Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia; Laboratory for Respiratory Neuroscience and Mucosal Immunity, School of Biomedical Sciences, University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia.
QIMR Berghofer Medical Research Institute, Brisbane, Australia.
J Allergy Clin Immunol. 2015 Oct;136(4):1065-73. doi: 10.1016/j.jaci.2015.02.032. Epub 2015 Apr 28.
BACKGROUND: A variant in the IL-6 receptor (IL-6R) gene increases asthma risk and is predicted to decrease IL-6 classic signaling and increase IL-6 trans-signaling. This suggests that inhibition of IL-6 trans-signaling, but not classic signaling, might suppress allergic airway inflammation. OBJECTIVES: We sought to determine whether IL-6 signaling contributes to (1) acute experimental asthma induced by clinically relevant allergens and (2) variation in asthma clinical phenotypes in asthmatic patients. METHODS: Mice were sensitized to house dust mite (HDM) or cockroach at day 0, treated with IL-6R inhibitors at day 13, and challenged with the same allergen at days 14 to 17. End points were measured 3 hours after the final challenge. IL-6 and soluble IL-6 receptor (sIL-6R) expression in induced sputum of asthmatic patients was correlated with asthma clinical phenotypes. RESULTS: Both HDM and cockroach induced a type 2/type 17 cytokine profile and mixed granulocytic inflammation in the airways. Both allergens increased IL-6 expression in the airways, but only cockroach induced sIL-6R expression. Therefore HDM challenge promoted IL-6 classic signaling but not trans-signaling; in this model treatment with anti-IL-6R did not suppress airway inflammation. In contrast, cockroach-induced inflammation involved activation of IL-6 trans-signaling and production of IL-17A by γδ T cells. Anti-IL-6R, selective blockade of sIL-6R, or γδ T-cell deficiency significantly attenuated cockroach-induced inflammation. Asthmatic patients with high airway IL-6 and sIL-6R levels were enriched for the neutrophilic and mixed granulocytic subtypes. CONCLUSION: Experimental asthma associated with both high IL-6 and high sIL-6R levels in the airways is attenuated by treatment with IL-6R inhibitors.
背景:白细胞介素 6 受体 (IL-6R) 基因的变异会增加哮喘的风险,并预计会降低 IL-6 经典信号转导,增加 IL-6 转信号转导。这表明抑制 IL-6 转信号转导,而不是经典信号转导,可能会抑制过敏性气道炎症。
目的:我们试图确定 IL-6 信号是否有助于(1)由临床相关变应原引起的急性实验性哮喘,以及(2)哮喘患者哮喘临床表型的变化。
方法:在第 0 天对小鼠进行屋尘螨(HDM)或蟑螂致敏,在第 13 天用 IL-6R 抑制剂治疗,并在第 14 至 17 天用相同的变应原进行攻击。在最后一次攻击后 3 小时测量终点。哮喘患者诱导痰中 IL-6 和可溶性 IL-6 受体(sIL-6R)的表达与哮喘临床表型相关。
结果:HDM 和蟑螂均诱导气道中 2 型/17 型细胞因子谱和混合粒细胞炎症。两种变应原均增加了气道中 IL-6 的表达,但只有蟑螂诱导了 sIL-6R 的表达。因此,HDM 攻击促进了 IL-6 经典信号转导,但没有转信号转导;在该模型中,抗 IL-6R 治疗不能抑制气道炎症。相比之下,蟑螂诱导的炎症涉及 IL-6 转信号转导的激活和 γδ T 细胞产生 IL-17A。抗 IL-6R、选择性阻断 sIL-6R 或 γδ T 细胞缺陷显著减轻了蟑螂诱导的炎症。气道中 IL-6 和 sIL-6R 水平较高的哮喘患者中富含中性粒细胞和混合粒细胞亚型。
结论:用 IL-6R 抑制剂治疗可减轻与气道中 IL-6 和 sIL-6R 水平均较高相关的实验性哮喘。
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