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Laubhahn K, Schaub B. From preschool wheezing to asthma: Immunological determinants. Pediatr Allergy Immunol 2023; 34:e14038. [PMID: 37877843 DOI: 10.1111/pai.14038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
Asthma represents a chronic respiratory disease affecting millions of children worldwide. The transition from preschool wheezing to school-age asthma involves a multifaceted interplay of various factors, including immunological aspects in early childhood. These factors include complex cellular interactions among different immune cell subsets, induction of pro-inflammatory mediators and the molecular impact of environmental factors like allergens or viral infections on the developing immune system. Furthermore, the activation of specific genes and signalling pathways during this early phase plays a pivotal role in the manifestation of symptoms and subsequent development of asthma. Early identification of the propensity or risk for asthma development, for example by allergen sensitisation and viral infections during this critical period, is crucial for understanding the transition from wheeze to asthma. Favourable immune regulation during a critical 'window of opportunity' in early childhood can induce persistent changes in immune cell behaviour. In this context, trained immunity, including memory function of innate immune cells, has significant implications for understanding immune responses, potentially shaping long-term immunological outcomes based on early-life environmental exposures. Exploration of these underlying immune mechanisms that drive disease progression will provide valuable insights to understand childhood asthma development. This will be instrumental to develop preventive strategies at different stages of disease development for (i) inhibiting progression from wheeze to asthma or (ii) reducing disease severity and (iii) uncovering novel therapeutic strategies and contributing to more tailored and effective treatments for childhood asthma. In the long term, this shall empower healthcare professionals to develop evidence-based interventions that reduce the burden of asthma for children, families and society overall.
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Affiliation(s)
- Kristina Laubhahn
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
- Member of German Centre for Lung Research - DZL, LMU Munich, Munich, Germany
| | - Bianca Schaub
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
- Member of German Centre for Lung Research - DZL, LMU Munich, Munich, Germany
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Garcia-Garcia ML, Sastre B, Arroyas M, Beato M, Alonso P, Rodrigo-Muñoz JM, Del Pozo V, Casas I, Calvo C. Nasal TSLP and periostin in infants with severe bronchiolitis and risk of asthma at 4 years of age. Respir Res 2023; 24:26. [PMID: 36694181 PMCID: PMC9872300 DOI: 10.1186/s12931-023-02323-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Severe bronchiolitis is often associated with subsequent respiratory morbidity, mainly recurrent wheezing and asthma. However, the underlying immune mechanisms remain unclear. The main goal of this study was to investigate the association of nasal detection of periostin and thymic stromal lymphopoietin (TSLP) during severe bronchiolitis with the development of asthma at 4 years of age. METHODS Observational, longitudinal, post-bronchiolitis, hospital-based, follow-up study. Children hospitalized for bronchiolitis between October/2013 and July/2017, currently aged 4 years, included in a previous study to investigate the nasal airway secretion of TSLP and periostin during bronchiolitis, were included. Parents were contacted by telephone, and were invited to a clinical interview based on a structured questionnaire to obtain information on the respiratory evolution. The ISAAC questionnaire for asthma symptoms for 6-7-year-old children, was also employed. RESULTS A total of 248 children were included (median age 4.4 years). The mean age at admission for bronchiolitis was 3.1 (IQR: 1.5-6.5) months. Overall, 21% had ever been diagnosed with asthma and 37% had wheezed in the last 12 months. Measurable nasal TSLP was detected at admission in 27(11%) cases and periostin in 157(63%). The detection of nasal TSLP was associated with the subsequent prescription of maintenance asthma treatment (p = 0.04), montelukast (p = 0.01), and the combination montelukast/inhaled glucocorticosteroids (p = 0.03). Admissions for asthma tended to be more frequent in children with TSLP detection (p = 0.07). In the multivariate analysis, adjusting for potential confounders, the detection of TSLP remained independently associated with chronic asthma treatment prescription (aOR:2.724; CI 1.051-7.063, p:0.04) and with current asthma (aOR:3.41; CI 1.20-9.66, p:0.02). Nasal detection of periostin was associated with lower frequency of ever use of short-acting beta2-agonists (SABA) (p = 0.04), lower prevalence of current asthma (p = 0.02), less prescription of maintenance asthma treatment in the past 12 months (p = 0.02, respectively). In the multivariate analysis, periostin was associated with lower risk of asthma at 4 years, independently of the atopic status (aOR:0.511 CI 95% 0.284-0.918, p:0.025). CONCLUSIONS Our results show a positive correlation between nasal TSLP detection in severe bronchiolitis and the presence of current asthma, prescription of asthma maintenance treatment and respiratory admissions up to the age of 4 years. By contrast, we found a protective association between nasal periostin detection and current asthma at 4 years, ever diagnosis of asthma, maintenance asthma treatment prescription, and respiratory admissions.
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Affiliation(s)
- Maria Luz Garcia-Garcia
- grid.411361.00000 0001 0635 4617Pediatrics Department, Hospital Universitario Severo Ochoa, Avenida Orellana s/n, 28911 Leganés, Madrid Spain ,grid.73221.350000 0004 1767 8416Fundación para la Investigación Biomédica, Hospital Universitario Puerta de Hierro, Majadahonda, Spain ,grid.512890.7CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain ,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Beatriz Sastre
- grid.419651.e0000 0000 9538 1950Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Maria Arroyas
- grid.411361.00000 0001 0635 4617Pediatrics Department, Hospital Universitario Severo Ochoa, Avenida Orellana s/n, 28911 Leganés, Madrid Spain ,grid.73221.350000 0004 1767 8416Fundación para la Investigación Biomédica, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Maite Beato
- grid.411361.00000 0001 0635 4617Pediatrics Department, Hospital Universitario Severo Ochoa, Avenida Orellana s/n, 28911 Leganés, Madrid Spain ,grid.73221.350000 0004 1767 8416Fundación para la Investigación Biomédica, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Patricia Alonso
- grid.411361.00000 0001 0635 4617Pediatrics Department, Hospital Universitario Severo Ochoa, Avenida Orellana s/n, 28911 Leganés, Madrid Spain ,grid.73221.350000 0004 1767 8416Fundación para la Investigación Biomédica, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - José Manuel Rodrigo-Muñoz
- grid.419651.e0000 0000 9538 1950Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain ,grid.512891.6CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Victoria Del Pozo
- grid.419651.e0000 0000 9538 1950Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain ,grid.512891.6CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Inmaculada Casas
- grid.413448.e0000 0000 9314 1427Respiratory Virus and Influenza Unit, National Microbiology Centre (ISCIII), Madrid, Spain
| | - Cristina Calvo
- grid.512890.7CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain ,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain ,grid.81821.320000 0000 8970 9163Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain ,Fundación IdiPaz, Madrid, Spain ,TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Madrid, Spain
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TSLP disease-associated genetic variants combined with airway TSLP expression influence asthma risk. J Allergy Clin Immunol 2022; 149:79-88. [PMID: 34111451 PMCID: PMC9119142 DOI: 10.1016/j.jaci.2021.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/18/2021] [Accepted: 05/26/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Thymic stromal lymphopoietin (TSLP) is an epithelial-derived cytokine important in initiation of allergic inflammation. Single nucleotide polymorphisms (SNPs) in TSLP are associated with asthma, yet studies have shown inconsistent associations between circulating TSLP and asthma. Studies that integrate the combined effects of TSLP genotype, TSLP mRNA, circulating TSLP levels, and asthma outcome are lacking. OBJECTIVES This study sought to recruit a novel cohort based on asthma-relevant TSLP SNPs and determine their impact on TSLP mRNA expression and TSLP circulating protein levels, and their individual and combined effects on asthma. METHODS This study developed an algorithm to prioritize TSLP SNPs and recruited 51 carriers and noncarriers based on TSLP genotypes. TSLP mRNA was quantified in nasal epithelial cells and circulating TSLP levels in plasma. This study determined the associations of defined TSLP risk genotypes and/or TSLP mRNA and protein levels with asthma. RESULTS TSLP mRNA expression, but not circulating TSLP, was significantly increased in people who are asthmatic compared with in people who are nonasthmatic (P = .007; odds ratio, 1.44). Notably, 90% of children with the defined TSLP risk genotypes and high nasal TSLP mRNA expression (top tertile) had asthma compared with 40% of subjects without risk genotypes and with low TSLP expression (bottom tertile) (P = .024). No association between circulating TSLP and asthma was observed. CONCLUSIONS Collectively, these data suggest childhood asthma is modified by the combined effects of TSLP genotype and TSLP expression in the nasal epithelium. The increased asthma risk likely manifests when genetic variation enables expression quantitative trait loci in the TSLP locus to elevate TSLP. It is important to consider both biomarkers when factoring asthma risk.
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van Heerden D, van Binnendijk RS, Tromp SAM, Savelkoul HFJ, van Neerven RJJ, den Hartog G. Asthma-Associated Long TSLP Inhibits the Production of IgA. Int J Mol Sci 2021; 22:ijms22073592. [PMID: 33808333 PMCID: PMC8036615 DOI: 10.3390/ijms22073592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022] Open
Abstract
Thymic stromal lymphopoietin (TSLP) contributes to asthmatic disease. The concentrations of protective IgA may be reduced in the respiratory tract of asthma patients. We investigated how homeostatic short TSLP (shTSLP) and asthma-associated long TSLP (loTSLP) regulate IgA production. B cells from healthy donors were stimulated in the presence or absence of shTSLP or loTSLP; the concentrations of IgA, IgM, IgE, and IgG antibodies were determined in cell culture supernatants; and B cells were analyzed by flow cytometry. LoTSLP, but not shTSLP, suppressed the secretion of IgA but not of IgE. The type 2 cytokine IL-4, which in addition to loTSLP contributes to asthmatic disease, did not affect the production of IgA or the frequency of IgA+ B cells. Instead, IL-4 increased IgG production, especially of the subclasses IgG2 and IgG4. LoTSLP inhibited IgA secretion by sorted memory B cells but not by naïve B cells. Although loTSLP inhibited IgA production, the vitamin A metabolite retinoic acid promoted the secretion of IgA, also in the presence of loTSLP, suggesting that vitamin A may promote IgA production in asthma. Our data demonstrate that asthma-associated loTSLP negatively regulates the secretion of IgA, which may negatively impact the surveillance of mucosal surfaces in asthma.
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Affiliation(s)
- Dorianne van Heerden
- Cell Biology and Immunology Group, Wageningen University, 6700 AH Wageningen, The Netherlands; (D.v.H.); (H.F.J.S.); (R.J.J.v.N.)
- Center for Immunology of Infectious Diseases and Vaccination, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands; (R.S.v.B.); (S.A.M.T.)
| | - Robert S. van Binnendijk
- Center for Immunology of Infectious Diseases and Vaccination, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands; (R.S.v.B.); (S.A.M.T.)
| | - Samantha A. M. Tromp
- Center for Immunology of Infectious Diseases and Vaccination, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands; (R.S.v.B.); (S.A.M.T.)
- Infection and Immunity Department, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Huub F. J. Savelkoul
- Cell Biology and Immunology Group, Wageningen University, 6700 AH Wageningen, The Netherlands; (D.v.H.); (H.F.J.S.); (R.J.J.v.N.)
| | - R. J. Joost van Neerven
- Cell Biology and Immunology Group, Wageningen University, 6700 AH Wageningen, The Netherlands; (D.v.H.); (H.F.J.S.); (R.J.J.v.N.)
| | - Gerco den Hartog
- Center for Immunology of Infectious Diseases and Vaccination, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands; (R.S.v.B.); (S.A.M.T.)
- Correspondence: ; Tel.: +31-(0)631135216
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Hales BJ, Hizawa N, Jenmalm M, Sverremark-Ekström E, Wardlaw AJ. Developments in the field of allergy in 2014 through the eyes of Clinical and Experimental Allergy. Clin Exp Allergy 2016; 45:1723-45. [PMID: 26492197 DOI: 10.1111/cea.12663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The pathogenesis of asthma continues to be a major topic of interest to our authors with reviews and original papers on the role of viruses, mechanisms of inflammation, biomarkers, and phenotypes of asthma being major topics. A number of papers described new treatments for asthma focusing on blocking the Th2 response reflecting the fact that two decades of work in this area is finally bearing fruit. The pathogenesis of chronic rhinosinusitis is a growing area of interest, but there has been less on the genetics of airways disease than in previous years possibly reflecting the degree of rigour (and therefore a smaller body of work), with which these sorts of studies are now being undertaken. There continues to be a wide range of papers dealing with mechanisms of allergic disease ranging from clinical-based studies to basic research and the use of in vivo animal models especially mice. As before, mechanisms and new approaches to immunotherapy are common themes. Several were published in the allergens section investigating modification of allergens to increase their effectiveness and reduce the risk of adverse events. Risk factors for allergic disease was a common theme in the epidemiology section and food allergy a common theme in clinical allergy with papers on the development of protocols to induce tolerance and attempts to find biomarkers to distinguish sensitization from allergic disease. This was another exciting year for the editors, and we hope the readers of the journal.
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Affiliation(s)
- B J Hales
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - N Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - M Jenmalm
- Unit of Autoimmunity and Immune Regulation, Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - E Sverremark-Ekström
- M.C., Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - A J Wardlaw
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK.,Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
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Turkoz M, Townsend RR, Kopan R. The Notch Intracellular Domain Has an RBPj-Independent Role during Mouse Hair Follicular Development. J Invest Dermatol 2016; 136:1106-1115. [PMID: 26940862 DOI: 10.1016/j.jid.2016.02.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/15/2016] [Accepted: 02/07/2016] [Indexed: 01/02/2023]
Abstract
Ligand-dependent activation, γ-secretase-processed cleavage, and recombining binding protein Jk (RBPj)-mediated downstream transcriptional activities of Notch receptors constitute the "canonical" Notch signaling pathway, which is essential for skin organogenesis. However, in Msx2-Cre mice, keratinocyte-specific deletion of the Rbpj gene in utero produced a significantly milder phenotype than either global Notch or γ-secretase loss. Herein, we investigated the underlying mechanisms for this apparent noncanonical signal using mouse genetics. We found no evidence that ligand back-signaling contributed to skin organogenesis. The perdurance of RBPj protein did not establish an epigenetic memory of a canonical signal in the youngest epidermal stem cells, and Notch targets were not derepressed. We provide evidence that γ-secretase-dependent but RBPj-independent Notch intracellular domain activity operating in the first hair follicles is responsible for a delay in follicular destruction, which results in lower serum thymic stromal lymphopoietin levels, milder B-cell lymphoproliferative disease, and improved survival in Msx2-Cre(+/tg);Rbpj(f/f) mice. Minimal amounts of the Notch intracellular domain were sufficient for rescue, which was not mediated by transcription, suggesting that the Notch intracellular domain is acting through a novel mechanism.
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Affiliation(s)
- Mustafa Turkoz
- Division of Developmental Biology, Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Developmental Biology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - R Reid Townsend
- Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Cell Biology and Physiology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Raphael Kopan
- Division of Developmental Biology, Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Developmental Biology, Washington University School of Medicine, Saint Louis, Missouri, USA.
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A clinical biomarker assay to quantitate thymic stromal lymphopoietin in human plasma at sub-pg/ml level. Bioanalysis 2015; 7:573-82. [PMID: 25826139 DOI: 10.4155/bio.14.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Thymic stromal lymphopoietin (TSLP) is an attractive therapeutic target for the treatment of allergic diseases, and plasma TSLP is a potential patient selection marker in the development of therapeutic agents. RESULTS We developed and validated an ultrasensitive electrochemiluminescence assay for measurement of TSLP in plasma with a lower limit of quantitation of 0.12 pg/ml, which allowed the quantitation of TSLP in approximately 90% of human plasma samples tested. The assay demonstrated excellent performance characteristics, including precision, accuracy, sensitivity and dilution linearity. Stability and biological variability of TSLP in plasma were also assessed for clinical sample analysis and data interpretation. CONCLUSION The validated TSLP assay enables assessment of circulating TSLP as a patient selection marker in the development of therapeutics to treat atopic diseases.
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Salter BM, Oliveria JP, Nusca G, Smith SG, Watson RM, Comeau M, Sehmi R, Gauvreau GM. Thymic stromal lymphopoietin activation of basophils in patients with allergic asthma is IL-3 dependent. J Allergy Clin Immunol 2015; 136:1636-1644. [PMID: 25962901 DOI: 10.1016/j.jaci.2015.03.039] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/19/2015] [Accepted: 03/25/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thymic stromal lymphopoietin (TSLP) released after antigenic stimulation of allergic asthmatic airways is a key initiator of type 2 inflammation. Basophils are important effectors of allergic inflammation in the airways. Murine basophils have been shown to respond to TSLP independently of IL-3 by increasing functional thymic stromal lymphopoietin receptor (TSLPR) expression. OBJECTIVE The purpose of this study was to investigate the effect of TSLP stimulation on human basophil function. METHODS Ten patients with mild allergic asthma underwent diluent and allergen inhalation challenges. Peripheral blood and sputum samples were collected at baseline and 7 and 24 hours after challenge, and bone marrow samples were collected at baseline and 24 hours after challenge to measure basophil TSLPR expression. In vitro experiments were conducted on purified human basophils to measure the effect of TSLP on degranulation, expression of activation markers and TH2 cytokines, and eotaxin-induced shape change. RESULTS Allergen inhalation increased basophil numbers in the airways and significantly upregulated the expression of activation markers, TH2 intracellular cytokines, and receptors for TSLP, IL-3, and eotaxin in blood, bone marrow, and sputum basophils. In vitro stimulation with TSLP primed basophil migration to eotaxin and induced rapid and sustained basophil activation mediated directly through TSLPR and indirectly through an IL-3-mediated basophil autocrine loop. Basophils responded to TSLP at a similar magnitude and potency as the well-described basophil-activating stimuli IL-3 and anti-IgE. CONCLUSION Our findings indicate that basophil activation during early- and late-phase responses to inhaled allergen might be driven at least in part by TSLP.
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Affiliation(s)
- Brittany M Salter
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Graeme Nusca
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Steve G Smith
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rick M Watson
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Micheal Comeau
- Department of Inflammation Research, Amgen, Seattle, Wash
| | - Roma Sehmi
- Firestone Institute for Respiratory Health, St Josephs, Hamilton, Ontario, Canada
| | - Gail M Gauvreau
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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