1
|
Gerday S, Schleich F, Henket M, Guissard F, Paulus V, Louis R. Asthmatics with concordant eosinophilic disease classified according to their serum IgE status. Respir Med Res 2020; 79:100797. [PMID: 33383519 DOI: 10.1016/j.resmer.2020.100797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 10/14/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Eosinophilic inflammation has long been associated with asthma. Looking at systemic and airway eosinophilia, we have recently identified a group of patients exhibiting diffuse eosinophilic inflammation. Among the mechanisms governing eosinophilic inflammation, IgE-mediated mast cell activation is a key event leading to eosinophilia in atopic asthmatics. METHODS We conducted a retrospective study on our asthma clinic database containing more than 1500 patients and identified 205 asthmatics with successful sputum induction and concordant eosinophilic phenotype. This phenotype was defined as a sputum eosinophil count≥3% and a blood eosinophils concentration≥400cells/mm3. IgE-high atopic phenotype was characterized by the presence of at least one positive specific IgE (>0.35kU/L) to common aeroallergens and a raised total serum IgE (≥113kU/L). RESULTS The largest group of asthmatics displaying concordant eosinophilic phenotype had a raised total serum IgE and atopy (45%). IgE-low non-atopic concordant eosinophilic asthma was a predominantly late onset disease, exhibited a more intense airway eosinophilic inflammation (P<0.05), required more often maintenance treatment with oral corticosteroids (P<0.05) but, surprisingly, had a reduced level of bronchial hyperresponsiveness to methacholine (P<0.05) despite similar baseline airway calibre impairment. CONCLUSION The more severe airway eosinophilic inflammation in IgE-low non-atopic asthmatics despite similar treatment with ICS and a higher burden of OCS points to a certain corticosteroid resistance in this asthma phenotype.
Collapse
Affiliation(s)
- S Gerday
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium.
| | - F Schleich
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium
| | - M Henket
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium
| | - F Guissard
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium
| | - V Paulus
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, GIGA I(3) Research Group, University of Liege, 4000 Liege, Belgium
| |
Collapse
|
2
|
Kurowski M, Jurczyk J, Olszewska-Ziąber A, Jarzębska M, Krysztofiak H, Kowalski ML. A similar pro/anti-inflammatory cytokine balance is present in the airways of competitive athletes and non-exercising asthmatics. Adv Med Sci 2018; 63:79-86. [PMID: 28822267 DOI: 10.1016/j.advms.2017.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/01/2017] [Accepted: 07/18/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Intensive exercise modifies airway inflammation and infection susceptibility. We aimed to determine the effect of exercise on pro- and anti-inflammatory cytokine (TNF-α, IL-1ra, IL-10) and innate immunity protein (HSPA1, sCD14) levels in exhaled breath condensate (EBC) and nasal secretions of competitive athletes, non-exercising asthmatics and healthy controls (HC). MATERIAL AND METHODS The study group consisted of 15 competitive athletes (five speed skaters and ten swimmers) aged 15-25. The control groups comprised 10 mild-to-moderate asthmatics (AC) and seven HC. Athletes were assessed in- and off-training while asthmatics and controls at one time point. Nasal lavages and EBC were collected before and after a treadmill exercise challenge. Protein levels were assessed using ELISA. RESULTS TNF-α levels in EBC were significantly higher in athletes than HC, but similar to asthmatic patients. In contrast, IL-1ra EBC concentrations were significantly lower in athletes than in HC, but again similar to asthmatics. Significant positive correlations were seen between baseline concentrations of TNF-α in EBC and fall in FEV1 following exercise challenge in athletes during training period (R=0.74, p<0.01) and in asthmatics (R=0.64, p<0.05). In nasal secretions, baseline IL-1ra levels were significantly higher in athletes and asthmatics than in HC. Exercise caused a slight, yet significant, increase in EBC HSPA1 in athletes (p=0.02). The exercise challenge did not considerably influence TNF-α, IL-1ra, HSPA1 and sCD14 in EBC or nasal secretions. CONCLUSIONS Dysregulation of the TNF-α/IL-1ra balance in EBC and nasal secretions from athletes may reflect the presence of airway inflammation induced by repeated strenuous exercise.
Collapse
|
3
|
da Silva J, Hilzendeger C, Moermans C, Schleich F, Henket M, Kebadze T, Mallia P, Edwards MR, Johnston SL, Louis R. Raised interferon-β, type 3 interferon and interferon-stimulated genes - evidence of innate immune activation in neutrophilic asthma. Clin Exp Allergy 2016; 47:313-323. [PMID: 27622317 DOI: 10.1111/cea.12809] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/30/2016] [Accepted: 06/26/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Interferons play an important role in innate immunity. Previous studies report deficiency in virus induction of interferon (IFN)-α, IFN-β and IFN-λ in bronchial epithelial and bronchial lavage cells in atopic asthmatics. It is now recognized that asthma is a heterogeneous disease comprising different inflammatory phenotypes, some of which may involve innate immune activation in the absence of overt infection. OBJECTIVE The aim of this study was to investigate whether the severity of asthma or a specific cellular sputum pattern may be linked to evidence of innate immune activation. METHODS Here we investigate the expression of IFN-β, IFN-λ1 (IL-29), IFN-λ2/3 (IL-28A/B) and the interferon-stimulated genes (ISGs) such as myxovirus resistance 1 (Mx1), oligoadenylate synthetase (OAS) and viperin in unstimulated sputum cells in 57 asthmatics (including 16 mild, 19 moderate and 22 severe asthma patients) and compared them with 19 healthy subjects. RESULTS We observed increased expression of IFN-β, IFN-λ1/IL-29, OAS and viperin in asthmatics compared with healthy subjects, while IL-28 was not expressed in any group. The overexpression was restricted to neutrophilic asthmatics (sputum neutrophils ≥ 76%), while eosinophilic asthmatics (sputum eosinophils ≥ 3%) did not differ from healthy subjects or even showed a lower expression of Mx1. No difference in interferon or ISG expression was observed according to clinical asthma severity. CONCLUSION AND CLINICAL RELEVANCE Neutrophilic, but not eosinophilic, asthmatics display overexpression of IFN-β, IFN-λ1/IL-29 and ISGs in their sputum cells that may reflect ongoing innate immune activation.
Collapse
Affiliation(s)
- J da Silva
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium.,Allergy Service, University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina (HU-UFSC), Florianopolis, SC, Brazil
| | - C Hilzendeger
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium.,Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - C Moermans
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium
| | - F Schleich
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium
| | - M Henket
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium
| | - T Kebadze
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - P Mallia
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M R Edwards
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - R Louis
- Department of Respiratory Medicine, CHU Liege, GIGA I3 University of Liege, Liege, Belgium
| |
Collapse
|
4
|
Kuo CH, Yang SN, Kuo HF, Lee MS, Huang MY, Huang SK, Lin YC, Hsieh CC, Hung CH. Cysteinyl leukotriene receptor antagonist epigenetically modulates cytokine expression and maturation of human myeloid dendritic cells. Pulm Pharmacol Ther 2016; 39:28-37. [PMID: 27312202 DOI: 10.1016/j.pupt.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 05/29/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cysteinyl leukotriene receptor antagonists are important controllers in treating asthma. Human myeloid DCs (mDCs) play critical roles in the pathogenesis of asthma. However, the effects of cysteinyl leukotriene receptor antagonist on human mDCs are unknown. METHODS To investigate the effects of cysteinyl leukotriene receptor antagonist on the function of human mDCs, circulating mDCs were isolated from six health subjects. Human mDCs were pretreated with montelukast and were stimulated with toll-like receptor (TLR) ligands lipopolysaccharide (LPS) or polyinosinic-polycytidylic acid (poly I:C). Tumor necrosis factor (TNF)-α and interleukin (IL)-10 were measured by ELISA. Intracellular signaling was investigated by pathway inhibitors, western blot and chromatin immunoprecipitation. Costimulatory molecules expression was investigated by flow cytometry. T cell polarization function of mDCs was investigated by measuring interferon (IFN)-γ, IL-13, IL-10 and IL-17A production by T cells using mDC/T cell coculture assay. RESULTS Montelukast suppressed TLR-mediated TNF-α expression via the NFκB-p65 and mitogen-activated protein kinase (MAPK)-JNK pathway, and enhanced TLR-mediated IL-10 expression via the MAPK-p38 pathway and epigenetic regulation by histone H3 acetylation. Montelukast suppressed LPS-induced CD80, CD86, CD40 and HLA-DR expression. Montelukast-treated mDCs suppressed IFN-γ and IL-13 production by T cells. CONCLUSION Cysteinyl leukotriene receptor antagonist alters the function of human mDCs by epigenetically modulating cytokine expression, suppressing costimulatory molecules expression and inhibiting the ability to initiate Th1/Th2 responses. The effects of cysteinyl leukotriene receptor antagonist on human mDCs can be an important mechanism in treating asthma.
Collapse
Affiliation(s)
- Chang-Hung Kuo
- Ta-Kuo Clinic, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - San-Nan Yang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hsuan-Fu Kuo
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Min-Sheng Lee
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Ming-Yii Huang
- Department of Radiation Oncology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shau-Ku Huang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Johns Hopkins University School of Medicine, Baltimore, MD, USA; National Health Research Institutes, Miaoli County, Taiwan
| | - Yi-Ching Lin
- Department of Laboratory Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chong-Chao Hsieh
- Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Hsing Hung
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
5
|
Moermans C, Bonnet C, Willems E, Baron F, Nguyen M, Henket M, Sele J, Corhay JL, Beguin Y, Louis R. Sputum cytokine levels in patients undergoing hematopoietic SCT and comparison with healthy subjects and COPD: a pilot study. Bone Marrow Transplant 2014; 49:1382-8. [DOI: 10.1038/bmt.2014.164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/08/2014] [Accepted: 06/12/2014] [Indexed: 01/08/2023]
|
6
|
Louis R, Schleich F, Barnes PJ. Corticosteroids: still at the frontline in asthma treatment? Clin Chest Med 2012; 33:531-41. [PMID: 22929100 DOI: 10.1016/j.ccm.2012.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inhaled corticosteroids (ICS) have led to improved asthma control and reduced asthma mortality in the Western world. ICS are effective in combating T-helper type 2-driven inflammation featuring mast cell and eosinophilic airway infiltration. Their effect on innate immunity-driven neutrophilic inflammation is poor and their ability to prevent airway remodeling and accelerated lung decline is controversial. Although ICS remain pivotal drugs in asthma management, research is needed to find drugs complementary to the combination ICS/long-acting β2-agonist in refractory asthma and perhaps a new class of drugs as a first-line treatment in mild to moderate noneosinophilic asthma.
Collapse
Affiliation(s)
- Renaud Louis
- Deparment of Pneumology, CHU Liege, GIGAI3 Research Group, University of Liege, Liege, Belgium.
| | | | | |
Collapse
|
7
|
Manise M, Schleich F, Quaedvlieg V, Moermans C, Henket M, Sele J, Corhay JL, Louis R. Disturbed cytokine production at the systemic level in difficult-to-control atopic asthma: evidence for raised interleukin-4 and decreased interferon-γ release following lipopolysaccharide stimulation. Int Arch Allergy Immunol 2011; 158:1-8. [PMID: 22205180 DOI: 10.1159/000329858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 05/30/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Disturbed cytokine production is thought to govern inflammation in asthma, which, in its turn, may lead to uncontrolled disease. The aim of this study was to assess the relationship between cytokine production from blood leucocytes and the level of asthma control. METHODS We compared the production of interleukin (IL)-4, IL-6, IL-10, interferon (IFN)-γ and tumour necrosis factor-α from peripheral blood leucocytes in non-atopic healthy subjects (n = 22), atopic non-asthmatics (n = 10), well-controlled asthmatics [Juniper asthma control questionnaire (ACQ) score <1.5; n = 20] and patients with uncontrolled asthma despite inhaled or oral corticoids (ACQ score ≥1.5; n = 20). Fifty microlitres of peripheral blood was incubated for 24 h with RPMIc, lipopolysaccharide (LPS; 1 ng/ml) or phytohaemagglutinin (1 μg/ml), and cytokines were measured by immunotrapping (ELISA). RESULTS Both controlled and uncontrolled asthmatics as well as atopic non-asthmatics spontaneously produced more IL-4 than non-atopic healthy subjects (p < 0.001). IL-4 production induced by LPS was significantly greater (p < 0.05) in both asthma groups compared to atopic non-asthmatics and non-atopic healthy subjects. By contrast, IFN-γ release induced by LPS was lower in uncontrolled asthmatics than in non-atopic healthy subjects (p < 0.05) and controlled asthmatics (p < 0.05). IL-10 release after LPS was greater in uncontrolled asthmatics than in atopic non-asthmatics (p < 0.05). No difference was observed regarding other cytokines. CONCLUSION Blood cells from patients with difficult-to-control atopic asthma display highly skewed Th2 cytokine release following LPS stimulation.
Collapse
Affiliation(s)
- M Manise
- Department of Respiratory Medicine, CHU Sart-Tilman, GIGA Research Group i(3), Liège, Belgium.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Moermans C, Heinen V, Nguyen M, Henket M, Sele J, Manise M, Corhay J, Louis R. Local and systemic cellular inflammation and cytokine release in chronic obstructive pulmonary disease. Cytokine 2011; 56:298-304. [DOI: 10.1016/j.cyto.2011.07.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/23/2011] [Accepted: 07/11/2011] [Indexed: 10/17/2022]
|
9
|
Kodesh E, Zaldivar F, Schwindt C, Tran P, Yu A, Camilon M, Nance DM, Leu SY, Cooper D, Adams GR. A rat model of exercise-induced asthma: a nonspecific response to a specific immunogen. Am J Physiol Regul Integr Comp Physiol 2011; 300:R917-24. [PMID: 21228339 DOI: 10.1152/ajpregu.00270.2010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Exercise-induced bronchoconstriction (EIB) is common; however, key aspects of its pathogenesis are still unclear. We investigated the feasibility of adapting an established animal model of asthma to investigate the earliest stages of EIB. The hypothesis was that a single exposure to a normally innocuous, and brief, exercise challenge could trigger EIB symptoms in rats previously sensitized to ovalbumin (OVA) but otherwise unchallenged. Brown-Norway rats were sensitized by intraperitoneal injection of OVA at 0 and 2 wk. At week 3, animals were exposed to either aerosolized OVA (SS) or exercise (EXS). A trained, blinded, clinical observer graded EIB by respiratory sounds. Plasma and lung cytokine levels were analyzed. No control rats with or without exercise (EX, CON) showed evidence of EIB. Eighty percent of the SS group demonstrated abnormal breath sounds upon exposure to aerosolized OVA. Approximately 30% of EXS rats sensitized to OVA but exposed only to exercise had abnormal breath sounds. Lung tissue levels of TNF-α, IL-1α, growth-related oncogene/keratinocyte/chemoattractant, and IFN-γ were significantly higher (P < 0.001) in the SS group, relative to all other groups. Changes in most of these cytokines were not notable in the EXS rats, suggesting a different mechanism of EIB. Remarkably, IFN-γ, but not the other cytokines measured, was significantly elevated following brief exercise in both sensitized and unsensitized rats. Exercise led to detectable breathing sound abnormalities in sensitized rats, but less severe than those observed following classical OVA challenge. Precisely how this immune crossover occurs is not known, but this model may be useful in elucidating essential mechanisms of EIB.
Collapse
Affiliation(s)
- Einat Kodesh
- Department of Pediatrics, University of California, Irvine, Irvine, California 92697-4560, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|