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Zhang L, Li L, Zhou M, Zhou QY, Tang JH, Liang M, Liu Q, Fu XF. Association of serum YKL-40 and DPP4 with T2-high asthma in Chinese adults. Medicine (Baltimore) 2024; 103:e37169. [PMID: 38335422 PMCID: PMC10860958 DOI: 10.1097/md.0000000000037169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to assess the utility of serum YKL-40 and serum dipeptidyl peptidase IV (DPP4) as biomarkers for distinguishing between type 2 (T2)-high and T2-low asthma in the Chinese population. Additionally, we sought to explore the associations of serum YKL-40 and DPP4 levels with asthma characteristics and conventional markers. A real-world observational cross-sectional study was conducted, involving a total of 75 adult asthma patients. We collected general information, including demographics and medical history. Measurements included complete blood count, fractional exhaled nitric oxide (FeNO), post-bronchodilator spirometry, serum YKL-40 and serum DPP4 levels. Asthma endotypes, T2-high and T2-low, were defined through a comprehensive review of existing literature and expert group discussions. Logistic and linear regression models were employed. Our findings indicated no significant association between serum YKL-40 or serum DPP4 levels and T2-high asthma across all models. In the fully adjusted model, their odds ratios (OR) were 0.967 (95% CI: 0.920-1.017) and 0.997 (95% CI: 0.993-1.001), respectively. Notably, serum YKL-40 exhibited a positive correlation with FeNO (β = 0.382, 95% CI: 0.230-0.533) after adjusting for confounding factors. This association, however, diminished in patients under 40 years old (P = .24), males (P = .25), and those with FEV1%pred of 80% or higher (P = .25). Serum DPP4 demonstrated a negative correlation with FEV1/FVC in the fully adjusted model (β: -0.005, 95% CI: -0.009, -0.000). Among Chinese adult asthma patients, a positive correlation was observed between serum YKL-40 levels and FeNO in females aged over 40 with FEV1%pred less than 80%. Additionally, a weak negative correlation was found between serum DPP4 levels and FEV1/FVC. However, neither serum YKL-40 nor serum DPP4 levels exhibited the capability to differentiate between T2-high and T2-low asthma.
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Affiliation(s)
- Li Zhang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Liang Li
- Department of Clinical Laboratory, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Mei Zhou
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Qian-Yun Zhou
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Ji-Hong Tang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Mei Liang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Qin Liu
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Xiao-Feng Fu
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
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Zhou Y, Liu Z, Liu Y. The potential roles and mechanisms of Chitinase-3-like-1 in the pathogenesis of type 2-biased airway diseases. Clin Immunol 2023; 257:109856. [PMID: 38036279 DOI: 10.1016/j.clim.2023.109856] [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: 09/13/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
The immune modulation in the epithelium is a protective feature of the epithelial function in the mucosal airways. Dysfunction of the epithelium can lead to chronic allergic airway inflammatory diseases, such as chronic rhinosinusitis with nasal polyps (CRSwNP), allergic rhinitis (AR), and allergic asthma. Chitinase-3-like-1 (CHI3L1) is a key modulator in the epithelium against irritants, pathogens, and allergens and is involved in cancers, autoimmune diseases, neurological disorders, and other chronic diseases. Induction of epithelial cell-derived CHI3L1 is also confirmed to be implicated in the pathogenesis of Th2-related airway diseases like CRSwNP, AR, and allergic asthma, triggering a cascade of subsequent inflammatory reactions leading to the disease development. The techniques that block the biological function of CHI3L1 include small interfering RNA, neutralizing antibodies, and microRNAs and these methods proved to be successful in preclinical and clinical investigation in cancers, autoimmune diseases, asthma, and chronic obstructive pulmonary disease. Therefore, treatment with CHI3L1-blocking methods could open up therapeutic options for allergic airway diseases. This review article discusses the role of epithelial cell-derived CHI3L1 in the development of CRSwNP, AR, and allergic asthma and examines the use of CHI3L1 as a potential therapeutic agent for allergic airway diseases.
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Affiliation(s)
- Yian Zhou
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, PR China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, PR China.
| | - Yang Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, PR China.
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Curtiss ML, Rosenberg AF, Scharer CD, Mousseau B, Benavides NAB, Bradley JE, León B, Steele C, Randall TD, Lund FE. Chitinase-3-like 1 regulates T H2 cells, T FH cells and IgE responses to helminth infection. Front Immunol 2023; 14:1158493. [PMID: 37575256 PMCID: PMC10415220 DOI: 10.3389/fimmu.2023.1158493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Data from patient cohorts and mouse models of atopic dermatitis, food allergy and asthma strongly support a role for chitinase-3-like-1 protein (CHI3L1) in allergic disease. Methods To address whether Chi3l1 also contributes to TH2 responses following nematode infection, we infected Chi3l1 -/- mice with Heligmosomoides polygyrus (Hp) and analyzed T cell responses. Results As anticipated, we observed impaired TH2 responses in Hp-infected Chi3l1 -/- mice. However, we also found that T cell intrinsic expression of Chi3l1 was required for ICOS upregulation following activation of naïve CD4 T cells and was necessary for the development of the IL-4+ TFH subset, which supports germinal center B cell reactions and IgE responses. We also observed roles for Chi3l1 in TFH, germinal center B cell, and IgE responses to alum-adjuvanted vaccination. While Chi3l1 was critical for IgE humoral responses it was not required for vaccine or infection-induced IgG1 responses. Discussion These results suggest that Chi3l1 modulates IgE responses, which are known to be highly dependent on IL-4-producing TFH cells.
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Affiliation(s)
- Miranda L. Curtiss
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Alabama Birmingham (UAB), Birmingham, AL, United States
- Department of Medicine, Section of Allergy and Immunology, Birmingham VA Medical Center, Birmingham, AL, United States
| | - Alexander F. Rosenberg
- Department of Microbiology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
- Informatics Institute, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Betty Mousseau
- Department of Microbiology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
| | - Natalia A. Ballesteros Benavides
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Alabama Birmingham (UAB), Birmingham, AL, United States
- Department of Microbiology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
| | - John E. Bradley
- Department of Medicine, Division of Rheumatology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
| | - Beatriz León
- Department of Microbiology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
| | - Chad Steele
- Department of Microbiology and Immunology, Tulane University, New Orleans, LA, United States
| | - Troy D. Randall
- Department of Medicine, Division of Rheumatology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
| | - Frances E. Lund
- Department of Microbiology, University of Alabama Birmingham (UAB), Birmingham, AL, United States
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Declercq J, Hammad H, Lambrecht BN, Smole U. Chitinases and chitinase-like proteins in asthma. Semin Immunol 2023; 67:101759. [PMID: 37031560 DOI: 10.1016/j.smim.2023.101759] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023]
Abstract
Despite the lack of endogenous chitin synthesis, mammalian genomes encode two enzymatically active true chitinases (chitotriosidase and acidic mammalian chitinase) and a variable number of chitinase-like proteins (CLPs) that have no enzyme activity but bind chitin. Chitinases and CLPs are prominent components of type-2 immune response-mediated respiratory diseases. However, despite extensive research into their role in allergic airway disease, there is still no agreement on whether they are mere biomarkers of disease or actual disease drivers. Functions ascribed to chitinases and CLPs include, but are not limited to host defense against chitin-containing pathogens, directly promoting inflammation, and modulating tissue remodeling and fibrosis. Here, we discuss in detail the chitin-dependent and -independent roles of chitinases and CLPs in the context of allergic airway disease, and recent advances and emerging concepts in the field that might identify opportunities for new therapies.
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Affiliation(s)
- Jozefien Declercq
- Immunoregulation Unit, VIB Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Hamida Hammad
- Immunoregulation Unit, VIB Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Bart N Lambrecht
- Immunoregulation Unit, VIB Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Department of Pulmonary Medicine, ErasmusMC, Rotterdam, the Netherlands.
| | - Ursula Smole
- Immunoregulation Unit, VIB Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
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Specjalski K, Romantowski J, Niedoszytko M. YKL-40 as a possible marker of neutrophilic asthma. Front Med (Lausanne) 2023; 10:1115938. [PMID: 36844232 PMCID: PMC9945318 DOI: 10.3389/fmed.2023.1115938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Asthma is a heterogeneous chronic disorder of the airways, with inflammation and bronchial hyperresponsiveness as its major underlying phenomena. Asthmatics vary in terms of inflammation pattern, concomitant pathologies, and factors aggravating the course of the disease. As a result, there is a need for sensitive and specific biomarkers that could facilitate diagnosing asthma as well as phenotyping in everyday practice. Chitinases and chitinase-like proteins (CLPs) seem promising in this field. Chitinases are evolutionarily conserved hydrolases that degrade chitin. In contrast, CLPs bind chitin but do not have degrading activity. Mammalian chitinases and CLPs are produced by neutrophils, monocytes, and macrophages in response to parasitic or fungal infections. Recently, several questions have been raised about their role in chronic airway inflammation. Several studies demonstrated that overexpression of CLP YKL-40 was associated with asthma. Moreover, it correlated with exacerbation rate, therapy resistance, poor control of symptoms, and, inversely, with FEV1. YKL-40 facilitated allergen sensitization and IgE production. Its concentration was elevated in bronchoalveolar lavage fluid after an allergen challenge. It was also found to promote the proliferation of bronchial smooth muscle cells and correlate with subepithelial membrane thickness. Thus, it may be involved in bronchial remodeling. Associations between YKL-40 and particular asthma phenotypes remain unclear. Some studies showed that YKL-40 correlates with blood eosinophilia and FeNO, suggesting a role in T2-high inflammation. Quite the opposite, cluster analyses revealed the highest upregulation in severe neutrophilic asthma and obesity-associated asthma. The main limitation in the practical application of YKL-40 as a biomarker is its low specificity. High serum levels of YKL-40 were also found in COPD and several malignancies, in addition to infectious and autoimmune diseases. To conclude, the level of YKL-40 correlates with asthma and some clinical features in the whole asthmatic population. The highest levels are found in neutrophilic and obesity-related phenotypes. However, due to its low specificity, the practical application of YKL-40 remains uncertain but could be useful in phenotyping, especially when combined with other biomarkers.
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Affiliation(s)
| | - Jan Romantowski
- Department of Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdańsk, Poland
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Grunig G, Durmus N, Zhang Y, Lu Y, Pehlivan S, Wang Y, Doo K, Cotrina-Vidal ML, Goldring R, Berger KI, Liu M, Shao Y, Reibman J. Molecular Clustering Analysis of Blood Biomarkers in World Trade Center Exposed Community Members with Persistent Lower Respiratory Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8102. [PMID: 35805759 PMCID: PMC9266229 DOI: 10.3390/ijerph19138102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Abstract
The destruction of the World Trade Center (WTC) on September 11, 2001 (9/11) released large amounts of toxic dusts and fumes into the air that exposed many community members who lived and/or worked in the local area. Many community members, defined as WTC survivors by the federal government, developed lower respiratory symptoms (LRS). We previously reported the persistence of these symptoms in patients with normal spirometry despite treatment with inhaled corticosteroids and/or long-acting bronchodilators. This report expands upon our study of this group with the goal to identify molecular markers associated with exposure and heterogeneity in WTC survivors with LRS using a selected plasma biomarker approach. Samples from WTC survivors with LRS (n = 73, WTCS) and samples from healthy control participants of the NYU Bellevue Asthma Registry (NYUBAR, n = 55) were compared. WTCS provided information regarding WTC dust exposure intensity. Hierarchical clustering of the linear biomarker data identified two clusters within WTCS and two clusters within NYUBAR controls. Comparison of the WTCS clusters showed that one cluster had significantly increased levels of circulating matrix metalloproteinases (MMP1, 2, 3, 8, 12, 13), soluble inflammatory receptors (receptor for advanced glycation end-products-RAGE, Interleukin-1 receptor antagonist (IL-1RA), suppression of tumorigenicity (ST)2, triggering receptor expressed on myeloid cells (TREM)1, IL-6Ra, tumor necrosis factor (TNF)RI, TNFRII), and chemokines (IL-8, CC chemokine ligand- CCL17). Furthermore, this WTCS cluster was associated with WTC exposure variables, ash at work, and the participant category workers; but not with the exposure variable WTC dust cloud at 9/11. A comparison of WTC exposure categorial variables identified that chemokines (CCL17, CCL11), circulating receptors (RAGE, TREM1), MMPs (MMP3, MMP12), and vascular markers (Angiogenin, vascular cell adhesion molecule-VCAM1) significantly increased in the more exposed groups. Circulating biomarkers of remodeling and inflammation identified clusters within WTCS and were associated with WTC exposure.
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Affiliation(s)
- Gabriele Grunig
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Nedim Durmus
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
| | - Yian Zhang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yuting Lu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Sultan Pehlivan
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Yuyan Wang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Kathleen Doo
- Pulmonary, Kaiser Permanente East Bay, Oakland, CA 94611, USA;
| | - Maria L. Cotrina-Vidal
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Roberta Goldring
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Kenneth I. Berger
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Mengling Liu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
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Bantulà M, Tubita V, Roca-Ferrer J, Mullol J, Valero A, Bobolea I, Pascal M, de Hollanda A, Vidal J, Picado C, Arismendi E. Differences in Inflammatory Cytokine Profile in Obesity-Associated Asthma: Effects of Weight Loss. J Clin Med 2022; 11:jcm11133782. [PMID: 35807067 PMCID: PMC9267201 DOI: 10.3390/jcm11133782] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity and asthma are associated with systemic inflammation maintained by mediators released by adipose tissue and lung. This study investigated the inflammatory serum mediator profile in obese subjects (O) (n = 35), non-obese asthma (NOA) patients (n = 14), obese asthmatics (OA) (n = 21) and healthy controls (HC) (n = 33). The effect of weight loss after bariatric surgery (BS) was examined in 10 OA and 31 O subjects. We analyzed serum markers including leptin, adiponectin, TGF-β1, TNFR2, MCP-1, ezrin, YKL-40, ST2, IL-5, IL-9, and IL-18. Compared with HC subjects, the O group showed increased levels of leptin, TGF-β1, TNFR2, MCP-1, ezrin, YKL-40, and ST2; the OA group presented increased levels of MCP-1, ezrin, YKL-40, and IL-18, and the NOA group had increased levels of ezrin, YKL-40, IL-5, and IL-18. The higher adiponectin/leptin ratio in NOA with respect to OA subjects was the only significant difference between the two groups. IL-9 was the only cytokine with significantly higher levels in OA with respect to O subjects. TNFR2, ezrin, MCP-1, and IL-18 concentrations significantly decreased in O subjects after BS. O, OA, and NOA showed distinct patterns of systemic inflammation. Leptin and adiponectin are regulated in asthma by obesity-dependent and -independent mechanisms. Combination of asthma and obesity does not result in significant additive effects on circulating cytokine levels.
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Affiliation(s)
- Marina Bantulà
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Correspondence: ; Tel.: +34-932275400
| | - Valeria Tubita
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
| | - Jordi Roca-Ferrer
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Joaquim Mullol
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, 08036 Barcelona, Spain
| | - Antonio Valero
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Pulmonology and Allergy Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Irina Bobolea
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Pulmonology and Allergy Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Mariona Pascal
- Immunology Department, CDB, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Ana de Hollanda
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic, 08036 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Fisopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Josep Vidal
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic, 08036 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red en Diabetes y Enfermedades Metabólicas (CIBERDEM), 28029 Madrid, Spain
| | - César Picado
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Pulmonology and Allergy Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Ebymar Arismendi
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (V.T.); (J.R.-F.); (J.M.); (A.V.); (I.B.); (A.d.H.); (J.V.); (C.P.); (E.A.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Pulmonology and Allergy Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
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Kimura H, Shimizu K, Tanabe N, Makita H, Taniguchi N, Kimura H, Suzuki M, Abe Y, Matsumoto-Sasaki M, Oguma A, Takimoto-Sato M, Takei N, Matsumoto M, Goudarzi H, Sato S, Ono J, Izuhara K, Hirai T, Nishimura M, Konno S. Further evidence for association of YKL-40 with severe asthma airway remodeling. Ann Allergy Asthma Immunol 2022; 128:682-688.e5. [PMID: 35342020 DOI: 10.1016/j.anai.2022.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The chitinase-like protein YKL-40 is associated with airflow limitation on spirometry and airway remodeling in patients with asthma. It remains unclear whether YKL-40 is associated with morphologic changes in the airways and parenchyma or with future progression of airflow limitation in severe asthma. OBJECTIVE To evaluate the association of circulating YKL-40 levels with morphologic changes in the airways and parenchyma and with longitudinal progression of airflow limitation. METHODS The patients were participants in the Hokkaido Severe Asthma Cohort Study (n = 127), including smokers. This study consisted of 2 parts. In analysis 1, we analyzed associations between circulating YKL-40 levels and several asthma-related indices, including computed tomography-derived indices of proximal wall area percentage, the complexity of the airways (airway fractal dimension), and the parenchyma (exponent D) cross-sectionally (n = 97). In analysis 2, we evaluated the impact of circulating YKL-40 levels on forced expiratory volume in 1 second (FEV1) decline longitudinally for a 5-year follow-up (n = 103). RESULTS Circulating YKL-40 levels were significantly associated with proximal wall area percentage and airway fractal dimension (r = 0.25, P = .01; r = -0.22, P = .04, respectively), but not with exponent D. The mean annual change in FEV1 was -33.7 (± 23.3) mL/y, and the circulating YKL-40 level was a significant independent factor associated with annual FEV1 decline (β = -0.24, P = .02), even after controlling for exponent D (β = -0.26, P = .01). CONCLUSION These results provide further evidence for the association of YKL-40 with the pathogenesis of airway remodeling in severe asthma.
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Affiliation(s)
- Hirokazu Kimura
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan.
| | - Kaoruko Shimizu
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Naoya Tanabe
- Graduate School of Medicine, Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - Hironi Makita
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Natsuko Taniguchi
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroki Kimura
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Masaru Suzuki
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Yuki Abe
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | | | - Akira Oguma
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Michiko Takimoto-Sato
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Nozomu Takei
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Munehiro Matsumoto
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Houman Goudarzi
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Susumu Sato
- Graduate School of Medicine, Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - Junya Ono
- R&D Center, Shino-Test Corporation, Kanagawa, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Toyohiro Hirai
- Graduate School of Medicine, Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - Masaharu Nishimura
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan; Hokkaido Medical Research Institute for Respiratory Diseases, Sapporo, Japan
| | - Satoshi Konno
- Faculty of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
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9
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Sun L, Peng B, Zhou J, Wang P, Mo Y, Xu G, Tao Y, Song H, Tang W, Jin M. Difference of Serum Cytokine Profile in Allergic Asthma Patients According to Disease Severity. J Asthma Allergy 2022; 15:315-326. [PMID: 35283636 PMCID: PMC8909512 DOI: 10.2147/jaa.s345759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Allergic asthma is a heterogeneous disease with complex underlying mechanisms. Cytokines are key mediators in immune system and potential indicators of disease status. The aim of this study is to compare the difference of serum cytokine profile in allergic asthma patients with different disease severity and explore candidate biomarkers for disease monitoring and targeting therapeutic agents. Patients and Methods A total of 40 allergic asthmatics (mild, n=22; moderate-to-severe, n=18) were included in this study. Serum samples, lung function and exhaled nitric oxide data were collected from each subject. A Meso Scale Discovery (MSD) electrochemiluminescence platform was applied to access serum levels of 33 cytokines. Serum cytokine profile was compared between mild and moderate-to-severe allergic asthmatics, and the correlation between serum cytokine levels, lung function and exhaled nitric oxide were analyzed. Results Moderate-to-severe allergic asthmatics displayed higher levels of eotaxin-1, eotaxin-2, MCP-1, MCP-2, MCP-3, YKL-40 and lower IL-23, IL-31 and TRAIL in serum in comparison with mild allergic asthmatics. Serum YKL-40, eotaxin-1 and MCP-1 had the best ability to discriminate mild and moderate-to-severe allergic asthmatics, with an AUC of 0.833, 0.811 and 0.760. Serum IP-10 was positively correlated with FeNO levels, while FnNO displayed a strong positive correlation with serum IL-25. Conclusion Compared with mild allergic asthmatics, significant increase in serum eotaxin-1, eotaxin-2, MCP-1, MCP-2, MCP-3, YKL-40 and decrease in serum IL-23, IL-31 and TRAIL was noted in moderate-to-severe allergic asthmatics. YKL-40, eotaxin-1 and MCP-1 might be candidate biomarkers in reflecting severity in allergic asthma patients.
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Affiliation(s)
- Lin Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, People’s Republic of China
| | - Bo Peng
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, People’s Republic of China
| | - Jun Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, People’s Republic of China
| | - Ping Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yuqing Mo
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Guofang Xu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yi Tao
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hejie Song
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, People’s Republic of China
| | - Wei Tang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, People’s Republic of China
- Correspondence: Wei Tang, Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email
| | - Meiling Jin
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- Meiling Jin, Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Email
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10
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Increased Plasma YKL-40 Level and Chitotriosidase Activity in Cystic Fibrosis Patients. Inflammation 2021; 45:627-638. [PMID: 34637032 DOI: 10.1007/s10753-021-01572-2] [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: 05/08/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
We investigated plasma YKL-40 levels and chitotriosidase (CHIT1) activity in patients with cystic fibrosis (CF) lung disease and evaluated clinically relevant factors that may affect their levels. Plasma samples were obtained from pediatric (n = 19) and adult patients (n = 15) during exacerbation, discharge, and stable period of the disease. YKL-40 levels and chitotriosidase activity were measured by enzyme-linked immunosorbent assay and fluorometric assay, respectively. Data were compared with healthy children and adults of similar age. YKL-40 levels of pediatric and adult CF patients at all periods were significantly higher than controls (p < 0.001 and p < 0.05). CHIT1 activities of adult patients at all periods were significantly higher compared to controls (p < 0.05). On the other hand, CHIT1 activities of pediatric CF patients were similar with controls. YKL-40 levels of exacerbation period of adult CF patients were negatively correlated with forced vital capacity (FVC) (r = - 0.800, p = 0.014) and forced expiratory volume in 1 s (FEV1) (r = - 0.735, p = 0.008). YKL-40 levels in the exacerbation period of pediatric CF patients were negatively correlated with FVC (r = - 0.697, p = 0.0082) and FEV1 (r = - 0.720, p = 0.006). CHIT1 activity may be a valuable marker of chronic inflammation in adult CF patients who suffer from CF for a longer period compared to pediatric patients. Increased YKL-40 levels in both pediatric and adult patients compared to controls may point to a role in between CF pathology.
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Abstract
PURPOSE OF REVIEW Finding suitable biomarkers to phenotype asthma, identify individuals at risk of worsening and guide treatment is highly prioritized in asthma research. We aimed to provide an analysis of currently used and upcoming biomarkers, focusing on developments published in the past 2 years. RECENT FINDINGS Type 2 inflammation is the most studied asthma mechanism with the most biomarkers in the pipeline. Blood eosinophils and fractional exhaled nitric oxide (FeNO) are those most used clinically. Recent developments include their ability to identify individuals at higher risk of exacerbations, faster decline in lung function and more likely to benefit from anti-IL-5 and anti-IL-4/-13 treatment. Certain patterns of urinary eicosanoid excretion also relate to type 2 inflammation. Results of recent trials investigating the use of serum periostin or dipeptidyl peptidase-4 to guide anti-IL-13 therapy were somewhat disappointing. Less is known about non-type 2 inflammation but blood neutrophils and YKL-40 may be higher in patients with evidence of non-type 2 asthma. Volatile organic compounds show promise in their ability to distinguish both eosinophilic and neutrophilic asthma. SUMMARY The ultimate panel of biomarkers for identification of activated inflammatory pathways and treatment strategies in asthma patients still lies in the future, particularly for non-type 2 asthma, but potential candidates are available.
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12
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Vezir E, Civelek E, Dibek Misirlioglu E, Toyran M, Capanoglu M, Karakus E, Kahraman T, Ozguner M, Demirel F, Gursel I, Kocabas CN. Effects of Obesity on Airway and Systemic Inflammation in Asthmatic Children. Int Arch Allergy Immunol 2021; 182:679-689. [PMID: 33752210 DOI: 10.1159/000513809] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obese asthma is a complex syndrome with certain phenotypes that differ in children and adults. There is no clear evidence regarding the presence of additive or synergistic pathological interaction between obesity and asthma in children. OBJECTIVES Our aim was to demonstrate the interaction of obesity and asthma in children in terms of airway and systemic inflammation by a controlled observational study. METHODS Four groups were formed: asthma obese (AO), asthma nonobese (ANO), non-AO (NAO), nonasthma nonobese (NANO). Spirometry test, fractional exhaled nitric oxide (FeNO) test, skin prick test, serum inflammatory biomarkers (C-reactive protein, C3, C4, adiponectin, leptin, resistin, periostin, YKL-40, Type 1, and Type 2 cytokines) were conducted and evaluated in all participants. Sputum inflammatory cells (sputum eosinophils and neutrophils) were evaluated in patients who could produce induced sputum and obesity-asthma interactions were determined. RESULTS A total of 153 participants aged 6-18 years were included in the study, including the AO group (n = 46), the ANO group (n = 45), the NAO group (n = 30), and the NANO group (n = 32). IL-4 (p < 0.001), IL-5 (p < 0.001), IL-13 (p < 0.001), resistin (p < 0.001), and YKL-40 (p < 0.001) levels were higher in patients with asthma independent of obesity. The lowest adiponectin level was found in the AO group and obesity-asthma interaction was detected (p < 0.001). Sputum eosinophilia (p < 0.01), sputum neutrophilia (p < 0.01), and FeNO levels (p = 0.07) were higher in asthmatic patients independent of obesity. In the group with paucigranulocytic inflammation, resistin and YKL-40 levels were significantly lower than in the group without paucigranulocytic inflammation (p < 0.01). CONCLUSION No interaction was found between obesity and asthma in terms of airway inflammation. Interaction between obesity and asthma was shown in terms of adiponectin level and resistin/adiponectin and leptin/adiponectin ratios. It was found that serum YKL-40 and resistin levels could be associated with airway inflammation.
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Affiliation(s)
- Emine Vezir
- Department of Pediatric Allergy and Clinical Immunology, Ankara Health Research and Application Center, University of Health Sciences, Ankara, Turkey,
| | - Ersoy Civelek
- Department of Pediatric Allergy and Clinical Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Emine Dibek Misirlioglu
- Department of Pediatric Allergy and Clinical Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Muge Toyran
- Department of Pediatric Allergy and Clinical Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Murat Capanoglu
- Department of Pediatric Allergy and Clinical Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Esra Karakus
- Department of Pathology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Tamer Kahraman
- Department of Molecular Biology and Genetics, Science Faculty, Ihsan Dogramacı Bilkent University, Ankara, Turkey
| | - Meltem Ozguner
- Department of Histology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Fatma Demirel
- Department of Pediatric Endocrinology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ihsan Gursel
- Department of Molecular Biology and Genetics, Science Faculty, Ihsan Dogramacı Bilkent University, Ankara, Turkey
| | - Can Naci Kocabas
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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13
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Mackel JJ, Garth JM, Jones M, Ellis DA, Blackburn JP, Yu Z, Matalon S, Curtiss M, Lund FE, Hastie AT, Meyers DA, Steele C. Chitinase 3-like-1 protects airway function despite promoting type 2 inflammation during fungal-associated allergic airway inflammation. Am J Physiol Lung Cell Mol Physiol 2021; 320:L615-L626. [PMID: 33533316 DOI: 10.1152/ajplung.00528.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Joseph J Mackel
- Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Jaleesa M Garth
- Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - MaryJane Jones
- Department of Microbiology and Immunology, Tulane University, New Orleans, Louisiana
| | - Diandra A Ellis
- Department of Microbiology and Immunology, Tulane University, New Orleans, Louisiana
| | | | - Zhihong Yu
- Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Sadis Matalon
- Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Miranda Curtiss
- Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama.,Department of Microbiology, University of Alabama Birmingham, Birmingham, Alabama
| | - Frances E Lund
- Department of Microbiology, University of Alabama Birmingham, Birmingham, Alabama
| | - Annette T Hastie
- Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | | | - Chad Steele
- Department of Microbiology and Immunology, Tulane University, New Orleans, Louisiana
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14
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James AJ, Nordlund B, Konradsen JR, Ebersjö C, Dahlén S, Berggren Broström E, Hedlin G. YKL-40 is a proposed biomarker of inflammation and remodelling elevated in children with bronchopulmonary dysplasia compared to asthma. Acta Paediatr 2021; 110:641-642. [PMID: 32772428 PMCID: PMC7891389 DOI: 10.1111/apa.15525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Anna J. James
- Experimental Asthma and Allergy Research Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Björn Nordlund
- Astrid Lindgren Children’s Hospital Lung and Allergy Unit Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Jon R. Konradsen
- Astrid Lindgren Children’s Hospital Lung and Allergy Unit Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Christina Ebersjö
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
- Sach’s Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Sven‐Erik Dahlén
- Experimental Asthma and Allergy Research Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Eva Berggren Broström
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
- Sach’s Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Gunilla Hedlin
- Astrid Lindgren Children’s Hospital Lung and Allergy Unit Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
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15
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Karwelat D, Schmeck B, Ringel M, Benedikter BJ, Hübner K, Beinborn I, Maisner A, Schulte LN, Vollmeister E. Influenza virus-mediated suppression of bronchial Chitinase-3-like 1 secretion promotes secondary pneumococcal infection. FASEB J 2020; 34:16432-16448. [PMID: 33095949 DOI: 10.1096/fj.201902988rr] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Abstract
Infections of the lung are among the leading causes of death worldwide. Despite the preactivation of innate defense programs during viral infection, secondary bacterial infection substantially elevates morbidity and mortality rates. Particularly problematic are co-infections with influenza A virus (IAV) and the major bacterial pathogen Streptococcus pneumoniae. However, the molecular processes underlying the severe course of such co-infections are not fully understood. Previously, the absence of secreted glycoprotein Chitinase-3-like 1 (CHI3L1) was shown to increase pneumococcal replication in mice. We therefore hypothesized that an IAV preinfection decreases CHI3L1 levels to promote pneumococcal infection. Indeed, in an air-liquid interface model of primary human bronchial epithelial cells (hBECs), IAV preinfection interfered with apical but not basolateral CHI3L1 release. Confocal time-lapse microscopy revealed that the gradual loss of apical CHI3L1 localization during co-infection with influenza and S. pneumoniae coincided with the disappearance of goblet as well as ciliated cells and increased S. pneumoniae replication. Importantly, extracellular restoration of CHI3L1 levels using recombinant protein significantly reduced bacterial load in influenza preinfected bronchial models. Thus, recombinant CHI3L1 may provide a novel therapeutic means to lower morbidity and mortality associated with post-influenza pneumococcal infections.
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Affiliation(s)
- Diana Karwelat
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Bernd Schmeck
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany.,Department of Pulmonary and Critical Care Medicine, University Medical Center Marburg, Universities of Giessen and Marburg Lung Center, Philipps University Marburg, Hesse, Germany.,German Center for Lung Research (DZL), Marburg, Hesse, Germany.,Center for Synthetic Microbiology (SYNMIKRO), Philipps University Marburg, Marburg, Hesse, Germany
| | - Marc Ringel
- Institute of Virology, Philipps University Marburg, Marburg, Hesse, Germany
| | - Birke J Benedikter
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Kathleen Hübner
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Isabell Beinborn
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Andrea Maisner
- Institute of Virology, Philipps University Marburg, Marburg, Hesse, Germany
| | - Leon N Schulte
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany.,German Center for Lung Research (DZL), Marburg, Hesse, Germany
| | - Evelyn Vollmeister
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
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16
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Wang L, Bao A, Zheng Y, Ma A, Wu Y, Shang H, Fang D, Ben S. Adenovirus vector-mediated YKL-40 shRNA attenuates eosinophil airway inflammation in a murine asthmatic model. Gene Ther 2020; 28:177-185. [PMID: 33046836 DOI: 10.1038/s41434-020-00202-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 12/23/2022]
Abstract
Recent studies have revealed that YKL-40 is involved in the pathogenesis of asthma. However, its specific mechanism remains unclear. The present study aims to investigate the effect of adenovirus vector-mediated YKL-40 short hairpin RNA (shRNA) on regulation of airway inflammation in a murine asthmatic model. Mice were assessed for airway hyperresponsiveness (AHR), total leukocytes and the percentage of eosinophil cells in bronchoalveolar lavage fluid (BALF). YKL-40 mRNA and protein expression levels were detected using quantitative real-time PCR and western blot assays. Enzyme-linked immunosorbent assay (ELISA) was used to detect YKL-40 and eosinophil-related chemokine expression levels in BALF and serum. Lung histology analyses were performed to evaluate the degree of inflammatory cell infiltration around the airway and airway mucus secretion.YKL-40 shRNA significantly inhibited the YKL-40 gene expression in asthmatic mice. In addition, YKL-40 shRNA alleviated eosinophilic airway inflammation, AHR, airway mucus secretion and decreased the levels of YKL-40 in BALF and serum in a murine asthmatic model. The levels and mRNA expression of IL-5, IL-13 in asthmatic mice lung tissues, eotaxin, and GM-CSF in BALF and serum significantly decreased. Bone marrow signaling molecules including IL-5, eotaxin, and GM-CSF were correlated with decreased levels of YKL-40. The study reveals that YKL-40 could be involved in asthma inflammation by altering bone marrow signaling molecules. YKL-40 gene RNA interference could provide new therapeutic strategies for asthma.
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Affiliation(s)
- Ling Wang
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aihua Bao
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zheng
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aying Ma
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wu
- Department of Respiratory Medicine, The Affiliated Hospital of Nantong University, Nantong, China
| | - Huanxia Shang
- Department of Respiratory Medicine, Chest Hospital of Hebei Province, Shijiazhuang, China
| | - Danruo Fang
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suqin Ben
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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17
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Zhu W, Lönnblom E, Förster M, Johannesson M, Tao P, Meng L, Lu S, Holmdahl R. Natural polymorphism of Ym1 regulates pneumonitis through alternative activation of macrophages. SCIENCE ADVANCES 2020; 6:6/43/eaba9337. [PMID: 33087360 PMCID: PMC7577715 DOI: 10.1126/sciadv.aba9337] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 09/02/2020] [Indexed: 05/12/2023]
Abstract
We have positionally cloned the Ym1 gene, with a duplication and a promoter polymorphism, as a major regulator of inflammation. Mice with the RIIIS/J haplotype, with the absence of Ym1 expression, showed reduced susceptibility to mannan-enhanced collagen antibody-induced arthritis and to chronic arthritis induced by intranasal exposure of mannan. Depletion of lung macrophages alleviated arthritis, whereas intranasal supplement of Ym1 protein to Ym1-deficient mice reversed the disease, suggesting a key role of Ym1 for inflammatory activity by lung macrophages. Ym1-deficient mice with pneumonitis had less eosinophil infiltration, reduced production of type II cytokines and IgG1, and skewing of macrophages toward alternative activation due to enhanced STAT6 activation. Proteomics analysis connected Ym1 polymorphism with changed lipid metabolism. Induced PPAR-γ and lipid metabolism in Ym1-deficient macrophages contributed to cellular polarization. In conclusion, the natural polymorphism of Ym1 regulates alternative activation of macrophages associated with pulmonary inflammation.
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Affiliation(s)
- Wenhua Zhu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 710061 Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, 710061 Xi'an, China
- The National Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, 710004 Xi'an, China
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Erik Lönnblom
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Michael Förster
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Martina Johannesson
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Pei Tao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 710061 Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, 710061 Xi'an, China
| | - Liesu Meng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 710061 Xi'an, China.
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, 710061 Xi'an, China
- The National Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, 710004 Xi'an, China
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Shemin Lu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 710061 Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, 710061 Xi'an, China
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
| | - Rikard Holmdahl
- The National Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, 710004 Xi'an, China.
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 171 77, Sweden
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18
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Amarnani D, Sanchez AV, Wong LL, Duffy BV, Ramos L, Freitag SK, Bielenberg DR, Kim LA, Lee NG. Characterization of a Murine Model of Oxazolone-Induced Orbital Inflammation. Transl Vis Sci Technol 2020; 9:26. [PMID: 32855872 PMCID: PMC7422768 DOI: 10.1167/tvst.9.8.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 05/04/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose Acute orbital inflammation can lead to irreversible vision loss in serious cases. Treatment thus far has been limited to systemic steroids or surgical decompression of the orbit. An animal model that mimics the characteristic features of acute orbital inflammation as found in thyroid eye disease can be used to explore novel treatment modalities. Methods We developed a murine model of orbital inflammation by injecting oxazolone into the mouse orbit. The mice underwent magnetic resonance imaging (MRI) and were euthanized at various time points for histologic examination. Immunofluorescence studies of specific inflammatory cells and cytokine arrays were performed. Results We found clinical and radiographic congruity between the murine model and human disease. After 72 hours, sensitized mice exhibited periorbital dermatitis and inflammation in the eyelids of the injected side. By one week, increased proptosis in the injected eye with significant eyelid edema was appreciated. By four weeks, inflammation and proptosis were decreased. At all three time points, the mice demonstrated exophthalmos and periorbital edema. Histopathologically, populations of inflammatory cells including T cells, macrophages, and neutrophils shared similarities with patient samples in thyroid eye disease. Proteomic changes in the levels of inflammatory and angiogenic markers correlated to the expected angiogenic, inflammatory, and fibrotic responses observed in patients with thyroid eye disease. Conclusions A murine model of orbital inflammation created using oxazolone recapitulates some of the clinical features of thyroid eye disease and potentially other nonspecific orbital inflammation, typified by inflammatory cell infiltration, orbital tissue expansion and remodeling, and subsequent fibrosis. Translational Relevance This animal model could serve as a viable platform with which to understand the underlying mechanisms of acute orbital inflammation and to investigate potential new, targeted treatments.
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Affiliation(s)
- Dhanesh Amarnani
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Angie V Sanchez
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Lindsay L Wong
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | | | | | - Suzanne K Freitag
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Diane R Bielenberg
- Vascular Biology Program, Boston Children's Hospital, Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Leo A Kim
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Nahyoung Grace Lee
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Abstract
PURPOSE OF REVIEW Mites are the most worldwide spread allergens and relevant causative of respiratory allergies. Life cycle, component allergens, biological activity and immunogenicity are discussed in depth. RECENT FINDINGS It is now known that mite allergens are able to stimulate the innate immune system through different receptors, for example, TLRs and PARs. The activation of the cells in the airway mucosa is followed by type 2 polarizing cytokine production in predisposed individuals. This complex network plays a pivotal role into the promotion of Th2 differentiation. SUMMARY This is a comprehensive review regarding all the mite allergens known so far, including their location within dust mites, composition, biological activities and binding receptors relevant to the fate of the immunological response.
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20
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Gomez JL, Chen A, Diaz MP, Zirn N, Gupta A, Britto C, Sauler M, Yan X, Stewart E, Santerian K, Grant N, Liu Q, Fry R, Rager J, Cohn L, Alexis N, Chupp GL. A Network of Sputum MicroRNAs Is Associated with Neutrophilic Airway Inflammation in Asthma. Am J Respir Crit Care Med 2020; 202:51-64. [PMID: 32255668 PMCID: PMC7328332 DOI: 10.1164/rccm.201912-2360oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/06/2020] [Indexed: 01/06/2023] Open
Abstract
Rationale: MicroRNAs are potent regulators of biologic systems that are critical to tissue homeostasis. Individual microRNAs have been identified in airway samples. However, a systems analysis of the microRNA-mRNA networks present in the sputum that contribute to airway inflammation in asthma has not been published.Objectives: Identify microRNA and mRNA networks in the sputum of patients with asthma.Methods: We conducted a genome-wide analysis of microRNA and mRNA in the sputum from patients with asthma and correlated expression with clinical phenotypes. Weighted gene correlation network analysis was implemented to identify microRNA networks (modules) that significantly correlate with clinical features of asthma and mRNA expression networks. MicroRNA expression in peripheral blood neutrophils and lymphocytes and in situ hybridization of the sputum were used to identify the cellular sources of microRNAs. MicroRNA expression obtained before and after ozone exposure was also used to identify changes associated with neutrophil counts in the airway.Measurements and Main Results: Six microRNA modules were associated with clinical features of asthma. A single module (nely) was associated with a history of hospitalizations, lung function impairment, and numbers of neutrophils and lymphocytes in the sputum. Of the 12 microRNAs in the nely module, hsa-miR-223-3p was the highest expressed microRNA in neutrophils and was associated with increased neutrophil counts in the sputum in response to ozone exposure. Multiple microRNAs in the nely module correlated with two mRNA modules enriched for TLR (Toll-like receptor) and T-helper cell type 17 (Th17) signaling and endoplasmic reticulum stress. hsa-miR-223-3p was a key regulator of the TLR and Th17 pathways in the sputum of subjects with asthma.Conclusions: This study of sputum microRNA and mRNA expression from patients with asthma demonstrates the existence of microRNA networks and genes that are associated with features of asthma severity. Among these, hsa-miR-223-3p, a neutrophil-derived microRNA, regulates TLR/Th17 signaling and endoplasmic reticulum stress.
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Affiliation(s)
- Jose L. Gomez
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Ailu Chen
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Maria Paula Diaz
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Nicholas Zirn
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Amolika Gupta
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Clemente Britto
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Maor Sauler
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Xiting Yan
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Emma Stewart
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Kyle Santerian
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Nicole Grant
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Qing Liu
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Rebecca Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and
| | - Julia Rager
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and
| | - Lauren Cohn
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Neil Alexis
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
| | - Geoffrey L. Chupp
- Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, Yale School of Medicine, New Haven, Connecticut
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21
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Horne E, Tibble H, Sheikh A, Tsanas A. Challenges of Clustering Multimodal Clinical Data: Review of Applications in Asthma Subtyping. JMIR Med Inform 2020; 8:e16452. [PMID: 32463370 PMCID: PMC7290450 DOI: 10.2196/16452] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/10/2019] [Accepted: 02/10/2020] [Indexed: 12/27/2022] Open
Abstract
Background In the current era of personalized medicine, there is increasing interest in understanding the heterogeneity in disease populations. Cluster analysis is a method commonly used to identify subtypes in heterogeneous disease populations. The clinical data used in such applications are typically multimodal, which can make the application of traditional cluster analysis methods challenging. Objective This study aimed to review the research literature on the application of clustering multimodal clinical data to identify asthma subtypes. We assessed common problems and shortcomings in the application of cluster analysis methods in determining asthma subtypes, such that they can be brought to the attention of the research community and avoided in future studies. Methods We searched PubMed and Scopus bibliographic databases with terms related to cluster analysis and asthma to identify studies that applied dissimilarity-based cluster analysis methods. We recorded the analytic methods used in each study at each step of the cluster analysis process. Results Our literature search identified 63 studies that applied cluster analysis to multimodal clinical data to identify asthma subtypes. The features fed into the cluster algorithms were of a mixed type in 47 (75%) studies and continuous in 12 (19%), and the feature type was unclear in the remaining 4 (6%) studies. A total of 23 (37%) studies used hierarchical clustering with Ward linkage, and 22 (35%) studies used k-means clustering. Of these 45 studies, 39 had mixed-type features, but only 5 specified dissimilarity measures that could handle mixed-type features. A further 9 (14%) studies used a preclustering step to create small clusters to feed on a hierarchical method. The original sample sizes in these 9 studies ranged from 84 to 349. The remaining studies used hierarchical clustering with other linkages (n=3), medoid-based methods (n=3), spectral clustering (n=1), and multiple kernel k-means clustering (n=1), and in 1 study, the methods were unclear. Of 63 studies, 54 (86%) explained the methods used to determine the number of clusters, 24 (38%) studies tested the quality of their cluster solution, and 11 (17%) studies tested the stability of their solution. Reporting of the cluster analysis was generally poor in terms of the methods employed and their justification. Conclusions This review highlights common issues in the application of cluster analysis to multimodal clinical data to identify asthma subtypes. Some of these issues were related to the multimodal nature of the data, but many were more general issues in the application of cluster analysis. Although cluster analysis may be a useful tool for investigating disease subtypes, we recommend that future studies carefully consider the implications of clustering multimodal data, the cluster analysis process itself, and the reporting of methods to facilitate replication and interpretation of findings.
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Affiliation(s)
- Elsie Horne
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Holly Tibble
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Aziz Sheikh
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Athanasios Tsanas
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
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22
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Phenotypes and endotypes of adult asthma: Moving toward precision medicine. J Allergy Clin Immunol 2020; 144:1-12. [PMID: 31277742 DOI: 10.1016/j.jaci.2019.05.031] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 02/07/2023]
Abstract
Asthma is a chronic inflammatory disease of the airways that is challenging to dissect into subgroups because of the heterogeneity present across the spectrum of the disease. Efforts to subclassify asthma using advanced computational methods have identified a number of different phenotypes that suggest that multiple pathobiologically driven clusters of disease exist. The main phenotypes that have been identified include (1) early-onset allergic asthma, (2) early-onset allergic moderate-to-severe remodeled asthma, (3) late-onset nonallergic eosinophilic asthma, and (4) late-onset nonallergic noneosinophilic asthma. Subgroups of these phenotypes also exist but have not been as consistently identified. Advances in our understanding of the diverse immunologic perturbations that drive airway inflammation are consistent with clinical traits associated with these phenotypes and their response to biologic therapies. This has improved the clinician's approach to characterizing asthmatic patients in the clinic. Being able to define asthma endotypes using clinical characteristics and biomarkers will move physicians toward even more personalized management of asthma and precision-based care in the future. Here we will review the most prominent phenotypes and immunologic advances that suggest these disease subtypes represent asthma endotypes.
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23
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Przysucha N, Górska K, Krenke R. Chitinases and Chitinase-Like Proteins in Obstructive Lung Diseases - Current Concepts and Potential Applications. Int J Chron Obstruct Pulmon Dis 2020; 15:885-899. [PMID: 32368034 PMCID: PMC7185641 DOI: 10.2147/copd.s236640] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/10/2020] [Indexed: 01/14/2023] Open
Abstract
Chitinases, enzymes that cleave chitin’s chain to low molecular weight chitooligomers, are widely distributed in nature. Mammalian chitinases belong to the 18-glycosyl-hydrolase family and can be divided into two groups: true chitinases with enzymatic activity (AMCase and chitotriosidase) and chitinase-like proteins (CLPs) molecules which can bind to chitin or chitooligosaccharides but lack enzymatic activity (eg, YKL-40). Chitinases are thought to be part of an innate immunity against chitin-containing parasites and fungal infections. Both groups of these hydrolases are lately evaluated also as chemical mediators or biomarkers involved in airway inflammation and fibrosis. The aim of this article is to present the current knowledge on the potential role of human chitinases and CLPs in the pathogenesis, diagnosis, and course of obstructive lung diseases. We also assessed the potential role of chitinase and CLPs inhibitors as therapeutic targets in chronic obstructive pulmonary disease and asthma.
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Affiliation(s)
- Natalia Przysucha
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Rafal Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
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24
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Sun Y, Shi Z, Liu B, Li X, Li G, Yang F, Tang H. YKL-40 mediates airway remodeling in asthma via activating FAK and MAPK signaling pathway. Cell Cycle 2020; 19:1378-1390. [PMID: 32286145 DOI: 10.1080/15384101.2020.1750811] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
YKL-40 is a chitinase-like protein which was significantly elevated in asthma patients and related closely to asthma severity and airway remodeling. Airway remodeling in asthma involves complicated physical and pathological processes, including increased airway smooth muscle mass due to proliferation, migration of airway smooth muscle cells, epithelial-mesenchymal transition (EMT) and sub-epithelial fibrosis. However, the precise effect and underlying mechanism of YKL-40 in this pathological alteration remained unelucidated. In this study, we demonstrated that YKL-40 could promote asthma airway remodeling by increasing airway smooth muscle mass, inducing EMT and sub-epithelial fibrosis. Furthermore, we identified that FAK and MAPK signaling pathways are activated in the process. Inhibiting FAK or MAPK pathway could significantly ameliorate airway remodeling induced by excessive secretion of YKL-40 in vitro. and in vivo. In conclusion, this study shed light upon the effects of YKL-40 in asthma airway remodeling and provided potential novel targets in asthma patients with high YKL-40 level.
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Affiliation(s)
- Yu Sun
- Insititute of Burn Surgery, Changhai Hospital, Second Military Medical University , Shanghai, China
| | - Zhaoquan Shi
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University , Shanghai, China
| | - Bing Liu
- Department of Respiratory Medicine, Shanghai Liqun Hospital , Shanghai, China
| | - Xian'Gui Li
- Department of Inorganic Chemistry, School of Pharmacy, Second Military Medical University , Shanghai, China
| | - Ge Li
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University , Shanghai, China
| | - Feng Yang
- Department of Inorganic Chemistry, School of Pharmacy, Second Military Medical University , Shanghai, China
| | - Hao Tang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University , Shanghai, China
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25
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Trinh HKT, Nguyen TVT, Kim SH, Cao TBT, Luu QQ, Kim SH, Park HS. Osteopontin contributes to late-onset asthma phenotypes in adult asthma patients. Exp Mol Med 2020; 52:253-265. [PMID: 32009132 PMCID: PMC7062758 DOI: 10.1038/s12276-020-0376-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 01/07/2023] Open
Abstract
Patients with late-onset asthma (LOA) have poor clinical outcomes. Osteopontin (OPN) is associated with airway inflammation and remodeling. To investigate the role of OPN in LOA compared to early-onset asthma (EOA), serum OPN levels were compared between 131 adult asthma patients (48 LOA and 83 EOA patients) and 226 healthy controls (HCs). BALB/c mice were sensitized with ovalbumin with/without polyinosinic-polycytidylic acid (poly(I:C)) from week 6 (A6 mice) or week 12 (A12 mice) after birth. Airway hyperresponsiveness (AHR), bronchoalveolar lavage fluid (BALF), cell counts, histology, and Spp1 expression were assessed. The levels of OPN, transforming growth factor β1 (TGF-β1), chitinase 3-like 1 (CH3L1), and interleukin (IL) 5 were measured by ELISA. The expression of Smad3 phosphorylation and tissue transglutaminase 2 (TGM2) was evaluated by Western blot. The serum OPN levels were significantly higher in asthma patients than in HCs and in LOA patients than in those with EOA (P < 0.05) and were positively correlated with serum TGF-β1 and CH3L1 (r = 0.174, r = 0.264; P < 0.05). A12 mice showed elevated AHR with increased levels of OPN/TGF-β1/IL-5 in BALF and Spp1 compared to A6 mice. Poly(I:C) induced remarkable TGF-β1, CH3L1, Th2 cytokine, and OPN levels in BALF and the expression of phosphorylated Smad3, TGM2, and Spp1 in the lungs. OPN triggered TGF-β1/Smad3 signaling in the lungs, which was suppressed by dexamethasone and anti-IL5 antibody. In conclusion, aging and exposure to viral infections may induce OPN release and consequently modulate inflammation and TGF-β1/Smad3-related remodeling, contributing to the development of LOA. Aging and viral infections in older individuals may combine to spur the release of an inflammatory protein implicated in late-onset asthma. A team led by Hae-Sim Park from Ajou University School of Medicine, Suwon, South Korea, showed that people who develop asthma after age 40 have higher blood levels of osteopontin, a multifunctional protein with roles in airway inflammation and tissue remodeling, than people who develop asthma at a younger age or healthy individuals. The researchers developed two ovalbumin-induced asthma models in younger and older mice, and found that older mice developed more severe airway hyperresponsiveness with higher levels of osteopontin, among other inflammatory markers, which were emnhanced by viral infection. Drug therapies that target osteopontin signaling could help combat the late-onset asthma.
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Affiliation(s)
- Hoang Kim Tu Trinh
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea.,Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuy Van Thao Nguyen
- Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Seo-Hee Kim
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Thi Bich Tra Cao
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Quoc Quang Luu
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Seung-Hyun Kim
- Translational Research Laboratory for Inflammatory Disease, Clinical Trial Center, Ajou University Medical Center, Suwon, South Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea. .,Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea.
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26
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Holgate ST, Walker S, West B, Boycott K. The Future of Asthma Care: Personalized Asthma Treatment. Clin Chest Med 2020; 40:227-241. [PMID: 30691714 DOI: 10.1016/j.ccm.2018.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although once considered a single disease entity, asthma is now known to be a complex inflammatory disease engaging a range of causal pathways. The most frequent forms of asthma are identified by sputum/blood eosinophilia and activation of type 2 inflammatory pathways involving interleukins-3, -4, -5, and granulocyte-macrophage colony-stimulating factor. The use of diagnostics that identify T2 engagement linked to the selective use of highly targeted biologics has opened up a new way of managing severe disease. Novel technologies, such as wearables and intelligent inhalers, enable real-time remote monitoring of asthma, creating a unique opportunity for personalized health care.
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Affiliation(s)
- Stephen T Holgate
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, The Sir Henry Wellcome Research Laboratories, Southampton General Hospital, Mail Point 810, Level, Southampton SO166YD, UK.
| | | | | | - Kay Boycott
- Asthma UK, 18 Mansell Street, London E1 8AA, UK
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27
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Guan R, Lin R, Jin R, Lu L, Liu X, Hu S, Sun L. Chitinase-like protein YKL-40 regulates human bronchial epithelial cells proliferation, apoptosis, and migration through TGF-β1/Smads pathway. Hum Exp Toxicol 2019; 39:451-463. [PMID: 31797699 DOI: 10.1177/0960327119891218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to study the effects of chitinase-like protein YKL-40 on proliferation, apoptosis, and migration of human bronchial epithelial cell line (BEAS-2B), and the underlying mechanisms, we cultured BEAS-2B alone or with different concentrations of YKL-40. thiazolyl blue tetrazolium bromide (MTT) assay was used to examine the cell proliferation. Annexin V-fluorescein isothiocyanate isomer (FITC)/propidium iodide staining and scratch assay were performed to test the cell apoptosis and migration. The concentrations of transforming growth factor-β1 (TGF-β1), Smad3, Smad7, alpha-smooth muscle actin (α-SMA), interleukin-4 (IL-4), IL-6, and IL-8 in the cell culture supernatant were detected by enzyme-linked immunosorbent assay. The messenger RNA and protein levels of YKL-40, TGF-β1, Smad3, Smad7, and α-SMA were detected by reverse transcription polymerase chain reaction and Western blot. BEAS-2B cells cultured with different concentrations of YKL-40 showed significantly higher cell proliferation and migration and inflammatory cytokines compared with that of control group, while the cell apoptosis was significantly lower than that of control group (p < 0.05). In addition, BEAS-2B cells cultured with YKL-40 had increased TGF-β1, Smad3, Smad7, and α-SMA levels in the supernatant, compared with that of BEAS-2B cells cultured alone (p < 0.05). Furthermore, LY364947, as TGF-β1/Smads signaling pathway inhibitor, decreased cell proliferation and migration ability and enhanced cell apoptosis of BEAS-2B cells compared with control group (p < 0.05). However, YKL-40 administration reversed the effect of LY364947 on the biological behavior of BEAS-2B cells. YKL-40 could affect the biological behaviors of BEAS-2B cells, which might be related to the TGF-β1/Smads pathway.
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Affiliation(s)
- R Guan
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China.,Both the authors contributed equally to this work
| | - R Lin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China.,Both the authors contributed equally to this work
| | - R Jin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - L Lu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - X Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - S Hu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - L Sun
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
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28
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Asthma Case Cluster during Renovation of a Water-Damaged and Toxic Building. Microorganisms 2019; 7:microorganisms7120642. [PMID: 31816917 PMCID: PMC6956061 DOI: 10.3390/microorganisms7120642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND An association between fungal exposure at work and asthma onset has been shown, but a causal relationship between them has not beTanle en established. METHODS The study describes an asthma cluster in workers in a building under renovation. Before renovation the work site had significant water damage, technical deficiencies, and ventilation problems. Worker protection was insufficient during renovation. In the building, toxicity was determined from dust as well as from cultured dust. Toxicity analysis was conducted in vitro using the boar spermatozoa motility assay. RESULTS During the 8-month renovation period, among 290 workers, 21 (7.2%) experienced new-onset asthma (9 women, 42.9%; 12 men, 57.1%; median age, 43 years (range, 30-60 years)). At the renovation site, they had been exposed to areas where remarkable toxicity was demonstrated in vitro. One year later, 13 (61.9%) of them still had moderate disease, and three (14.8%) had severe disease. Most patients had a poor response to inhaled corticosteroids. CONCLUSIONS This study documents a clear temporal association between occupational exposure during renovation of a water-damaged building and a cluster of 21 new occupational asthma cases. In addition, dust and cultured dust from their work spaces showed remarkable toxicity based on inhibition of boar sperm motility in vitro.
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Knihtilä H, Kotaniemi-Syrjänen A, Pelkonen AS, Savinko T, Malmberg LP, Mäkelä MJ. Serum chitinase-like protein YKL-40 is linked to small airway function in children with asthmatic symptoms. Pediatr Allergy Immunol 2019; 30:803-809. [PMID: 31487401 DOI: 10.1111/pai.13119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Lung function impairment among asthmatic children begins in early life, and biomarkers for identifying this impairment are needed. The chitinase-like protein YKL-40 has been associated with asthma and lung function in adults, but studies in children have yielded conflicting results. We evaluated the potential of YKL-40 and other systemic biomarkers for identifying lung function deficits in children with asthmatic symptoms. METHODS We determined the levels of serum YKL-40, periostin, and high-sensitivity C-reactive protein (hs-CRP) from the blood samples of 49 children with asthmatic symptoms. Lung function was assessed with impulse oscillometry (IOS) and spirometry, combined with an exercise challenge and a bronchodilator test. Fractional exhaled nitric oxide was measured at multiple flow rates. RESULTS Serum levels of YKL-40 showed significant correlations with most IOS indices at baseline (P = .008-.039), but there was no association between YKL-40 and spirometry parameters. Neither periostin nor hs-CRP were associated with baseline lung function. Children with a significant response in either the exercise challenge or the bronchodilator test had increased serum levels of YKL-40 (P = .003) and periostin (P = .035). YKL-40 correlated significantly with the blood neutrophil count (rs = .397, P = .005) but was not associated with biomarkers of eosinophilic inflammation. CONCLUSION Serum YKL-40 is a potential biomarker for lung function deficits in children with asthmatic symptoms. These deficits appear to be focused on small airways and may remain undetected with spirometry.
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Affiliation(s)
- Hanna Knihtilä
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anne Kotaniemi-Syrjänen
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna S Pelkonen
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Terhi Savinko
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Leo Pekka Malmberg
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mika J Mäkelä
- Department of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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30
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Denlinger LC, Heymann P, Lutter R, Gern JE. Exacerbation-Prone Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:474-482. [PMID: 31765853 DOI: 10.1016/j.jaip.2019.11.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/28/2019] [Accepted: 11/12/2019] [Indexed: 02/07/2023]
Abstract
Patients who are prone to exacerbations of asthma experience significant costs in terms of missed work and school, acute care visits, and hospitalizations. Exacerbations are largely driven by environmental exposures including pollutants, stress, and viral and bacterial pathogens. These exposures are most likely to induce acute severe "asthma attacks" in high-risk patients. These personal risk factors for exacerbations can vary with the phenotype of asthma and age of the patient. In children, allergic sensitization is a strong risk factor, especially for those children who develop sensitization early in life. Airway inflammation is an important risk factor, and biomarkers are under evaluation for utility in detecting eosinophilic and type 2 inflammation and neutrophilic inflammation as indicators of risk for recurrent exacerbations. Insights into inflammatory mechanisms have led to new approaches to prevent exacerbations using mAb-based biologics that target specific type 2 pathways. Challenges remain in developing an evidence base to support precision interventions with these effective yet expensive therapies, and in determining whether these treatments will be safe and effective in young children. Unfortunately, there has been less progress in developing treatments for acute exacerbations. Hopefully, greater understanding of mechanisms relating airway viruses, bacteria, mucin production, and neutrophilic inflammatory responses will lead to additional treatment options for patients experiencing acute exacerbations.
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Affiliation(s)
- Loren C Denlinger
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis.
| | - Peter Heymann
- Department of Pediatrics, University of Virginia, Charlottesville, Va
| | - Rene Lutter
- Departments of Respiratory Medicine and Experimental Immunology, Amsterdam University Centers, University of Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - James E Gern
- Department of Pediatrics, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wis
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31
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Guida G, Riccio AM. Immune induction of airway remodeling. Semin Immunol 2019; 46:101346. [PMID: 31734128 DOI: 10.1016/j.smim.2019.101346] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/17/2019] [Accepted: 11/06/2019] [Indexed: 12/17/2022]
Abstract
Airway remodeling is accepted to be a determining component within the natural history of asthma. It is a phenomenon characterized by changes in the airways structures that marches in parallel with and can be influenced by airway inflammation, floating at the interface between both natural and adaptive immunity and physical and mechanical cells behavior. In this review we aimed to highlight the comprehensive, yet not exhaustive, evidences of how immune cells induce, regulate and adapt to the recognized markers of airway remodeling. Mucous cell hyperplasia, epithelial dysfunction and mesenchymal transition, extracellular matrix protein synthesis and restructuration, fibroblast to myofibroblast transition, airway smooth muscle proliferation, bioactive and contractile properties, and vascular remodeling encompass complex physiopathological mechanisms that can be induced, suppressed or regulated by different cellular and molecular pathways. Growth factors, cytokines, chemokines and adhesion molecules expressed or derived either from the immune network of cells infiltrating the asthmatic airways and involving T helper lymphocytes, immune lymphoid cells, dendritic cells, eosinophils, neutrophils, mast cells or by the structural components such as epithelial cells, fibroblasts, myocytes, airway smooth muscle cells concur with protein cellular matrix component and metalloproteases in modifying the airway structure in a detrimental way. The consequences in lung function decline, fixed airway obstruction and clinical severity of the disease suggest the possibility of identify among the immune molecular pathway of remodeling some biological parameters or signal pathway to be either a good tracer for monitoring the disease evolution or a target for hypothetical phenotypes and endotypes. In the era of personalized medicine, a biomarker of remodeling might predict a response to small-molecule inhibitors or biologicals potentially targeting a fundamental aspect of asthma pathogenesis that impacts on the low responsiveness to airway inflammation directed treatments.
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Affiliation(s)
- Giuseppe Guida
- Allergology and Lung Pathology, Santa Croce and Carle Hospital, Cuneo - Antonio Carle Hospital, Via Antonio Carle 5, 12100, Confreria (CN), Italy.
| | - Anna Maria Riccio
- Allergy and Respiratory Diseases - Department of Internal Medicine, University of Genoa, Italy.
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32
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Narendra D, Blixt J, Hanania NA. Immunological biomarkers in severe asthma. Semin Immunol 2019; 46:101332. [PMID: 31735516 DOI: 10.1016/j.smim.2019.101332] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022]
Abstract
Severe asthma is heterogeneous in its clinical presentation, underlying pathophysiology, course and response to therapy. Clinical and physiological assessment of severe asthma is often inadequate in predicting underlying disease mechanisms and or response to medications. With the emergence of novel targeted therapies in severe asthma, the need for reproducible, easily measured biomarkers became obvious but only few are currently available for clinical use. These biomarkers along with the clinical presentation of the patient play an important role in identifying phenotypes and endotypes, predicting the clinical course and prognosis and improving the precision therapeutic approach to asthma.
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Affiliation(s)
- Dharani Narendra
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - John Blixt
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States.
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Shirai T, Hirai K, Gon Y, Maruoka S, Mizumura K, Hikichi M, Itoh K, Hashimoto S. Forced oscillation technique may identify severe asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2857-2860.e1. [PMID: 31231062 DOI: 10.1016/j.jaip.2019.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/27/2019] [Accepted: 05/23/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan.
| | - Keita Hirai
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shuichiro Maruoka
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kenji Mizumura
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mari Hikichi
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kunihiko Itoh
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Shu Hashimoto
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
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Santus P, Saad M, Damiani G, Patella V, Radovanovic D. Current and future targeted therapies for severe asthma: Managing treatment with biologics based on phenotypes and biomarkers. Pharmacol Res 2019; 146:104296. [PMID: 31173886 DOI: 10.1016/j.phrs.2019.104296] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 12/14/2022]
Abstract
Asthma is a respiratory disorder with considerable heterogeneity in aetiology, triggers, clinical characteristics and response to therapy. This diversity reflects different inflammatory pathways that can be subdivided into clinically similar categories called phenotypes, or pathogenically comparable groups called endotypes. In recent years, a great amount of research has been dedicated to the investigation and understanding of the heterogeneity of asthma pathophysiology and to the identification of treatable traits, biomarkers, mediators and therapeutic targets. Severe asthma is defined as an uncontrolled disease despite a maximal conventional therapeutic approach. While, to date, some target therapies showing improvements in lung function, asthma symptoms and a reduction of the annual rate of exacerbations in patients with severe asthma have been already approved, other treatments are currently being studied, specifically targeting Type 2 asthma. Further progress however, is still needed to tackle the molecular pathways for non-Type 2 asthma. The aim of the present narrative review is to discuss and examine the indication, mechanisms of action and therapeutic effects of currently available and emerging biologic agents for the treatment of severe asthma.
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Affiliation(s)
- Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Via G.B. Grassi, 74, 20157, Milan, Italy.
| | - Marina Saad
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Via G.B. Grassi, 74, 20157, Milan, Italy.
| | - Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi, 4, 20161, Milan, Italy.
| | - Vincenzo Patella
- Allergology and Clinical Immunology Unit, Department of Medical Sciences, Battipaglia Hospital, Via Fiorignano, 1, 84091, Battipaglia, Salerno, Italy.
| | - Dejan Radovanovic
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Via G.B. Grassi, 74, 20157, Milan, Italy.
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Liu L, Zhang X, Liu Y, Zhang L, Zheng J, Wang J, Hansbro PM, Wang L, Wang G, Hsu ACY. Chitinase-like protein YKL-40 correlates with inflammatory phenotypes, anti-asthma responsiveness and future exacerbations. Respir Res 2019; 20:95. [PMID: 31113430 PMCID: PMC6530174 DOI: 10.1186/s12931-019-1051-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/15/2019] [Indexed: 02/05/2023] Open
Abstract
Background Asthma is a heterogeneous chronic airway disease, which may be classified into different phenotypes. YKL-40 is a chitin-binding glycoprotein with unclear functions, but its expression is associated with inflammation and tissue remodeling. However, few studies have explored whether YKL-40 is associated with inflammatory phenotypes of asthma. Methods The study had two parts. Study I (n = 115) was a one-year prospective cohort designed to explore the relationship of serum YKL-40 levels with inflammatory phenotypes of asthma at baseline, and during exacerbations. Study II (n = 62) was a four-week prospective cohort designed to define whether serum YKL-40 levels could predict responses to a fixed anti-asthma regimen. YKL-40, IL-6 and CCL22 levels were detected using ELISA, and a sputum inflammatory panel (including IL-1β, IL-5, IL-8 and TNF-α) was assessed using Luminex-based MILLIPLEX assay. Results Study I: Serum YKL-40 levels in non-eosinophilic asthma (NEA) i.e. neutrophilic (47.77 [29.59, 74.97] ng/mL, n = 40) and paucigranulocytic (47.36 [28.81, 61.68] ng/mL, n = 31) were significantly elevated compared with eosinophilic asthma (31.05 [22.41, 51.10] ng/mL, n = 44) (P = 0.015). Serum YKL-40levels positively correlated with blood neutrophils, sputum IL-1β and plasma IL-6 but negatively correlated with serum IgE and blood eosinophils (all P ≤ 0.05). Baseline YKL-40 levels predicted moderate to severe exacerbations within a one-year period (aOR = 4.13, 95% CI = [1.08, 15.83]). Study II: Serum YKL-40 was an independent biomarker of negative responses to anti-asthma regimens (adjusted Odds Ratio [aOR] = 0.82, 95% CI = [0.71, 0.96]. Conclusions These studies show that YKL-40 is a non-type 2 inflammatory signature for NEA, which could predict responsiveness or insensitivity to anti-asthma medications and more exacerbations. Further studies are needed to assess whether monitoring YKL-40 levels could provide potential implications for clinical relevance. Electronic supplementary material The online version of this article (10.1186/s12931-019-1051-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lei Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xin Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, 21224, MD, USA.,Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ying Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Li Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jing Zheng
- Department of Integrated Traditional Chinese and Western Medicine, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Ji Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, 21224, MD, USA
| | - Philip M Hansbro
- Centre for Inflammation, Centenary Institute, Sydney, NSW, 2050, Australia.,Faculty of Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Lei Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Centre for Biotherapy, Chengdu, 610041, Sichuan, China.,Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Alan Chen-Yu Hsu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW, 2305, Australia
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YKL-40 and adult-onset asthma: Elevated levels in clusters with poorest outcome. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2466-2468.e3. [PMID: 30954645 DOI: 10.1016/j.jaip.2019.03.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/13/2019] [Accepted: 03/27/2019] [Indexed: 02/03/2023]
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Kanazawa J, Kitazawa H, Masuko H, Yatagai Y, Sakamoto T, Kaneko Y, Iijima H, Naito T, Saito T, Noguchi E, Konno S, Nishimura M, Hirota T, Tamari M, Hizawa N. A cis-eQTL allele regulating reduced expression of CHI3L1 is associated with late-onset adult asthma in Japanese cohorts. BMC MEDICAL GENETICS 2019; 20:58. [PMID: 30940096 PMCID: PMC6444873 DOI: 10.1186/s12881-019-0786-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022]
Abstract
Background The chitinase-like protein YKL-40 plays a major role in inhibiting the inflammasome. Deregulation of inflammasome activation is emerging as a key modulator of pathologic airway inflammation in patients with asthma. We determined whether cis-expression quantitative trait loci (eQTLs) of the gene that encodes YKL-40, chitinase 3-like 1 (CHI3L1), are involved in the onset of asthma or in specific asthma phenotypes. Methods This case-control study, which was conducted at the University of Tsukuba, Japan, included a total of 2709 adults from the Tsukuba genome-wide association study (GWAS) cohort (734 healthy volunteers and 237 asthma patients), the Tsukuba replication cohort (375 healthy adult volunteers and 381 adult asthma patients), and the Hokkaido replication cohort (554 healthy adult volunteers and 428 adult asthma patients). Among 34 cis-eQTLs in CHI3L1 in the lung, rs946261 was associated with adult asthma in these Japanese cohorts. The genetic impact of rs946261 on asthma was also examined according to the age at onset and adult asthma clusters. Results In the Tsukuba GWAS cohort, the C allele at rs946261 was significantly associated with reduced expression of CHI3L1 mRNA in the lung and with development of asthma (odds ratio (OR) 1.27; P = 0.036). The association was also observed following analysis of the three Japanese cohorts (OR 1.16; P = 0.013). A stronger association was found with late-onset asthma that developed at 41 years of age or later (OR 1.24; 95% confidence interval (CI) 1.07–1.45; P = 0.0058) and with a specific asthma phenotype characterized by late onset, less atopy, and mild airflow obstruction (OR 1.29; 95% CI 1.03–1.61; P = 0.027). Conclusions The genotype consisting of the cis-eQTL allele that reduces expression of CHI3L1 was specifically associated with late-onset adult asthma. Given the important role of YKL-40 in many pathophysiological processes, including cell growth, migration, chemotaxis, reorganization, and tissue remodeling, it may be involved in an important pathogenic role in the establishment of inflammation and remodeling in asthmatic airways. Our findings may indicate the presence of a specific endotype related to exaggerated activation of YKL-40 in the pathogenesis of late-onset adult asthma.
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Affiliation(s)
- Jun Kanazawa
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Haruna Kitazawa
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yohei Yatagai
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroaki Iijima
- Tsukuba Medical Center, Amakubo 1-3-1, Tsukuba, Ibaraki, 305-8558, Japan
| | - Takashi Naito
- Tsukuba Medical Center, Amakubo 1-3-1, Tsukuba, Ibaraki, 305-8558, Japan
| | - Takefumi Saito
- National Hospital Organization Ibaraki Higashi National Hospital, Terunuma 825, Tokai, Ibaraki, 319-1113, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita15, Nishi7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita15, Nishi7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tomomitsu Hirota
- Research Center for Medical Science, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mayumi Tamari
- Research Center for Medical Science, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
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Abstract
The recent Lancet commission has highlighted that "asthma" should be used to describe a clinical syndrome of wheeze, breathlessness, chest tightness, and sometimes cough. The next step is to deconstruct the airway into components of fixed and variable airflow obstruction, inflammation, infection and altered cough reflex, setting the airway disease in the context of extra-pulmonary co-morbidities and social and environmental factors. The emphasis is always on delineating treatable traits, including variable airflow obstruction caused by airway smooth muscle constriction (treated with short- and long-acting β-2 agonists), eosinophilic airway inflammation (treated with inhaled corticosteroids) and chronic bacterial infection (treated with antibiotics with benefit if it is driving the disease). It is also important not to over-treat the untreatable, such as fixed airflow obstruction. These can all be determined using simple, non-invasive tests such as spirometry before and after acute administration of a bronchodilator (reversible airflow obstruction); peripheral blood eosinophil count, induced sputum, exhaled nitric oxide (airway eosinophilia); and sputum or cough swab culture (bacterial infection). Additionally, the pathophysiology of risk domains must be considered: these are risk of an asthma attack, risk of poor airway growth, and in pre-school children, risk of progression to eosinophilic school age asthma. Phenotyping the airway will allow more precise diagnosis and targeted treatment, but it is important to move to endotypes, especially in the era of increasing numbers of biologicals. Advances in -omics technology allow delineation of pathways, which will be particularly important in TH2 low eosinophilic asthma, and also pauci-inflammatory disease. It is very important to appreciate the difficulties of cluster analysis; a patient may have eosinophilic airway disease because of a steroid resistant endotype, because of non-adherence to basic treatment, and a surge in environmental allergen burden. Sophisticated -omics approaches will be reviewed in this manuscript, but currently they are not being used in clinical practice. However, even while they are being evaluated, management of the asthmas can and should be improved by considering the pathophysiologies of the different airway diseases lumped under that umbrella term, using simple, non-invasive tests which are readily available, and treating accordingly.
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Affiliation(s)
- Andrew Bush
- Departments of Paediatrics and Paediatric Respiratory Medicine, Royal Brompton Harefield NHS Foundation Trust and Imperial College, London, United Kingdom
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Abstract
Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechanisms. The implementation of precision medicine in the management of asthma requires the identification of phenotype-specific markers measurable in biological fluids. To become useful, these biomarkers need to be quantifiable by reliable systems, reproducible in the clinical setting, easy to obtain and cost-effective. Using biomarkers to predict asthma outcomes and therapeutic response to targeted therapies has a great clinical significance, particularly in severe asthma. In the last years, significant research has been realized in the identification of valid biomarkers for asthma. This review focuses on the existent and emerging biomarkers with clinical higher applicability in the management of asthma.
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Affiliation(s)
- Angelica Tiotiu
- Pulmonology Department, University Hospital, 9, Rue du Morvan, 54511 Nancy, Vandœuvre-lès-Nancy France
- EA 3450 DevAH, Development, Adaptation, Cardio-Respiratory Regulations and Motor Control, University of Lorraine, Nancy, France
- National Heart and Lung Institute, Airway Disease Section, Imperial College London, London, UK
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40
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Eguiluz-Gracia I, Tay TR, Hew M, Escribese MM, Barber D, O'Hehir RE, Torres MJ. Recent developments and highlights in biomarkers in allergic diseases and asthma. Allergy 2018; 73:2290-2305. [PMID: 30289997 DOI: 10.1111/all.13628] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/22/2022]
Abstract
The potential of precision medicine in allergy and asthma has only started to be explored. A significant clarification in the pathophysiology of rhinitis, chronic rhinosinusitis, asthma, food allergy and drug hypersensitivity was made in the last decade. This improved understanding led to a better classification of the distinct phenotypes and to the discovery of new drugs such as biologicals, targeting phenotype-specific mechanisms. Nevertheless, many conditions remain poorly understood such as non-eosinophilic airway diseases or non-IgE-mediated food allergy. Moreover, there is a need to predict the response to specific therapies and the outcome of drug and food provocations. The identification of patients at risk of progression towards severity is also an unmet need in order to establish adequate preventive or therapeutic measures. The implementation of precision medicine in the clinical practice requires the identification of phenotype-specific markers measurable in biological matrices. To become useful, these biomarkers need to be quantifiable by reliable systems, and in samples obtained in an easy, rapid and cost-efficient way. In the last years, significant research resources have been put in the identification of valid biomarkers for asthma and allergic diseases. This review summarizes these recent advances with focus on the biomarkers with higher clinical applicability.
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Affiliation(s)
- Ibon Eguiluz-Gracia
- Unidad de Alergia; IBIMA-Hospital Regional Universitario de Malaga-UMA; ARADyAL; Malaga Spain
| | - Tunn Ren Tay
- Department of Respiratory and Critical Care Medicine; Changi General Hospital; Singapore Singapore
| | - Mark Hew
- Allergy, Asthma and Clinical Immunology Service; The Alfred Hospital; Melbourne Victoria Australia
- School of Public Health & Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Maria M. Escribese
- Facultad de Medicina; Instituto de Medicina Molecular Aplicada (IMMA); Universidad San Pablo CEU; Madrid Spain
- Departamento de Ciencias Médicas Básicas; Facultad de Medicina; Universidad San Pablo CEU; Madrid Spain
| | - Domingo Barber
- Facultad de Medicina; Instituto de Medicina Molecular Aplicada (IMMA); Universidad San Pablo CEU; Madrid Spain
| | - Robyn E. O'Hehir
- Allergy, Asthma and Clinical Immunology Service; The Alfred Hospital; Melbourne Victoria Australia
- Department of Allergy, Clinical Immunology & Respiratory Medicine; Central Clinical School; Monash University; Melbourne Victoria Australia
| | - Maria J. Torres
- Unidad de Alergia; IBIMA-Hospital Regional Universitario de Malaga-UMA; ARADyAL; Malaga Spain
- Andalusian Center for Nanomedicine and Biotechnology - BIONAND; Malaga Spain
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Sharma N, Akkoyunlu M, Rabin RL. Macrophages-common culprit in obesity and asthma. Allergy 2018; 73:1196-1205. [PMID: 29178573 DOI: 10.1111/all.13369] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 12/29/2022]
Abstract
Macrophages are essential innate immune cells that also regulate local metabolism. Endogenous or exogenous stimuli may polarize macrophages toward phenotypes that serve distinct innate immunological metabolic functions. IFN-γ or lipopolysaccharide (LPS) polarizes macrophages toward the M1, or "classically activated" phenotype that participates in defense against intracellular pathogens. IL-4, IL-13, or chitin polarizes macrophages toward the M2, or "alternatively activated" phenotype, which defends against multicellular nematodes and fungi. As macrophages polarize in local environments, M1 and M2 macrophages may coexist in different organs and may differentially affect asthma and obesity, two comorbid diseases where polarized macrophages contribute to their pathogenesis. While M1 macrophages are considered beneficial in asthma and contribute to the pathology of obesity, M2 macrophages contribute to the pathology of asthma, but limit metabolic syndrome associated with obesity. Here, we discuss the roles for M1 and M2 macrophages in asthma and obesity, and propose a model by which M1-mediated inflammation in adipose tissue enhances M2-mediated inflammation in the asthmatic lung.
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Affiliation(s)
- N. Sharma
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
| | - M. Akkoyunlu
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
| | - R. L. Rabin
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
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Licari A, Castagnoli R, Brambilla I, Marseglia A, Tosca MA, Marseglia GL, Ciprandi G. Asthma Endotyping and Biomarkers in Childhood Asthma. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2018; 31:44-55. [PMID: 30069422 PMCID: PMC6069590 DOI: 10.1089/ped.2018.0886] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/23/2018] [Indexed: 12/17/2022]
Abstract
Childhood asthma represents a heterogeneous challenging disease, in particular in its severe forms. The identification of different asthma phenotypes has stimulated research in underlying molecular mechanisms, such as the endotypes, and paved the way to the search for related specific biomarkers, which may guide diagnosis, management, and predict response to treatment. A limited number of biomarkers are currently available in clinical practice in the pediatric population, mostly reflecting type 2-high airway inflammation. The identification of biomarkers of childhood asthma is an active area of research that holds a potential great clinical utility and may represent a step forward toward tailored management and therapy: the so-called Precision Medicine. The aim of the present review is to provide an updated overview of asthma endotyping, mostly focusing on novel noninvasive biomarkers in childhood asthma.
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Affiliation(s)
- Amelia Licari
- Pediatric Clinic, Fondazione IRCCS San Matteo, Pavia, Italy
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Tong X, Wang D, Liu S, Ma Y, Fan H. Can YKL-40 be used as a biomarker and therapeutic target for adult asthma? Eur Respir J 2018; 51:51/1/1702194. [PMID: 29348186 DOI: 10.1183/13993003.02194-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/27/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Xiang Tong
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Dongguang Wang
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Sitong Liu
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Yao Ma
- The Center of Gerontology and Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Hong Fan
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
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