TH2 和 TH17 炎症途径在哮喘中相互调节。

TH2 and TH17 inflammatory pathways are reciprocally regulated in asthma.

机构信息

Genentech Inc., South San Francisco, CA 94080, USA.

Program in Tissue Immunity and Repair, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

Sci Transl Med. 2015 Aug 19;7(301):301ra129. doi: 10.1126/scitranslmed.aab3142.

Abstract

Increasing evidence suggests that asthma is a heterogeneous disorder regulated by distinct molecular mechanisms. In a cross-sectional study of asthmatics of varying severity (n = 51), endobronchial tissue gene expression analysis revealed three major patient clusters: TH2-high, TH17-high, and TH2/17-low. TH2-high and TH17-high patterns were mutually exclusive in individual patient samples, and their gene signatures were inversely correlated and differentially regulated by interleukin-13 (IL-13) and IL-17A. To understand this dichotomous pattern of T helper 2 (TH2) and TH17 signatures, we investigated the potential of type 2 cytokine suppression in promoting TH17 responses in a preclinical model of allergen-induced asthma. Neutralization of IL-4 and/or IL-13 resulted in increased TH17 cells and neutrophilic inflammation in the lung. However, neutralization of IL-13 and IL-17 protected mice from eosinophilia, mucus hyperplasia, and airway hyperreactivity and abolished the neutrophilic inflammation, suggesting that combination therapies targeting both pathways may maximize therapeutic efficacy across a patient population comprising both TH2 and TH17 endotypes.

摘要

越来越多的证据表明,哮喘是一种由不同分子机制调控的异质性疾病。在一项对不同严重程度哮喘患者(n=51)的横断面研究中,支气管内组织基因表达分析显示了三个主要的患者群:TH2 高、TH17 高和 TH2/17 低。TH2 高和 TH17 高模式在个体患者样本中是相互排斥的,它们的基因特征与白细胞介素-13(IL-13)和 IL-17A 呈负相关和差异调节。为了理解这种 TH2 和 TH17 特征的二分模式,我们在过敏原诱导的哮喘的临床前模型中研究了抑制 2 型细胞因子在促进 TH17 反应方面的潜力。IL-4 和/或 IL-13 的中和导致肺中 TH17 细胞和中性粒细胞炎症增加。然而,IL-13 和 IL-17 的中和保护小鼠免受嗜酸性粒细胞增多、粘液增生和气道高反应性,并消除中性粒细胞炎症,这表明针对这两种途径的联合治疗可能会在包括 TH2 和 TH17 表型在内的患者群体中最大限度地提高治疗效果。

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