Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Division of Respirology, Toho University Ohashi Medical Center, Tokyo, Japan.
Ann Allergy Asthma Immunol. 2014 Aug;113(2):180-6. doi: 10.1016/j.anai.2014.05.011. Epub 2014 Jun 3.
Aspergillus fumigatus (Af) sometimes colonizes and persists within the respiratory tree in some patients with asthma. To date, the precise reasons why the clearance of Af is impaired in patients with asthma remain unknown.
To characterize the effects of allergic airway inflammation on clearance of Af.
Control and Dermatophagoides farinae (Df) allergen-sensitized BALB/c mice were intranasally infected with Af. After 2 and 9 days of infection, the pathology, fungal burden, and cytokine profile in lung tissue were compared. In a different set of experiments, the phagocytotic activity of alveolar macrophages and the expression of their pathogen recognition receptors also were determined.
The Af conidia and neutrophilic airway inflammation disappeared by day 9 after infection in control mice. In Df-sensitized mice, Af conidia and neutrophilic and eosinophilic airway inflammation persisted at day 9 after infection. Compared with control mice, Df allergen-sensitized mice showed significant increases in interleukin (IL)-5 and decreases in IL-12 and interferon-γ in lung tissues at day 2 after infection. Most importantly, compared with Af-infected non-Df-sensitized mice, IL-17 in lung tissues was significantly decreased in Df allergen-sensitized Af-infected mice at day 2 after infection but was significantly increased at day 9. Alveolar macrophages isolated from Df allergen-sensitized mice exhibited significant decreases in phagocytotic activity and expression of Toll-like receptor-4 and dectin-1 compared with those from control mice.
In the airway of patients with allergy, T-helper cell type 2-dominant immunity potentially affects the expression of pathogen recognition receptors and attenuates cellular defense against Af. Prolonged IL-17 production also could play an important role.
烟曲霉(Af)有时会在一些哮喘患者的呼吸道中定植并持续存在。迄今为止,哮喘患者清除 Af 能力受损的确切原因仍不清楚。
描述过敏性气道炎症对 Af 清除的影响。
对照组和屋尘螨(Df)过敏原致敏 BALB/c 小鼠经鼻腔感染 Af。在感染后第 2 天和第 9 天,比较肺组织的病理学、真菌负荷和细胞因子谱。在另一组实验中,还测定了肺泡巨噬细胞的吞噬活性及其病原体识别受体的表达。
在对照组小鼠中,感染后第 9 天 Af 分生孢子和中性粒细胞性气道炎症消失。在 Df 致敏小鼠中,Af 分生孢子和中性粒细胞性及嗜酸性粒细胞性气道炎症在感染后第 9 天仍持续存在。与对照组小鼠相比,Df 过敏原致敏小鼠在感染后第 2 天肺组织中白细胞介素(IL)-5 显著增加,IL-12 和干扰素-γ 显著减少。最重要的是,与感染 Af 的非 Df 致敏小鼠相比,感染 Af 的 Df 过敏原致敏小鼠在感染后第 2 天肺组织中的 IL-17 明显减少,但在第 9 天明显增加。与对照组小鼠相比,从 Df 过敏原致敏小鼠分离的肺泡巨噬细胞的吞噬活性和 Toll 样受体-4 和 dectin-1 的表达显著降低。
在过敏患者的气道中,辅助性 T 细胞 2 型优势免疫可能会影响病原体识别受体的表达,并减弱机体对 Af 的细胞防御。延长的 IL-17 产生也可能发挥重要作用。