1
|
Duecker RP, Alemdar O, Wimmers A, Gronau L, Chiocchetti AG, Valesky EM, Donath H, Trischler J, Blumchen K, Zielen S, Schubert R. MicroRNA Profiling of the Inflammatory Response after Early and Late Asthmatic Reaction. Int J Mol Sci 2024; 25:1356. [PMID: 38279356 PMCID: PMC10817008 DOI: 10.3390/ijms25021356] [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: 11/23/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024] Open
Abstract
A high proportion of house dust mite (HDM)-allergic asthmatics suffer from both an early asthmatic reaction (EAR) and a late asthmatic reaction (LAR) which follows it. In these patients, allergic inflammation is more relevant. MiRNAs have been shown to play an important role in the regulation of asthma's pathology. The aim of this study was to analyze the miRNA profile in patients with mild asthma and an HDM allergy after bronchial allergen provocation (BAP). Seventeen patients with EAR/no LAR and 17 patients with EAR plus LAR, determined by a significant fall in FEV1 after BAP, were differentially analyzed. As expected, patients with EAR plus LAR showed a more pronounced allergic inflammation and FEV1 delta drop after 24 h. NGS-miRNA analysis identified the down-regulation of miR-15a-5p, miR-15b-5p, and miR-374a-5p after BAP with the highest significance in patients with EAR plus LAR, which were negatively correlated with eNO and the maximum decrease in FEV1. These miRNAs have shared targets like CCND1, VEGFA, and GSK3B, which are known to be involved in airway remodeling, basement membrane thickening, and Extracellular Matrix deposition. NGS-profiling identified miRNAs involved in the inflammatory response after BAP with HDM extract, which might be useful to predict a LAR.
Collapse
Affiliation(s)
- Ruth P. Duecker
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| | - Oguzhan Alemdar
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
- Respiratory Research Institute, Medaimun GmbH, 60596 Frankfurt am Main, Germany
| | - Andreas Wimmers
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
- Respiratory Research Institute, Medaimun GmbH, 60596 Frankfurt am Main, Germany
| | - Lucia Gronau
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| | - Andreas G. Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany;
| | - Eva M. Valesky
- Department of Dermatology, Venerology and Allergology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany;
| | - Helena Donath
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| | - Jordis Trischler
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| | - Katharina Blumchen
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| | - Stefan Zielen
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
- Respiratory Research Institute, Medaimun GmbH, 60596 Frankfurt am Main, Germany
| | - Ralf Schubert
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.A.); (A.W.); (L.G.); (H.D.); (J.T.); (K.B.); (S.Z.); (R.S.)
| |
Collapse
|
2
|
Campion NJ, Villazala-Merino S, Thwaites RS, Stanek V, Killick H, Pertsinidou E, Zghaebi M, Toth J, Fröschl R, Perkmann T, Gangl K, Schneider S, Ristl R, Scott IC, Cohen ES, Molin M, Focke-Tejkl M, Regelsberger G, Hansel TT, Valenta R, Niederberger-Leppin V, Eckl-Dorna J. Nasal IL-13 production identifies patients with late-phase allergic responses. J Allergy Clin Immunol 2023; 152:1167-1178.e12. [PMID: 37536510 DOI: 10.1016/j.jaci.2023.06.026] [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: 01/13/2023] [Revised: 05/09/2023] [Accepted: 06/23/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND There is limited knowledge on how local cytokine secretion patterns after nasal allergen challenge correlate with clinical symptoms especially with regard to the "late allergic response," which occurs in approximately 40% to 50% of patients with allergy. OBJECTIVE We sought to characterize the immunologic and clinical nasal responses to birch pollen allergen challenge with a special focus on the late allergic response. METHODS In this randomized, double-blind, placebo-controlled trial, birch pollen-allergic participants were challenged with birch pollen extract (n = 20) or placebo (n = 10) on 3 consecutive days. On days 1 and 3, nasal secretions were collected at selected time points over a 24-hour time course for the measurement of 33 inflammatory mediators. Clinical responses were determined through subjective symptom scores and objective nasal airflow measurements. RESULTS Provoked participants had significantly greater clinical responses and showed significant increases in tryptase and the soluble IL-33 receptor serum stimulation 2 (sST2) in nasal secretions within minutes compared with the placebo group. Eight of 20 provoked participants displayed high IL-13 levels 2 to 8 hours after allergen provocation. This group also showed significant changes in clinical parameters, with a secondary drop in nasal airflow measured by peak nasal inspiratory flow and increased symptoms of nasal obstruction, which significantly differed from IL-13 nonresponders after 6 hours. CONCLUSIONS IL-13 response status correlates with clinical responses and type 2 cytokine responses in the late phase after allergen provocation.
Collapse
Affiliation(s)
- Nicholas J Campion
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | | | - Ryan S Thwaites
- National Heart and Lung Institute, Imperial College of London, London, United Kingdom
| | - Victoria Stanek
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Helen Killick
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | | | - Mohammed Zghaebi
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Josef Toth
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Renate Fröschl
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Katharina Gangl
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Sven Schneider
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ian C Scott
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Emma Suzanne Cohen
- Bioscience Asthma, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Magnus Molin
- Research and Development, Thermo Fisher Scientific, Uppsala, Sweden
| | - Margit Focke-Tejkl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria; Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Guenther Regelsberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Trevor T Hansel
- National Heart and Lung Institute, Imperial College of London, London, United Kingdom
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria; Karl Landsteiner University of Health Sciences, Krems, Austria
| | | | - Julia Eckl-Dorna
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
3
|
van der Burg N, Tufvesson E. Is asthma's heterogeneity too vast to use traditional phenotyping for modern biologic therapies? Respir Med 2023; 212:107211. [PMID: 36924848 DOI: 10.1016/j.rmed.2023.107211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Nicole van der Burg
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
| | - Ellen Tufvesson
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| |
Collapse
|
4
|
van der Burg N, Stenberg H, Ekstedt S, Diamant Z, Bornesund D, Ankerst J, Kumlien Georén S, Cardell LO, Bjermer L, Erjefält J, Tufvesson E. Neutrophil phenotypes in bronchial airways differentiate single from dual responding allergic asthmatics. Clin Exp Allergy 2023; 53:65-77. [PMID: 35437872 PMCID: PMC10083921 DOI: 10.1111/cea.14149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/18/2022] [Accepted: 04/11/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Allergic asthmatics with both an early (EAR) and a late allergic reaction (LAR) following allergen exposure are termed 'dual responders' (DR), while 'single responders' (SR) only have an EAR. Mechanisms that differentiate DR from SR are largely unknown, particularly regarding the role and phenotypes of neutrophils. Therefore, we aimed to study neutrophils in DR and SR asthmatics. METHODS Thirty-four allergic asthmatics underwent an inhaled allergen challenge, samples were collected before and up to 24 h post-challenge. Cell differentials were counted from bronchial lavage, alveolar lavage and blood; and tissue neutrophils were quantified in immune-stained bronchial biopsies. Lavage neutrophil nuclei lobe segmentation was used to classify active (1-4 lobes) from suppressive neutrophils (≥5 lobes). Levels of transmigration markers: soluble (s)CD62L and interleukin-1Ra, and activity markers: neutrophil elastase (NE), DNA-histone complex and dsDNA were measured in lavage fluid and plasma. RESULTS Compared with SR at baseline, DR had more neutrophils in their bronchial airways at baseline, both in the lavage (p = .0031) and biopsies (p = .026) and elevated bronchial neutrophils correlated with less antitransmigratory IL-1Ra levels (r = -0.64). DR airways had less suppressive neutrophils and more 3-lobed (active) neutrophils (p = .029) that correlated with more bronchial lavage histone (p = .020) and more plasma NE (p = .0016). Post-challenge, DR released neutrophil extracellular trap factors in the blood earlier and had less pro-transmigratory sCD62L during the late phase (p = .0076) than in SR. CONCLUSION DR have a more active airway neutrophil phenotype at baseline and a distinct neutrophil response to allergen challenge that may contribute to the development of an LAR. Therefore, neutrophil activity should be considered during targeted diagnosis and bio-therapeutic development for DR.
Collapse
Affiliation(s)
- Nicole van der Burg
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Henning Stenberg
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.,Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sandra Ekstedt
- Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Zuzana Diamant
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.,Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium.,Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Daisy Bornesund
- Department of Experimental Medical Science, Cell and Tissue biology, Lund University, Lund, Sweden
| | - Jaro Ankerst
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olaf Cardell
- Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Skane University Hospital, Lund, Sweden
| | - Leif Bjermer
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Jonas Erjefält
- Department of Experimental Medical Science, Cell and Tissue biology, Lund University, Lund, Sweden
| | - Ellen Tufvesson
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| |
Collapse
|
5
|
Zhu Y, Esnault S, Ge Y, Jarjour NN, Brasier AR. Segmental Bronchial Allergen Challenge Elicits Distinct Metabolic Phenotypes in Allergic Asthma. Metabolites 2022; 12:metabo12050381. [PMID: 35629885 PMCID: PMC9145767 DOI: 10.3390/metabo12050381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Asthma is a complex syndrome associated with episodic decompensations provoked by aeroallergen exposures. The underlying pathophysiological states driving exacerbations are latent in the resting state and do not adequately inform biomarker-driven therapy. A better understanding of the pathophysiological pathways driving allergic exacerbations is needed. We hypothesized that disease-associated pathways could be identified in humans by unbiased metabolomics of bronchoalveolar fluid (BALF) during the peak inflammatory response provoked by a bronchial allergen challenge. We analyzed BALF metabolites in samples from 12 volunteers who underwent segmental bronchial antigen provocation (SBP-Ag). Metabolites were quantified using liquid chromatography-tandem mass spectrometry (LC–MS/MS) followed by pathway analysis and correlation with airway inflammation. SBP-Ag induced statistically significant changes in 549 features that mapped to 72 uniquely identified metabolites. From these features, two distinct inducible metabolic phenotypes were identified by the principal component analysis, partitioning around medoids (PAM) and k-means clustering. Ten index metabolites were identified that informed the presence of asthma-relevant pathways, including unsaturated fatty acid production/metabolism, mitochondrial beta oxidation of unsaturated fatty acid, and bile acid metabolism. Pathways were validated using proteomics in eosinophils. A segmental bronchial allergen challenge induces distinct metabolic responses in humans, providing insight into pathogenic and protective endotypes in allergic asthma.
Collapse
Affiliation(s)
- Yanlong Zhu
- Department of Cell and Regenerative Biology, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA; (Y.Z.); (Y.G.)
- Human Proteomics Program, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Stephane Esnault
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Ying Ge
- Department of Cell and Regenerative Biology, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA; (Y.Z.); (Y.G.)
- Human Proteomics Program, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Nizar N. Jarjour
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI 53705, USA;
- Correspondence: (N.N.J.); (A.R.B.)
| | - Allan R. Brasier
- Institute for Clinical and Translational Research (ICTR), University of Wisconsin-Madison, Madison, WI 53705, USA
- Correspondence: (N.N.J.); (A.R.B.)
| |
Collapse
|
6
|
Wisgrill L, Fyhrquist N, Ndika J, Paalanen L, Berger A, Laatikainen T, Karisola P, Haahtela T, Alenius H. Bet v 1 triggers antiviral-type immune signaling in birch pollen allergic individuals. Clin Exp Allergy 2022; 52:929-941. [PMID: 35147263 PMCID: PMC9540660 DOI: 10.1111/cea.14108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/22/2022] [Accepted: 02/06/2022] [Indexed: 11/28/2022]
Abstract
Background In allergic patients, clinical symptoms caused by pollen remind of symptoms triggered by viral respiratory infections, which are also the main cause of asthmatic exacerbations. In patients sensitized to birch pollen, Bet v 1 is the major symptom‐causing allergen. Immune mechanisms driving Bet v 1‐related responses of human blood cells have not been fully characterized. Objective To characterize the immune response to Bet v 1 in peripheral blood in patients allergic to birch pollen. Methods The peripheral blood mononuclear cells of birch‐allergic (n = 24) and non‐allergic (n = 47) adolescents were stimulated ex‐vivo followed by transcriptomic profiling. Systems‐biology approaches were employed to decipher disease‐relevant gene networks and deconvolution of associated cell populations. Results Solely in birch‐allergic patients, co‐expression analysis revealed activation of networks of innate immunity and antiviral signalling as the immediate response to Bet v 1 stimulation. Toll‐like receptors and signal transducer transcription were the main drivers of gene expression patterns. Macrophages and dendritic cells were the main cell subsets responding to Bet v 1. Conclusions and clinical relevance In birch‐pollen‐allergic patients, the activated innate immune networks seem to be, in part, the same as those activated during viral infections. This tendency of the immune system to read pollens as viruses may provide new insight to allergy prevention and treatment.
Collapse
Affiliation(s)
- Lukas Wisgrill
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nanna Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
| | - Joseph Ndika
- Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
| | - Laura Paalanen
- National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Piia Karisola
- Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Harri Alenius
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
| |
Collapse
|
7
|
Gauvreau GM, Davis BE, Scadding G, Boulet LP, Bjermer L, Chaker A, Cockcroft DW, Dahlén B, Fokkens W, Hellings P, Lazarinis N, O'Byrne PM, Tufvesson E, Quirce S, Van Maaren M, de Jongh FH, Diamant Z. Allergen Provocation Tests in Respiratory Research: Building on 50 Years of Experience. Eur Respir J 2022; 60:13993003.02782-2021. [PMID: 35086834 PMCID: PMC9403392 DOI: 10.1183/13993003.02782-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/29/2021] [Indexed: 11/05/2022]
Abstract
Allergen provocation test is an established model of allergic airway diseases, including asthma and allergic rhinitis, allowing the study of allergen-induced changes in respiratory physiology and inflammatory mechanisms in sensitised individuals as well as their associations. In the upper airways, allergen challenge is focused on the clinical and pathophysiological sequelae of the early allergic response and applied both as a diagnostic tool and in research settings. In contrast, the bronchial allergen challenge has almost exclusively served as a research tool in specialised research settings with a focus on the late asthmatic response and the underlying type 2 inflammation. The allergen-induced late asthmatic response is also characterised by prolonged airway narrowing, increased non-specific airway hyperresponsiveness and features of airway remodelling including the small airways, and hence, allows the study of several key mechanisms and features of asthma. In line with these characteristics, the allergen challenge has served as a valued tool to study the crosstalk of the upper and lower airways and in proof of mechanism studies of drug development. In recent years, several new insights into respiratory phenotypes and endotypes including the involvement of the upper and small airways, innovative biomarker sampling methods and detection techniques, refined lung function testing as well as targeted treatment options, further shaped the applicability of the allergen provocation test in precision medicine. These topics, along with descriptions of subject populations and safety, in line with the updated GINA2021, will be addressed in this paper.
Collapse
Affiliation(s)
- Gail M Gauvreau
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Beth E Davis
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Guy Scadding
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Louis-Philippe Boulet
- Institut Universitaire de Cardiologie et de Pneumologie de Quebec, University of Laval, Laval, Quebec, Canada
| | - Leif Bjermer
- Department of Clinical Sciences Lund, Respiratory medicine and Allergology, Lund University, Lund, Sweden
| | - Adam Chaker
- TUM School of Medicine, Dept. of Otolaryngology and Center of Allergy and Environment, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Donald W Cockcroft
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Barbro Dahlén
- Department of Medicine, Huddinge Karolinska Institutet, Stockholm, Sweden
| | - Wyste Fokkens
- Department of Otorhinolaryngology, Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Hellings
- Department of Otorhinolaryngology, Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Nikolaos Lazarinis
- Department of Medicine, Huddinge Karolinska Institutet, Stockholm, Sweden
| | - Paul M O'Byrne
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Tufvesson
- Department of Clinical Sciences Lund, Respiratory medicine and Allergology, Lund University, Lund, Sweden
| | - Santiago Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | | | - Frans H de Jongh
- Faculty of Engineering Technology, University of Twente, Enschede, Netherlands
| | - Zuzana Diamant
- Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium.,Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden.,Department of Pharmacology & Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
8
|
Boulet LP, Côté A, Abd-Elaziz K, Gauvreau G, Diamant Z. Allergen bronchoprovocation test: an important research tool supporting precision medicine. Curr Opin Pulm Med 2021; 27:15-22. [PMID: 33065599 DOI: 10.1097/mcp.0000000000000742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Allergen bronchoprovocation test (ABT) has been used to study asthma pathophysiology and as a disease-modelling tool to assess the properties and efficacy of new asthma drugs. In view of the complexity and heterogeneity of asthma, which has driven the definition of several phenotypes and endotypes, we aim to discuss the role of ABT in the era of precision medicine and provide guidance for clinicians how to interpret and use available data to understand the implications for the benefits of asthma treatment. RECENT FINDINGS In this review, we summarize background knowledge and applications of ABT and provide an update with recent publications on this topic. In the past years, several studies have been published on ABT in combination with non-invasive and invasive airway samplings and innovative detection techniques allowing to study several inflammatory mechanisms linked to Th2-pathway and allergen-induced pathophysiology throughout the airways. SUMMARY ABT is a valuable research tool, which has strongly contributed to precision medicine by helping to define allergen-triggered key inflammatory pathways and airway pathophysiology, and thus helped to shape our understanding of allergen-driven asthma phenotypes and endotypes. In addition, ABT has been instrumental to assess the interactions and effects of new-targeted asthma treatments along these pathways.
Collapse
Affiliation(s)
- Louis-Philippe Boulet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Université Laval, Québec, Canada
| | - Andréanne Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Université Laval, Québec, Canada
| | | | - Gail Gauvreau
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Zuzana Diamant
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department Clinical Pharmacy and Pharmacology, University Groningen, University Medicine Ctr Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Precision Medicine in House Dust Mite-Driven Allergic Asthma. J Clin Med 2020; 9:jcm9123827. [PMID: 33255966 PMCID: PMC7761474 DOI: 10.3390/jcm9123827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
House dust mites (HDMs) are the allergenic sources most frequently involved in airway allergy. Nevertheless, not every sensitized patient develops respiratory symptoms upon exposure to HDM, and there is a clinical need to differentiate allergic asthmatics (AAs) from atopic non-allergic asthmatics with HDM sensitization. This differentiation sometimes requires in vivo provocations like the bronchial allergen challenge (BAC). Interestingly, recent data demonstrate that non-atopic patients with asthma can also develop positive BAC results. This novel phenotype has been termed local allergic asthma (LAA). The interest in identifying the allergic triggers of asthma resides in the possibility of administering allergen immunotherapy (AIT). AIT is a disease-modifying intervention, the clinical benefit of which persists after therapy discontinuation. Recently, new modalities of sublingual tablets of HDM immunotherapy registered as pharmaceutical products (HDM-SLIT tablets) have become commercially available. HDM-SLIT tablets have demonstrated a robust effect over critical asthma parameters (dose of inhaled corticosteroids, exacerbations, and safety), thus being recommended by international guidelines for patients with HDM-driven AA. In this review, we will summarize the current knowledge on the phenotype and endotype of HDM-driven AA, and LAA, address the difficulties for BAC implementation in the clinic, and discuss the effects of AIT in AA and LAA.
Collapse
|
10
|
Zhang R, Wang J, Liu B, Wang W, Fan X, Zheng B, Yuan Q, Xue M, Xu F, Guo P, Chen Y. Differentially expressed lncRNAs, miRNAs and mRNAs with associated ceRNA networks in a mouse model of myocardial ischemia/reperfusion injury. Mol Med Rep 2020; 22:2487-2495. [PMID: 32705277 PMCID: PMC7411395 DOI: 10.3892/mmr.2020.11300] [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: 11/15/2019] [Accepted: 06/05/2020] [Indexed: 12/17/2022] Open
Abstract
Non‑coding RNAs, including long non‑coding RNAs (lncRNAs) and microRNAs (miRNAs/miRs), have significant regulatory effects on a number of biological processes in myocardial ischemia/reperfusion (I/R) injury, including cell differentiation, proliferation and apoptosis. In the present study, the expression levels of lncRNAs, miRNAs and mRNAs were evaluated in a mouse model of myocardial I/R injury. The potential functions of these differentially expressed genes were then analyzed via Gene Ontology and pathway analyses. Additionally, the interactions between lncRNA‑miRNA‑mRNA were predicted by constructing a competing endogenous RNA regulatory network. It was found that 14,366 lncRNAs, 151 miRNAs and 9,377 mRNAs were differentially expressed in mice hearts after I/R compared with the Sham group (fold change >2; P<0.05). The results indicated that these differentially expressed genes were involved in multiple molecular functions, including 'guanosine diphosphate binding', 'RNA polymerase II carboxy‑terminal domain kinase activity', 'TATA‑binding protein‑class protein binding', 'nicotinamide adenine dinucleotide binding' and 'protein phosphatase type 2A regulator activity'. The interactions between lncRNA‑miRNA‑mRNA, including five lncRNAs, 38 miRNAs and 196 mRNAs, were predicted, specifically Gm12040‑mmu‑miR‑125a‑5p‑decapping mRNA 1B, Rpl7l1‑ps1‑mmu‑miR‑124‑3p‑G protein‑coupled receptor 146, Gm11407‑mmu‑miR‑190a‑5p‑homeobox and leucine zipper encoding (HOMEZ), 1600029O15Rik‑mmu‑miR‑132‑3p‑HOMEZ and AK155692‑mmu‑miR‑1224‑3p‑activating transcription factor 6β. Collectively, these findings provided novel insights for future research on lncRNAs, miRNAs and mRNAs in myocardial I/R injury.
Collapse
Affiliation(s)
- Rui Zhang
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Jiali Wang
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Baoshan Liu
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Wenjun Wang
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Xinhui Fan
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Boyuan Zheng
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Qiuhuan Yuan
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Mengyang Xue
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Feng Xu
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Ping Guo
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Yuguo Chen
- Department of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| |
Collapse
|
11
|
Niu X, Zhang J, Zhang L, Hou Y, Pu S, Chu A, Bai M, Zhang Z. Weighted Gene Co-Expression Network Analysis Identifies Critical Genes in the Development of Heart Failure After Acute Myocardial Infarction. Front Genet 2019; 10:1214. [PMID: 31850068 PMCID: PMC6889910 DOI: 10.3389/fgene.2019.01214] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The development of heart failure (HF) remains a common complication following an acute myocardial infarction (AMI), and is associated with substantial adverse outcomes. However, the specific predictive biomarkers and candidate therapeutic targets for post-infarction HF have not been fully established. We sought to perform a weighted gene co-expression network analysis (WGCNA) to identify key modules, hub genes, and possible regulatory targets involved in the development of HF following AMI. Methods: Genes exhibiting the most (top 50%) variation in expression levels across samples in a GSE59867 dataset were imported to the WGCNA. Gene Ontology and pathway enrichment analyses were performed on genes identified in the key module by Metascape. Gene regulatory networks were constructed using the microarray probe reannotation and bioinformatics database. Hub genes were screened out from the key module and validated using other datasets. Results: A total of 10,265 most varied genes and six modules were identified between AMI patients who developed HF within 6 months of follow-up and those who did not. Specifically, the blue module was found to be the most significantly related to the development of post-infarction HF. Functional enrichment analysis revealed that the blue module was primarily associated with the inflammatory response, immune system, and apoptosis. Seven transcriptional factors, including SPI1, ZBTB7A, IRF8, PPARG, P65, KLF4, and Fos, were identified as potential regulators of the expression of genes identified in the blue module. Further, non-coding RNAs, including miR-142-3p and LINC00537, were identified as having close interactions with genes from the blue module. A total of six hub genes (BCL3, HCK, PPIF, S100A9, SERPINA1, and TBC1D9B) were identified and validated for their predictive value in identifying future HFs. Conclusions: By using the WGCNA, we provide new insights into the underlying molecular mechanism and molecular markers correlated with HF development following an AMI, which may serve to improve risk stratification, therapeutic decisions, and prognosis prediction in AMI patients.
Collapse
Affiliation(s)
- Xiaowei Niu
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Clinical Medical Research Center for Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Key Laboratory of Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,The Quality Improvement Project for the Diagnosis and Treatment of Complicated Cardiovascular and Cerebrovascular Diseases (2018), The First Hospital of Lanzhou University, Lanzhou, China
| | - Jingjing Zhang
- Department of Internal Medicine, Baiyin Second People's Hospital, Baiyin, China
| | - Lanlan Zhang
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Clinical Medical Research Center for Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Key Laboratory of Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,The Quality Improvement Project for the Diagnosis and Treatment of Complicated Cardiovascular and Cerebrovascular Diseases (2018), The First Hospital of Lanzhou University, Lanzhou, China
| | - Yangfan Hou
- Department of Digestive, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuangshuang Pu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Aiai Chu
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, China
| | - Ming Bai
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Clinical Medical Research Center for Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Key Laboratory of Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,The Quality Improvement Project for the Diagnosis and Treatment of Complicated Cardiovascular and Cerebrovascular Diseases (2018), The First Hospital of Lanzhou University, Lanzhou, China
| | - Zheng Zhang
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Clinical Medical Research Center for Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Key Laboratory of Cardiovascular Diseases, The First Hospital of Lanzhou University, Lanzhou, China.,The Quality Improvement Project for the Diagnosis and Treatment of Complicated Cardiovascular and Cerebrovascular Diseases (2018), The First Hospital of Lanzhou University, Lanzhou, China
| |
Collapse
|
12
|
Rajasekaran A, He D, Yue A, Singh A, Shannon CP, FitzGerald JM, Boulet LP, O'Byrne PM, Gauvreau GM, Tebbutt SJ. Cholinergic synapse pathway gene polymorphisms associated with allergen-induced late asthmatic responses. ERJ Open Res 2019; 5:00107-2019. [PMID: 31720291 PMCID: PMC6826244 DOI: 10.1183/23120541.00107-2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/25/2019] [Indexed: 01/21/2023] Open
Abstract
Allergen inhalation challenge triggers well-defined airway responses in mild, allergic asthmatics. Some individuals develop only an isolated early response (early responders (ERs)) characterised by acute airway smooth muscle constriction immediately following allergen inhalation. Others develop a late response (dual responders (DRs)) that begins 3–4 h later, resulting in prolonged reduction of airway function, associated with cellular infiltration, inflammation and hyperresponsiveness of the airways [1]. It is not well understood how certain individuals are protected from developing a late response. Our previous research identified novel RNA transcripts in peripheral blood that are predictive of asthmatics who could develop a late response. Our findings pointed towards the presence of inherent differences underlying molecular mechanisms that predispose asthmatic individuals to the late response [2]. Cholinergic synapse pathway gene polymorphisms may play a role in regulating a type of asthmatic airway response triggered upon allergen challengehttp://bit.ly/2lJx1VG
Collapse
Affiliation(s)
- Ashwini Rajasekaran
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada
| | - Daniel He
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada
| | - Alice Yue
- Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada.,School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Amrit Singh
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada.,Dept of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Casey P Shannon
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada
| | - J Mark FitzGerald
- Vancouver Coastal Health Research Institute, Vancouver General Hospital, Vancouver, BC, Canada.,Dept of Medicine, Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Paul M O'Byrne
- Dept of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Scott J Tebbutt
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, BC, Canada.,Dept of Medicine, Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
13
|
Djukanović R. Predicting Asthmatic Responses to Inhaled Allergen Using an Unbiased Transcriptomics Approach. Am J Respir Crit Care Med 2019; 197:415-416. [PMID: 29182887 DOI: 10.1164/rccm.201711-2237ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ratko Djukanović
- 1 Faculty of Medicine University of Southampton Southampton, United Kingdom and.,2 NIHR Southampton Biomedical Research Centre Southampton, United Kingdom
| |
Collapse
|