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Wawryk-Gawda E, Żybowska M, Ostrowicz K. The Neutrophil to Lymphocyte Ratio in Children with Bronchial Asthma. J Clin Med 2023; 12:6869. [PMID: 37959334 PMCID: PMC10649350 DOI: 10.3390/jcm12216869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The discovery of an effective airway inflammation marker which correctly identifies the condition and phenotype of asthma still constitutes a significant challenge. The determination of NLR, that is, the ratio of neutrophils to lymphocytes, would overcome this challenge. The role of the neutrophil-lymphocytic index in the diagnosis of specific types of asthma is investigated in the present study. The results of laboratory tests of 482 pediatric patients were used for the analysis. The results of 107 children without allergic disease symptoms were selected for the control group. The mean NLR in patients with asthma was 3.42 ± 4.05, and in the control group it was 1.94 ± 1.91. The difference between the NLR in allergic and non-allergic asthma was statistically significant in the allergic asthma and control groups. There was no statistically significant difference between NLR and body temperature, BMI, and gender. The value of NLR was significantly higher in the blood of patients suffering from asthma compared to the control group. The NLR was the highest among patients with allergic asthma. The use of this blood test in daily practice may facilitate the diagnosis of asthma and differentiation between asthma types, especially when the results of other tests are inconclusive.
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Affiliation(s)
- Ewelina Wawryk-Gawda
- Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Monika Żybowska
- Students’ Scientific Group of Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Klaudia Ostrowicz
- Students’ Scientific Group of Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, 20-093 Lublin, Poland;
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Agarwal S. Neutrophil-Lymphocyte Ratio Predicting Case Severity in SARS-CoV-2 Infection: A Review. Cureus 2022; 14:e29760. [PMID: 36187170 PMCID: PMC9521818 DOI: 10.7759/cureus.29760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 12/15/2022] Open
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Jahan P, Tahseen R, Parvez M, Kumar GS. Combined Neutrophil-to-Lymphocyte Ratio and Serum Neutrophil Elastase: Is it an Emerging Marker of Asthma Prognosis? BIOMEDICAL AND BIOTECHNOLOGY RESEARCH JOURNAL (BBRJ) 2022. [DOI: 10.4103/bbrj.bbrj_290_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Jahan P, Tahseen R, Parvez M, Kumar GS. A correlational study on neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in bronchial asthma. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_44_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Esmaeilzadeh H, Nouri F, Nabavizadeh SH, Alyasin S, Mortazavi N. Can eosinophilia and neutrophil-lymphocyte ratio predict hospitalization in asthma exacerbation? ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2021; 17:16. [PMID: 33568198 PMCID: PMC7874466 DOI: 10.1186/s13223-021-00512-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Asthma is one of the most common diseases amongst children. Blood eosinophil count and neutrophil-lymphocyte ratio (NLR) are known as markers for phenotyping asthma. This study was performed to investigate blood eosinophil count and NLR as predictors of hospitalization in pediatric asthma exacerbations. DATA SOURCES AND STUDY SELECTIONS In this cross-sectional study, children admitted to hospital ward for more severe asthma exacerbation were compared with non-hospitalized children with moderate to severe asthma exacerbation whose asthma exacerbation was managed in emergency department or outpatient clinic. We investigated patients' characteristic and factors associated with hospitalization. RESULTS A total of 211 children with moderate to severe asthma exacerbation (mean age [Formula: see text] years old) were enrolled in the study including 91 hospitalized patients and 120 non-hospitalized patients. For the prediction of hospitalization, an ROC Curve analysis was performed and revealed a cut-off of 298 cells/µL and 2.52 of blood eosinophil count and NLR, respectively. In multivariate analysis, not using an asthma action plan (OR 2.22, 95% CI 1.09-4.49; P = 0.027), a blood eosinophil count [Formula: see text] 298 (OR 8.79, 95% CI 4.44-17.4; P < 0.001) and an NLR [Formula: see text] 2.52 (OR 2.13, 95% CI 1.09-4.14; P = 0.027) were associated with hospitalization. CONCLUSION Blood eosinophil count and NLR were found to be higher in hospitalized children with more severe asthma exacerbation compared to non-hospitalized patients. These markers can be indicators for asthma exacerbation severity.
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Affiliation(s)
- Hossein Esmaeilzadeh
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Nouri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Hesamodin Nabavizadeh
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Alyasin
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Mortazavi
- Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bedolla-Barajas M, Morales-Romero J, Hernández-Colín DD, Larenas-Linnemann D, Mariscal-Castro J, Flores-Razo MM, Bedolla-Pulido A. Beyond eosinophilia: inflammatory patterns in patients with asthma. J Asthma 2020; 59:255-263. [PMID: 33203290 DOI: 10.1080/02770903.2020.1852413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Recently, inflammatory cell ratios have gained importance as useful indicators in the categorization of asthma.Objective: We compared the concentration of white blood cells in peripheral blood, as well as their respective inflammatory cell ratios, between patients with asthma and a healthy control group.Methods: We performed cross-sectional analyses of the data obtained from 53 adult patients with asthma and 109 adult controls. In our study, we estimated and compared the following inflammatory cell ratios: Neutrophil-Lymphocyte Ratio (NLR), Eosinophil-Lymphocyte Ratio (ELR), Eosinophil-Neutrophil Ratio (ENR), Eosinophil-Monocyte Ratio (EMR), and Platelet-Lymphocyte Ratio (PLR). The magnitude of association was quantified with the odds ratio.Results: In both groups, the average age was 33 years. In asthmatic patients, we obtained the following results: eosinophils ≥ 400 cells/µl, accounted for 37.7%; basophils ≥ 110 cells/µl, comprised 37.7%; and monocytes < 320 cells/µl, reached 11.3%. In the control group, the results were as follows: 4.6%, 9.2% and 0.9%, respectively. When compared to the control group, asthmatic patients had higher odds of eosinophils ≥ 400 cells/µl (OR = 12.61, p < 0.0001); higher odds of basophils ≥ 110 cells/µl (OR = 6.00, p < 0.0001); and increased odds of monocytes < 320 cells/µl (OR = 13.79, p = 0.017). NLR did not differ between our two groups; however, ELR, ENR, EMR and PLR were significantly higher in the asthma group.Conclusions: Overall, patients with asthma have a higher concentration of eosinophils and basophils, fewer monocytes in their blood, and higher ratios of increased chronic inflammation.
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Affiliation(s)
- Martín Bedolla-Barajas
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | | | - Dante Daniel Hernández-Colín
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | | | - Juan Mariscal-Castro
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Miriam Montzerrat Flores-Razo
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Angie Bedolla-Pulido
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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Darwesh MAS, Abd Alhaleem IS, Al-Obaidy MWS. The Correlation Between Asthma Severity and Neutrophil to Lymphocyte Ratio. EUROPEAN JOURNAL OF MEDICAL AND HEALTH SCIENCES 2020; 2. [DOI: 10.24018/ejmed.2020.2.2.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background—The prognosis is essential in management and follows up of asthmatic patients. Neutrophil to lymphocyte ratio is considered as the common prognostic marker for many diseases especially the asthma.
Aim of study—To assess the relationship between asthma severity and neutrophil to lymphocyte ratio in comparison to healthy controls.
Patients and methods—This study is a cross sectional study conducted in Respiratory Consultancy Clinic in Baghdad Teaching Hospital in Medical City during the period from 1st of October, 2018 to 31st of March, 2019 on sample of 50 asthmatic patients and 50 healthy controls. The diagnosis of asthma was confirmed by the supervisor through clinical symptoms, signs, spirometery with reversibility test (according to GINA guideline.).
Results—A highly significant difference was observed between asthmatic cases and controls regarding age (p<0.001). A significant association was observed between obesity and asthmatic cases (p=0.001). There was a highly significant association between high neutrophil/lymphocyte ratio and asthmatic cases (p<0.001). The neutrophil/lymphocyte ratio was significantly increased with advanced age, females, severe and uncontrolled asthma.
Conclusions—The neutrophil to lymphocyte ratio is useful biomarker in assessment of asthma severity.
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Cag Y, Pacal Y, Gunduz M, Isik S, Kertmen BA, Toprak N, Ozaydin SE, Ozcetin M, Kut A. The effect of peripheral blood eosinophilia on inflammatory markers in asthmatic patients with lower respiratory tract infections. J Int Med Res 2019; 47:2452-2460. [PMID: 31006357 PMCID: PMC6567716 DOI: 10.1177/0300060519844859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections. Methods This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils). Results A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR (r = −0.34) and CRP (r = −0.20). Conclusion The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.
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Affiliation(s)
- Yakup Cag
- 1 Department of Paediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Yakup Pacal
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Gunduz
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sakine Isik
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Birgul Altinsoy Kertmen
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Necmettin Toprak
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sadik Erhan Ozaydin
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozcetin
- 3 Department of Paediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arif Kut
- 4 Department of Paediatric Pulmonology, Medical Faculty, Maltepe University, Istanbul, Turkey
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Conti P, Carinci F, Lessiani G, Spinas E, Kritas SK, Ronconi G, Caraffa A, Theoharides TC. Potential therapeutic use of IL-37: a key suppressor of innate immunity and allergic immune responses mediated by mast cells. Immunol Res 2018; 65:982-986. [PMID: 28748328 DOI: 10.1007/s12026-017-8938-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The host response to either exogenous or endogenous insults produces a series of changes, characterized by alterations in immunological functions and generation of mediators called cytokines which include the interleukin-1 (IL-1) family members. IL-1 acts as a hormone mediating the host responses to infection and inflammation. Blocking inflammatory IL-1 family members can be effective against inflammatory disorders, including allergies. IL-37, (formerly IL-1 family member 7), emerges as an inhibitor of innate and adaptive immunity by reducing circulating and organ cytokine levels. IL-37, mainly expressed in dendritic cells, monocytes, and plasma cells after TIR ligand activation, inhibits inflammatory cytokines and augments the level of anti-inflammatory IL-10. IL-37 is involved in allergic reaction and its expression in dendritic cells causes tollerogenicity and inhibits inflammatory response. Mast cells (MCs) are ubiquitous in the body, reside in numerous mucosal tissues, and are mediators of allergic reaction, and innate and adaptive immunity. MCs are important regulators of cytokine generation in the course of inflammatory responses and allergy, and are implicated in the pathophysiology of allergic asthma. Cysteine protease caspase-1 activation leads to the cleavage of pro-form of IL-1 into active mature IL-1 which is present in stimulated and unstimulated inflammatory MCs. Inflammatory cytokine inhibition, along with the augmentation of anti-inflammatory IL-10 by IL-37, is certainly beneficial and improves the pathogenesis of allergic disorders. However, in these studies, the exact mechanism(s) of IL-37-induced anti-inflammatory and anti-allergic activity along with its side effect(s) remain to be determined.
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Affiliation(s)
- Pio Conti
- Immunology Division, Postgraduate Medical School, University of Chieti-Pescara, Viale Unità dell'Italia 73, 66013, Chieti, Italy.
| | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | | | - Enrico Spinas
- Department of Surgery and Odontostomatological Sciences, University of Cagliari, Cagliari, Italy
| | - Spyridon K Kritas
- Department of Microbiology, University of Thessaloniki, Thessaloniki, Greece
| | - Gianpaolo Ronconi
- Clinica dei Pazienti del Territorio, Policlinico Gemelli, Rome, Italy
| | | | - Theoharis C Theoharides
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, MA, USA
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De Iuliis V, Ursi S, Pennelli A, Caruso M, Nunziata A, Marino A, Flati V, Cipollone F, Giamberardino MA, Vitullo G, Toniato E, Conti P, Martinotti S. Differential TBXA2 receptor transcript stability is dependent on the C924T polymorphism. Prostaglandins Other Lipid Mediat 2018; 134:141-147. [DOI: 10.1016/j.prostaglandins.2017.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/26/2017] [Accepted: 07/03/2017] [Indexed: 12/28/2022]
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Conti P, Lessiani G, Kritas SK, Ronconi G, Caraffa A, Theoharides TC. Mast cells emerge as mediators of atherosclerosis: Special emphasis on IL-37 inhibition. Tissue Cell 2017; 49:393-400. [PMID: 28420489 DOI: 10.1016/j.tice.2017.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 02/06/2023]
Abstract
In atherosclerosis lipoproteins stimulate the innate immune response, leading to the release of inflammatory cytokines and chemokines. Hypercholesterolemia may activate the synthesis and release of inflammatory cytokines such as IL-1, which induces TNF release in mast cells (MCs). IL-1 and IL-1 family members orchestrate a broadening list of inflammatory diseases, including atherosclerosis. MCs are implicated in the pathophysiology of several diseases including allergy and inflammation. Activated MCs, located perivascularly, contribute to inflammation in atherosclerosis by producing inflammatory cytokines. MC IL-1-activation leads to the immediate release of inflammatory chemical mediators and TNF, and late inflammatory compounds such as cytokines. MCs can be activated by exogenous cytokines, antigens, microbial products (LPS) and neurotransmitters and generate IL-1 beta, TNF and several other inflammatory cytokines/chemokines along with PGD2, leukotrienes, histamine and proteases. MCs activated with IL-1 induce selective release of IL-6 without degranulation. TNF emerges as one of the most potent inflammatory cytokines involved in the response due to LDL. Cytokines, such as IL-1, IL-6, IL-33 and TNF, are generated in the inflammatory sites by both macrophages and MCs, mediating atherosclerosis. IL-37 (IL-1 family member 7) binds IL-18Ra chain and acts by an intracellular mechanism down-regulating the expression of pro-inflammatory signals cJun, MAP kinase p38a, STAT transcription factors and p53. Blocking IL-1 with IL-37 alleviates the symptoms in patients with inflammatory diseases including arteriosclerosis. The impact of IL-37 on inflammatory cytokines mediating atherosclerosis is beneficial and protective. However, more studies are needed to better define this mechanism and the safety and tolerability of IL-37.
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Affiliation(s)
- Pio Conti
- Immunology Division, Postgraduate Medical School, University of Chieti-Pescara, Viale Unità dell'Italia 73, 66013, Chieti, Italy.
| | - Gianfranco Lessiani
- Angiology Unit, Medicine and Geriatria, Villa Serena Hospital, Città Sant'Angelo, Italy
| | | | - Gianpaolo Ronconi
- Clinica dei Pazienti del Territorio, Policlinico Gemelli, Roma, Italy
| | | | - Theoharis C Theoharides
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, MA, USA
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Conti P, Ronconi G, Caraffa A, Lessiani G, Duraisamy K. IL-37 a New IL-1 Family Member Emerges as a Key Suppressor of Asthma Mediated by Mast Cells. Immunol Invest 2016; 46:239-250. [PMID: 27982737 DOI: 10.1080/08820139.2016.1250220] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In 1986, we reported a multiple biological effect of IL-1 including immunological, inflammatory, and tumor killing activity. Since then other IL-1 family cytokines have been discovered, some with inflammatory and other with anti-inflammatory activity. In this review article, we speculate on the possible inhibitory effect of IL-37 in the light of new findings. IL-37, formerly termed IL-1 family member 7 (IL-1F7), binding IL-18 receptor α chain, acts as a cytokine with intracellular as well as extracellular functionality and as a natural inhibitor of immune responses and inflammation. IL-37 inhibits many pro-inflammatory cytokine and increases anti-inflammatory cytokines such as IL-10. Asthma pathogenesis involves multiple cell types including mast cells, which are important cellular constituents of the human innate and adaptive immunity. IL-37 has an impact on inflammatory cytokines generated by mast cells and is beneficial for and protective in asthma. However, the precise mechanism(s), safety, and tolerability of IL-37 are unclear and still remain a mystery. ABBREVIATIONS GBP (Guanylate Binding Proteins); HMGB1 (High Mobility Group Box protein 1); NLRP (Nucleotide-like Receptor Pyrin domain 1); ASC (Apoptosis-associated Speck-like protein containing CARD, Caspase Recruitment Domain); FGF2 (Fibroblast Growth Factor 2).
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Affiliation(s)
- P Conti
- a Immunology Division, Postgraduate Medical School, University of Chieti-Pescara , Chieti , Italy
| | - G Ronconi
- b UOS Clinica dei Pazienti del Territorio, Policlinico Gemelli , Roma , Italy
| | - A Caraffa
- c Department of Pharmacology , University of Perugia , Perugia , Italy
| | - G Lessiani
- d Center of Intensive Rehabilitation, "S. Agnese" , Pineto ( TE ), Italy
| | - Kempuraj Duraisamy
- e Department of Neurology , Carver College of Medicine, University of Iowa , Iowa City , IA , USA
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