Division of Mucosal Immunology and Diagnostics, Research Center Borstel, Borstel, Germany.
Airway Research Center North, German Center for Lung Research (DZL), Borstel, Germany.
Front Immunol. 2020 Apr 28;11:761. doi: 10.3389/fimmu.2020.00761. eCollection 2020.
Allergic bronchial asthma is a chronic disease of the airways that is characterized by symptoms like respiratory distress, chest tightness, wheezing, productive cough, and acute episodes of broncho-obstruction. This symptom-complex arises on the basis of chronic allergic inflammation of the airway wall. Consequently, the airway epithelium is central to the pathogenesis of this disease, because its multiple abilities directly have an impact on the inflammatory response and thus the formation of the disease. In turn, its structure and functions are markedly impaired by the inflammation. Hence, the airway epithelium represents a sealed, self-cleaning barrier, that prohibits penetration of inhaled allergens, pathogens, and other noxious agents into the body. This barrier is covered with mucus that further contains antimicrobial peptides and antibodies that are either produced or specifically transported by the airway epithelium in order to trap these particles and to remove them from the body by a process called mucociliary clearance. Once this first line of defense of the lung is overcome, airway epithelial cells are the first cells to get in contact with pathogens, to be damaged or infected. Therefore, these cells release a plethora of chemokines and cytokines that not only induce an acute inflammatory reaction but also have an impact on the alignment of the following immune reaction. In case of asthma, all these functions are impaired by the already existing allergic immune response that weakens the barrier integrity and self-cleaning abilities of the airway epithelium making it more vulnerable to penetration of allergens as well as of infection by bacteria and viruses. Recent studies indicate that the history of allergy- and pathogen-derived insults can leave some kind of memory in these cells that can be described as imprinting or trained immunity. Thus, the airway epithelium is in the center of processes that lead to formation, progression and acute exacerbation of asthma.
变应性支气管哮喘是一种气道慢性疾病,其特征是呼吸困难、胸闷、喘息、咳痰和急性气道阻塞。这种症状群是基于气道壁的慢性过敏炎症。因此,气道上皮细胞是这种疾病发病机制的核心,因为其多种能力直接影响炎症反应,从而影响疾病的形成。反过来,其结构和功能因炎症而明显受损。因此,气道上皮细胞代表一个封闭的、自我清洁的屏障,阻止吸入的过敏原、病原体和其他有害物质进入体内。该屏障覆盖有黏液,黏液中进一步含有抗菌肽和抗体,这些物质由气道上皮细胞产生或特异性转运,以捕获这些颗粒,并通过称为黏液纤毛清除的过程将其从体内清除。一旦肺部的第一道防线被突破,气道上皮细胞就是首先与病原体接触、受损或感染的细胞。因此,这些细胞释放大量趋化因子和细胞因子,不仅诱导急性炎症反应,而且对后续免疫反应的排列产生影响。在哮喘的情况下,所有这些功能都因已经存在的过敏免疫反应而受损,这种免疫反应削弱了气道上皮细胞的屏障完整性和自我清洁能力,使气道上皮细胞更容易受到过敏原以及细菌和病毒的侵袭。最近的研究表明,过敏和病原体相关损伤的历史可以在这些细胞中留下某种记忆,可以描述为印迹或训练免疫。因此,气道上皮细胞是导致哮喘形成、进展和急性加重的过程的中心。