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Hizawa N. The understanding of asthma pathogenesis in the era of precision medicine. Allergol Int 2023; 72:3-10. [PMID: 36195530 DOI: 10.1016/j.alit.2022.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Asthma is a syndrome with extremely diverse clinical phenotypes in which the onset, severity, and response to treatment are defined by the complex interplay of many genetic and environmental factors. Environmental factors epigenetically affect gene expression, and the disease is driven by a multidimensional dynamic network involving RNA and protein molecules derived from gene expression, as well as various metabolic products. In other words, specific pathophysiological mechanisms or endotypes are dynamic networks that arise in response to individual genotypes and the various environmental factors to which individuals have been exposed since before birth, such as diet, infection, air pollution, smoking, antibiotic use, and the bacterial flora of the intestinal tract, skin, and lungs. A key feature of asthma genome scans is their potential to reveal the molecular pathways that lead to pathogenesis. Endotypes that drive the disease have a significant impact on the phenotypes of asthma patients, including their drug responsiveness. Understanding endotypes will lead to not only the implementation of therapies that are tailored to the specific molecular network(s) underlying the patient's condition, but also to the development of therapeutic strategies that target individual endotypes, as well as to precision health, which will enable the prediction of disease onset with high accuracy from an early stage and the implementation of preventive strategies based on endotypes. Understanding of endotypes will pave the way for the practice of precision medicine in asthma care, moving away from 'one-size-fits-all' medicine and population-based prevention approaches that do not take individuals' susceptibility into account.
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Affiliation(s)
- Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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Shigemasa R, Masuko H, Oshima H, Hyodo K, Kitazawa H, Kanazawa J, Iijima H, Naito T, Saito T, Sakamoto T, Hizawa N. Dust mite-dominant sensitization pattern as a causal factor for adult-onset asthma. Allergol Int 2021; 70:368-369. [PMID: 33762158 DOI: 10.1016/j.alit.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/05/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Rie Shigemasa
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Hisayuki Oshima
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kentaro Hyodo
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | - Haruna Kitazawa
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jun Kanazawa
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | - Takefumi Saito
- National Hospital Organization Ibaraki Higashi National Hospital, Tokai, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan
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Yamada H, Hida N, Masuko H, Sakamoto T, Hizawa N. Effects of Lung Function-Related Genes and TSLP on COPD Phenotypes. COPD 2020; 17:59-64. [PMID: 31910693 DOI: 10.1080/15412555.2019.1708296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A weighted genetic risk score (GRS) based on 16 SNPs implicated in reduced lung function in both Japanese and non-Japanese populations was previously associated with the onset of COPD and asthma. We here examine the genetic impact of this lung function GRS on specific COPD phenotypes. A cohort of Japanese COPD patients (N = 270) underwent lung function testing followed by genotyping with allele-specific arrays for 16 SNPs as well as expression quantitative trait loci at TSLP (rs2289276, rs3806933). Lung function GRS scoring and two-step cluster analyses grouped patients into different COPD phenotypes based on gender, age, smoking index, %FEV1 and lung function GRS. The genetic effect of TSLP on COPD phenotypes was also examined for interactions with the lung function GRS. A total of 270 participants were grouped into 5 clusters. The cluster with the highest levels of lung function GRS was characterized by moderate to severe airflow obstruction and the highest blood eosinophil counts. Regarding TSLP, an increased number of T alleles at both SNPs was found in the cluster characterized by moderate to severe airflow obstruction and heavy smoking (rs2289276, p value = 0.035; rs3806933, p value = 0.047) independent of the lung function GRS. A genetic susceptibility to impaired lung function carries an increased risk of developing COPD characterized by increased eosinophil counts and severe airflow obstruction while individuals with increased TSLP responses to external stimuli have an independent risk of developing severe airflow obstruction in the presence of heavy smoking.
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Affiliation(s)
- Hideyasu Yamada
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Respiratory Medicine, Hitachi Ltd, Hitachinaka General Hospital, Hitachinaka, Ibaraki, Japan
| | - Norihito Hida
- Department of Respiratory Medicine, Hitachi Ltd, Hitachinaka General Hospital, Hitachinaka, Ibaraki, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Kanazawa J, Masuko H, Yamada H, Yatagai Y, Sakamoto T, Kitazawa H, Iijima H, Naito T, Hirota T, Tamari M, Hizawa N. How important is allergic sensitization as a cause of atopic asthma? Allergol Int 2018; 67:292-294. [PMID: 29103905 DOI: 10.1016/j.alit.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/01/2017] [Accepted: 10/15/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Jun Kanazawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
| | - Hideyasu Yamada
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yohei Yatagai
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Haruna Kitazawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroaki Iijima
- Department of Pulmonary Medicine, Tsukuba Medical Center, Ibaraki, Japan
| | - Takashi Naito
- Department of Pulmonary Medicine, Tsukuba Medical Center, Ibaraki, Japan
| | - Tomomitsu Hirota
- Laboratory for Respiratory and Allergic Diseases, Center for Integrative Medical Sciences, Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan
| | - Mayumi Tamari
- Laboratory for Respiratory and Allergic Diseases, Center for Integrative Medical Sciences, Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Kumar V, Behr M, Kiritsi D, Scheffschick A, Grahnert A, Homberg M, Schwieger-Briel A, Jakob T, Bruckner-Tuderman L, Magin TM. Keratin-dependent thymic stromal lymphopoietin expression suggests a link between skin blistering and atopic disease. J Allergy Clin Immunol 2016; 138:1461-1464.e6. [DOI: 10.1016/j.jaci.2016.04.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 04/01/2016] [Accepted: 04/12/2016] [Indexed: 12/16/2022]
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Oetjen LK, Noti M, Kim BS. New insights into basophil heterogeneity. Semin Immunopathol 2016; 38:549-61. [PMID: 27178409 PMCID: PMC5010479 DOI: 10.1007/s00281-016-0567-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/26/2016] [Indexed: 02/06/2023]
Abstract
Basophils have become increasingly recognized as important innate immune cells that mediate antihelminth immunity and barrier inflammation. Recent discoveries have uncovered previously unrecognized heterogeneity in basophil populations. However, how diversity in basophil regulation and function impacts human disease remains poorly defined. The goal of the present review is to highlight how new insights into basophil heterogeneity can help us to better understand disease pathogenesis and inform the development of new therapeutics.
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Affiliation(s)
- Landon K Oetjen
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8123, St. Louis, MO, 63110, USA
- Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Mario Noti
- Division of Experimental Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Brian S Kim
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8123, St. Louis, MO, 63110, USA.
- Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO, USA.
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
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Glück J, Rymarczyk B, Kasprzak M, Rogala B. Increased Levels of Interleukin-33 and Thymic Stromal Lymphopoietin in Exhaled Breath Condensate in Chronic Bronchial Asthma. Int Arch Allergy Immunol 2016; 169:51-6. [PMID: 26953567 DOI: 10.1159/000444017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/14/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Epithelium-derived cytokines such as thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33 are important contributors to inflammation in asthma. Exhaled breath condensate (EBC) is a noninvasive method used to assess the inflammation of airways. Our aim was to assess the levels of TSLP, IL-25, IL-33, and its receptor ST2l/IL-1 R4 in EBC in patients with asthma and to correlate these with serum levels and asthma control. METHODS EBC and serum levels of TSLP, IL-25, IL-33, and ST2l/IL-1 R4 were measured in 44 patients with chronic bronchial asthma (14 in the uncontrolled phase) and 19 healthy control participants. RESULTS EBC levels of IL-33 and TSLP and serum levels of IL-33 were statistically higher in patients with asthma than in controls. IL-25 and ST2l/IL-1 R4 were present in EBC at barely detectable levels and were not analyzed. The EBC and serum levels of all studied mediators did not differ between controlled and uncontrolled asthma patients, except for the serum level of ST2l/IL-1 R4, which was higher in uncontrolled asthma. There were no correlations between serum and EBC levels of TSLP and IL-33 or between either serum and EBC levels and the forced expiratory volume in 1 s or the total IgE level. CONCLUSIONS Higher levels of IL-33 and TSLP in EBC provide evidence supporting a role for these mediators in asthma. Their levels do not discriminate between controlled and uncontrolled asthma. The local reaction within the epithelium is independent of the systemic reaction.
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Affiliation(s)
- Joanna Glück
- Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
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Calderón MA, Linneberg A, Kleine-Tebbe J, De Blay F, Hernandez Fernandez de Rojas D, Virchow JC, Demoly P. Respiratory allergy caused by house dust mites: What do we really know? J Allergy Clin Immunol 2014; 136:38-48. [PMID: 25457152 DOI: 10.1016/j.jaci.2014.10.012] [Citation(s) in RCA: 308] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 09/18/2014] [Accepted: 10/02/2014] [Indexed: 12/13/2022]
Abstract
The house dust mite (HDM) is a major perennial allergen source and a significant cause of allergic rhinitis and allergic asthma. However, awareness of the condition remains generally low. This review assesses the links between exposure to HDM, development of the allergic response, and pathologic consequences in patients with respiratory allergic diseases. We investigate the epidemiology of HDM allergy to explore the interaction between mites and human subjects at the population, individual, and molecular levels. Core and recent publications were identified by using "house dust mite" as a key search term to evaluate the current knowledge of HDM epidemiology and pathophysiology. Prevalence data for HDM allergen sensitization vary from 65 to 130 million persons in the general population worldwide to as many as 50% among asthmatic patients. Heterogeneity of populations, terminology, and end points in the literature confound estimates, indicating the need for greater standardization in epidemiologic research. Exposure to allergens depends on multiple ecological strata, including climate and mite microhabitats within the domestic environment, with the latter providing opportunity for intervention measures to reduce allergen load. Inhaled mite aeroallergens are unusually virulent: they are able to activate both the adaptive and innate immune responses, potentially offering new avenues for intervention. The role of HDM allergens is crucial in the development of allergic rhinitis and asthma, but the translation of silent sensitization into symptomatic disease is still incompletely understood. Improved understanding of HDMs, their allergens, and their microhabitats will enable development of more effective outcomes for patients with HDM allergy.
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Affiliation(s)
- Moisés A Calderón
- Section of Allergy and Clinical Immunology, Imperial College London-NHLI, Royal Brompton Hospital, London, United Kingdom.
| | - Allan Linneberg
- Research Centre for Prevention and Health, Capital Region of Denmark, the Department of Clinical Experimental Research, Glostrup University Hospital, and the Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jörg Kleine-Tebbe
- Allergy and Asthma Center Westend Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Berlin, Germany
| | - Frédéric De Blay
- Chest Diseases Department, Hôpitaux Universitaires de Strasbourg, Fédération de médecine translationnelle, Université de Strasbourg, Strasbourg, France
| | | | - Johann Christian Virchow
- Department of Pneumology and Intensive Care Medicine, Zentrum für Innere Medizin, Klinik I, Universitätsklinikum Rostock, Rostock, Germany
| | - Pascal Demoly
- Department of Pulmonology, Division of Allergy, University Hospital of Montpellier, and Sorbonne Universités, Paris, France
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Environmental and genetic contribution in airway epithelial barrier in asthma pathogenesis. Curr Opin Allergy Clin Immunol 2014; 13:495-9. [PMID: 23945177 DOI: 10.1097/aci.0b013e328364e9fe] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW To examine the recent, most relevant genetic and epigenetic modifications of the epithelial barrier in response to the environmental factors, including allergens, viruses, and pollutants, susceptible to participate to asthma. RECENT FINDINGS IL-33 and TSLP gene polymorphisms are found in almost all asthma studies. Recent data have highlighted a new population of innate lymphoid cells, activated by these two cytokines, and mediating type 2 innate immunity dependent asthma. Gene variants of innate pattern recognition receptors associated with asthma have been evidenced in early viral infected high-risk birth cohorts, as well as polymorphisms in pathways involved in type I interferon (IFN) production, giving further insight into the role of viruses in asthma development. Novel epigenetic mechanisms have been evidenced in asthma and in response to the environmental pollutants, and point out genes like TSLP, which may link environmental pollution and asthma. SUMMARY Genetic data support the role of a specific set of epithelial-derived proTh2 cytokines, including IL-33 and TSLP, as well as the role of decreased type I IFN in virus-induced impaired epithelial barrier. Epigenetic modifications of epithelial genes are promising mechanisms that warrant further investigation.
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Segawa R, Yamashita S, Mizuno N, Shiraki M, Hatayama T, Satou N, Hiratsuka M, Hide M, Hirasawa N. Identification of a cell line producing high levels of TSLP: Advantages for screening of anti-allergic drugs. J Immunol Methods 2014; 402:9-14. [DOI: 10.1016/j.jim.2013.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 10/03/2013] [Accepted: 10/30/2013] [Indexed: 12/27/2022]
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Siracusa MC, Kim BS, Spergel JM, Artis D. Basophils and allergic inflammation. J Allergy Clin Immunol 2013; 132:789-801; quiz 788. [PMID: 24075190 DOI: 10.1016/j.jaci.2013.07.046] [Citation(s) in RCA: 195] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 12/19/2022]
Abstract
Basophils were discovered by Paul Ehrlich in 1879 and represent the least abundant granulocyte population in mammals. The relative rarity of basophils and their phenotypic similarities with mast cells resulted in this cell lineage being historically overlooked, both clinically and experimentally. However, recent studies in human subjects and murine systems have shown that basophils perform nonredundant effector functions and significantly contribute to the development and progression of TH2 cytokine-mediated inflammation. Although the potential functions of murine and human basophils have provoked some controversy, recent genetic approaches indicate that basophils can migrate into lymphoid tissues and, in some circumstances, cooperate with other immune cells to promote optimal TH2 cytokine responses in vivo. This article provides a brief historical perspective on basophil-related research and discusses recent studies that have identified previously unappreciated molecules and pathways that regulate basophil development, activation, and function in the context of allergic inflammation. Furthermore, we highlight the unique effector functions of basophils and discuss their contributions to the development and pathogenesis of allergic inflammation in human disease. Finally, we discuss the therapeutic potential of targeting basophils in preventing or alleviating the development and progression of allergic inflammation.
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Affiliation(s)
- Mark C Siracusa
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
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12
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Saito H. Allergy: from history to today. Allergol Int 2013; 62:1-2. [PMID: 23565528 DOI: 10.2332/allergolint.13-ed-0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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