Jacobsen Elizabeth A, Ochkur Sergei I, Doyle Alfred D, LeSuer William E, Li Wen, Protheroe Cheryl A, Colbert Dana, Zellner Katie R, Shen HuaHao H, Irvin Charles G, Lee James J, Lee Nancy A
1 Division of Pulmonary Medicine and.
2 Department of Medicine, Guizhou Provincial People's Hospital, Guizhou, China; and.
Am J Respir Crit Care Med. 2017 May 15;195(10):1321-1332. doi: 10.1164/rccm.201606-1129OC.
The release of eosinophil granule proteins in the lungs of patients with asthma has been dogmatically linked with lung remodeling and airway hyperresponsiveness. However, the demonstrated inability of established mouse models to display the eosinophil degranulation occurring in human subjects has prevented a definitive in vivo test of this hypothesis.
To demonstrate in vivo causative links between induced pulmonary histopathologies/lung dysfunction and eosinophil degranulation.
A transgenic mouse model of chronic T-helper cell type 2-driven inflammation overexpressing IL-5 from T cells and human eotaxin 2 in the lung (I5/hE2) was used to test the hypothesis that chronic histopathologies and the development of airway hyperresponsiveness occur as a consequence of extensive eosinophil degranulation in the lung parenchyma.
Studies targeting specific inflammatory pathways in I5/hE2 mice surprisingly showed that eosinophil-dependent immunoregulative events and not the release of individual secondary granule proteins are the central contributors to T-helper cell type 2-induced pulmonary remodeling and lung dysfunction. Specifically, our studies highlighted a significant role for eosinophil-dependent IL-13 expression. In contrast, extensive degranulation leading to the release of major basic protein-1 or eosinophil peroxidase was not causatively linked to many of the induced pulmonary histopathologies. However, these studies did define a previously unappreciated link between the release of eosinophil peroxidase (but not major basic protein-1) and observed levels of induced airway mucin.
These data suggest that improvements observed in patients with asthma responding to therapeutic strategies ablating eosinophils may occur as a consequence of targeting immunoregulatory mechanisms and not by simply eliminating the destructive activities of these purportedly end-stage effector cells.
哮喘患者肺部嗜酸性粒细胞颗粒蛋白的释放一直被教条地认为与肺重塑和气道高反应性有关。然而,已建立的小鼠模型无法显示人类受试者中发生的嗜酸性粒细胞脱颗粒现象,这使得无法对这一假设进行明确的体内试验。
证明诱导性肺部组织病理学/肺功能障碍与嗜酸性粒细胞脱颗粒之间的体内因果关系。
使用一种慢性2型辅助性T细胞驱动的炎症转基因小鼠模型,该模型在肺中过表达来自T细胞的白细胞介素-5和人嗜酸性粒细胞趋化因子2(I5/hE2),以检验以下假设:慢性组织病理学和气道高反应性的发展是肺实质中广泛嗜酸性粒细胞脱颗粒的结果。
针对I5/hE2小鼠特定炎症途径的研究出人意料地表明,嗜酸性粒细胞依赖性免疫调节事件而非单个二级颗粒蛋白的释放是2型辅助性T细胞诱导的肺重塑和肺功能障碍的主要促成因素。具体而言,我们的研究强调了嗜酸性粒细胞依赖性白细胞介素-13表达的重要作用。相比之下,导致主要碱性蛋白-1或嗜酸性粒细胞过氧化物酶释放的广泛脱颗粒与许多诱导性肺部组织病理学没有因果关系。然而,这些研究确实确定了嗜酸性粒细胞过氧化物酶(而非主要碱性蛋白-1)的释放与观察到的诱导气道粘蛋白水平之间以前未被认识到的联系。
这些数据表明,哮喘患者对消除嗜酸性粒细胞的治疗策略有反应时所观察到的改善,可能是由于针对免疫调节机制,而不是简单地消除这些据称是终末效应细胞的破坏活性。