IgE在过敏性气道炎症和气道高反应性发展中的作用——小鼠模型

Role of IgE in the development of allergic airway inflammation and airway hyperresponsiveness--a murine model.

作者信息

Hamelmann E, Tadeda K, Oshiba A, Gelfand E W

机构信息

Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA.

出版信息

Allergy. 1999 Apr;54(4):297-305. doi: 10.1034/j.1398-9995.1999.00085.x.

Abstract

The importance of IgE in airway inflammation and development of AHR in allergen-sensitized mice has been compared and contrasted in different models of sensitization and challenge. Using different modes of sensitization in normal and genetically manipulated mice after anti-IgE treatment, we have been able to distinguish the role of IgE under these different conditions. Striking differences in the three sensitization protocols were delineated in terms of the role of allergen-specific IgE, extent of eosinophilic airway inflammation, and development of AHR (Table 1). The highest levels of IgE and eosinophil infiltration (approximately 20-fold increases) were achieved after systemic sensitization with allergen (plus adjuvant) followed by repeated airway challenge. Passive sensitization with allergen-specific IgE followed by limited airway challenge induced a modest eosinophilic inflammatory response in the airways despite high levels of serum IgE. Exposure to allergen exclusively via the airways also resulted in a modest serum IgE response and a limited eosinophilic inflammatory response (approximately fourfold increases). Under all of these conditions, inhibition of IL-5-mediated eosinophilic airway inflammation was associated with attenuation of AHR. In contrast, the differences in the responses to the different modes of allergen exposure were associated with differences in the requirements for IgE in the development of AHR (Table 1). In the two models associated with mild eosinophil infiltration (passive sensitization and exclusive airway exposure), IgE was required for the development of AHR but did not substantially enhance airway inflammation on its own. However, IgE-allergen interaction was able to enhance T-cell function in vitro and induce T-cell expansion in vivo. In mice systemically sensitized and challenged via the airways, IgE (or IgE-mediated mast-cell activation) was not required for T-cell activation, eosinophilic inflammation and activation in the airways, or development of AHR. This was most clearly seen in B-cell-deficient and mast-cell-deficient, low-IgE-responder mouse strains (B6, B10) and in anti-IgE-treated high-IgEresponder mice (BALB/c). At the same time, we confirmed the importance of IgE in the induction of immediate-type hypersensitivity (mast-cell activation, immediate cutaneous hypersensitivity, passive cutaneous and systemic anaphylaxis). These differences were also highlighted by the means used to detect altered airway function. Passive sensitization and limited airway challenge or exclusive airway exposure to allergen over 10 days elicited changes in airway function that could be detected only in tracheal smooth-muscle preparations exposed to EFS. In contrast, systemic sensitization followed by repeated airway challenge resulted not only in changes in the contractile response to EFS but also in increased responsiveness to inhaled MCh. Thus, these results distinguish not only the differential involvement of IgE and eosinophil numbers but also their contribution to the readouts used to monitor airway function. Based on these studies, we conclude that IgE plays an important role in the development of airway inflammation and AHR under conditions in which limited IL-5-mediated eosinophilic airway infiltration is induced. In conditions where a robust eosinophilic inflammation of the airways is elicited, IgE (and IgE-mediated mast-cell activation) does not appear to be essential for airway inflammation and the development of AHR, detected as increased responsiveness to inhaled MCh. These findings reveal the potential importance of differential targeting in the treatment of allergic diseases with a predominance of IgE-mediated symptoms, e.g., allergic rhinitis and conjunctivitis, where anti-IgE may be an effective therapy, compared to those diseases with a predominant inflammatory component, e.g., AHR in atopic bronchial asthma, where anti-inflammatory or anti-IL-5 therapy may be more beneficial.

摘要

在变应原致敏小鼠中,IgE在气道炎症和气道高反应性(AHR)发展中的重要性已在不同的致敏和激发模型中进行了比较和对比。在抗IgE治疗后的正常小鼠和基因操作小鼠中,使用不同的致敏方式,我们得以区分IgE在这些不同条件下的作用。就变应原特异性IgE的作用、嗜酸性粒细胞气道炎症的程度以及AHR的发展而言,三种致敏方案存在显著差异(表1)。在用变应原(加佐剂)进行全身致敏后,再进行反复气道激发,可实现最高水平的IgE和嗜酸性粒细胞浸润(增加约20倍)。用变应原特异性IgE进行被动致敏,随后进行有限的气道激发,尽管血清IgE水平较高,但在气道中诱导了适度的嗜酸性粒细胞炎症反应。仅通过气道暴露于变应原也导致适度的血清IgE反应和有限的嗜酸性粒细胞炎症反应(增加约四倍)。在所有这些条件下,抑制IL-5介导的嗜酸性粒细胞气道炎症与AHR的减轻相关。相比之下,对不同变应原暴露方式的反应差异与AHR发展中对IgE的需求差异相关(表1)。在与轻度嗜酸性粒细胞浸润相关的两种模型(被动致敏和单纯气道暴露)中,AHR的发展需要IgE,但IgE本身并不会显著增强气道炎症。然而,IgE-变应原相互作用能够在体外增强T细胞功能,并在体内诱导T细胞扩增。在通过气道进行全身致敏和激发的小鼠中,T细胞活化、气道中的嗜酸性粒细胞炎症和活化以及AHR的发展并不需要IgE(或IgE介导的肥大细胞活化)。这在B细胞缺陷和肥大细胞缺陷的低IgE反应小鼠品系(B6、B10)以及抗IgE治疗的高IgE反应小鼠(BALB/c)中最为明显。同时,我们证实了IgE在诱导速发型超敏反应(肥大细胞活化、即刻皮肤超敏反应、被动皮肤和全身过敏反应)中的重要性。用于检测气道功能改变的方法也突出了这些差异。被动致敏和有限的气道激发或在10天内单纯气道暴露于变应原引起的气道功能变化,仅在暴露于电场刺激(EFS)的气管平滑肌制剂中才能检测到。相比之下,全身致敏后再进行反复气道激发不仅导致对EFS的收缩反应发生变化,还导致对吸入的乙酰甲胆碱(MCh)的反应性增加。因此,这些结果不仅区分了IgE和嗜酸性粒细胞数量的不同参与情况,还区分了它们对用于监测气道功能的指标的贡献。基于这些研究,我们得出结论,在诱导有限的IL-5介导的嗜酸性粒细胞气道浸润的条件下,IgE在气道炎症和AHR的发展中起重要作用。在引发强烈的气道嗜酸性粒细胞炎症的条件下,IgE(和IgE介导的肥大细胞活化)对于气道炎症和以对吸入MCh反应性增加为检测指标的AHR的发展似乎并非必不可少。这些发现揭示了在治疗以IgE介导症状为主的过敏性疾病(如过敏性鼻炎和结膜炎,抗IgE可能是一种有效疗法)与以炎症成分为主的疾病(如特应性支气管哮喘中的AHR,抗炎或抗IL-5疗法可能更有益)时,差异靶向治疗的潜在重要性。

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