Division of Clinical Medicine, Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
J Immunol. 2013 Feb 1;190(3):1056-65. doi: 10.4049/jimmunol.1202386. Epub 2013 Jan 4.
In refractory asthma, neutrophils, rather than eosinophils, often predominate in the airways. Neutrophilic airway inflammation appears to be resistant to steroids and may be related to the Th17, rather than the Th2, cytokine milieu. However, the role of GATA-3 and RORγt, transcription factors for Th2 and Th17 cell differentiation, respectively, in the pathogenesis of steroid-insensitive asthma remains unclear. To examine the effect of GATA-3- and RORγt-overexpression backgrounds on airway inflammation and steroid sensitivity, we generated two strains of transgenic mice overexpressing GATA-3 or RORγt. Mice were sensitized and challenged with OVA. Some OVA-sensitized/challenged mice were treated with dexamethasone, anti-IL-17 Ab, CXCR2 antagonist, or anti-IL-6R Ab to demonstrate their therapeutic effects on airway inflammation. Although Ag-specific airway inflammation and hyperresponsiveness were induced in each mouse, the phenotype of inflammation showed a distinct difference that was dependent upon the genotype. GATA-3-overexpressing mice exhibited steroid-sensitive eosinophilic inflammation with goblet cell hyperplasia and mucus hyperproduction under Th2-biased conditions, and RORγt-overexpressing mice developed steroid-insensitive neutrophilic inflammation under Th17-biased conditions. The levels of keratinocyte-derived chemokine, MIP-2, IL-6, and other neutrophil chemotaxis-related mediators were significantly elevated in OVA-exposed RORγt-overexpressing mice compared with wild-type mice. Interestingly, airway hyperresponsiveness accompanied by neutrophilic airway inflammation in RORγt-overexpressing mice was effectively suppressed by anti-IL-17 Ab, CXCR2 antagonist, or anti-IL-6R Ab administration. In conclusion, our results suggest that the expression levels of GATA-3 and RORγt may be important for determining the phenotype of asthmatic airway inflammation. Furthermore, blockade of the Th17-signaling pathway may be a treatment option for steroid-insensitive asthma.
在难治性哮喘中,气道中往往以中性粒细胞而非嗜酸性粒细胞为主。中性粒细胞性气道炎症似乎对类固醇有抗性,并且可能与 Th17 细胞因子环境而不是 Th2 细胞因子环境有关。然而,GATA-3 和 RORγt 在类固醇不敏感哮喘发病机制中的作用仍然不清楚,GATA-3 和 RORγt 分别是 Th2 和 Th17 细胞分化的转录因子。为了研究 GATA-3 和 RORγt 过表达背景对气道炎症和类固醇敏感性的影响,我们生成了两种过表达 GATA-3 或 RORγt 的转基因小鼠品系。将小鼠致敏并用 OVA 进行攻毒。一些 OVA 致敏/攻毒的小鼠接受了地塞米松、抗 IL-17 Ab、CXCR2 拮抗剂或抗 IL-6R Ab 的治疗,以证明它们对气道炎症的治疗效果。尽管每种小鼠都诱导了抗原特异性气道炎症和高反应性,但炎症表型的差异取决于基因型。GATA-3 过表达小鼠在 Th2 偏向条件下表现出对类固醇敏感的嗜酸性粒细胞炎症,伴有杯状细胞增生和黏液高分泌,而 RORγt 过表达小鼠在 Th17 偏向条件下发展为对类固醇不敏感的中性粒细胞炎症。与野生型小鼠相比,OVA 暴露的 RORγt 过表达小鼠的角质细胞衍生趋化因子、MIP-2、IL-6 和其他中性粒细胞趋化相关介质的水平显著升高。有趣的是,RORγt 过表达小鼠的气道高反应性伴随着中性粒细胞性气道炎症,通过给予抗 IL-17 Ab、CXCR2 拮抗剂或抗 IL-6R Ab 治疗可得到有效抑制。总之,我们的结果表明,GATA-3 和 RORγt 的表达水平可能对确定哮喘气道炎症的表型很重要。此外,阻断 Th17 信号通路可能是治疗类固醇不敏感哮喘的一种选择。
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