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预防白细胞介素-6 信号转导可改善甲苯二异氰酸酯诱导的类固醇耐药性哮喘。

Prevention of IL-6 signaling ameliorates toluene diisocyanate-induced steroid-resistant asthma.

机构信息

Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), The First Affiliated Hospital of Southern University of Science and Technology (Shenzhen People's Hospital), Shenzhen, China; Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Jinan University, Guangzhou, China.

Department of Clinical Laboratory, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China.

出版信息

Allergol Int. 2022 Jan;71(1):73-82. doi: 10.1016/j.alit.2021.07.004. Epub 2021 Jul 28.

Abstract

BACKGROUND

Accumulating evidence indicated the crucial role for interleukin 6 (IL-6) signaling in the development of allergic asthma. Yet, the role of IL-6 signaling in toluene diisocyanate (TDI)-induced mixed granulocytic airway inflammation still remains unclear. Thus, the aims of this study were to dissect the role of IL-6 signaling and to evaluate the effect of tocilizumab on TDI-induced steroid-resistant asthma.

METHODS

TDI-induced asthma model was prepared and asthmatic mice were respectively given IL-6 monoclonal antibody, IL-6R monoclonal antibody (tocilizumab, 5 mg/kg, i.p. after each challenge) for therapeutic purposes or isotype IgG as control.

RESULTS

TDI exposure just elevated IL-6R expression in the infiltrated inflammatory cells around the airway, but increased glycoprotein 130 expression in the whole lung, especially in bronchial epithelium. Moreover, TDI inhalation increased airway hyperresponsiveness (AHR) to methacholine, coupled with mixed granulocytic inflammation, exaggerated epithelial denudation, airway smooth muscle thickening, goblet cell metaplasia, extensive submucosal collagen deposition, dysregulated Th2/Th17 responses, as well as innate immune responses and raised serum IgE. And almost all these responses except for raised serum IgE were markedly ameliorated by the administration of IL-6 neutralizing antibody or tocilizumab, but exhibited poor response to systemic steroid treatment. Also, TDI challenge induced nucleocytoplasm translocation of HMGB1 and promoted its release in the BALF, as well as elevated lung level of STAT3 phosphorylation, which were inhibited by anti-IL-6 and anti-IL-6R treatment.

CONCLUSIONS

Our data suggested that IL-6 monoclonal antibody and tocilizumab might effectively abrogate TDI-induced airway inflammation and remodeling, which could be used as a clinical potential therapy for patients with severe asthma.

摘要

背景

越来越多的证据表明白细胞介素 6(IL-6)信号在过敏性哮喘的发展中起着关键作用。然而,IL-6 信号在甲苯二异氰酸酯(TDI)诱导的混合粒细胞性气道炎症中的作用仍不清楚。因此,本研究旨在探讨 IL-6 信号的作用,并评估托珠单抗对 TDI 诱导的皮质类固醇抵抗性哮喘的影响。

方法

制备 TDI 诱导的哮喘模型,哮喘小鼠分别给予 IL-6 单克隆抗体、IL-6R 单克隆抗体(托珠单抗,5mg/kg,每次激发后腹腔注射)进行治疗,或给予同型 IgG 作为对照。

结果

TDI 暴露仅增加气道周围浸润性炎症细胞中的 IL-6R 表达,但增加整个肺组织中的糖蛋白 130 表达,尤其是在支气管上皮细胞中。此外,TDI 吸入增加了气道对乙酰甲胆碱的高反应性(AHR),同时伴有混合粒细胞性炎症、上皮脱落加剧、气道平滑肌增厚、杯状细胞化生、广泛的黏膜下胶原沉积、Th2/Th17 反应失调以及固有免疫反应,血清 IgE 升高。除了血清 IgE 升高外,几乎所有这些反应都被 IL-6 中和抗体或托珠单抗治疗显著改善,但对全身皮质类固醇治疗反应不佳。此外,TDI 激发诱导 HMGB1 的核质转位并促进其在 BALF 中的释放,并增加肺组织中 STAT3 磷酸化水平,这些反应均被抗 IL-6 和抗 IL-6R 治疗所抑制。

结论

我们的数据表明,IL-6 单克隆抗体和托珠单抗可能有效地阻断 TDI 诱导的气道炎症和重塑,可作为严重哮喘患者的潜在临床治疗方法。

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