Fastiggi V Amanda, Mank Madeleine M, Caporizzo Matthew A, Poynter Matthew E
Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington, VT, 05405, USA.
Cellular, Molecular, and Biomedical Sciences Doctoral Program, University of Vermont, Burlington, VT, 05405, USA.
bioRxiv. 2025 Feb 26:2025.02.24.639075. doi: 10.1101/2025.02.24.639075.
Asthma is a chronic respiratory condition characterized by airway inflammation, remodeling, and hyperresponsiveness to triggers causing airway constriction. Bronchial smooth muscle plays a critical role by narrowing airways, leading to obstruction and breathing difficulties, often exacerbated by mast cell infiltration and histamine release. Whereas current treatments, including bronchodilators, corticosteroids, and biologics provide effective management for most patients, alternative therapies are needed for difficult-to-treat asthma. Recent research highlights the potential of therapeutic ketosis, achieved through dietary interventions or supplementation with exogenous ketones, to reduce airway hyperresponsiveness and inflammation. Ketone bodies, known for providing energy during carbohydrate scarcity, also influence asthma by activating cell-surface receptors and transporters. , interventions like weight loss and caloric restriction increase ketone body levels, correlating with improved asthma symptoms, reduced oxidative stress, and inflammation. These effects suggest ketone bodies, particularly β-hydroxybutyrate, may play a therapeutic role in mitigating bronchoconstriction and smooth muscle contraction in asthma. We utilize human bronchial smooth muscle cells () and mouse precision-cut lung slices (PCLS) () to assess the effects of BHB on histamine-induced bronchoconstriction. Brightfield microscopy showed that BHB reduces contraction in human bronchial smooth muscle cells, an effect involving free fatty acid receptor 3 (FFAR3) activation. Light microscopy of PCLS revealed that BHB inhibits airway narrowing and cellular extrusion, demonstrating its ability to mitigate bronchoconstriction by suppressing smooth muscle contraction. These results implicate bronchial smooth muscle as a cellular target of therapeutic ketosis, an important contributor to the beneficial effects of BHB in preclinical models of asthma.
哮喘是一种慢性呼吸道疾病,其特征为气道炎症、重塑以及对引发气道收缩的触发因素产生高反应性。支气管平滑肌通过使气道变窄发挥关键作用,导致气道阻塞和呼吸困难,肥大细胞浸润和组胺释放常常会加剧这些症状。尽管目前的治疗方法,包括支气管扩张剂、皮质类固醇和生物制剂能为大多数患者提供有效的管理,但对于难治性哮喘仍需要替代疗法。最近的研究突出了通过饮食干预或补充外源性酮体实现的治疗性酮症在降低气道高反应性和炎症方面的潜力。酮体在碳水化合物缺乏时提供能量,还通过激活细胞表面受体和转运体影响哮喘。减肥和热量限制等干预措施会提高酮体水平,这与哮喘症状改善、氧化应激和炎症减轻相关。这些效应表明酮体,尤其是β-羟基丁酸酯,可能在减轻哮喘中的支气管收缩和平滑肌收缩方面发挥治疗作用。我们利用人支气管平滑肌细胞()和小鼠精密切割肺切片(PCLS)()来评估β-羟基丁酸酯(BHB)对组胺诱导的支气管收缩的影响。明场显微镜显示BHB可减少人支气管平滑肌细胞的收缩,这一效应涉及游离脂肪酸受体3(FFAR3)的激活。PCLS的光学显微镜显示BHB可抑制气道狭窄和细胞挤出,证明其通过抑制平滑肌收缩减轻支气管收缩的能力。这些结果表明支气管平滑肌是治疗性酮症的细胞靶点,这是BHB在哮喘临床前模型中产生有益作用的一个重要因素。
bioRxiv. 2025-2-26
J Allergy Clin Immunol Glob. 2022-11
Zhonghua Jie He He Hu Xi Za Zhi. 2024-2-12
Am J Respir Cell Mol Biol. 2018-5
Am J Physiol Lung Cell Mol Physiol. 2022-2-1
Am J Physiol Lung Cell Mol Physiol. 2018-8-2
Science. 2024-4-5
Am J Physiol Lung Cell Mol Physiol. 2024-1-1
NPJ Prim Care Respir Med. 2023-2-8
J Allergy Clin Immunol Glob. 2022-11