Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Pharmacol Res. 2019 Oct;148:104441. doi: 10.1016/j.phrs.2019.104441. Epub 2019 Sep 7.
Asthma is a complex airways disease with a wide spectrum which ranges from eosinophilic (Th2 driven) to mixed granulocytic (Th2/Th17 driven) phenotypes. Mixed granulocytic asthma is a cause of concern as corticosteroids often fail to control this phenotype. Different kinases such as Brutons's tyrosine kinase (BTK) and IL-2 inducible T cell kinase (ITK) play a pivotal role in shaping allergic airway inflammation. Ibrutinib is primarily a BTK inhibitor, however it is reported to be an ITK inhibitor as well. In this study, we sought to determine the effect of Ibrutinib on Th1, Th17 and Th2 immune responses in a cockroach allergen extract (CE)-induced mixed granulocytic (eosinophilic and neutrophilic) mouse model in preventative mode. Ibrutinib attenuated neutrophilic inflammation at a much lower doses (25-75 μg/mouse) in CE-induced mixed granulocytic asthma whereas Th2/Th17 immune responses remained unaffected at these doses. However, at a much higher dose, i.e. 250 μg/mouse, Ibrutinib remarkably suppressed both Th17/Th2 and lymphocytic/neutrophilic/eosinophilic airway inflammation. At molecular level, Ibrutinib suppressed phosphorylation of BTK in neutrophils at lower doses and ITK in CD4 + T cells at higher doses in CE-treated mice. Further, effects of Ibrutinib were compared with dexamethasone on CE-induced mixed granulocytic asthma in therapeutic mode. Ibrutinib was able to control granulocytic inflammation along with Th2/Th17 immune response in therapeutic mode whereas dexamethasone limited only Th2/eosinophilic inflammation. Thus, Ibrutinib has the potential to suppress both Th17/Th2 and neutrophilic/eosinophilic inflammation during mixed granulocytic asthma and therefore may be pursued as alternative therapeutic option in difficult-to-treat asthma which is resistant to corticosteroids.
哮喘是一种复杂的气道疾病,其表型范围广泛,从嗜酸性粒细胞(Th2 驱动)到混合粒细胞(Th2/Th17 驱动)。混合粒细胞性哮喘是一个令人关注的问题,因为皮质类固醇通常无法控制这种表型。不同的激酶,如布鲁顿酪氨酸激酶(BTK)和白细胞介素 2 诱导的 T 细胞激酶(ITK),在塑造过敏性气道炎症中起着关键作用。伊布替尼主要是一种 BTK 抑制剂,但据报道它也是一种 ITK 抑制剂。在这项研究中,我们试图确定伊布替尼在预防模式下对蟑螂过敏原提取物(CE)诱导的混合粒细胞性(嗜酸性粒细胞和中性粒细胞)小鼠模型中的 Th1、Th17 和 Th2 免疫反应的影响。伊布替尼在较低剂量(25-75μg/只)下减轻了 CE 诱导的混合粒细胞性哮喘中的中性粒细胞炎症,而在这些剂量下 Th2/Th17 免疫反应不受影响。然而,在更高的剂量,即 250μg/只,伊布替尼显著抑制了 Th17/Th2 和淋巴细胞/中性粒细胞/嗜酸性粒细胞气道炎症。在分子水平上,伊布替尼在较低剂量下抑制中性粒细胞中 BTK 的磷酸化,在较高剂量下抑制 CD4+T 细胞中 ITK 的磷酸化。此外,还比较了伊布替尼与地塞米松在治疗模式下对 CE 诱导的混合粒细胞性哮喘的作用。伊布替尼在治疗模式下能够控制粒细胞炎症以及 Th2/Th17 免疫反应,而地塞米松仅能限制 Th2/嗜酸性粒细胞炎症。因此,伊布替尼有可能在混合粒细胞性哮喘中抑制 Th17/Th2 和嗜中性粒细胞/嗜酸性粒细胞炎症,因此可能作为治疗对皮质类固醇耐药的难治性哮喘的替代治疗选择。
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