guanosine-containing oligodeoxynucleotides (CpG-ODN), 1alpha,25-dihydroxyvitamin D3, and fetal liver tyrosine kinase 3 ligand (Flt3L) are involved in the modulation of the function of DCs. Based on the critical review of the interaction between DCs and other inflammatory cells, we propose that activation of T cells by DCs and sensitization to inhaled allergen and resulting airway inflammation are dependent on plasmacytoid and myeloid subset of lung DCs to induce an immune response or tolerance and are tightly regulated by T-regulatory cells. Effects of various therapeutic agents to modulate the function of lung myeloid DCs have been discussed.
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Affiliation(s)
- Arpita S Bharadwaj
- Department of Medical Microbiology, Creighton University School of Medicine, CRISS II, Room 510, California Plaza, Omaha, NE 68178, USA
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6
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Dharajiya N, Choudhury BK, Bacsi A, Boldogh I, Alam R, Sur S. Inhibiting pollen reduced nicotinamide adenine dinucleotide phosphate oxidase-induced signal by intrapulmonary administration of antioxidants blocks allergic airway inflammation. J Allergy Clin Immunol 2007; 119:646-53. [PMID: 17336614 PMCID: PMC3042252 DOI: 10.1016/j.jaci.2006.11.634] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2006] [Revised: 10/26/2006] [Accepted: 11/01/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND Ragweed extract (RWE) contains NADPH oxidases that induce oxidative stress in the airways independent of adaptive immunity (signal 1) and augment antigen (signal 2)-induced allergic airway inflammation. OBJECTIVE To test whether inhibiting signal 1 by administering antioxidants inhibits allergic airway inflammation in mice. METHODS The ability of ascorbic acid (AA), N-acetyl cystenine (NAC), and tocopherol to scavenge pollen NADPH oxidase-generated reactive oxygen species (ROS) was measured. These antioxidants were administered locally to inhibit signal 1 in the airways of RWE-sensitized mice. Recruitment of inflammatory cells, mucin production, calcium-activated chloride channel 3, IL-4, and IL-13 mRNA expression was quantified in the lungs. RESULTS Antioxidants inhibited ROS generation by pollen NADPH oxidases and intracellular ROS generation in cultured epithelial cells. AA in combination with NAC or Tocopherol decreased RWE-induced ROS levels in cultured bronchial epithelial cells. Coadministration of antioxidants with RWE challenge inhibited 4-hydroxynonenal adduct formation, upregulation of Clca3 and IL-4 in lungs, mucin production, recruitment of eosinophils, and total inflammatory cells into the airways. Administration of antioxidants with a second RWE challenge also inhibited airway inflammation. However, administration of AA+NAC 4 or 24 hours after RWE challenge failed to inhibit allergic inflammation. CONCLUSION Signal 1 plays a proinflammatory role during repeated exposure to pollen extract. We propose that inhibiting signal 1 by increasing antioxidant potential in the airways may be a novel therapeutic strategy to attenuate pollen-induced allergic airway inflammation. CLINICAL IMPLICATIONS Administration of antioxidants in the airways may constitute a novel therapeutic strategy to prevent pollen induced allergic airway inflammation.
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Affiliation(s)
- Nilesh Dharajiya
- National Heart, Lung, and Blood Institute Proteomics Center at the University of Texas Medical Branch, Division of Allergy and Immunology, Department of Internal Medicine, Denver
| | - Barun K. Choudhury
- National Heart, Lung, and Blood Institute Proteomics Center at the University of Texas Medical Branch, Division of Allergy and Immunology, Department of Internal Medicine, Denver
| | - Attila Bacsi
- Institute of Immunology, University of Debrecen, Denver
| | - Istvan Boldogh
- Department of Microbiology and Immunology, University of Texas Medical Branch, Denver
| | - Rafeul Alam
- National Jewish Medical and Research Center, Denver
| | - Sanjiv Sur
- National Heart, Lung, and Blood Institute Proteomics Center at the University of Texas Medical Branch, Division of Allergy and Immunology, Department of Internal Medicine, Denver
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7
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Boldogh I, Bacsi A, Choudhury BK, Dharajiya N, Alam R, Hazra TK, Mitra S, Goldblum RM, Sur S. ROS generated by pollen NADPH oxidase provide a signal that augments antigen-induced allergic airway inflammation. J Clin Invest 2005; 115:2169-79. [PMID: 16075057 PMCID: PMC1180538 DOI: 10.1172/jci24422] [Citation(s) in RCA: 282] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2005] [Accepted: 05/10/2005] [Indexed: 01/14/2023] Open
Abstract
Pollen exposure induces allergic airway inflammation in sensitized subjects. The role of antigenic pollen proteins in the induction of allergic airway inflammation is well characterized, but the contribution of other constituents in pollen grains to this process is unknown. Here we show that pollen grains and their extracts contain intrinsic NADPH oxidases. The pollen NADPH oxidases rapidly increased the levels of ROS in lung epithelium as well as the amount of oxidized glutathione (GSSG) and 4-hydroxynonenal (4-HNE) in airway-lining fluid. These oxidases, as well as products of oxidative stress (such as GSSG and 4-HNE) generated by these enzymes, induced neutrophil recruitment to the airways independent of the adaptive immune response. Removal of pollen NADPH oxidase activity from the challenge material reduced antigen-induced allergic airway inflammation, the number of mucin-containing cells in airway epithelium, and antigen-specific IgE levels in sensitized mice. Furthermore, challenge with Amb a 1, the major antigen in ragweed pollen extract that does not possess NADPH oxidase activity, induced low-grade allergic airway inflammation. Addition of GSSG or 4-HNE to Amb a 1 challenge material boosted allergic airway inflammation. We propose that oxidative stress generated by pollen NADPH oxidases (signal 1) augments allergic airway inflammation induced by pollen antigen (signal 2).
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Affiliation(s)
- Istvan Boldogh
- Department of Microbiology and Immunology, University of Texas Medical Branch (UTMB), Galveston, Texas 77555, USA
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8
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Ferreira MAR. Cytokine expression in allergic inflammation: systematic review of in vivo challenge studies. Mediators Inflamm 2004; 12:259-67. [PMID: 14760932 PMCID: PMC1781628 DOI: 10.1080/09629350310001619717] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Allergic inflammatory responses are driven by cells of the immune system that rely on cytokines to regulate the activity of other immune and structural cells. OBJECTIVE To review published studies to (1) identify cytokines consistently increased after allergen challenge in atopic patients and (2) investigate temporal variation in cytokine expression. METHODS A PUBMED systematic search was used to extract data from studies involving analysis of cytokine expression in fluids or biopsies following in vivo allergen challenge in atopic patients. RESULTS Data were extracted from 82 studies. There were no consistent reports of cytokine protein increase in fluids of patients at 0-1 h after challenge. At 4-12 h, the chemokines eotaxin, macrophage inflammatory protein-1alpha, RANTES (regulated on activation normal T cell expressed and secreted) and interleukin (IL)-8 have all been consistently reported to be up-regulated. At 18-24 h after challenge, the lymphokines IL-4, IL-5 and IL-13, as well as the pro-inflammatory cytokines granulocyte-macrophage colony-stimulating factor, tumour necrosis factor-alpha and IL-6 are consistently increased when compared with the respective control value. There were no reports of up-regulation in interferon-gamma protein and mRNA and in IL-2 mRNA. CONCLUSION The expression of granulocyte-macrophage colony-stimulating factor is consistently increased in tissues at 4-12 h after challenge. The influence of this cytokine on antigen capture and presentation by dendritic cells should be further investigated. Additionally, allergen challenge studies are needed that investigate the expression of macrophage-derived chemokine and thymus-regulated and activation-regulated chemokine in tissues of atopic patients. Blocking the effects of these lymphocyte-specific chemokines might provide new therapeutic approaches for the control of allergic inflammation.
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Affiliation(s)
- Manuel A R Ferreira
- Queensland Institute of Medical Research, P.O. Royal Brisbane Hospital, Brisbane 4029, Australia.
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9
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Abstract
There is now strong evidence that airway inflammation is a predominant underlying problem in patients with asthma, and it has been suggested that ongoing inflammation may lead to airway injury and remodeling. There is also recent evidence that longstanding asthma could be associated with loss of elastic recoil, which can enhance airway obstruction and worsen asthma control [82,83]. Therefore, the use of anti-inflammatory therapy has been advocated in all guidelines, including the National Asthma Education and Prevention Program (NAEPP) Expert Panel Report [84] and its recent update [85] that recommended inhaled steroids as a first mode of therapy for patients with mild, moderate, or severe, persistent asthma. There is preliminary evidence that early institution of anti-inflammatory therapy might lead to disease modification and limit the progression of subepithelial fibrosis and airway remodeling. The pathogenesis of asthma clearly involves many cells and mediators, although the contribution of each individual factor is probably different from patient to patient depending on the setting and stimulus. Although currently available therapies are highly effective in controlling asthma symptoms and limiting exacerbations in the majority of patients, there is still a subset of patients that proceed to develop severe asthma with decreased lung function, lack of responsiveness to therapy, or frequent exacerbations. It is hoped that rapid progress in the area of asthma genetics and pharmacogenetics will yield a more precise and patient-specific understanding of asthma pathogenesis and allow practitioners to prescribe therapies that are designed for a particular patient or exacerbation. That will undoubtedly help to improve the care of asthma, limit its morbidity, and reduce the side effect of medications.
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Affiliation(s)
- Nizar N Jarjour
- Section of Pulmonary and Critical Care Medicine, 600 Highland Avenue, CSC K4/930, University of Wisconsin School of Medicine, Madison, WI 53792, USA.
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10
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Foster PS, Hogan SP, Yang M, Mattes J, Young IG, Matthaei KI, Kumar RK, Mahalingam S, Webb DC. Interleukin-5 and eosinophils as therapeutic targets for asthma. Trends Mol Med 2002; 8:162-7. [PMID: 11927273 DOI: 10.1016/s1471-4914(02)02302-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Extensive clinical investigations have implicated eosinophils in the pathogenesis of asthma. In a recent clinical trial, humanized monoclonal antibody to interleukin (IL)-5 significantly limited eosinophil migration to the lung. However, treatment did not affect the development of the late-phase response or airways hyperresponsiveness in experimental asthma. Although IL-5 is a key regulator of eosinophilia and attenuation of its actions without signs of clinical improvement raises questions about the contribution of these cells to disease, further studies are warranted to define the effects of anti-IL-5 in the processes that lead to chronic asthma. Furthermore, eosinophil accumulation into allergic tissues should not be viewed as a process that is exclusively regulated by IL-5 but one in which IL-5 greatly contributes. Indeed, data on anti-IL-5 treatments (human and animal models) are confounded by the failure of this approach to completely resolve tissue eosinophilia and the belief that IL-5 alone is the critical molecular switch for eosinophil development and migration. The contribution of these IL-5-independent pathways should be considered when assessing the role of eosinophils in disease processes.
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Affiliation(s)
- Paul S Foster
- Division of Biochemistry and Molecular Biology, John Curtin School of Medical Research, Australian National University, Canberra, ACT, 0200, Australia.
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11
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Hunt LW, Gleich GJ, Kita H, Weiler DA, Schroeder DR, Vuk-Pavlovic Z, Sur S. Removal of bronchoalveolar cells augments the late eosinophilic response to segmental allergen challenge. Clin Exp Allergy 2002; 32:210-6. [PMID: 11929484 DOI: 10.1046/j.1365-2222.2002.01228.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In patients with quiescent asthma, macrophages are the most prevalent cells recovered by bronchoalveolar lavage (BAL). Through activation via their FcepsilonRII receptors or by acting as antigen-presenting cells, macrophages could, in theory, promote the late airway response to allergen. OBJECTIVE In order to investigate the importance of macrophages and other airway luminal cells in inducing the late airway response, a novel washout experiment was designed. METHODS Five patients with ragweed-allergic asthma underwent bronchoscopy and segmental bronchial challenge with either normal saline or short ragweed extract in two segments of one lung. In a third segment of the opposite lung, 12 successive BALs (25 mL each) were performed, followed by challenge with an identical dose of short ragweed (washed-challenged segment). After 24 h, all three challenged segments underwent BAL. RESULTS Initially, in the washed-challenged segment, over 80% (mean 80.4%, range 68-88%) of the recoverable airway dwelling cells were removed. Unexpectedly, 24 h later these same washed-challenged segments contained more eosinophils in the BAL than the challenged segments from the opposite lung (P = 0.033). CONCLUSIONS Removing the majority of airway luminal cells followed by allergen bronchoprovocation increased the number of eosinophils recovered 24 h after challenge. Our results suggest that in quiescent allergic asthma, the airway luminal cells are protective and attenuate the late eosinophilic response to allergen challenge.
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Affiliation(s)
- L W Hunt
- Division of Allergic Diseases/Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA.
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12
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Hertz M, Mahalingam S, Dalum I, Klysner S, Mattes J, Neisig A, Mouritsen S, Foster PS, Gautam A. Active vaccination against IL-5 bypasses immunological tolerance and ameliorates experimental asthma. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 167:3792-9. [PMID: 11564796 DOI: 10.4049/jimmunol.167.7.3792] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Current therapeutic approaches to asthma have had limited impact on the clinical management and resolution of this disorder. By using a novel vaccine strategy targeting the inflammatory cytokine IL-5, we have ameliorated hallmark features of asthma in mouse models. Delivery of a DNA vaccine encoding murine IL-5 modified to contain a promiscuous foreign Th epitope bypasses B cell tolerance to IL-5 and induces neutralizing polyclonal anti-IL-5 Abs. Active vaccination against IL-5 reduces airways inflammation and prevents the development of eosinophilia, both hallmark features of asthma in animal models and humans. The reduced numbers of inflammatory T cells and eosinophils in the lung also result in a marked reduction of Th2 cytokine levels. Th-modified IL-5 DNA vaccination reduces the expression of IL-5 and IL-4 by approximately 50% in the airways of allergen-challenged mice. Most importantly, Th-modified IL-5 DNA vaccination restores normal bronchial hyperresponsiveness to beta-methacholine. Active vaccination against IL-5 reduces key pathological events associated with asthma, such as Th2 cytokine production, airways inflammation, and hyperresponsiveness, and thus represents a novel therapeutic approach for the treatment of asthma and other allergic conditions.
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Affiliation(s)
- M Hertz
- Pharmexa A/S, DK-2970 Hørsholm, Denmark
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13
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Abstract
Over the past 15 years, much has been learned about the presence of airway inflammation in asthma through the use of investigative bronchoscopy. It has become quite clear that inflammation is present even in mild asthma. In addition to the eosinophils, T-lymphocytes and a variety of cytokines have been identified to play a prominent role in asthmatic inflammation. The concept of delayed asthmatic response after allergen exposure and its relationship to cellular inflammation and airway hyper-reactivity has become more clearly established. Our understanding of asthmatic airway inflammation, however, is incomplete. As interesting as the database has been so far, investigative FB has not defined a unique profile for patients with asthma. Specifically, lavage or endobronchial biopsy has not identified parameters that help in the diagnosis, assessment of disease severity, prognosis, or likelihood to respond to specific therapies. Also, the exact relationship between parameters in lavage compared with mucosal biopsy and how these are related to airway hyper-reactivity and the clinical syndrome of asthma remains poorly understood. In this regard, it must be confessed that currently FB with lavage and biopsy in asthmatics needs to be considered as a research tool for specimen retrieval to help characterize and express inflammation. Although these techniques have contributed immensely to our understanding of asthma pathogenesis, presently these techniques do not have any practical role or clinical usefulness.
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Affiliation(s)
- M S Kavuru
- Pulmonary Function Laboratory, Cleveland Clinic Foundation, Ohio, USA
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Lagging E, van Hage-Hamsten M, Grönneberg R, Elfman L, Härfast B. Cytokine production in PBMC from allergics and non-allergics following in vitro allergen stimulation. Immunol Lett 1998; 60:45-9. [PMID: 9541462 DOI: 10.1016/s0165-2478(97)00130-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Dysregulation of cytokine production in atopic individuals has previously been clearly demonstrated. In the present study we aimed to assess whether a prolonged in vitro exposure of peripheral blood lymphocytes (PBMC) to allergen would result in a, by time, changed cytokine profile in allergic subjects. Blood was taken from 11 atopic asthmatic subjects and nine healthy non-atopic controls during the birch pollen season. PBMC were stimulated with birch pollen allergen (100, 1000 and 10,000 SQ-U/ml). After different times of exposure (1, 3 and 5 weeks) interleukin (IL)-5 and interferon-gamma (IFN-gamma) production was measured. Prior to the IL5 and IFN-gamma determinations, PHA was added to the cultures to ensure maximal release of cytokines. The asthmatic group always displayed a lower IFN-gamma:IL-5 ratio. Significant differences in ratio between the two groups were observed. Furthermore, PBMC challenged in vitro with 10,000 SQ-U/ml resulted in significantly elevated levels of IL-5 in the asthmatic group compared to the control group when determined after 3 and 5 weeks stimulation. In the asthmatic group the balance between IL-5 and IFN-gamma is shifted towards increased IL-5 production following prolonged in vitro stimulation. This might illustrate the in vivo situation, where an increased IL-5 production is of importance in the pathogenesis of asthma.
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Affiliation(s)
- E Lagging
- Department of Laboratory Medicine, Karolinska Hospital, Stockholm, Sweden
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Kelly EA, Rodriguez RR, Busse WW, Jarjour NN. The effect of segmental bronchoprovocation with allergen on airway lymphocyte function. Am J Respir Crit Care Med 1997; 156:1421-8. [PMID: 9372655 DOI: 10.1164/ajrccm.156.5.9703054] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We hypothesized that allergen-induced airway eosinophilia is linked to activation or recruitment of T cells in the airway and generation of interleukin-5 (IL-5). To evaluate this hypothesis, we performed bronchoscopy with segmental antigen bronchoprovocation in 12 atopic subjects. Bronchoalveolar lavage (BAL) was done 5 min and 48 h after challenge with saline or antigen. Airway cells were isolated and then stimulated ex vivo with a T-cell mitogen, phytohemagglutinin (PHA), and cytokine release was determined. Cells retrieved from the saline-challenged segment secreted principally interferon-gamma (IFN-gamma) and IL-2. In contrast, cells obtained 48 h after allergen challenge secreted high levels of IL-5 and small but increased amounts of IL-4, IL-10, and granulocyte-macrophage colony-stimulating factor (GM-CSF). Although CD4+ T cells were a major source of IL-5, there were no significant changes in the relative proportion of CD4+ cells in response to bronchoprovocation. Additionally, ex vivo secretion of IL-5 by airway cells correlated closely with amounts of IL-5 and eosinophils present in the bronchoalveolar lavage fluid (BALF). These observations suggest that following exposure to allergen, airway T cells are functionally but not phenotypically different from resident airway T cells, and that T cells within the airway contribute to eosinophilic airway inflammation through the secretion of IL-5.
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Affiliation(s)
- E A Kelly
- Department of Medicine, University Wisconsin School of Medicine, Madison 53972, USA
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