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Nedeva D, Kowal K, Mihaicuta S, Guidos Fogelbach G, Steiropoulos P, Jose Chong-Neto H, Tiotiu A. Epithelial alarmins: a new target to treat chronic respiratory diseases. Expert Rev Respir Med 2023; 17:773-786. [PMID: 37746733 DOI: 10.1080/17476348.2023.2262920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION In response to injury, epithelial cells release alarmins including thymic stromal lymphopoietin (TSLP), high mobility group-box-1 (HMGB1), interleukin (IL)-33 and -25 that can initiate innate immune responses. These alarmins are recognized as activators of T2-immune responses characteristic for asthma, but recent evidence highlighted their role in non-T2 inflammation, airway remodeling, and pulmonary fibrosis making them an attractive therapeutic target for chronic respiratory diseases (CRD). AREAS COVERED In this review, firstly we discuss the role of TSLP, IL-33, IL-25, and HMGB1 in the pathogenesis of asthma, COPD, idiopathic pulmonary fibrosis, and cystic fibrosis according to the published data. In the second part, we summarize the current evidence concerning the efficacy of the antialarmin therapies in CRD. Recent clinical trials showed that anti-TSLP and IL-33/R antibodies can improve severe asthma outcomes. Blocking the IL-33-mediated pathway decreased the exacerbation rate in COPD patients with more important benefit for former-smokers. EXPERT OPINION Despite progress in the understanding of the alarmins' role in the pathogenesis of CRD, all their mechanisms of action are not yet identified. Blocking IL-33 and TSLP pathways offers an interesting option to treat severe asthma and COPD, but future investigations are needed to establish their place in the treatment strategies.
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Affiliation(s)
- Denislava Nedeva
- Clinic of Asthma and Allergology, UMBAL Alexandrovska, Medical University Sofia, Sofia, Bulgaria
| | - Krzysztof Kowal
- Department of Experimental Allergology and Immunology, Department of Internal Medicine and Allergology, Medical University of Bialystok, Bialystok, Poland
| | - Stefan Mihaicuta
- Center for Research and Innovation in Precision Medicine and Pharmacy, University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pulmonology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Herberto Jose Chong-Neto
- Division of Allergy and Immunology, Complexo Hospital de Clinicas Federal University of Paraná, Curitiba, PR, Brazil
| | - Angelica Tiotiu
- Department of Pulmonology, University Hospital of Nancy, Vandœuvre-lès-Nancy, France
- Development, Adaptation and Disadvantage. Cardiorespiratory regulations and motor control (EA 3450 DevAH), University of Lorraine, Vandœuvre-lès-Nancy, France
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Kim M, Kim YM, Lee JY, Yang HK, Kim H, Ahn S, Baek SY, Kim J, Ahn K. Seasonal and monthly variation in peak expiratory flow rate in children with asthma. Asia Pac Allergy 2021; 11:e19. [PMID: 34007829 PMCID: PMC8103013 DOI: 10.5415/apallergy.2021.11.e19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/25/2021] [Indexed: 12/22/2022] Open
Abstract
Background Although understanding the seasonal patterns of asthma deterioration is important to prevent asthma exacerbation, previous approaches have limitations in evaluating the actual trend of asthma exacerbation. Objective This study aimed to evaluate the seasonal and monthly variations in the peak expiratory flow rate (PEFR) among children with asthma. Methods A total of 89 patients with asthma were enrolled between December 2012 and March 2015. The PEFR in the morning and evening was recorded daily, and the percentage change in PEFR from baseline was calculated. Generalized estimating equation models were constructed after adjusting for age, sex, body mass index, and sensitization to house dust mites or pollen. Results The PEFR records of 11,222 person-days showed a significant decrease in the morning and evening in autumn than in winter by -1.9% (95% confidence interval [CI], -3.73 to -0.15) and -2.1% (95% CI, -3.80 to -0.37), respectively. The morning PEFR was significantly lower in April, August, October, and December than in January with changes of -4.2% (95% CI, -7.08 to -1.23) in April, -3.1% (95% CI, -5.79 to -0.47) in August, -3.7% (95% CI, -6.09 to -1.21) in October, and -1.9% (95% CI, -3.62 to -0.12) in December. The percentage change of evening PEFR significantly decreased by -3.3% (95% CI, -6.38 to -0.25) in April and by -3.3% (95% CI, -5.56 to -1.07) in October. Conclusion The PEFR in children with asthma was lower in autumn than in winter. In terms of monthly patterns, the PEFR was significantly reduced in April and October than in January. These results can serve as a basis for preventing asthma exacerbations by developing seasonal or monthly management strategies for children with asthma.
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Affiliation(s)
- Minji Kim
- Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Young-Min Kim
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
| | - Ji Young Lee
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Hea-Kyoung Yang
- Department of Pediatrics, Oz Pediatrics Clinic, Yongin, Korea
| | - Hyunmi Kim
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
| | - Soohyun Ahn
- Department of Mathematics, Ajou University, Suwon, Korea
| | - Sun-Young Baek
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Jihyun Kim
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.,Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.,Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Duong-Quy S, Ngo-Minh X, Tang-Le-Quynh T, Tang-Thi-Thao T, Nguyen-Quoc B, Le-Quang K, Tran-Thanh D, Doan-Thi-Quynh N, Canty E, Do T, Craig T. The use of exhaled nitric oxide and peak expiratory flow to demonstrate improved breathability and antimicrobial properties of novel face mask made with sustainable filter paper and Folium Plectranthii amboinicii oil: additional option for mask shortage during COVID-19 pandemic. Multidiscip Respir Med 2020; 15:664. [PMID: 32549983 PMCID: PMC7282423 DOI: 10.4081/mrm.2020.664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022] Open
Abstract
Background Medical face masks are integral personal protective equipment against infectious airborne disease and become scarce during epidemic outbreaks such as COVID-19. A novel, sustainably manufactured face mask with antimicrobial and anti-inflammatory properties from oil of Folium Plectranthii amboinicii can be an effective alternative to internationally sold masks. Methods This prospective, randomized study assigned subjects (n=67) to either conventional surgical face mask or Lamdong Medical College (LMC) face mask for three hours. Fractional concentration of nitric oxide in exhaled breath (FENO) and peak expiratory flow (PEF) was measured before and after mask use. Subjective reporting on respiratory symptoms was also analyzed. Masks were then incubated and analyzed for microorganism growth. Results Subjects assigned the LMC mask had a lowered FENO (p<0.05) compared to conventional face masks after mask wearing. Subjects with LMC mask use reported higher comfortability (p<0.05), breathability (p<0.05), and lower allergy symptoms (p<0.05). The LMC mask has visually less microorganism growth in the cultured medium, measured by sterile ring radius. Conclusions The LMC face mask is a renewably manufactured personal protective tool with antibacterial capacity that can serve as an effective alternative to internationally sold surgical face mask during shortage of mask due to COVID-19.
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Affiliation(s)
- Sy Duong-Quy
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam.,Division of Immuno-Allergology, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA.,Pham Ngoc Thach Medical University, Ho Chi Minh city, Vietnam Co-first author
| | - Xuan Ngo-Minh
- Pham Ngoc Thach Medical University, Ho Chi Minh city, Vietnam Co-first author
| | - Trinh Tang-Le-Quynh
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Tram Tang-Thi-Thao
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Bao Nguyen-Quoc
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Khiet Le-Quang
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Dinh Tran-Thanh
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Nhu Doan-Thi-Quynh
- Medical-Biological Research Center, Lamdong Medical College, Da Lat city, Vietnam
| | - Ethan Canty
- Division of Immuno-Allergology, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA
| | - Toan Do
- Division of Immuno-Allergology, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA
| | - Timothy Craig
- Division of Immuno-Allergology, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA
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Wang K, Verbakel JY, Oke J, Fleming-Nouri A, Brewin J, Roberts N, Harada N, Atsuta R, Takahashi K, Mori K, Fujisawa T, Shirai T, Kawayama T, Inoue H, Lazarus S, Szefler S, Martinez F, Shaw D, Pavord ID, Thomas M. Using fractional exhaled nitric oxide to guide step-down treatment decisions in patients with asthma: a systematic review and individual patient data meta-analysis. Eur Respir J 2020; 55:13993003.02150-2019. [PMID: 32139458 DOI: 10.1183/13993003.02150-2019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND High exhaled nitric oxide fraction (F ENO) levels are associated with greater risk of asthma exacerbation. However, it is not clear how F ENO can be used to guide safe reductions in inhaled corticosteroid (ICS) doses in asthma patients. This study assesses the ability of F ENO to guide ICS reductions. METHODS Systematic searching of electronic databases identified prospective observational studies and randomised controlled trials which recruited participants with mild-to-moderate asthma aged ≥12 years and measured F ENO before reducing ICS. We performed multilevel mixed-effects logistic regression in relation to acute exacerbations and estimated each participant's exacerbation risk using our logistic regression model. RESULTS We included data from seven out of eight eligible studies, representing 384 participants. ICS doses were halved in four studies and withdrawn in three studies. A baseline F ENO measurement of ≥50 ppb was associated with increased risk of exacerbations (crude OR 3.14, 95% CI 1.41-7.00, p=0.005; adjusted OR 3.08, 95% CI 1.36-6.98, p=0.007) and corresponded to an estimated exacerbation risk cut-off of 15%. Reducing ICS when estimated exacerbation risk was <15% versus <10% would result in fewer patients remaining on the same ICS dose (40 (10.4%) out of 384 versus 141 (36.7%) out of 384), but similar proportions of patients avoiding exacerbations (222 (91.4%) out of 243, 95% CI 87.1-94.6% versus 311 (90.4%) out of 344, 95% CI 86.8-93.3%). CONCLUSION In patients with mild-to-moderate asthma, gradual ICS reduction when F ENO is <50 ppb may help decrease ICS use without increasing exacerbations. Future research should aim to validate these findings in larger populations.
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Affiliation(s)
- Kay Wang
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jan Y Verbakel
- KU Leuven, Dept of Public Health and Primary Care, Leuven, Belgium
| | - Jason Oke
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Josh Brewin
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Norihiro Harada
- Dept of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Ryo Atsuta
- Dept of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Kazuhisa Takahashi
- Dept of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Kazutaka Mori
- Second Division Dept of Internal Medicine, Hamamatsu University School of Medicine, Hammamatsu, Japan
| | - Tomoyuki Fujisawa
- Second Division Dept of Internal Medicine, Hamamatsu University School of Medicine, Hammamatsu, Japan
| | - Toshihiro Shirai
- Dept of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Japan
| | - Hiromasa Inoue
- Dept of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Stephen Lazarus
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA, USA
| | - Stanley Szefler
- Children's Hospital Colorado, The Breathing Institute, Dept of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Fernando Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Dominick Shaw
- Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, UK
| | - Ian D Pavord
- Oxford Respiratory NIHR BRC and Respiratory Medicine Unit, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
| | - Mike Thomas
- Primary Care, Population Sciences and Medical Education (PPM), University of Southampton, Southampton, UK
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Wong A, Hardaker K, Field P, Huvanandana J, King GG, Reddel H, Selvadurai H, Thamrin C, Robinson PD. Home-based Forced Oscillation Technique Day-to-Day Variability in Pediatric Asthma. Am J Respir Crit Care Med 2020; 199:1156-1160. [PMID: 30822109 DOI: 10.1164/rccm.201809-1659le] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Alexander Wong
- 1 The Children's Hospital at Westmead Westmead, Australia
| | - Kate Hardaker
- 1 The Children's Hospital at Westmead Westmead, Australia.,2 The University of Sydney Sydney, Australia and
| | - Penny Field
- 1 The Children's Hospital at Westmead Westmead, Australia
| | | | - Gregory G King
- 2 The University of Sydney Sydney, Australia and.,3 The Woolcock Institute for Medical Research Glebe, Australia
| | - Helen Reddel
- 3 The Woolcock Institute for Medical Research Glebe, Australia
| | - Hiran Selvadurai
- 1 The Children's Hospital at Westmead Westmead, Australia.,2 The University of Sydney Sydney, Australia and
| | - Cindy Thamrin
- 2 The University of Sydney Sydney, Australia and.,3 The Woolcock Institute for Medical Research Glebe, Australia
| | - Paul D Robinson
- 1 The Children's Hospital at Westmead Westmead, Australia.,2 The University of Sydney Sydney, Australia and.,3 The Woolcock Institute for Medical Research Glebe, Australia
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Schatz M, Sicherer SH, Khan D, Zeiger RS. The Journal of Allergy and Clinical Immunology: In Practice 2018 Highlights. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:393-411. [PMID: 30557718 DOI: 10.1016/j.jaip.2018.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Abstract
A large number of clinically impactful studies and reviews were published in this journal in 2018. This article provides highlights of the original research published in 2018 issues of The Journal of Allergy and Clinical Immunolgy: In Practice on the subjects of anaphylaxis, asthma, dermatitis, drug allergy, eosinophilic disorders, food allergy, immune deficiency, rhinitis, and urticaria/angioedema and mast cell disorders. Within each topic, practical aspects of diagnosis and management are emphasized. Treatments discussed include lifestyle modifications, allergen avoidance therapy, positive and negative effects of pharmacologic therapy, and various forms of immunologic and desensitization management. We hope this review will help readers consolidate and use this extensive and practical knowledge for the benefit of patients.
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Affiliation(s)
- Michael Schatz
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif.
| | - Scott H Sicherer
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David Khan
- Department of Internal Medicine, Division of Allergy & Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert S Zeiger
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
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Pérez de Llano L, García-Rivero JL, Urrutia I, Martínez-Moragón E, Ramos J, Cebollero P, Carballada F, Blanco-Aparicio M, Vennera MDC, Merino M, Torralba-García Y, Plaza V. A Simple Score for Future Risk Prediction in Patients with Controlled Asthma Who Undergo a Guidelines-Based Step-Down Strategy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:1214-1221.e3. [PMID: 30368006 DOI: 10.1016/j.jaip.2018.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/13/2018] [Accepted: 10/15/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The minimum controlling dose of treatment must be established in patients with asthma, but the outcome of step-down is unpredictable. OBJECTIVE To identify factors associated with risk of control loss when stepping down asthma treatment and to develop a score to predict this risk. METHODS A prospective, multicenter study including adults with well-controlled asthma was performed. Treatment was stepped up or stepped down over a 12-month period to maintain asthma control. We determined associations between clinical and functional variables and step-down failure. Finally, we derived a score to predict loss of control in 1 cohort and validated it in an independent cohort. RESULTS The derivation cohort consisted of 228 patients; 218 completed at least 1 step-down episode and a total of 495 step-down episodes were evaluated. A medical-record documented postbronchodilator spirometry result of <70% forced expiratory volume in 1 second (FEV1)/forced vital capacity (odds ratio [OR] = 2.08; 95% confidence interval [CI]: 1.26-3.43), current FEV1 < 80% (OR = 1.80; 95% CI: 1.03-3.14), ≥1 severe exacerbation in the previous 12 months (OR = 2.43; 95% CI: 1.48-4.01), and Asthma Control Test score < 25 (OR = 2.30; 95% CI: 1.35-3.92) were independently associated with failure. The score showed an area under the curve of 0.690 (95% CI: 0.633-0.747; P < .05) in the derivation cohort and 0.76 (95% CI: 0.643-0.882; P < .001) in a validation cohort of 114 patients. A score <4.5 implies a low risk of failure (<20%), whereas a score >8 implies a high risk (>40%). CONCLUSION This score can facilitate the prediction of step-down failure before medication taper in patients with well-controlled asthma.
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Affiliation(s)
| | | | - Isabel Urrutia
- Pneumology Service, Hospital de Galdakao, Bizkaia, Spain
| | | | - Jacinto Ramos
- Pneumology Service, Complejo Asistencial de Salamanca, Salamanca, València, Spain
| | - Pilar Cebollero
- Pneumology Service, Complejo Hospitalario de Navarra, Navarra, Spain
| | | | - Marina Blanco-Aparicio
- Pneumology Service, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
| | - María Del Carmen Vennera
- Servei de Pneumologia i Allèrgia Respiratòria, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - María Merino
- Health Outcomes Research Department, Weber, Economía y Salud, Madrid, Spain
| | - Yolanda Torralba-García
- Servei de Pneumologia i Allèrgia Respiratòria, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain
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Tsurikisawa N, Oshikata C, Watanabe M, Tsuburai T, Kaneko T, Saito H. Innate immune response reflects disease activity in eosinophilic granulomatosis with polyangiitis. Clin Exp Allergy 2018; 48:1305-1316. [PMID: 29908086 DOI: 10.1111/cea.13209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Eosinophilic granulomatosis with polyangiitis (EGPA) is a disease characterized by allergic granulomatosis, necrotizing vasculitis, and peripheral blood eosinophilia. Interleukin (IL)-33, thymic stromal lymphopoietin (TSLP), and type 2 innate lymphoid cells (ILC2) are involved in the innate and type 2 immune responses in EGPA. However, the relationships among these molecules and the mechanisms underlying the development of EGPA remain unknown. OBJECTIVE We investigated the relationships among peripheral blood eosinophil count, serum IL-33 and TSLP concentration, and peripheral blood ILC2 count in patients with EGPA, chronic eosinophilic pneumonia (CEP), or bronchial asthma (BA). METHODS We recruited 86 patients with EGPA in three groups (remission, relapse, and onset), 25 patients with CEP at active or inactive stages of disease, and 11 patients with BA. In patients with EGPA, CEP, or BA, serum IL-33, sST2, and TSLP concentrations were determined using ELISA and peripheral blood ILC2 counts (as Lin-1- CD127+ CRTH2+ cells) were determined using flow cytometry. RESULTS Peripheral blood eosinophil count or ILC2 count, and serum sST2 or TSLP concentration were higher in patients with EGPA at onset than in those with EGPA at relapse or remission, or in those with BA or CEP. Serum IL-33 concentration was higher in patients with EGPA at relapse than in those with EGPA at onset or remission, or in those with BA or CEP. In a logistic regression model, EGPA disease activity was correlated with serum IL-33 concentration and peripheral blood ILC2 count, but not daily systemic and inhaled corticosteroid dose or immunosuppressant use. Eosinophil count was correlated with peripheral blood ILC2 count and serum TSLP concentration, but not serum IL-33 concentration. CONCLUSIONS Increased peripheral blood ILC2 count and serum IL-33 concentration were associated with disease activity in EGPA. Increases in serum IL-33 concentration may indicate the presence of active vasculitis rather than peripheral or tissue eosinophilia.
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Affiliation(s)
- Naomi Tsurikisawa
- Department of Allergy, Hiratuska City Hospital, Hiratsuka, Japan.,Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Chiyako Oshikata
- Department of Allergy, Hiratuska City Hospital, Hiratsuka, Japan.,Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Maiko Watanabe
- Division of Microbiology, National Institute of Health Science, Kawasaki, Japan
| | - Takahiro Tsuburai
- Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Respirology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroshi Saito
- Clinical Research Center, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
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