Holtzman Michael J, Shornick Laurie P, Grayson Mitchell H, Kim Edy Y, Tyner Jeffrey W, Patel Anand C, Agapov Eugene, Zhang Yong
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Pediatr Infect Dis J. 2004 Nov;23(11 Suppl):S235-45. doi: 10.1097/01.inf.0000144674.24802.c1.
The traditional scheme for asthma pathogenesis depends on increased T helper type 2 (Th2) over T helper type 1 (Th1) responses to allergic and nonallergic stimuli and consequent airway inflammation, hyperreactivity and hypersecretion. Here we question whether the innate immune system, including airway epithelial cells, and the adaptive one may manifest an aberrant antiviral response as an additional basis for chronic inflammatory diseases, including asthma.
We focused on the signal transduction and genetic basis for mucosal immunity, inflammation and remodeling, especially in relation to airway diseases. We concentrated on the response to paramyxoviruses because these agents are closely associated with common acute and chronic airway diseases. We used viral, cellular and mouse models, as well as human subjects, for study and made comparisons among these systems. Our approach aims to answer 2 major questions: (1) what are the factors that control acute paramyxoviral infection; and (2) how can these transient infections cause long term airway disease?
Our studies show that antiviral defense depends on a special network of epithelial immune response genes that signal to the adaptive immune system. Viruses ordinarily trigger this network, but it is also permanently activated in asthma, even in the absence of viral infection. In addition, we find that, in susceptible genetic backgrounds, respiratory viruses cause a "hit-and-run" phenomenon indicated by the development of an asthmatic phenotype long after the infection has cleared. On the basis of this information, we developed a new scheme for asthma pathogenesis that includes epithelial, viral and allergic components and allows viral reprogramming of host behavior.
传统的哮喘发病机制方案依赖于辅助性T细胞2型(Th2)相对于辅助性T细胞1型(Th1)对变应性和非变应性刺激的反应增加,以及随之而来的气道炎症、高反应性和高分泌。在此,我们质疑包括气道上皮细胞在内的固有免疫系统和适应性免疫系统是否可能表现出异常的抗病毒反应,作为包括哮喘在内的慢性炎症性疾病的另一个基础。
我们专注于黏膜免疫、炎症和重塑的信号转导及遗传基础,特别是与气道疾病相关的方面。我们着重研究对副黏病毒的反应,因为这些病原体与常见的急慢性气道疾病密切相关。我们使用病毒、细胞和小鼠模型以及人类受试者进行研究,并在这些系统之间进行比较。我们的方法旨在回答两个主要问题:(1)控制急性副黏病毒感染的因素有哪些;(2)这些短暂感染如何导致长期气道疾病?
我们的研究表明,抗病毒防御依赖于一个特殊的上皮免疫反应基因网络,该网络向适应性免疫系统发出信号。病毒通常会触发这个网络,但在哮喘中,即使没有病毒感染,它也会被永久激活。此外,我们发现,在易感遗传背景下,呼吸道病毒会导致一种“打了就跑”的现象表现为感染清除很久之后出现哮喘表型。基于这些信息,我们制定了一种新的哮喘发病机制方案,该方案包括上皮、病毒和变应性成分,并允许病毒对宿主行为进行重新编程。