Ali Md Khadem, Kim Richard Y, Brown Alexandra C, Mayall Jemma R, Karim Rafia, Pinkerton James W, Liu Gang, Martin Kristy L, Starkey Malcolm R, Pillar Amber L, Donovan Chantal, Pathinayake Prabuddha S, Carroll Olivia R, Trinder Debbie, Tay Hock L, Badi Yusef E, Kermani Nazanin Z, Guo Yi-Ke, Aryal Ritambhara, Mumby Sharon, Pavlidis Stelios, Adcock Ian M, Weaver Jessica, Xenaki Dikaia, Oliver Brian G, Holliday Elizabeth G, Foster Paul S, Wark Peter A, Johnstone Daniel M, Milward Elizabeth A, Hansbro Philip M, Horvat Jay C
Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA.
Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia.
Eur Respir J. 2020 Apr 23;55(4). doi: 10.1183/13993003.01340-2019. Print 2020 Apr.
Accumulating evidence highlights links between iron regulation and respiratory disease. Here, we assessed the relationship between iron levels and regulatory responses in clinical and experimental asthma.We show that cell-free iron levels are reduced in the bronchoalveolar lavage (BAL) supernatant of severe or mild-moderate asthma patients and correlate with lower forced expiratory volume in 1 s (FEV). Conversely, iron-loaded cell numbers were increased in BAL in these patients and with lower FEV/forced vital capacity (FVC) ratio. The airway tissue expression of the iron sequestration molecules divalent metal transporter 1 () and transferrin receptor 1 () are increased in asthma, with expression correlating with reduced lung function and increased Type-2 (T2) inflammatory responses in the airways. Furthermore, pulmonary iron levels are increased in a house dust mite (HDM)-induced model of experimental asthma in association with augmented expression in airway tissue, similar to human disease. We show that macrophages are the predominant source of increased Tfr1 and Tfr1 macrophages have increased expression. We also show that increased iron levels induce increased pro-inflammatory cytokine and/or extracellular matrix (ECM) responses in human airway smooth muscle (ASM) cells and fibroblasts and induce key features of asthma , including airway hyper-responsiveness (AHR) and fibrosis, and T2 inflammatory responses.Together these complementary clinical and experimental data highlight the importance of altered pulmonary iron levels and regulation in asthma, and the need for a greater focus on the role and potential therapeutic targeting of iron in the pathogenesis and severity of disease.
越来越多的证据表明铁调节与呼吸系统疾病之间存在联系。在此,我们评估了临床和实验性哮喘中铁水平与调节反应之间的关系。我们发现,重度或轻度 - 中度哮喘患者支气管肺泡灌洗(BAL)上清液中的游离铁水平降低,且与1秒用力呼气量(FEV)降低相关。相反,这些患者BAL中含铁细胞数量增加,且FEV/用力肺活量(FVC)比值降低。哮喘患者气道组织中铁螯合分子二价金属转运体1( )和转铁蛋白受体1( )的表达增加,其中 的表达与肺功能降低和气道中2型(T2)炎症反应增加相关。此外,在屋尘螨(HDM)诱导的实验性哮喘模型中,肺铁水平升高,同时气道组织中 表达增加,与人类疾病相似。我们发现巨噬细胞是Tfr1增加的主要来源,且Tfr1巨噬细胞的 表达增加。我们还发现,铁水平升高会诱导人气道平滑肌(ASM)细胞和成纤维细胞中促炎细胞因子和/或细胞外基质(ECM)反应增加,并诱导哮喘的关键特征,包括气道高反应性(AHR)和纤维化以及T2炎症反应。这些互补的临床和实验数据共同突出了哮喘中肺铁水平改变和调节的重要性,以及需要更加关注铁在疾病发病机制和严重程度中的作用及潜在治疗靶点。