Department of Pediatrics, Division of Allergy & Immunology, The Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
Clin Exp Allergy. 2010 Nov;40(11):1678-88. doi: 10.1111/j.1365-2222.2010.03545.x.
Chronic allergic asthma is the result of a T-helper type 2 (Th2)-biased immune status. Current asthma therapies control symptoms in some patients, but a long-lasting therapy has not been established. Anti-Asthma Simplified Herbal Medicine Intervention (ASHMI™), a Chinese herbal formula, improved symptoms and lung function, and reduced Th2 responses in a controlled trial of patients with persistent moderate to severe asthma.
We evaluated the persistence of ASHMI™ beneficial effects following therapy in a murine model of chronic asthma and the immunological mechanisms underlying such effects. Methods BALB/c mice sensitized intraperitoneally with ovalbumin (OVA) received 3 weekly intratracheal OVA challenges to induce airway hyper-reactivity (AHR) and inflammation (OVA mice). Additionally, OVA mice were treated with ASHMI™ (OVA/ASHMI™) or water (OVA/sham) for 4 weeks, and then challenged immediately and 8 weeks post-therapy. In other experiments, OVA mice received ASHMI™ treatment with concomitant neutralization of IFN-γ or TGF-β. Effects on airway responses, cytokine- and OVA-specific IgE levels were determined 8 weeks post-therapy.
Before treatment, OVA mice exhibited AHR and pulmonary eosinophilic inflammation following OVA challenge, which was almost completely resolved immediately after completing treatment with ASHMI™ and did not re-occur following OVA re-challenge up to 8 weeks post-therapy. Decreased allergen-specific IgE and Th2 cytokine levels, and increased IFN-γ levels also persisted at least 8 weeks post-therapy. ASHMI™ effects were eliminated by the neutralization of IFN-γ, but not TGF-β, during therapy.
ASHMI™ induced long-lasting post-therapy tolerance to antigen-induced inflammation and AHR. IFN-γ is a critical factor in ASHMI™ effects.
慢性过敏性哮喘是 T 辅助型 2(Th2)偏向性免疫状态的结果。目前的哮喘治疗方法可以控制部分患者的症状,但尚未建立长期治疗方法。中药抗哮喘简化干预(ASHMI)是一种中药配方,在一项针对持续性中重度哮喘患者的对照试验中,改善了症状和肺功能,并降低了 Th2 反应。
我们评估了 ASHMI 在慢性哮喘小鼠模型中的治疗后持续有益效果及其免疫机制。方法 BALB/c 小鼠用卵清蛋白(OVA)腹腔内致敏,接受 3 次每周一次的气道内 OVA 挑战,以诱导气道高反应性(AHR)和炎症(OVA 小鼠)。此外,OVA 小鼠接受 ASHMI 治疗(OVA/ASHMI)或水(OVA/sham)治疗 4 周,然后立即和治疗后 8 周进行挑战。在其他实验中,OVA 小鼠接受 ASHMI 治疗的同时中和 IFN-γ 或 TGF-β。治疗后 8 周测定气道反应、细胞因子和 OVA 特异性 IgE 水平。
治疗前,OVA 小鼠在 OVA 挑战后表现出 AHR 和肺嗜酸性粒细胞炎症,在完成 ASHMI 治疗后立即几乎完全缓解,并且在治疗后 8 周内再次接受 OVA 挑战时不再发生。过敏原特异性 IgE 和 Th2 细胞因子水平降低,IFN-γ 水平升高至少持续 8 周。在治疗过程中中和 IFN-γ 而不是 TGF-β 可消除 ASHMI 的作用。
ASHMI 诱导了抗原诱导的炎症和 AHR 的持久治疗后耐受。IFN-γ 是 ASHMI 作用的关键因素。