1
|
Strickson S, Houslay KF, Negri VA, Ohne Y, Ottosson T, Dodd RB, Huntington CC, Baker T, Li J, Stephenson KE, O'Connor AJ, Sagawe JS, Killick H, Moore T, Rees DG, Koch S, Sanden C, Wang Y, Gubbins E, Ghaedi M, Kolbeck R, Saumyaa S, Erjefält JS, Sims GP, Humbles AA, Scott IC, Romero Ros X, Cohen ES. Oxidised IL-33 drives COPD epithelial pathogenesis via ST2-independent RAGE/EGFR signalling complex. Eur Respir J 2023; 62:2202210. [PMID: 37442582 PMCID: PMC10533947 DOI: 10.1183/13993003.02210-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Epithelial damage, repair and remodelling are critical features of chronic airway diseases including chronic obstructive pulmonary disease (COPD). Interleukin (IL)-33 released from damaged airway epithelia causes inflammation via its receptor, serum stimulation-2 (ST2). Oxidation of IL-33 to a non-ST2-binding form (IL-33ox) is thought to limit its activity. We investigated whether IL-33ox has functional activities that are independent of ST2 in the airway epithelium. METHODS In vitro epithelial damage assays and three-dimensional, air-liquid interface (ALI) cell culture models of healthy and COPD epithelia were used to elucidate the functional role of IL-33ox. Transcriptomic changes occurring in healthy ALI cultures treated with IL-33ox and COPD ALI cultures treated with an IL-33-neutralising antibody were assessed with bulk and single-cell RNA sequencing analysis. RESULTS We demonstrate that IL-33ox forms a complex with receptor for advanced glycation end products (RAGE) and epidermal growth factor receptor (EGFR) expressed on airway epithelium. Activation of this alternative, ST2-independent pathway impaired epithelial wound closure and induced airway epithelial remodelling in vitro. IL-33ox increased the proportion of mucus-producing cells and reduced epithelial defence functions, mimicking pathogenic traits of COPD. Neutralisation of the IL-33ox pathway reversed these deleterious traits in COPD epithelia. Gene signatures defining the pathogenic effects of IL-33ox were enriched in airway epithelia from patients with severe COPD. CONCLUSIONS Our study reveals for the first time that IL-33, RAGE and EGFR act together in an ST2-independent pathway in the airway epithelium and govern abnormal epithelial remodelling and muco-obstructive features in COPD.
Collapse
Affiliation(s)
- Sam Strickson
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- These authors contributed equally to this work
| | - Kirsty F Houslay
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- These authors contributed equally to this work
| | - Victor A Negri
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Yoichiro Ohne
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Tomas Ottosson
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Roger B Dodd
- Biologics Engineering, R&D, AstraZeneca, Cambridge, UK
| | | | - Tina Baker
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Jingjing Li
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Katherine E Stephenson
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Andy J O'Connor
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - J Sophie Sagawe
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Helen Killick
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Tom Moore
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - D Gareth Rees
- Biologics Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Sofia Koch
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Caroline Sanden
- Experimental Medical Sciences, Lund University, Lund, Sweden
- Medetect AB, Lund, Sweden
| | - Yixin Wang
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Elise Gubbins
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Mahboobe Ghaedi
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Roland Kolbeck
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
- Current: Spirovant Sciences, Philadelphia, PA, USA
| | - Saumyaa Saumyaa
- Discovery Biology, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Jonas S Erjefält
- Experimental Medical Sciences, Lund University, Lund, Sweden
- Allergology and Respiratory Medicine, Lund University, Skåne University Hospital, Lund, Sweden
| | - Gary P Sims
- Bioscience Immunology, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Alison A Humbles
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- Current: Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Ian C Scott
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Xavier Romero Ros
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- These authors contributed equally to this work
| | - E Suzanne Cohen
- Bioscience Asthma and Skin Immunity, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- These authors contributed equally to this work
| |
Collapse
|
2
|
Erjefält JS. Anatomical and histopathological approaches to asthma phenotyping. Respir Med 2023; 210:107168. [PMID: 36822489 DOI: 10.1016/j.rmed.2023.107168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
Asthma is typically characterized by variable respiratory symptoms and airflow limitation. Along with the pathophysiology and symptoms are immunological and inflammatory processes. The last decades research has revealed that the immunology of asthma is highly heterogeneous. This has clinical consequences and identification of immunological phenotypes is currently used to guide biological treatment. The focus of this review is on another dimension of asthma diversity, namely anatomical heterogeneity. Immunopathological alterations may go beyond the central airways to also involve the distal airways, the alveolar parenchyma, and pulmonary vessels. Also, extrapulmonary tissues are affected. The anatomical distribution of inflammation in asthma has remained relatively poorly discussed despite its potential implication on both clinical presentation and response to treatment. There is today evidence that a significant proportion of the asthma patients has small airway disease with type 2 immunity, eosinophilia and smooth muscle infiltration of mast cells. The small airways in asthma are also subjected to remodelling, constriction, and luminal plugging, events that are likely to contribute to the elevated distal airway resistance seen in some patients. In cases when the inflammation extends into the alveolar parenchyma alveolar FCER1-high mast cells, eosinophilia, type 2 immunity and activated alveolar macrophages, together with modest interstitial remodelling, create a complex immunopathological picture. Importantly, the distal lung inflammation in asthma can be pharmacologically targeted by use of inhalers with more distal drug deposition. Biological treatments, which are readily distributed to the distal lung, may also be beneficial in eligible patients with more severe and anatomically widespread disease.
Collapse
Affiliation(s)
- Jonas S Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Research, Lund University, Lund, Sweden; Department of Allergology and Respiratory Medicine, Skane University Hospital, Lund, Sweden.
| |
Collapse
|
3
|
Frøssing L, Klein DK, Hvidtfeldt M, Obling N, Telg G, Erjefält JS, Bodtger U, Porsbjerg C. Distribution of type 2 biomarkers and association with severity, clinical characteristics and comorbidities in the BREATHE real-life asthma population. ERJ Open Res 2023; 9:00483-2022. [PMID: 36949964 PMCID: PMC10026007 DOI: 10.1183/23120541.00483-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background Type 2 (T2) high asthma is recognised as a heterogenous entity consisting of several endotypes; however, the prevalence and distribution of the T2 biomarkers in the general asthma population, across asthma severity, and across compartments is largely unknown. The objective of the present study was to describe expression and overlaps of airway and systemic T2 biomarkers in a clinically representative asthma population. Methods Patients with asthma from the real-life BREATHE cohort referred to a specialist centre were included and grouped according to T2 biomarkers: blood and sputum eosinophilia (≥0.3×109 cells·L-1 and 3% respectively), total IgE (≥150 U·mL-1), and fractional exhaled nitric oxide (≥25 ppb). Results Patients with mild-to-moderate asthma were younger (41 versus 49 years, p<0.001), had lower body mass index (25.9 versus 28.0 kg·m-2, p=0.002) and less atopy (47% versus 58%, p=0.05), higher forced expiratory volume in 1 s (3.2 versus 2.8 L, p<0.001) and forced vital capacity (4.3 versus 3.9 L, p<0.001) compared with patients with severe asthma, who had higher blood (0.22×109 versus 0.17×109 cells·L-1, p=0.01) and sputum (3.0% versus 1.5%, p=0.01) eosinophils. Co-expression of all T2 biomarkers was a particular characteristic of severe asthma (p<0.001). In patients with eosinophilia, sputum eosinophilia without blood eosinophilia was present in 45% of patients with mild-to-moderate asthma and 35% with severe asthma. Conclusion Severe asthma is more commonly associated with activation of several T2 pathways, indicating that treatments targeting severe asthma may need to act more broadly on T2 inflammatory pathways. Implementation of airway inflammometry in clinical care is of paramount importance, as the best treatable trait is otherwise is overlooked in a large proportion of patients irrespective of disease severity.
Collapse
Affiliation(s)
- Laurits Frøssing
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
- Contributed equally
- Corresponding author: Laurits Frøssing ()
| | - Ditte K. Klein
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
- Contributed equally
| | - Morten Hvidtfeldt
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Nicolai Obling
- Respiratory Research Unit PLUZ, Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | | | | | - Uffe Bodtger
- Respiratory Research Unit PLUZ, Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Celeste Porsbjerg
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| |
Collapse
|
4
|
Tanner L, Single AB, Bhongir RKV, Heusel M, Mohanty T, Karlsson CAQ, Pan L, Clausson CM, Bergwik J, Wang K, Andersson CK, Oommen RM, Erjefält JS, Malmström J, Wallner O, Boldogh I, Helleday T, Kalderén C, Egesten A. Small-molecule-mediated OGG1 inhibition attenuates pulmonary inflammation and lung fibrosis in a murine lung fibrosis model. Nat Commun 2023; 14:643. [PMID: 36746968 PMCID: PMC9902543 DOI: 10.1038/s41467-023-36314-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/26/2023] [Indexed: 02/08/2023] Open
Abstract
Interstitial lung diseases such as idiopathic pulmonary fibrosis (IPF) are caused by persistent micro-injuries to alveolar epithelial tissues accompanied by aberrant repair processes. IPF is currently treated with pirfenidone and nintedanib, compounds which slow the rate of disease progression but fail to target underlying pathophysiological mechanisms. The DNA repair protein 8-oxoguanine DNA glycosylase-1 (OGG1) has significant roles in the modulation of inflammation and metabolic syndromes. Currently, no pharmaceutical solutions targeting OGG1 have been utilized in the treatment of IPF. In this study we show Ogg1-targeting siRNA mitigates bleomycin-induced pulmonary fibrosis in male mice, highlighting OGG1 as a tractable target in lung fibrosis. The small molecule OGG1 inhibitor, TH5487, decreases myofibroblast transition and associated pro-fibrotic gene expressions in fibroblast cells. In addition, TH5487 decreases levels of pro-inflammatory mediators, inflammatory cell infiltration, and lung remodeling in a murine model of bleomycin-induced pulmonary fibrosis conducted in male C57BL6/J mice. OGG1 and SMAD7 interact to induce fibroblast proliferation and differentiation and display roles in fibrotic murine and IPF patient lung tissue. Taken together, these data suggest that TH5487 is a potentially clinically relevant treatment for IPF but further study in human trials is required.
Collapse
Affiliation(s)
- L Tanner
- Respiratory Medicine, Allergology, & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 84, Lund, Sweden.
| | - A B Single
- Respiratory Medicine, Allergology, & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 84, Lund, Sweden
| | - R K V Bhongir
- Respiratory Medicine, Allergology, & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 84, Lund, Sweden
| | - M Heusel
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - T Mohanty
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - C A Q Karlsson
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - L Pan
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX, 77555, USA
| | - C-M Clausson
- Division of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - J Bergwik
- Respiratory Medicine, Allergology, & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 84, Lund, Sweden
| | - K Wang
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX, 77555, USA
| | - C K Andersson
- Respiratory Cell Biology, Department of Experimental Medical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - R M Oommen
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - J S Erjefält
- Division of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - J Malmström
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - O Wallner
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - I Boldogh
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX, 77555, USA
| | - T Helleday
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, SE-171 76, Stockholm, Sweden
- Oxcia AB, Norrbackagatan 70C, SE-113 34, Stockholm, Sweden
- Weston Park Cancer Centre, Department of Oncology and Metabolism, University of Sheffield, Sheffield, S10 2RX, UK
| | - C Kalderén
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, SE-171 76, Stockholm, Sweden
- Oxcia AB, Norrbackagatan 70C, SE-113 34, Stockholm, Sweden
| | - A Egesten
- Respiratory Medicine, Allergology, & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 84, Lund, Sweden
| |
Collapse
|
5
|
Tanner L, Bergwik J, Bhongir RKV, Puthia M, Lång P, Ali MN, Welinder C, Önnerfjord P, Erjefält JS, Palmberg L, Andersson G, Egesten A. Tartrate resistant acid phosphatase 5 (TRAP5) mediates immune cell recruitment in a murine model of pulmonary bacterial infection. Front Immunol 2022; 13:1079775. [PMID: 36569898 PMCID: PMC9779928 DOI: 10.3389/fimmu.2022.1079775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction During airway infection, upregulation of proinflammatory cytokines and subsequent immune cell recruitment is essential to mitigate bacterial infection. Conversely, during prolonged and non-resolving airway inflammation, neutrophils contribute to tissue damage and remodeling. This occurs during diseases including cystic fibrosis (CF) and COPD where bacterial pathogens, not least Pseudomonas aeruginosa, contribute to disease progression through long-lasting infections. Tartrate-resistant acid phosphatase (TRAP) 5 is a metalloenzyme expressed by alveolar macrophages and one of its target substrates is the phosphoglycoprotein osteopontin (OPN). Methods We used a knockout mouse strain (Trap5-/-) and BALB/c-Tg (Rela-luc)31Xen mice paired with siRNA administration or functional protein add-back to elucidate the role of Trap5 during bacterial infection. In a series of experiments, Trap5-/- and wild-type control mice received intratracheal administration of P.aerugniosa (Xen41) or LPS, with mice monitored using intravital imaging (IVIS). In addition, multiplex cytokine immunoassays, flow cytometry, multispectral analyses, histological staining were performed. Results In this study, we found that Trap5-/- mice had impaired clearance of P. aeruginosa airway infection and reduced recruitment of immune cells (i.e. neutrophils and inflammatory macrophages). Trap5 knockdown using siRNA resulted in a decreased activation of the proinflammatory transcription factor NF-κB in reporter mice and a subsequent decrease of proinflammatory gene expression. Add-back experiments of enzymatically active TRAP5 to Trap5-/- mice restored immune cell recruitment and bacterial killing. In human CF lung tissue, TRAP5 of alveolar macrophages was detected in proximity to OPN to a higher degree than in normal lung tissue, indicating possible interactions. Discussion Taken together, the findings of this study suggest a key role for TRAP5 in modulating airway inflammation. This could have bearing in diseases such as CF and COPD where excessive neutrophilic inflammation could be targeted by pharmacological inhibitors of TRAP5.
Collapse
Affiliation(s)
- Lloyd Tanner
- Respiratory Medicine, Allergology & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Jesper Bergwik
- Respiratory Medicine, Allergology & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Ravi K. V. Bhongir
- Respiratory Medicine, Allergology & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Manoj Puthia
- Department of Dermatology and Venereology, Lund University and Skåne University Hospital, Lund, Sweden,Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Pernilla Lång
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mohamad N. Ali
- Respiratory Medicine, Allergology & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Charlotte Welinder
- Swedish National Infrastructure for Biological Mass Spectrometry (BioMS), Lund University, Lund, Sweden
| | - Patrik Önnerfjord
- Molecular Skeletal Biology, Section for Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas S. Erjefält
- Unit of Airway Inflammation, Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Lena Palmberg
- Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Göran Andersson
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arne Egesten
- Respiratory Medicine, Allergology & Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden,*Correspondence: Arne Egesten,
| |
Collapse
|
6
|
Erjefält JS, de Souza Xavier Costa N, Jönsson J, Cozzolino O, Dantas KC, Clausson CM, Siddhuraj P, Lindö C, Alyamani M, Lombardi SCFS, Mendroni Júnior A, Antonangelo L, Faria CS, Duarte-Neto AN, de Almeida Monteiro RA, Rebello Pinho JR, Gomes-Gouvêa MS, Verciano Pereira R, Monteiro JS, Setubal JC, de Oliveira EP, Theodoro Filho J, Sanden C, Orengo JM, Sleeman MA, da Silva LFF, Saldiva PHN, Dolhnikoff M, Mauad T. Diffuse alveolar damage patterns reflect the immunological and molecular heterogeneity in fatal COVID-19. EBioMedicine 2022; 83:104229. [PMID: 36027872 PMCID: PMC9398470 DOI: 10.1016/j.ebiom.2022.104229] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Severe COVID-19 lung disease exhibits a high degree of spatial and temporal heterogeneity, with different histological features coexisting within a single individual. It is important to capture the disease complexity to support patient management and treatment strategies. We provide spatially decoded analyses on the immunopathology of diffuse alveolar damage (DAD) patterns and factors that modulate immune and structural changes in fatal COVID-19. Methods We spatially quantified the immune and structural cells in exudative, intermediate, and advanced DAD through multiplex immunohistochemistry in autopsy lung tissue of 18 COVID-19 patients. Cytokine profiling, viral, bacteria, and fungi detection, and transcriptome analyses were performed. Findings Spatial DAD progression was associated with expansion of immune cells, macrophages, CD8+ T cells, fibroblasts, and (lymph)angiogenesis. Viral load correlated positively with exudative DAD and negatively with disease/hospital length. In all cases, enteric bacteria were isolated, and Candida parapsilosis in eight cases. Cytokines correlated mainly with macrophages and CD8+T cells. Pro-coagulation and acute repair were enriched pathways in exudative DAD whereas intermediate/advanced DAD had a molecular profile of elevated humoral and innate immune responses and extracellular matrix production. Interpretation Unraveling the spatial and molecular immunopathology of COVID-19 cases exposes the responses to SARS-CoV-2-induced exudative DAD and subsequent immune-modulatory and remodeling changes in proliferative/advanced DAD that occur side-by-side together with secondary infections in the lungs. These complex features have important implications for disease management and the development of novel treatments. Funding CNPq, Bill and Melinda Gates Foundation, HC-Convida, FAPESP, Regeneron Pharmaceuticals, and the Swedish Heart & Lung Foundation.
Collapse
Affiliation(s)
- Jonas S Erjefält
- Unit of Airway inflammation, Department of Experimental Medicine Sciences, Lund University, Sweden; Department of Allergology and Respiratory Medicine, Lund University, Sweden
| | - Natália de Souza Xavier Costa
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Olga Cozzolino
- Unit of Airway inflammation, Department of Experimental Medicine Sciences, Lund University, Sweden
| | - Katia Cristina Dantas
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carl-Magnus Clausson
- Unit of Airway inflammation, Department of Experimental Medicine Sciences, Lund University, Sweden
| | - Premkumar Siddhuraj
- Unit of Airway inflammation, Department of Experimental Medicine Sciences, Lund University, Sweden
| | | | - Manar Alyamani
- Unit of Airway inflammation, Department of Experimental Medicine Sciences, Lund University, Sweden
| | - Suzete Cleusa Ferreira Spina Lombardi
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil; Laboratório Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia (LIM-31), Departamento de Hematologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alfredo Mendroni Júnior
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil; Laboratório Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia (LIM-31), Departamento de Hematologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Leila Antonangelo
- Laboratório de Investigação Médica (LIM03), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Divisão de Patologia Clínica - Departamento de Patologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Caroline Silvério Faria
- Laboratório de Investigação Médica (LIM03), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Amaro Nunes Duarte-Neto
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - João Renato Rebello Pinho
- Laboratório de Investigação Médica (LIM03), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Michele Soares Gomes-Gouvêa
- Departamento de Gastroenterologia (LIM-07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Roberta Verciano Pereira
- Laboratório de Investigação Médica (LIM03), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - João Carlos Setubal
- Departamento de Bioquímica, Instituto de Química Universidade de São Paulo, São Paulo, Brazil
| | - Ellen Pierre de Oliveira
- Departamento de Cardiopneumologia, Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jair Theodoro Filho
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Luiz Fernando Ferraz da Silva
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Hilário Nascimento Saldiva
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thais Mauad
- Departamento de Patologia, LIM-05 Laboratório de Patologia Ambiental, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| |
Collapse
|
7
|
Siddhuraj P, Nordström FU, Jogdand P, Elangovan G, Mori M, Bjermer L, Greiff L, Erjefält JS. Histology-based blood leukocyte profiling reveals parallel Th2 and Th17 signatures in seasonal allergic rhinitis. Acta Otolaryngol 2022; 142:696-704. [PMID: 36562632 DOI: 10.1080/00016489.2022.2155316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Allergic rhinitis (AR), a common condition in the westernized world, is suggested to be more immunologically complex than the archetypical 'Th2' inflammation. New approaches are needed to decode this complexity. AIMS/OBJECTIVES In this study, we explored a novel histology-based analysis for circulating blood leukocyte profiling in 16 patients with seasonal AR outside and during the pollen season. MATERIAL AND METHODS Leukocytes were purified with minimal ex-vivo artefacts, embedded into agarose-paraffin pellets for immunohistochemistry-based immune cell profiling. Blood leukocyte mapping was performed. RESULTS Samples collected during the pollen season had statistically increased eosinophils, neutrophils, monocytes, and CD8+ T-lymphocytes compared to the off-season baseline. In contrast, no change was observed for CD20+ B-lymphocytes and CD3+ T-lymphocytes. Subclassification of CD4+ T-helper cells demonstrated a parallel and significant expansion of Th2 and Th17-cells during the pollen season, while Th1-cells remained unchanged. Whereas absolute basophils numbers were unaltered, the basophil markers GATA2 and CPA3 increased during the pollen season. CONCLUSIONS AND SIGNIFICANCE This study introduces a novel and applicable method for systemic immune cell screening and provides further evidence of complex and parallel Th2 and Th17-immune signatures in seasonal AR. It also forwards GATA2 and CPA3 as potential biomarkers for ongoing allergic inflammation.
Collapse
Affiliation(s)
| | - Franziska U Nordström
- Department of ORL, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Prajakta Jogdand
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Gayathri Elangovan
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden
| | - Lennart Greiff
- Department of ORL, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jonas S Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden.,Department of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden
| |
Collapse
|
8
|
Mori M, Clausson CM, Sanden C, Jönsson J, Andersson CK, Siddhuraj P, Shikhagaie M, Åkesson K, Bergqvist A, Löfdahl CG, Erjefält JS. Expansion of Phenotypically Altered Dendritic Cell Populations in the Small Airways and Alveolar Parenchyma in Patients with Chronic Obstructive Pulmonary Disease. J Innate Immun 2022; 15:188-203. [PMID: 35998572 PMCID: PMC10643891 DOI: 10.1159/000526080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/06/2022] [Indexed: 11/19/2022] Open
Abstract
Contrasting the antigen-presenting dendritic cells (DCs) in the conducting airways, the alveolar DC populations in human lungs have remained poorly investigated. Consequently, little is known about how alveolar DCs are altered in diseases such as chronic obstructive pulmonary disease (COPD). This study maps multiple tissue DC categories in the distal lung across COPD severities. Specifically, single-multiplex immunohistochemistry was applied to quantify langerin/CD207+, CD1a+, BDCA2+, and CD11c+ subsets in distal lung compartments from patients with COPD (GOLD stage I-IV) and never-smoking and smoking controls. In the alveolar parenchyma, increased numbers of CD1a+langerin- (p < 0.05) and BDCA-2+ DCs (p < 0.001) were observed in advanced COPD compared with controls. Alveolar CD11c+ DCs also increased in advanced COPD (p < 0.01). In small airways, langerin+ and BDCA-2+ DCs were also significantly increased. Contrasting the small airway DCs, most alveolar DC subsets frequently extended luminal protrusions. Importantly, alveolar and small airway langerin+ DCs in COPD lungs displayed site-specific marker profiles. Further, multiplex immunohistochemistry with single-cell quantification was used to specifically profile langerin DCs and reveal site-specific expression patterns of the maturation and activation markers S100, fascin, MHC2, and B7. Taken together, our results show that clinically advanced COPD is associated with increased levels of multiple alveolar DC populations exhibiting features of both adaptive and innate immunity phenotypes. This expansion is likely to contribute to the distal lung immunopathology in COPD patients.
Collapse
Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | | | | | | | | | | | - Medya Shikhagaie
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Karolina Åkesson
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Anders Bergqvist
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Claes-Göran Löfdahl
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jonas S. Erjefält
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| |
Collapse
|
9
|
Siddhuraj P, Jönsson J, Alyamani M, Prabhala P, Magnusson M, Lindstedt S, Erjefält JS. Dynamically upregulated mast cell CPA3 patterns in chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. Front Immunol 2022; 13:924244. [PMID: 35983043 PMCID: PMC9378779 DOI: 10.3389/fimmu.2022.924244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe mast cell-specific metalloprotease CPA3 has been given important roles in lung tissue homeostasis and disease pathogenesis. However, the dynamics and spatial distribution of mast cell CPA3 expression in lung diseases remain unknown.MethodsUsing a histology-based approach for quantitative spatial decoding of mRNA and protein single cell, this study investigates the dynamics of CPA3 expression across mast cells residing in lungs from control subjects and patients with severe chronic obstructive pulmonary disease (COPD) or idiopathic lung fibrosis (IPF).ResultsMast cells in COPD lungs had an anatomically widespread increase of CPA3 mRNA (bronchioles p < 0.001, pulmonary vessels p < 0.01, and alveolar parenchyma p < 0.01) compared to controls, while granule-stored CPA3 protein was unaltered. IPF lungs had a significant upregulation of both mast cell density, CPA3 mRNA (p < 0.001) and protein (p < 0.05), in the fibrotic alveolar tissue. Spatial expression maps revealed altered mast cell mRNA/protein quotients in lung areas subjected to disease-relevant histopathological alterations. Elevated CPA3 mRNA also correlated to lung tissue eosinophils, CD3 T cells, and declined lung function. Single-cell RNA sequencing of bronchial mast cells confirmed CPA3 as a top expressed gene with potential links to both inflammatory and protective markers.ConclusionThis study shows that lung tissue mast cell populations in COPD and IPF lungs have spatially complex and markedly upregulated CPA3 expression profiles that correlate with immunopathological alterations and lung function. Given the proposed roles of CPA3 in tissue homeostasis, remodeling, and inflammation, these alterations are likely to have clinical consequences.
Collapse
Affiliation(s)
- Premkumar Siddhuraj
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | | | - Manar Alyamani
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Pavan Prabhala
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Lund, Sweden
| | - Mattias Magnusson
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Lund, Sweden
| | - Sandra Lindstedt
- Department of Thoracic Surgery, Lund University Skane University Hospital, Lund, Sweden
| | - Jonas S. Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
- Department of Allergology and Respiratory Medicine, Lund University, Skane University Hospital, Lund, Sweden
- *Correspondence: Jonas S. Erjefält,
| |
Collapse
|
10
|
Tanner L, Bergwik J, Single AB, Bhongir RKV, Erjefält JS, Egesten A. Zoledronic Acid Targeting of the Mevalonate Pathway Causes Reduced Cell Recruitment and Attenuates Pulmonary Fibrosis. Front Pharmacol 2022; 13:899469. [PMID: 35721132 PMCID: PMC9201219 DOI: 10.3389/fphar.2022.899469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aim: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease causing irreparable scarring of lung tissue, with most patients succumbing rapidly after diagnosis. The mevalonate pathway, which is involved in the regulation of cell proliferation, survival, and motility, is targeted by the bisphosphonate zoledronic acid (ZA). The aim of this study was to assess the antifibrotic effects of ZA and to elucidate the mechanisms by which potential IPF treatment occurs. Methods: A series of in vitro and in vivo models were employed to identify the therapeutic potential of ZA in treating IPF. In vitro transwell assays were used to assess the ability of ZA to reduce fibrotic-related immune cell recruitment. Farnesyl diphosphate synthase (FDPS) was screened as a potential antifibrotic target using a bleomycin mouse model. FDPS-targeting siRNA and ZA were administered to mice following the onset of experimentally-induced lung fibrosis. Downstream analyses were conducted on murine lung tissues and lung fluids including 23-plex cytokine array, flow cytometry, histology, Western blotting, immunofluorescent staining, and PCR analysis. Results:In vitro administration of ZA reduced myofibroblast transition and blocked NF-κB signaling in macrophages leading to impaired immune cell recruitment in a transwell assay. FDPS-targeting siRNA administration significantly attenuated profibrotic cytokine production and lung damage in a murine lung fibrosis model. Furthermore, ZA treatment of mice with bleomycin-induced lung damage displayed decreased cytokine levels in the BALF, plasma, and lung tissue, resulting in less histologically visible fibrotic scarring. Bleomycin-induced upregulation of the ZA target, FDPS, was reduced in lung tissue and fibroblasts upon ZA treatment. Confirmatory increases in FDPS immunoreactivity was seen in human IPF resected lung samples compared to control tissue indicating potential translational value of the approach. Additionally, ZA polarized macrophages towards a less profibrotic phenotype contributing to decreased IPF pathogenesis. Conclusion: This study highlights ZA as an expedient and efficacious treatment option against IPF in a clinical setting.
Collapse
Affiliation(s)
- Lloyd Tanner
- Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Jesper Bergwik
- Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Andrew B Single
- Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Ravi K V Bhongir
- Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| | - Jonas S Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Arne Egesten
- Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden
| |
Collapse
|
11
|
Lamb D, De Sousa D, Quast K, Fundel-Clemens K, Erjefält JS, Sandén C, Hoffmann HJ, Kästle M, Schmid R, Menden K, Delic D. RORγt inhibitors block both IL-17 and IL-22 conferring a potential advantage over anti-IL-17 alone to treat severe asthma. Respir Res 2021; 22:158. [PMID: 34022896 PMCID: PMC8141258 DOI: 10.1186/s12931-021-01743-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND RORγt is a transcription factor that enables elaboration of Th17-associated cytokines (including IL-17 and IL-22) and is proposed as a pharmacological target for severe asthma. METHODS IL-17 immunohistochemistry was performed in severe asthma bronchial biopsies (specificity confirmed with in situ hybridization). Primary human small airway epithelial cells in air liquid interface and primary bronchial smooth muscle cells were stimulated with recombinant human IL-17 and/or IL-22 and pro-inflammatory cytokines measured. Balb/c mice were challenged intratracheally with IL-17 and/or IL-22 and airway hyperreactivity, pro-inflammatory cytokines and airway neutrophilia measured. Balb/c mice were sensitized intraperitoneally and challenged intratracheally with house dust mite extract and the effect of either a RORγt inhibitor (BIX119) or an anti-IL-11 antibody assessed on airway hyperreactivity, pro-inflammatory cytokines and airway neutrophilia measured. RESULTS We confirmed in severe asthma bronchial biopsies both the presence of IL-17-positive lymphocytes and that an IL-17 transcriptome profile in a severe asthma patient sub-population. Both IL-17 and IL-22 stimulated the release of pro-inflammatory cytokine and chemokine release from primary human lung cells and in mice. Furthermore, IL-22 in combination with IL-17, but neither alone, elicits airway hyperresponsiveness (AHR) in naïve mice. A RORγt inhibitor specifically blocked both IL-17 and IL-22, AHR and neutrophilia in a mouse house dust mite model unlike other registered or advanced pipeline modes of action. Full efficacy versus these parameters was associated with 90% inhibition of IL-17 and 50% inhibition of IL-22. In contrast, anti-IL-17 also blocked IL-17, but not IL-22, AHR or neutrophilia. Moreover, the deregulated genes in the lungs from these mice correlated well with deregulated genes from severe asthma biopsies suggesting that this model recapitulates significant severe asthma-relevant biology. Furthermore, these genes were reversed upon RORγt inhibition in the HDM model. Cell deconvolution suggested that the responsible cells were corticosteroid insensitive γδ-T-cells. CONCLUSION These data strongly suggest that both IL-17 and IL-22 are required for Th2-low endotype associated biology and that a RORγt inhibitor may provide improved clinical benefit in a severe asthma sub-population of patients by blocking both IL-17 and IL-22 biology compared with blocking IL-17 alone.
Collapse
MESH Headings
- Adolescent
- Adult
- Aged
- Animals
- Anti-Asthmatic Agents/pharmacology
- Asthma/drug therapy
- Asthma/immunology
- Asthma/metabolism
- Asthma/physiopathology
- Cells, Cultured
- Disease Models, Animal
- Epithelial Cells/drug effects
- Epithelial Cells/immunology
- Epithelial Cells/metabolism
- Female
- Humans
- Interleukin-17/metabolism
- Interleukins/antagonists & inhibitors
- Interleukins/metabolism
- Lung/drug effects
- Lung/immunology
- Lung/metabolism
- Lung/physiopathology
- Male
- Mice, Inbred BALB C
- Middle Aged
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/immunology
- Myocytes, Smooth Muscle/metabolism
- Nuclear Receptor Subfamily 1, Group F, Member 3/antagonists & inhibitors
- Nuclear Receptor Subfamily 1, Group F, Member 3/metabolism
- Pyroglyphidae/immunology
- Signal Transduction
- Th17 Cells/drug effects
- Th17 Cells/immunology
- Th17 Cells/metabolism
- Young Adult
- Interleukin-22
- Mice
Collapse
Affiliation(s)
- David Lamb
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany.
| | | | - Karsten Quast
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| | - Katrin Fundel-Clemens
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| | | | | | | | - Marc Kästle
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| | - Ramona Schmid
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| | - Kevin Menden
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| | - Denis Delic
- Immunology and Respiratory Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach-an-der-Riss, Germany
| |
Collapse
|
12
|
Schmid JM, Würtzen PA, Siddhuraj P, Jogdand P, Petersen CG, Dahl R, Erjefält JS, Hoffmann HJ. Basophil sensitivity reflects long-term clinical outcome of subcutaneous immunotherapy in grass pollen-allergic patients. Allergy 2021; 76:1528-1538. [PMID: 32145088 DOI: 10.1111/all.14264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Allergic rhinoconjunctivitis is a public health problem. Allergen Immunotherapy is an effective and safe treatment, that modifies the natural course of allergic disease and induces long-term tolerance. OBJECTIVE To correlate basophil and antibody biomarkers of subcutaneous immunotherapy to clinical outcomes and cellular changes in target tissue. METHODS Adults suffering from allergic rhinoconjunctivitis due to grass pollen allergy were randomized to receive subcutaneous immunotherapy (n = 18) or to an open control group (n = 6). Patients reported daily symptom and medication scores and weekly rhinitis related quality of life scores during four pollen seasons. Biomarkers were measured every 3 months for three years treatment and every 6 months in the follow-up year. Nasal and cutaneous allergen challenge tests were performed annually. Leukocyte subsets were assessed in nasal mucosa biopsies at baseline and after treatment. RESULTS Subcutaneous immunotherapy led to a 447-fold decrease in basophil sensitivity during the first treatment year. This remained 100-fold lower than baseline during the 3 year-treatment period and 10-fold lower during the follow-up year (n = 18, P = .03). Decrease in basophil sensitivity after three weeks of treatment predicted long-term improvement in seasonal combined symptom and medication scores (ῥ=-0.69, P = .0027) during three years of treatment. AUC of IgE-blocking factor correlated to nasal allergen challenge (ῥ = 0.63, P = .0012) and SPT (ῥ = 0.45, P = .03). Plasma cell numbers in the nasal mucosa increased during treatment (P = .02). CONCLUSION Decrease in basophil sensitivity after three weeks of subcutaneous allergen immunotherapy predicted the clinical outcome of this treatment.
Collapse
Affiliation(s)
- Johannes M. Schmid
- Department of Respiratory Diseases and Allergy Aarhus University Hospital Aarhus Denmark
| | | | | | | | - Claus G. Petersen
- Department of Otorhinolaryngology Aarhus University Hospital Aarhus Denmark
| | - Ronald Dahl
- Department of Respiratory Diseases and Allergy Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine, Aarhus University Aarhus Denmark
| | | | - Hans Jürgen Hoffmann
- Department of Respiratory Diseases and Allergy Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine, Aarhus University Aarhus Denmark
| |
Collapse
|
13
|
Siddhuraj P, Clausson CM, Sanden C, Alyamani M, Kadivar M, Marsal J, Wallengren J, Bjermer L, Erjefält JS. Lung Mast Cells Have a High Constitutive Expression of Carboxypeptidase A3 mRNA That Is Independent from Granule-Stored CPA3. Cells 2021; 10:cells10020309. [PMID: 33546258 PMCID: PMC7913381 DOI: 10.3390/cells10020309] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
The mast cell granule metalloprotease CPA3 is proposed to have important tissue homeostatic functions. However, the basal CPA3 mRNA and protein expression among mast cell populations has remained poorly investigated. Using a novel histology-based methodology that yields quantitative data on mRNA and protein expression at a single-cell level, the present study maps CPA3 mRNA and protein throughout the MCT and MCTC populations in healthy skin, gut and lung tissues. MCTC cells had both a higher frequency of CPA3 protein-containing cells and a higher protein-staining intensity than the MCT population. Among the tissues, skin MCs had highest CPA3 protein intensity. The expression pattern at the mRNA level was reversed. Lung mast cells had the highest mean CPA3 mRNA staining. Intriguingly, the large alveolar MCT population, that lack CPA3 protein, had uniquely high CPA3 mRNA intensity. A broader multi-tissue RNA analysis confirmed the uniquely high CPA3 mRNA quantities in the lung and corroborated the dissociation between chymase and CPA3 at the mRNA level. Taken together, our novel data suggest a hitherto underestimated contribution of mucosal-like MCT to baseline CPA3 mRNA production. The functional consequence of this high constitutive expression now reveals an important area for further research.
Collapse
Affiliation(s)
- Premkumar Siddhuraj
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
| | - Carl-Magnus Clausson
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
| | - Caroline Sanden
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
- Medetect AB, Medicon Village, 223 81 Lund, Sweden
| | - Manar Alyamani
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
| | - Mohammad Kadivar
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
| | - Jan Marsal
- Department of Gastroenterology, Lund University, Skane University Hospital, 221 85 Lund, Sweden;
| | - Joanna Wallengren
- Department of Dermatology, Lund University Skane University Hospital, 221 85 Lund, Sweden;
| | - Leif Bjermer
- Department of Allergology and Respiratory Medicine, Lund University, Skane University Hospital, 221 85 Lund, Sweden;
| | - Jonas S. Erjefält
- Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden; (P.S.); (C.-M.C.); (C.S.); (M.A.); (M.K.)
- Department of Allergology and Respiratory Medicine, Lund University, Skane University Hospital, 221 85 Lund, Sweden;
- Correspondence: ; Tel.: +46-462-220-960
| |
Collapse
|
14
|
Nilsson JS, Sobti A, Swoboda S, Erjefält JS, Forslund O, Lindstedt M, Greiff L. Immune Phenotypes of Nasopharyngeal Cancer. Cancers (Basel) 2020; 12:cancers12113428. [PMID: 33218184 PMCID: PMC7699205 DOI: 10.3390/cancers12113428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 12/21/2022] Open
Abstract
Simple Summary As for many solid cancers, nasopharyngeal cancer (NPC) interacts with the immune system. In this retrospective study, immune features of NPC were explored and assessed against Epstein-Barr virus status, clinical stage, and survival. Specific immune phenotypes were identified based on presence and distribution of CD8+ T-cells: i.e., “inflamed”, “excluded”, and “deserted” NPC, which carried important prognostic information. Presence and distribution of CD207+ cells, likely representing antigen-presenting dendritic cells, were demonstrated, suggesting a potential for immune cell targeting. Gene expression revealed differences in immune profiles between NPC and control tissue as well as between subgroups of NPC based on CD8 expression (high vs. low). Taken together, the observations may be of relevance to prognostication of NPC as well as for explorations into the field of immunotherapy. Abstract Nasopharyngeal cancer (NPC) features intralesional immune cells, but data are lacking on presence/distribution of T-cells and dendritic cells (DCs). Based on intralesional distribution of lymphocytes, a series of NPC biopsies (n = 48) were classified into “inflamed”, “excluded”, and “deserted” phenotypes. In addition, CD8+ T-cells and CD207+ DCs were quantified. The data were analyzed in relation to Epstein–Barr virus-encoded small RNA (EBER), Epstein-Barr virus (EBV) DNA, and survival. Separately, data on gene expression from a public database were analyzed. 61.7% of NPC lesions were “inflamed”, 29.8% were “excluded”, and 8.5% were “deserted”. While CD8+ cells were present in cancer cell areas and in surrounding stroma, CD207+ cells were observed largely in cancer cell areas. High CD8+ T-cell presence was associated with EBV+ disease, but no such pattern was observed for CD207+ DCs. There was a difference in disease-free survival in favor of “inflamed” over “excluded” NPC. Gene expression analysis revealed differences between NPC and control tissue (e.g., with regard to interferon activity) as well as between subgroups of NPC based on CD8 expression (high vs. low). In conclusion, NPC lesions are heterogeneous with regard to distribution of CD8+ T-cells and CD207+ DCs. NPC can be classified into immune phenotypes that carry prognostic information. CD207+ DCs may represent a target for immunotherapy with potential to facilitate the antigen cross-presentation necessary to execute cytotoxic T-lymphocyte responses.
Collapse
Affiliation(s)
- Johan S. Nilsson
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
- Correspondence:
| | - Aastha Sobti
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (A.S.); (M.L.)
| | - Sabine Swoboda
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
| | - Jonas S. Erjefält
- Department of Experimental Medicine, Lund University, 221 84 Lund, Sweden;
| | - Ola Forslund
- Department of Microbiology, Lund University, 221 85 Lund, Sweden;
| | - Malin Lindstedt
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (A.S.); (M.L.)
| | - Lennart Greiff
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
| |
Collapse
|
15
|
Jogdand P, Siddhuraj P, Mori M, Sanden C, Jönsson J, Walls AF, Kearley J, Humbles AA, Kolbeck R, Bjermer L, Newbold P, Erjefält JS. Eosinophils, basophils and type 2 immune microenvironments in COPD-affected lung tissue. Eur Respir J 2020; 55:13993003.00110-2019. [PMID: 32060064 PMCID: PMC7236868 DOI: 10.1183/13993003.00110-2019] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/06/2020] [Indexed: 01/20/2023]
Abstract
Although elevated blood or sputum eosinophils are present in many patients with COPD, uncertainties remain regarding the anatomical distribution pattern of lung-infiltrating eosinophils. Basophils have remained virtually unexplored in COPD. This study mapped tissue-infiltrating eosinophils, basophils and eosinophil-promoting immune mechanisms in COPD-affected lungs. Surgical lung tissue and biopsies from major anatomical compartments were obtained from COPD patients with severity grades Global Initiative for Chronic Obstructive Lung Disease stages I–IV; never-smokers/smokers served as controls. Automated immunohistochemistry and in situ hybridisation identified immune cells, the type 2 immunity marker GATA3 and eotaxins (CCL11, CCL24). Eosinophils and basophils were present in all anatomical compartments of COPD-affected lungs and increased significantly in very severe COPD. The eosinophilia was strikingly patchy, and focal eosinophil-rich microenvironments were spatially linked with GATA3+ cells, including type 2 helper T-cell lymphocytes and type 2 innate lymphoid cells. A similarly localised and interleukin-33/ST2-dependent eosinophilia was demonstrated in influenza-infected mice. Both mice and patients displayed spatially confined eotaxin signatures with CCL11+ fibroblasts and CCL24+ macrophages. In addition to identifying tissue basophilia as a novel feature of advanced COPD, the identification of spatially confined eosinophil-rich type 2 microenvironments represents a novel type of heterogeneity in the immunopathology of COPD that is likely to have implications for personalised treatment. Highly localised Th2- and eosinophil-rich pockets were identified in COPD-affected lungs, which increased in number with increasing disease severity and included basophils. This exemplifies a novel type of heterogeneity in the immunopathology of COPD.http://bit.ly/2HexTco
Collapse
Affiliation(s)
- Prajakta Jogdand
- Dept of Experimental Medical Science, Lund University, Lund, Sweden
| | | | - Michiko Mori
- Dept of Experimental Medical Science, Lund University, Lund, Sweden
| | - Caroline Sanden
- Dept of Experimental Medical Science, Lund University, Lund, Sweden.,Medetect AB, Lund, Sweden
| | | | - Andrew F Walls
- Clinical and Experimental Sciences, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jennifer Kearley
- Dept of Respiratory, Inflammation and Autoimmunity, AstraZeneca, Gaithersburg, MD, USA
| | - Alison A Humbles
- Dept of Respiratory, Inflammation and Autoimmunity, AstraZeneca, Gaithersburg, MD, USA
| | - Roland Kolbeck
- Dept of Respiratory, Inflammation and Autoimmunity, AstraZeneca, Gaithersburg, MD, USA
| | - Leif Bjermer
- Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Paul Newbold
- Dept of Translational Sciences, AstraZeneca, Gaithersburg, MD, USA
| | - Jonas S Erjefält
- Dept of Experimental Medical Science, Lund University, Lund, Sweden .,Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| |
Collapse
|
16
|
Backer V, Klein DK, Bodtger U, Romberg K, Porsbjerg C, Erjefält JS, Kristiansen K, Xu R, Silberbrandt A, Frøssing L, Hvidtfeldt M, Obling N, Jarenbäck L, Nasr A, Tufvesson E, Mori M, Winther-Jensen M, Karlsson L, Nihlén U, Veje Flintegaard T, Bjermer L. Clinical characteristics of the BREATHE cohort - a real-life study on patients with asthma and COPD. Eur Clin Respir J 2020; 7:1736934. [PMID: 32284828 PMCID: PMC7144315 DOI: 10.1080/20018525.2020.1736934] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/24/2020] [Indexed: 01/06/2023] Open
Abstract
Background: The BREATHE study is a cross-sectional study of real-life patients with asthma and/or COPD in Denmark and Sweden aiming to increase the knowledge across severities and combinations of obstructive airway disease. Design: Patients with suspicion of asthma and/or COPD and healthy controls were invited to participate in the study and had a standard evaluation performed consisting of questionnaires, physical examination, FeNO and lung function, mannitol provocation test, allergy test, and collection of sputum and blood samples. A subgroup of patients and healthy controls had a bronchoscopy performed with a collection of airway samples. Results: The study population consisted of 1403 patients with obstructive airway disease (859 with asthma, 271 with COPD, 126 with concurrent asthma and COPD, 147 with other), and 89 healthy controls (smokers and non-smokers). Of patients with asthma, 54% had moderate-to-severe disease and 46% had mild disease. In patients with COPD, 82% had groups A and B, whereas 18% had groups C and D classified disease. Patients with asthma more frequently had childhood asthma, atopic dermatitis, and allergic rhinitis, compared to patients with COPD, asthma + COPD and Other, whereas FeNO levels were higher in patients with asthma and asthma + COPD compared to COPD and Other (18 ppb and 16 ppb vs 12.5 ppb and 14 ppb, p < 0.001). Patients with asthma, asthma + COPD and Other had higher sputum eosinophilia (1.5%, 1.5%, 1.2% vs 0.75%, respectively, p < 0.001) but lower sputum neutrophilia (39.3, 43.5%, 40.8% vs 66.8%, p < 0.001) compared to patients with COPD. Conclusions: The BREATHE study provides a unique database and biobank with clinical information and samples from 1403 real-life patients with asthma, COPD, and overlap representing different severities of the diseases. This research platform is highly relevant for disease phenotype- and biomarker studies aiming to describe a broad spectrum of obstructive airway diseases.
Collapse
Affiliation(s)
- Vibeke Backer
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Ditte K Klein
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Uffe Bodtger
- Department of Respiratory and Internal Medicine, Naestved Hospital, Naestved, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Kerstin Romberg
- Health Care Centre, Näsets Läkargrupp, Höllviken, Sweden.,Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Celeste Porsbjerg
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Karsten Kristiansen
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Ruiqi Xu
- North Europe Regional Department, BGI-Europe, Copenhagen, Denmark
| | - Alexander Silberbrandt
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Laurits Frøssing
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Morten Hvidtfeldt
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Nicolai Obling
- Department of Respiratory and Internal Medicine, Naestved Hospital, Naestved, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Linnea Jarenbäck
- Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Abir Nasr
- Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Ellen Tufvesson
- Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Michiko Mori
- Unit of Airway Inflammation, Lund University, Lund, Sweden
| | - Matilde Winther-Jensen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Lisa Karlsson
- Unit of Airway Inflammation, Lund University, Lund, Sweden
| | - Ulf Nihlén
- Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Thomas Veje Flintegaard
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Leif Bjermer
- Respiratory Medicine and Allergology, Clinical Sciences Lund, Lund University, Lund, Sweden
| |
Collapse
|
17
|
Seys SF, Quirce S, Agache I, Akdis CA, Alvaro‐Lozano M, Antolín‐Amérigo D, Bjermer L, Bobolea I, Bonini M, Bossios A, Brinkman P, Bush A, Calderon M, Canonica W, Chanez P, Couto M, Davila I, Del Giacco S, Del Pozo V, Erjefält JS, Gevaert P, Hagedoorn P, G. Heaney L, Heffler E, Hellings PW, Jutel M, Kalayci O, Kurowski MM, Loukides S, Nair P, Palomares O, Polverino E, Sanchez‐Garcia S, Sastre J, Schwarze J, Spanevello A, Ulrik CS, Usmani O, Van den Berge M, Vasakova M, Vijverberg S, Diamant Z. Severe asthma: Entering an era of new concepts and emerging therapies: Highlights of the 4th international severe asthma forum, Madrid, 2018. Allergy 2019; 74:2244-2248. [PMID: 31021446 DOI: 10.1111/all.13843] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Sven F. Seys
- Laboratory of Clinical Immunology, Department of Clinical Immunology KU Leuven Leuven Belgium
| | - Santiago Quirce
- Department of Allergy Hospital Universitario La Paz, CIBER of Respiratory Diseases (CIBERES) Madrid Spain
| | - Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Montserrat Alvaro‐Lozano
- Pediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Déu, Universitat de Barcelona Esplugues (Barcelona) Spain
| | | | - Leif Bjermer
- Skane University hospital, Lund University Lund Sweden
| | - Irina Bobolea
- Allergy Section/ Severe Asthma Unit, Department of Pulmonology and Respiratory Allergy Hospital Clinic Barcelona Barcelona Spain
| | - Matteo Bonini
- National Heart and Lung Institute, Imperial College London London UK
- Department of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A. Gemelli, IRCCS Rome Italy
- Universita’ Cattolica del Sacro Cuore Rome Italy
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy Karolinska University Hospital Huddinge Sweden
- Department of Medicine Karolinska Institutet Stockholm Sweden
| | - Paul Brinkman
- Department of Respiratory Medicine Amsterdam UMC Amsterdam The Netherlands
| | - Andy Bush
- Department of Paediatrics and Paediatric Respiratory Medicine Imperial College and Royal Brompton Hospital London UK
| | - Moises Calderon
- Section of Allergy and Clinical Immunology Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital London UK
| | - Walter Canonica
- Personalized Medicine, Asthma and Allergy ‐ Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Sciences Humanitas University Pieve Emanuele Italy
| | - Psacal Chanez
- Assistance Publique des Hôpitaux de Marseille ‐ Clinique des bronches, allergies et sommeil Aix Marseille Université Marseille France
| | | | - Ignacio Davila
- Department of Biomedical and Diagnostic Sciences Universidad de Salamanca Salamanca Spain
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health "M. Aresu" University of Cagliari Cagliari Italy
| | - Victoria Del Pozo
- Department of Immunology IIS‐Fundación Jiménez Díaz, and CIBERES Madrid Spain
| | - Jonas S. Erjefält
- Unit of Airway Inflammation, Department of Respiratory Medicine Lund University Lund Sweden
| | - Philippe Gevaert
- Department of Otorhinolaryngology Ghent University Ghent Belgium
| | - Paul Hagedoorn
- Pharmaceutical Technology and Biopharmacy Groningen Research Institute of Pharmacy, University of Groningen Groningen The Netherlands
| | - Liam G. Heaney
- Centre for Experimental Medicine Queen's University of Belfast Belfast UK
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy ‐ Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Sciences Humanitas University Pieve Emanuele Italy
| | | | - Marek Jutel
- ALL‐MED Medical Research Institute Wroclaw Poland
- Department of Clinical Immunology Wroclaw Medical University Wrocław Poland
| | - Omer Kalayci
- Hacettepe University School of Medicine Ankara Turkey
| | | | - Stelios Loukides
- Medical School, 2nd Respiratory Medicine Department National Kapodistrian University of Athens Athens Greece
| | - Parameswaran Nair
- Department of Medicine St Joseph’s Healthcare & McMaster University Hamilton Ontario Canada
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, Chemistry School Complutense University of Madrid Madrid Spain
| | - Eva Polverino
- Respiratory Disease Dept Hospital Universitari Vall d'Hebron (HUVH) Institut de Recerca Vall d'Hebron (VHIR) Passeig Vall d'Hebron, CIBERES Barcelona Spain
| | | | - Joaquin Sastre
- Department of Allergy CIBER of Respiratory Diseases (CIBERES) Fundación Jiménez Díaz Madrid Spain
| | - Jürgen Schwarze
- Child Life and Health and Centre for Inflammation Research The University of Edinburgh Edinburgh UK
| | | | - Charlotte S. Ulrik
- Respiratory Research Unit, Department of Respiratory Medicine Hvidovre Hospital and Institute of Clinical Medicine, University of Copenhagen Copenhagen Denmark
| | - Omar Usmani
- National Heart and Lung Institute, Imperial College London London UK
| | - Maarten Van den Berge
- University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Pulmonology Groningen Research Institute for Asthma and COPD Research Institute Groningen The Netherlands
| | - Martina Vasakova
- Department of Respiratory Medicine First Faculty of Medicine of Charles University, Thomayer Hospital Prague Czech
| | - Susanne Vijverberg
- Department of Respiratory Medicine Amsterdam UMC Amsterdam The Netherlands
| | - Zuzana Diamant
- Skane University hospital, Lund University Lund Sweden
- University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Pulmonology Groningen Research Institute for Asthma and COPD Research Institute Groningen The Netherlands
- Department of Respiratory Medicine First Faculty of Medicine of Charles University, Thomayer Hospital Prague Czech
| |
Collapse
|
18
|
Allinne J, Scott G, Lim WK, Birchard D, Erjefält JS, Sandén C, Ben LH, Agrawal A, Kaur N, Kim JH, Kamat V, Fury W, Huang T, Stahl N, Yancopoulos GD, Murphy AJ, Sleeman MA, Orengo JM. IL-33 blockade affects mediators of persistence and exacerbation in a model of chronic airway inflammation. J Allergy Clin Immunol 2019; 144:1624-1637.e10. [PMID: 31562870 DOI: 10.1016/j.jaci.2019.08.039] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/15/2019] [Accepted: 08/24/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Severe inflammatory airway diseases are associated with inflammation that does not resolve, leading to structural changes and an overall environment primed for exacerbations. OBJECTIVE We sought to identify and inhibit pathways that perpetuate this heightened inflammatory state because this could lead to therapies that allow for a more quiescent lung that is less predisposed to symptoms and exacerbations. METHODS Using prolonged exposure to house dust mite in mice, we developed a mouse model of persistent and exacerbating airway disease characterized by a mixed inflammatory phenotype. RESULTS We show that lung IL-33 drives inflammation and remodeling beyond the type 2 response classically associated with IL-33 signaling. IL-33 blockade with an IL-33 neutralizing antibody normalized established inflammation and improved remodeling of both the lung epithelium and lung parenchyma. Specifically, IL-33 blockade normalized persisting and exacerbating inflammatory end points, including eosinophilic, neutrophilic, and ST2+CD4+ T-cell infiltration. Importantly, we identified a key role for IL-33 in driving lung remodeling because anti-IL-33 also re-established the presence of ciliated cells over mucus-producing cells and decreased myofibroblast numbers, even in the context of continuous allergen exposure, resulting in improved lung function. CONCLUSION Overall, this study shows that increased IL-33 levels drive a self-perpetuating amplification loop that maintains the lung in a state of lasting inflammation and remodeled tissue primed for exacerbations. Thus IL-33 blockade might ameliorate symptoms and prevent exacerbations by quelling persistent inflammation and airway remodeling.
Collapse
Affiliation(s)
| | | | | | | | - Jonas S Erjefält
- Unit of Airway Inflammation, Lund University, Lund, Sweden; Medetect AB, Lund, Sweden
| | | | | | | | | | | | | | - Wen Fury
- Regeneron Pharmaceuticals, Tarrytown, NY
| | | | - Neil Stahl
- Regeneron Pharmaceuticals, Tarrytown, NY
| | | | | | | | | |
Collapse
|
19
|
Tufvesson E, Jogdand P, Che KF, Levänen B, Erjefält JS, Bjermer L, Lindén A. Enhanced local production of IL-26 in uncontrolled compared with controlled adult asthma. J Allergy Clin Immunol 2019; 144:1134-1136.e10. [PMID: 31288043 DOI: 10.1016/j.jaci.2019.06.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/17/2019] [Accepted: 06/11/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Ellen Tufvesson
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund
| | - Prajakta Jogdand
- Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund
| | - Karlhans Fru Che
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm
| | - Bettina Levänen
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm
| | - Jonas S Erjefält
- Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund
| | - Leif Bjermer
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund
| | - Anders Lindén
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden.
| |
Collapse
|
20
|
Andersson CK, Shikhagaie M, Mori M, Al-Garawi A, Reed JL, Humbles AA, Welliver R, Mauad T, Bjermer L, Jordana M, Erjefält JS. Distal respiratory tract viral infections in young children trigger a marked increase in alveolar mast cells. ERJ Open Res 2018; 4:00038-2018. [PMID: 30480000 PMCID: PMC6250563 DOI: 10.1183/23120541.00038-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/05/2018] [Indexed: 01/28/2023] Open
Abstract
Viral infections predispose to the development of childhood asthma, a disease associated with increased lung mast cells (MCs). This study investigated whether viral lower respiratory tract infections (LRTIs) can already evoke a MC response during childhood. Lung tissue from young children who died following LRTIs were processed for immunohistochemical identification of MCs. Children who died from nonrespiratory causes served as controls. MCs were examined in relation to sensitisation in infant mice exposed to allergen during influenza A infection. Increased numbers of MCs were observed in the alveolar parenchyma of children infected with LRTIs (median (range) 12.5 (0–78) MCs per mm2) compared to controls (0.63 (0–4) MCs per mm2, p=0.0005). The alveolar MC expansion was associated with a higher proportion of CD34+ tryptase+ progenitors (controls: 0% (0–1%); LRTIs: 0.9% (0–3%) CD34+ MCs (p=0.01)) and an increased expression of the vascular cell adhesion molecule (VCAM)-1 (controls: 0.2 (0.07–0.3); LRTIs: 0.3 (0.02–2) VCAM-1 per mm2 (p=0.04)). Similarly, infant mice infected with H1N1 alone or together with house dust mite (HDM) developed an increase in alveolar MCs (saline: 0.4 (0.3–0.5); HDM: 0.6 (0.4–0.9); H1N1: 1.4 (0.4–2.0); HDM+H1N1: 2.2 (1.2–4.4) MCs per mm2 (p<0.0001)). Alveolar MCs continued to increase and remained significantly higher into adulthood when exposed to H1N1+HDM (day 36: 2.2 (1.2–4.4); day 57: 4.6 (1.6–15) MCs per mm2 (p=0.01)) but not when infected with H1N1 alone. Our data demonstrate that distal viral infections in young children evoke a rapid accumulation of alveolar MCs. Apart from revealing a novel immune response to distal infections, our data may have important implications for the link between viral infections during early childhood and subsequent asthma development. Viral infections in children evokes a rapid recruitment and accumulation of mast cells in the alveolar parenchymahttp://ow.ly/i9eN30meNM7
Collapse
Affiliation(s)
- Cecilia K Andersson
- Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.,Unit of Airway Inflammation, Lund University, Lund, Sweden
| | | | - Michiko Mori
- Unit of Airway Inflammation, Lund University, Lund, Sweden
| | - Amal Al-Garawi
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Jennifer L Reed
- Laboratory of Plasma Derivatives, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, MD, USA
| | - Alison A Humbles
- Dept of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, USA
| | - Robert Welliver
- Dept of Pediatrics, University of Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Thais Mauad
- Dept of Pathology, São Paulo University, São Paulo, Brazil
| | - Leif Bjermer
- Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Manel Jordana
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | | |
Collapse
|
21
|
Ravanetti L, Dijkhuis A, Dekker T, Sabogal Pineros YS, Ravi A, Dierdorp BS, Erjefält JS, Mori M, Pavlidis S, Adcock IM, Rao NL, Lutter R. IL-33 drives influenza-induced asthma exacerbations by halting innate and adaptive antiviral immunity. J Allergy Clin Immunol 2018; 143:1355-1370.e16. [PMID: 30316823 DOI: 10.1016/j.jaci.2018.08.051] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 07/12/2018] [Accepted: 08/28/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Influenza virus triggers severe asthma exacerbations for which no adequate treatment is available. It is known that IL-33 levels correlate with exacerbation severity, but its role in the immunopathogenesis of exacerbations has remained elusive. OBJECTIVE We hypothesized that IL-33 is necessary to drive asthma exacerbations. We intervened with the IL-33 cascade and sought to dissect its role, also in synergy with thymic stromal lymphopoietin (TSLP), in airway inflammation, antiviral activity, and lung function. We aimed to unveil the major source of IL-33 in the airways and IL-33-dependent mechanisms that underlie severe asthma exacerbations. METHODS Patients with mild asthma were experimentally infected with rhinovirus. Mice were chronically exposed to house dust mite extract and then infected with influenza to resemble key features of exacerbations in human subjects. Interventions included the anti-IL-33 receptor ST2, anti-TSLP, or both. RESULTS We identified bronchial ciliated cells and type II alveolar cells as a major local source of IL-33 during virus-driven exacerbation in human subjects and mice, respectively. By blocking ST2, we demonstrated that IL-33 and not TSLP was necessary to drive exacerbations. IL-33 enhanced airway hyperresponsiveness and airway inflammation by suppressing innate and adaptive antiviral responses and by instructing epithelial cells and dendritic cells of house dust mite-sensitized mice to dampen IFN-β expression and prevent the TH1-promoting dendritic cell phenotype. IL-33 also boosted luminal NETosis and halted cytolytic antiviral activities but did not affect the TH2 response. CONCLUSION Interventions targeting the IL-33/ST2 axis could prove an effective acute short-term therapy for virus-induced asthma exacerbations.
Collapse
Affiliation(s)
- Lara Ravanetti
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands.
| | - Annemiek Dijkhuis
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| | - Tamara Dekker
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| | - Yanaika S Sabogal Pineros
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| | - Abilash Ravi
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| | - Barbara S Dierdorp
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| | - Jonas S Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Stelios Pavlidis
- Airway Disease Section, National Heart & Lung Institute, Imperial College London, Royal Brompton Campus, London, United Kingdom
| | - Ian M Adcock
- Airway Disease Section, National Heart & Lung Institute, Imperial College London, Royal Brompton Campus, London, United Kingdom
| | - Navin L Rao
- Immunology Discovery, Janssen Research and Development, San Diego, Calif
| | - René Lutter
- Department of Experimental Immunology, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
22
|
Hvidtfeldt M, Pulga A, Hostrup M, Sanden C, Mori M, Bornesund D, Larsen KR, Erjefält JS, Porsbjerg C. Bronchoscopic mucosal cryobiopsies as a method for studying airway disease. Clin Exp Allergy 2018; 49:27-34. [PMID: 30244522 DOI: 10.1111/cea.13281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/13/2018] [Accepted: 09/17/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies are larger and more intact and are being increasingly used. However, the technique has not yet been explored for obtaining mucosa biopsies. OBJECTIVE To investigate differences in size and quality of endobronchial mucosal biopsies obtained with cryotechnique and forceps. Further, to check for eligibility of cryobiopsies to be evaluated with immunohistochemistry and in situ hybridization and to investigate tolerability and safety of the technique. METHODS Endobronchial mucosal biopsies were obtained with cryotechnique and forceps from patients with haemoptysis undergoing bronchoscopy and evaluated by quantitative morphometry, automated immunohistochemistry and in situ hybridization. RESULTS A total of 40 biopsies were obtained from 10 patients. Cross-sectional areas were threefold larger in cryobiopsies (median: 3.08 mm2 (IQR: 1.79) vs 1.03 mm2 (IQR: 1.10), P < 0.001). Stretches of intact epithelium were 8-fold longer (median: 4.61 mm (IQR: 4.50) vs 0.55 mm (IQR: 1.23), P = 0.001). Content of glands (median: 0.095 mm2 (IQR: 0.30) vs 0.00 mm2 (IQR: 0.01), P = 0.002) and airway smooth muscle (median: 0.25 mm2 (IQR: 0.30) vs 0.060 mm2 (IQR: 0.11), P = 0.02) was higher in the cryobiopsies compared with forceps biopsies. Further, the cryobiopsies had well-preserved protein antigens and mRNA. Mild to moderate bleeding was the only complication observed. CONCLUSION AND CLINICAL RELEVANCE By yielding significantly larger and more intact biopsies, the cryotechnique represents a valuable new research tool to explore the bronchi in airway disease. Ultimately with the potential to create better understanding of underlying disease mechanisms and improvement of treatments.
Collapse
Affiliation(s)
| | - Alexis Pulga
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Morten Hostrup
- Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen Ø, Denmark
| | | | - Michiko Mori
- Unit of Airway Inflammation, Lund University, Lund, Sweden
| | | | - Klaus R Larsen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Celeste Porsbjerg
- Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
23
|
Scott IC, Majithiya JB, Sanden C, Thornton P, Sanders PN, Moore T, Guscott M, Corkill DJ, Erjefält JS, Cohen ES. Interleukin-33 is activated by allergen- and necrosis-associated proteolytic activities to regulate its alarmin activity during epithelial damage. Sci Rep 2018; 8:3363. [PMID: 29463838 PMCID: PMC5820248 DOI: 10.1038/s41598-018-21589-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022] Open
Abstract
Interleukin (IL)-33 is an IL-1 family alarmin released from damaged epithelial and endothelial barriers to elicit immune responses and allergic inflammation via its receptor ST2. Serine proteases released from neutrophils, mast cells and cytotoxic lymphocytes have been proposed to process the N-terminus of IL-33 to enhance its activity. Here we report that processing of full length IL-33 can occur in mice deficient in these immune cell protease activities. We sought alternative mechanisms for the proteolytic activation of IL-33 and discovered that exogenous allergen proteases and endogenous calpains, from damaged airway epithelial cells, can process full length IL-33 and increase its alarmin activity up to ~60-fold. Processed forms of IL-33 of apparent molecular weights ~18, 20, 22 and 23 kDa, were detected in human lungs consistent with some, but not all, proposed processing sites. Furthermore, allergen proteases degraded processed forms of IL-33 after cysteine residue oxidation. We suggest that IL-33 can sense the proteolytic and oxidative microenvironment during tissue injury that facilitate its rapid activation and inactivation to regulate the duration of its alarmin function.
Collapse
Affiliation(s)
- Ian C Scott
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom.
| | - Jayesh B Majithiya
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Caroline Sanden
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Peter Thornton
- Neuroscience, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Philip N Sanders
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Tom Moore
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Molly Guscott
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Dominic J Corkill
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| | - Jonas S Erjefält
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - E Suzanne Cohen
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune, Granta Park, Cambridge, CB21 6GH, United Kingdom
| |
Collapse
|
24
|
Karnevi E, Sasor A, Hilmersson KS, Ansari D, Erjefält JS, Rosendahl AH, Andersson R. Intratumoural leukocyte infiltration is a prognostic indicator among pancreatic cancer patients with type 2 diabetes. Pancreatology 2018; 18:85-93. [PMID: 29158145 DOI: 10.1016/j.pan.2017.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/10/2017] [Accepted: 11/08/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The life expectancy of pancreatic cancer patients remains minimal. The disease progression may be influenced by type 2 diabetes (T2D) and inflammatory status, although important gaps persist around their joint effects on disease outcome. The aim of this study was to investigate the clinical significance of the tumour immune microenvironment on pancreatic cancer prognosis in relation to T2D status. METHOD Tumour-infiltrating macrophages, neutrophils and eosinophils were studied in primary pancreatic tumours and paired lymph node metastases in relation to patient and tumour characteristics, T2D status and overall survival in a retrospective cohort of patients with resectable pancreatic cancer in Sweden. RESULTS Of the 80 included pancreatic cancer patients, 22 (27.2%) had T2D. The diabetic pancreatic cancer patients had significantly higher systemic high white blood cell count than those without diabetes (P = 0.028). Macrophage infiltration levels were higher in lymph node metastases compared with primary tumours (P = 0.040) among pancreatic cancer patients with diabetes. Type 2 diabetes or intra-tumoural leukocyte (macrophage, neutrophil or eosinophil) infiltration alone did not significantly influence pancreatic cancer prognosis. However, among cancer patients with T2D high macrophage or neutrophil tumour-infiltration was associated with a significant reduction in overall survival (adjusted hazard ratio [HR] 7.2; 95% CI 1.5-35.0 and HR 5.4; 95% CI 1.1-26.3, respectively). CONCLUSION These results demonstrate associations between T2D and enhanced inflammatory processes with significant implications on survival among pancreatic cancer patients with T2D. Validation in larger independent patient cohorts may identify additional prognostic tools and improved treatment strategies for specific patient subsets.
Collapse
Affiliation(s)
- Emelie Karnevi
- Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Surgery, Lund, Sweden; Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund, Sweden.
| | - Agata Sasor
- Skåne Regional Laboratories, Department of Pathology, Lund, Sweden
| | - Katarzyna Said Hilmersson
- Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Surgery, Lund, Sweden
| | - Daniel Ansari
- Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Surgery, Lund, Sweden
| | - Jonas S Erjefält
- Lund University, Department of Experimental Medical Sciences, Division of Respiratory Medicine and Allergology, Lund, Sweden
| | - Ann H Rosendahl
- Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund, Sweden
| | - Roland Andersson
- Lund University and Skåne University Hospital, Department of Clinical Sciences Lund, Division of Surgery, Lund, Sweden
| |
Collapse
|
25
|
Shikhagaie MM, Björklund ÅK, Mjösberg J, Erjefält JS, Cornelissen AS, Ros XR, Bal SM, Koning JJ, Mebius RE, Mori M, Bruchard M, Blom B, Spits H. Neuropilin-1 Is Expressed on Lymphoid Tissue Residing LTi-like Group 3 Innate Lymphoid Cells and Associated with Ectopic Lymphoid Aggregates. Cell Rep 2017; 18:1761-1773. [PMID: 28199847 PMCID: PMC5318658 DOI: 10.1016/j.celrep.2017.01.063] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/09/2016] [Accepted: 01/24/2017] [Indexed: 10/26/2022] Open
Abstract
Here, we characterize a subset of ILC3s that express Neuropilin1 (NRP1) and are present in lymphoid tissues, but not in the peripheral blood or skin. NRP1+ group 3 innate lymphoid cells (ILC3s) display in vitro lymphoid tissue inducer (LTi) activity. In agreement with this, NRP1+ ILC3s are mainly located in proximity to high endothelial venules (HEVs) and express cell surface molecules involved in lymphocyte migration in secondary lymphoid tissues via HEVs. NRP1 was also expressed on mouse fetal LTi cells, indicating that NRP1 is a conserved marker for LTi cells. Human NRP1+ ILC3s are primed cells because they express CD45RO and produce higher amounts of cytokines than NRP1- cells, which express CD45RA. The NRP1 ligand vascular endothelial growth factor A (VEGF-A) served as a chemotactic factor for NRP1+ ILC3s. NRP1+ ILC3s are present in lung tissues from smokers and patients with chronic obstructive pulmonary disease, suggesting a role in angiogenesis and/or the initiation of ectopic pulmonary lymphoid aggregates.
Collapse
Affiliation(s)
- Medya Mara Shikhagaie
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.
| | - Åsa K Björklund
- Department of Cell and Molecular Biology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jenny Mjösberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jonas S Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden
| | - Anne S Cornelissen
- Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, 1006 AN Amsterdam, the Netherlands
| | - Xavier Romero Ros
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Suzanne M Bal
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Jasper J Koning
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, 1081 HV Amsterdam, the Netherlands
| | - Reina E Mebius
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, 1081 HV Amsterdam, the Netherlands
| | - Michiko Mori
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, 221 84 Lund, Sweden
| | - Melanie Bruchard
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Bianca Blom
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Hergen Spits
- Department of Experimental Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.
| |
Collapse
|
26
|
Briend E, Ferguson GJ, Mori M, Damera G, Stephenson K, Karp NA, Sethi S, Ward CK, Sleeman MA, Erjefält JS, Finch DK. IL-18 associated with lung lymphoid aggregates drives IFNγ production in severe COPD. Respir Res 2017; 18:159. [PMID: 28830544 PMCID: PMC5568255 DOI: 10.1186/s12931-017-0641-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background Increased interferon gamma (IFNγ) release occurs in Chronic Obstructive Pulmonary Disease (COPD) lungs. IFNγ supports optimal viral clearance, but if dysregulated could increase lung tissue destruction. Methods The present study investigates which mediators most closely correlate with IFNγ in sputum in stable and exacerbating disease, and seeks to shed light on the spatial requirements for innate production of IFNγ, as reported in mouse lymph nodes, to observe whether such microenvironmental cellular organisation is relevant to IFNγ production in COPD lung. Results We show tertiary follicle formation in severe disease alters the dominant mechanistic drivers of IFNγ production, because cells producing interleukin-18, a key regulator of IFNγ, are highly associated with such structures. Interleukin-1 family cytokines correlated with IFNγ in COPD sputum. We observed that the primary source of IL-18 in COPD lungs was myeloid cells within lymphoid aggregates and IL-18 was increased in severe disease. IL-18 released from infected epithelium or from activated myeloid cells, was more dominant in driving IFNγ when IL-18-producing and responder cells were in close proximity. Conclusions Unlike tight regulation to control infection spread in lymphoid organs, this local interface between IL-18-expressing and responder cell is increasingly supported in lung as disease progresses, increasing its potential to increase tissue damage via IFNγ. Electronic supplementary material The online version of this article (doi:10.1186/s12931-017-0641-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Emmanuel Briend
- MedImmune Ltd, Granta Park, Cambridge, CB21 6GH, UK.,Present address: Agenus Ltd, Cambridge, UK
| | | | - Michiko Mori
- Department of Experimental Medical Science, BMC D12, Lund University, SE-221 84, Lund, Sweden
| | - Gautam Damera
- MedImmune LLC, 1 MedImmune Way, Gaithersburg, MD, USA
| | - Katherine Stephenson
- MedImmune Ltd, Granta Park, Cambridge, CB21 6GH, UK.,Present address: University of Nottingham, Nottingham, UK
| | - Natasha A Karp
- Quantitative Biology IMED, AstraZeneca R&D, Cambridge, UK
| | - Sanjay Sethi
- Department of Medicine, University at Buffalo, 3495 Bailey Avenue, Buffalo, NY, 14215, USA
| | - Christine K Ward
- MedImmune LLC, 1 MedImmune Way, Gaithersburg, MD, USA.,Present address: Bristol-Myers Squibb, Princeton, NJ, USA
| | - Matthew A Sleeman
- MedImmune Ltd, Granta Park, Cambridge, CB21 6GH, UK.,Present address: Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
| | - Jonas S Erjefält
- Department of Experimental Medical Science, BMC D12, Lund University, SE-221 84, Lund, Sweden.,Department of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden
| | - Donna K Finch
- MedImmune Ltd, Granta Park, Cambridge, CB21 6GH, UK.
| |
Collapse
|
27
|
Forkel M, Berglin L, Kekäläinen E, Carlsson A, Svedin E, Michaëlsson J, Nagasawa M, Erjefält JS, Mori M, Flodström-Tullberg M, Bergquist A, Ljunggren HG, Westgren M, Lindforss U, Friberg D, Jorns C, Ellis E, Björkström NK, Mjösberg J. Composition and functionality of the intrahepatic innate lymphoid cell-compartment in human nonfibrotic and fibrotic livers. Eur J Immunol 2017; 47:1280-1294. [PMID: 28613415 DOI: 10.1002/eji.201646890] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 05/08/2017] [Accepted: 06/07/2017] [Indexed: 12/31/2022]
Abstract
Human innate lymphoid cells have been described to exist in different organs, with functional deregulation of these cells contributing to several disease states. Here, we performed the first detailed characterization of the phenotype, tissue-residency properties, and functionality of ILC1s, ILC2s, and ILC3s in the human adult and fetal liver. In addition, we investigated changes in the ILC compartment in liver fibrosis. A unique composition of tissue-resident ILCs was observed in nonfibrotic livers as compared with that in mucosal tissues, with NKp44- ILC3s accounting for the majority of total intrahepatic ILCs. The frequency of ILC2s, representing a small fraction of ILCs in nonfibrotic livers, increased in liver fibrosis and correlated directly with the severity of the disease. Notably, intrahepatic ILC2s secreted the profibrotic cytokine IL-13 when exposed to IL-33 and thymic stromal lymphopoetin (TSLP); these cytokines were produced by hepatocytes, hepatic stellate cells (HSCs), and Kupffer cells in response to TLR-3 stimulation. In summary, the present results provide the first detailed characterization of intrahepatic ILCs in human adult and fetal liver. The results indicate a role for ILC2s in human liver fibrosis, implying that targeting ILC2s might be a novel therapeutic strategy for its treatment.
Collapse
Affiliation(s)
- Marianne Forkel
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Lena Berglin
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Eliisa Kekäläinen
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Adrian Carlsson
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Emma Svedin
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Jakob Michaëlsson
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Maho Nagasawa
- Department of Cell Biology and Histology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Jonas S Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Michiko Mori
- Unit of Airway Inflammation, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | | | - Annika Bergquist
- Department of Molecular Medicine and Surgery, Karolinska Institute and Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Hans-Gustaf Ljunggren
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Magnus Westgren
- Center for Fetal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Ulrik Lindforss
- Department of Molecular Medicine and Surgery, Karolinska Institute and Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Danielle Friberg
- Department of Otorhinolaryngology, CLINTEC, KI, Stockholm, Sweden
| | - Carl Jorns
- Division of Transplantation Surgery, CLINTEC, Karolinska Institutet (KI), Stockholm, Sweden
| | - Ewa Ellis
- Division of Transplantation Surgery, CLINTEC, Karolinska Institutet (KI), Stockholm, Sweden
| | - Niklas K Björkström
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden
| | - Jenny Mjösberg
- Center for Infectious Medicine, Department of Medicine, Karolinska Institute Stockholm, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Sweden
| |
Collapse
|
28
|
Sanden C, Mori M, Jogdand P, Jönsson J, Krishnan R, Wang X, Erjefält JS. Broad Th2 neutralization and anti-inflammatory action of pentosan polysulfate sodium in experimental allergic rhinitis. Immun Inflamm Dis 2017; 5:300-309. [PMID: 28497614 PMCID: PMC5569365 DOI: 10.1002/iid3.164] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/04/2017] [Accepted: 04/07/2017] [Indexed: 01/21/2023]
Abstract
Background Th2 cytokines like interleukin‐4, ‐5, and ‐13 are regarded as important drivers of the immunopathology underlying allergic rhinitis (AR) and asthma. The present study explores the capacity of pentosan polysulfate sodium (PPS), a semi‐synthetic heparin‐like macromolecular carbohydrate, to bind Th2 cytokines and exert biological neutralization in vitro, as well as anti‐inflammatory actions in vivo. Methodology The capacity of PPS to bind recombinant Th2 cytokines was tested with surface plasmon resonance (SPR) technology and biological Th2 neutralization was assessed by Th2‐dependent proliferation assays. The in vivo anti‐inflammatory action of PPS was studied using a validated Guinea‐pig model of AR. Results Binding studies revealed a strong and specific binding of PPS to IL‐4, IL‐5, and IL‐13 with IC values suggesting as stronger cytokine binding than for heparin. Cytokine binding translated to a biological neutralization as PPS dose dependently inhibited Th2‐dependent cell proliferation. Topical administration of PPS 30 min prior to nasal allergen challenge of sensitized animals significantly reduced late phase plasma extravasation, luminal influx of eosinophils, neutrophils, and total lavage leukocytes. Similar, albeit not statistically secured, effects were found for tissue leukocytes and mucus hyper‐secretion. The anti‐inflammatory effects of PPS compared favorably with established topical nasal steroid treatment. Conclusion This study points out PPS as a potent Th2 cytokine‐binding molecule with biological neutralization capacity and broad anti‐inflammatory effects in vivo. As such PPS fulfills the role as a potential candidate molecule for the treatment of AR and further studies of clinical efficacy seems highly warranted.
Collapse
Affiliation(s)
- Caroline Sanden
- Unit of Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund, Sweden.,Medetect AB, Lund, Sweden
| | - Michiko Mori
- Unit of Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Prajakta Jogdand
- Unit of Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Jimmie Jönsson
- Unit of Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund, Sweden.,Medetect AB, Lund, Sweden
| | - Ravi Krishnan
- Paradigm Biopharmaceuticals Ltd., Melbourne, Victoria, Australia
| | - Xiangdong Wang
- Zhongshan Hospital Institute of Clinical Science, Shanghai Institute of Clinical Bioinformatics, Shanghai, China
| | - Jonas S Erjefält
- Unit of Airway Inflammation, Department of Experimental Medical Science, Lund University, Lund, Sweden
| |
Collapse
|
29
|
Roos AB, Mori M, Gura HK, Lorentz A, Bjermer L, Hoffmann HJ, Erjefält JS, Stampfli MR. Increased IL-17RA and IL-17RC in End-Stage COPD and the Contribution to Mast Cell Secretion of FGF-2 and VEGF. Respir Res 2017; 18:48. [PMID: 28298222 PMCID: PMC5353957 DOI: 10.1186/s12931-017-0534-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/02/2017] [Indexed: 12/13/2022] Open
Abstract
Mast cells are accumulated in advanced chronic obstructive pulmonary disease (COPD), and interleukin (IL)-17 signaling plays a role in disease progression. The expression, localization and functional relevance of IL-17 receptor (R)A and IL-17RC was explored in COPD by immunodetection, and functional assays. IL-17RA and IL-17RC was increased in very severe COPD, and expressed by mast cells. Increased secretion of the pro-angiogenic basic fibroblast growth factor and vascular endothelial growth factor was observed in vitro-maintained mast cells stimulated with IL-17A. Expression of these mediators was confirmed in end-stage COPD. Thus, accumulation of mast cells in COPD may contribute to vascular remodeling.
Collapse
Affiliation(s)
- Abraham B Roos
- Department of Experimental Medical Science, Lund University, Lund, Sweden. .,Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada. .,AstraZeneca R&D Gothenburg, Respiratory, Inflammation and Autoimmunity, Innovative Medicines, Pepparedsleden 1, 431 83, Mölndal, Sweden.
| | - Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Harpreet K Gura
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Axel Lorentz
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Hans Jürgen Hoffmann
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jonas S Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Martin R Stampfli
- Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada.,Department of Medicine, Firestone Institute of Respiratory Health at St. Joseph's Health Care, Hamilton, ON, Canada
| |
Collapse
|
30
|
Sverrild A, Kiilerich P, Brejnrod A, Pedersen R, Porsbjerg C, Bergqvist A, Erjefält JS, Kristiansen K, Backer V. Eosinophilic airway inflammation in asthmatic patients is associated with an altered airway microbiome. J Allergy Clin Immunol 2016; 140:407-417.e11. [PMID: 28042058 DOI: 10.1016/j.jaci.2016.10.046] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Asthmatic patients have higher microbiome diversity and an altered composition, with more Proteobacteria and less Bacteroidetes compared with healthy control subjects. Studies comparing airway inflammation and the airway microbiome are sparse, especially in subjects not receiving anti-inflammatory treatment. OBJECTIVE We sought to describe the relationship between the airway microbiome and patterns of airway inflammation in steroid-free patients with asthma and healthy control subjects. METHODS Bronchoalveolar lavage fluid was collected from 23 steroid-free nonsmoking patients with asthma and 10 healthy control subjects. Bacterial DNA was extracted from and subjected to Illumina MiSeq sequencing of the 16S rDNA V4 region. Eosinophils and neutrophils in the submucosa were quantified by means of immunohistochemical identification and computerized image analysis. Induced sputum was obtained, and airway hyperresponsiveness to mannitol and fraction of exhaled nitric oxide values were measured. Relationships between airway microbial diversity and composition and inflammatory profiles were analyzed. RESULTS In asthmatic patients airway microbial composition was associated with airway eosinophilia and AHR to mannitol but not airway neutrophilia. The overall composition of the airway microbiome of asthmatic patients with the lowest levels of eosinophils but not asthmatic patients with the highest levels of eosinophils deviated significantly from that of healthy subjects. Asthmatic patients with the lowest levels of eosinophils had an altered bacterial abundance profile, with more Neisseria, Bacteroides, and Rothia species and less Sphingomonas, Halomonas, and Aeribacillus species compared with asthmatic patients with more eosinophils and healthy control subjects. CONCLUSION The level of eosinophilic airway inflammation correlates with variations in the microbiome across asthmatic patients, whereas neutrophilic airway inflammation does not. This warrants further investigation on molecular pathways involved in both patients with eosinophilic and those with noneosinophilic asthma.
Collapse
Affiliation(s)
| | - Pia Kiilerich
- Department of Biology, University of Copenhagen, Denmark
| | - Asker Brejnrod
- Department of Biology, University of Copenhagen, Denmark
| | | | | | - Anders Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science, Lund University, Lund, Sweden
| | - Jonas S Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science, Lund University, Lund, Sweden
| | | | | |
Collapse
|
31
|
Mori M, Jogdand P, Sanden C, Jönsson J, Krishnan R, Wang X, Erjefält JS. ASCIA-P33: TH2 NEUTRALIZATION AND IN VIVO ANTI-INFLAMMATORY ACTION OF PENTOSAN POLYSUPHATE SODIUM (PPS) IN AN ALLERGIC RHINITIS MODEL. Intern Med J 2016. [DOI: 10.1111/imj.33_13197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Science; Lund University; Lund Sweden
| | - Prajakta Jogdand
- Department of Experimental Medical Science; Lund University; Lund Sweden
| | - Caroline Sanden
- Department of Experimental Medical Science; Lund University; Lund Sweden
| | - Jimmie Jönsson
- Department of Experimental Medical Science; Lund University; Lund Sweden
| | - Ravi Krishnan
- Paradigm BioPharmaceutical Ltd; Melbourne Victoria Australia
| | - Xiangdong Wang
- Department of Respiratory Medicine; Fudan University; Shanghai China
| | - Jonas S Erjefält
- Department of Experimental Medical Science; Lund University; Lund Sweden
| |
Collapse
|
32
|
Pretolani M, Bergqvist A, Thabut G, Dombret MC, Knapp D, Hamidi F, Alavoine L, Taillé C, Chanez P, Erjefält JS, Aubier M. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlations. J Allergy Clin Immunol 2016; 139:1176-1185. [PMID: 27609656 DOI: 10.1016/j.jaci.2016.08.009] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 07/08/2016] [Accepted: 08/08/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma, yet its effect on different bronchial structures remains unknown. OBJECTIVE We sought to examine the effect of BT on bronchial structures and to explore the association with clinical outcome in patients with severe refractory asthma. METHODS Bronchial biopsy specimens (n = 300) were collected from 15 patients with severe uncontrolled asthma before and 3 months after BT. Immunostained sections were assessed for airway smooth muscle (ASM) area, subepithelial basement membrane thickness, nerve fibers, and epithelial neuroendocrine cells. Histopathologic findings were correlated with clinical parameters. RESULTS BT significantly improved asthma control and quality of life at both 3 and 12 months and decreased the numbers of severe exacerbations and the dose of oral corticosteroids. At 3 months, this clinical benefit was accompanied by a reduction in ASM area (median values before and after BT, respectively: 19.7% [25th-75th interquartile range (IQR), 15.9% to 22.4%] and 5.3% [25th-75th IQR], 3.5% to 10.1%, P < .001), subepithelial basement membrane thickening (4.4 μm [25th-75th IQR, 4.0-4.7 μm] and 3.9 μm [25th-75th IQR, 3.7-4.6 μm], P = 0.02), submucosal nerves (1.0 ‰ [25th-75th IQR, 0.7-1.3 ‰] immunoreactivity and 0.3 ‰ [25th-75th IQR, 0.1-0.5 ‰] immunoreactivity, P < .001), ASM-associated nerves (452.6 [25th-75th IQR, 196.0-811.2] immunoreactive pixels per mm2 and 62.7 [25th-75th IQR, 0.0-230.3] immunoreactive pixels per mm2, P = .02), and epithelial neuroendocrine cells (4.9/mm2 [25th-75th IQR, 0-16.4/mm2] and 0.0/mm2 [25th-75th IQR, 0-0/mm2], P = .02). Histopathologic parameters were associated based on Asthma Control Test scores, numbers of exacerbations, and visits to the emergency department (all P ≤ .02) 3 and 12 months after BT. CONCLUSION BT is a treatment option in patients with severe therapy-refractory asthma that downregulates selectively structural abnormalities involved in airway narrowing and bronchial reactivity, particularly ASM, neuroendocrine epithelial cells, and bronchial nerve endings.
Collapse
Affiliation(s)
- Marina Pretolani
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France
| | | | - Gabriel Thabut
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Unit of Airway Inflammation, Lund University, Lund, Sweden; Department of Pneumology B, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Marie-Christine Dombret
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Dominique Knapp
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Fatima Hamidi
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France
| | - Loubna Alavoine
- Clinical Investigation Center, Bichat-Claude Bernard University Hospital, Paris, France
| | - Camille Taillé
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Pascal Chanez
- Inserm U1067 and CNRS UMR7733, Department of Respiratory Diseases, APHM Aix-Marseille University, Marseille, France
| | | | - Michel Aubier
- Inserm UMR1152, Physiopathology and Epidemiology of Respiratory Diseases, Paris, France; Paris Diderot University, Faculty of Medicine, Bichat campus, Paris, France; Laboratory of Excellence, INFLAMEX, Université Sorbonne Paris Cité, and DHU FIRE, Paris, France; Department of Pneumology A, Bichat-Claude Bernard University Hospital, Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France.
| |
Collapse
|
33
|
Mori M, Dictor M, Brodszki N, López-Gutiérrez JC, Beato M, Erjefält JS, Eklund EA. Pulmonary and pleural lymphatic endothelial cells from pediatric, but not adult, patients with Gorham-Stout disease and generalized lymphatic anomaly, show a high proliferation rate. Orphanet J Rare Dis 2016; 11:67. [PMID: 27194137 PMCID: PMC4870727 DOI: 10.1186/s13023-016-0449-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/10/2016] [Indexed: 11/12/2022] Open
Abstract
Background Gorham-Stout disease (OMIM 123880) and generalized lymphatic anomaly are two rare disorders of lymphendothelial growth in which thoracic involvement with chylothorax is a feared complication. Currently it is believed that both disorders are prenatal malformations that progress slowly after birth. Several pharmaceuticals with antiproliferative properties, including interferon-α-2b, rapamycin and propranolol, have however been shown to affect the disease course in some patients. Deeper knowledge of the growth characteristics of these malformations are therefore needed to guide the clinical approach. Methods Lymphatic vessels in lung and pleural tissue from both children and adult patients with generalized lymphatic anomaly or Gorham-Stout disease were studied using an immunohistochemical approach, targeting lymphendothelial markers (D2-40/Prox-1) and a proliferation marker (Ki-67). Results We found significant proliferation and growth in these lesions in pediatric patients but not in adults. Furthermore, the data may suggest that the disease process is at least partly reversible. Conclusions These malformations of the lymphatic system proliferate at a significant rate long after birth, which could suggest that the clinical approach for children should be different from adults. Electronic supplementary material The online version of this article (doi:10.1186/s13023-016-0449-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Sciences, Unit of Airway Inflammation, Lund University, Lund, Sweden
| | - Michael Dictor
- Department of Clinical Sciences, Section for Pathology, Lund University, Lund, Sweden
| | - Nicholas Brodszki
- Department of Clinical Sciences, Section for Pediatrics, Lund University, Lund, Sweden
| | | | - María Beato
- Department of Pathology, La Paz Children's Hospital, Madrid, Spain
| | - Jonas S Erjefält
- Department of Experimental Medical Sciences, Unit of Airway Inflammation, Lund University, Lund, Sweden
| | - Erik A Eklund
- Department of Clinical Sciences, Section for Pediatrics, Lund University, Lund, Sweden.
| |
Collapse
|
34
|
Bal SM, Bernink JH, Nagasawa M, Groot J, Shikhagaie MM, Golebski K, van Drunen CM, Lutter R, Jonkers RE, Hombrink P, Bruchard M, Villaudy J, Munneke JM, Fokkens W, Erjefält JS, Spits H, Ros XR. IL-1β, IL-4 and IL-12 control the fate of group 2 innate lymphoid cells in human airway inflammation in the lungs. Nat Immunol 2016; 17:636-45. [DOI: 10.1038/ni.3444] [Citation(s) in RCA: 308] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 03/22/2016] [Indexed: 12/14/2022]
|
35
|
Gela A, Bhongir RKV, Mori M, Keenan P, Mörgelin M, Erjefält JS, Herwald H, Egesten A, Kasetty G. Osteopontin That Is Elevated in the Airways during COPD Impairs the Antibacterial Activity of Common Innate Antibiotics. PLoS One 2016; 11:e0146192. [PMID: 26731746 PMCID: PMC4712133 DOI: 10.1371/journal.pone.0146192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 12/14/2015] [Indexed: 11/18/2022] Open
Abstract
Bacterial infections of the respiratory tract contribute to exacerbations and disease progression in chronic obstructive pulmonary disease (COPD). There is also an increased risk of invasive pneumococcal disease in COPD. The underlying mechanisms are not fully understood but include impaired mucociliary clearance and structural remodeling of the airways. In addition, antimicrobial proteins that are constitutively expressed or induced during inflammatory conditions are an important part of the airway innate host defense. In the present study, we show that osteopontin (OPN), a multifunctional glycoprotein that is highly upregulated in the airways of COPD patients co-localizes with several antimicrobial proteins expressed in the airways. In vitro, OPN bound lactoferrin, secretory leukocyte peptidase inhibitor (SLPI), midkine, human beta defensin-3 (hBD-3), and thymic stromal lymphopoietin (TSLP) but showed low or no affinity for lysozyme and LL-37. Binding of OPN impaired the antibacterial activity against the important bacterial pathogens Streptococcus pneumoniae and Pseudomonas aeruginosa. Interestingly, OPN reduced lysozyme-induced killing of S. pneumoniae, a finding that could be explained by binding of OPN to the bacterial surface, thereby shielding the bacteria. A fragment of OPN generated by elastase of P. aeruginosa retained some inhibitory effect. Some antimicrobial proteins have additional functions. However, the muramidase-activity of lysozyme and the protease inhibitory function of SLPI were not affected by OPN. Taken together, OPN can contribute to the impairment of innate host defense by interfering with the function of antimicrobial proteins, thus increasing the vulnerability to acquire infections during COPD.
Collapse
Affiliation(s)
- Anele Gela
- Respiratory Medicine & Allergology, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Ravi K. V. Bhongir
- Respiratory Medicine & Allergology, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Michiko Mori
- Airway Inflammation Unit, Department of Experimental Medical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - Paul Keenan
- Respiratory Medicine & Allergology, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Matthias Mörgelin
- Infection Medicine, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Jonas S. Erjefält
- Airway Inflammation Unit, Department of Experimental Medical Sciences, Lund University, SE-221 84, Lund, Sweden
| | - Heiko Herwald
- Infection Medicine, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Arne Egesten
- Respiratory Medicine & Allergology, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
| | - Gopinath Kasetty
- Respiratory Medicine & Allergology, Department of Clinical Sciences Lund, Lund University, SE-221 84, Lund, Sweden
- * E-mail:
| |
Collapse
|
36
|
Roos AB, Sethi S, Nikota J, Wrona CT, Dorrington MG, Sandén C, Bauer CMT, Shen P, Bowdish D, Stevenson CS, Erjefält JS, Stampfli MR. IL-17A and the Promotion of Neutrophilia in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2015; 192:428-37. [PMID: 26039632 DOI: 10.1164/rccm.201409-1689oc] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Nontypeable Haemophilus influenzae (NTHi) causes acute exacerbation of chronic obstructive pulmonary disease (AECOPD). IL-17A is central for neutrophilic inflammation and has been linked to COPD pathogenesis. OBJECTIVES We investigated whether IL-17A is elevated in NTHi-associated AECOPD and required for NTHi-exacerbated pulmonary neutrophilia induced by cigarette smoke. METHODS Experimental studies with cigarette smoke and NTHi infection were pursued in gene-targeted mice and using antibody intervention. IL-17A was measured in sputum collected from patients with COPD at baseline, during, and after AECOPD. MEASUREMENTS AND MAIN RESULTS Exacerbated airway neutrophilia in cigarette smoke-exposed mice infected with NTHi was associated with an induction of IL-17A. In agreement, elevated IL-17A was observed in sputum collected during NTHi-associated AECOPD, compared with samples collected before or after the event. NTHi-exacerbated neutrophilia and induction of neutrophil chemoattractants over the background of cigarette smoke, as observed in wild-type mice, was absent in Il17a(-/-) mice and in mice treated with a neutralizing anti-IL-17A antibody. Further studies revealed that IL-1 receptor (R)1 signaling was required for IL-17A-dependent neutrophilia. Moreover, deficiency or therapeutic neutralization of IL-17A did not increase bacterial burden or delay bacterial clearance. CONCLUSIONS IL-17A is induced during NTHi-associated AECOPD. Functionally, IL-1R1-dependent IL-17A is required for NTHi-exacerbated pulmonary neutrophilia induced by cigarette smoke. Targeting IL-17A in AECOPD may thus be beneficial to reduce neutrophil recruitment to the airways.
Collapse
Affiliation(s)
- Abraham B Roos
- 1 Department of Experimental Medical Science, Lund University, Lund, Sweden.,2 Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre
| | - Sanjay Sethi
- 3 Pulmonary Medicine Division, Department of Veterans Affairs Western New York Healthcare System, University at Buffalo, State University of New York, Buffalo, New York; and
| | | | - Catherine T Wrona
- 3 Pulmonary Medicine Division, Department of Veterans Affairs Western New York Healthcare System, University at Buffalo, State University of New York, Buffalo, New York; and
| | | | - Caroline Sandén
- 1 Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Carla M T Bauer
- 5 Hoffmann-La Roche, pRED, Pharma Research and Early Development, DTA Inflammation, Nutley, New Jersey
| | - Pamela Shen
- 3 Pulmonary Medicine Division, Department of Veterans Affairs Western New York Healthcare System, University at Buffalo, State University of New York, Buffalo, New York; and
| | - Dawn Bowdish
- 2 Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre
| | - Christopher S Stevenson
- 5 Hoffmann-La Roche, pRED, Pharma Research and Early Development, DTA Inflammation, Nutley, New Jersey
| | - Jonas S Erjefält
- 1 Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Martin R Stampfli
- 2 Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre.,6 Department of Medicine, Firestone Institute of Respiratory Health at St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
37
|
Mori M, Bjermer L, Erjefält JS, Stampfli MR, Roos AB. Small airway epithelial-C/EBPβ is increased in patients with advanced COPD. Respir Res 2015; 16:133. [PMID: 26511475 PMCID: PMC4625456 DOI: 10.1186/s12931-015-0297-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/22/2015] [Indexed: 12/30/2022] Open
Abstract
The expression of CCAAT/enhancer-binding protein (C/EBP)β in the small airway epithelium of COPD is unknown. C/EBPβ was assessed in peripheral lung tissue of non-smoking/smoking controls and patients with GOLD I-IV COPD by quantitative immunohistochemistry. The expression of C/EBPβ was decreased in smokers compared to never smokers. Furthermore, C/EBPβ was significantly elevated in advanced COPD vs. asymptomatic smokers, and the expression correlated to lung function decline. As C/EBPβ exerts pro-inflammatory effects in the context of cigarette smoke, the elevated C/EBPβ in advanced COPD may be an indication of a breakdown of regulatory mechanisms and excessive inflammation.
Collapse
Affiliation(s)
- Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
| | - Jonas S Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden. .,Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
| | - Martin R Stampfli
- Department of Pathology and Molecular Medicine, McMaster University, MDCL 4084, 1280 Main Street West, Hamilton, ON, L8S 4P1, Canada. .,Department of Medicine, Firestone Institute of Respiratory Health at St. Joseph's Health Care, Hamilton, ON, Canada.
| | - Abraham B Roos
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden. .,Department of Pathology and Molecular Medicine, McMaster University, MDCL 4084, 1280 Main Street West, Hamilton, ON, L8S 4P1, Canada.
| |
Collapse
|
38
|
Jovic S, Shikhagaie M, Mörgelin M, Erjefält JS, Kjellström S, Egesten A. Osteopontin is increased in cystic fibrosis and can skew the functional balance between ELR-positive and ELR-negative CXC-chemokines. J Cyst Fibros 2015; 14:453-63. [DOI: 10.1016/j.jcf.2014.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 12/13/2022]
|
39
|
Roos AB, Sandén C, Mori M, Bjermer L, Stampfli MR, Erjefält JS. IL-17A Is Elevated in End-Stage Chronic Obstructive Pulmonary Disease and Contributes to Cigarette Smoke–induced Lymphoid Neogenesis. Am J Respir Crit Care Med 2015; 191:1232-41. [DOI: 10.1164/rccm.201410-1861oc] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
40
|
Abstract
By virtue of their undisputed role in allergy, the study of airway mast cells has focused on nasal and bronchial mast cells and their involvement in allergic rhinitis and asthma. However, recent mechanistic and human studies suggest that peripheral mast cells also have an important role in asthma, as well as chronic obstructive pulmonary disease, respiratory infections and lung fibrosis. Pathogenic roles include immune-modulatory, pro-inflammatory and pro-fibrotic activities. Importantly, mast cells also actively downregulate inflammation and participate in the defence against respiratory infections. Another complicating factor is the notorious mast cell heterogeneity, where each anatomical compartment of the lung harbours site-specific mast cell populations. Alveolar mast cells stand out as they lack the cardinal expression of the high affinity IgE receptor. Supporting the emerging concept of alveolar inflammation in asthma, alveolar mast cells shift to a highly FcϵRI-expressing phenotype in uncontrolled asthma. Site-specific and disease-associated mast cell changes have also recently been described in most other inflammatory conditions of the lung. Thus, in the exploration of new anti-mast cell treatment strategies the search has widened to include the lung periphery and the delicate task of identifying which of the countless potential roles are the critical disease modifying ones in a given clinical situation.
Collapse
Affiliation(s)
- Jonas S Erjefält
- Experimental Medical Science, Unit of Airway Inflammation, Lund University, Lund, Sweden
| |
Collapse
|
41
|
Holmkvist P, Roepstorff K, Uronen-Hansson H, Sandén C, Gudjonsson S, Patschan O, Grip O, Marsal J, Schmidtchen A, Hornum L, Erjefält JS, Håkansson K, Agace WW. A major population of mucosal memory CD4+ T cells, coexpressing IL-18Rα and DR3, display innate lymphocyte functionality. Mucosal Immunol 2015; 8:545-58. [PMID: 25269704 PMCID: PMC4424383 DOI: 10.1038/mi.2014.87] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/18/2014] [Indexed: 02/04/2023]
Abstract
Mucosal tissues contain large numbers of memory CD4(+) T cells that, through T-cell receptor-dependent interactions with antigen-presenting cells, are believed to have a key role in barrier defense and maintenance of tissue integrity. Here we identify a major subset of memory CD4(+) T cells at barrier surfaces that coexpress interleukin-18 receptor alpha (IL-18Rα) and death receptor-3 (DR3), and display innate lymphocyte functionality. The cytokines IL-15 or the DR3 ligand tumor necrosis factor (TNF)-like cytokine 1A (TL1a) induced memory IL-18Rα(+)DR3(+)CD4(+) T cells to produce interferon-γ, TNF-α, IL-6, IL-5, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), and IL-22 in the presence of IL-12/IL-18. TL1a synergized with IL-15 to enhance this response, while suppressing IL-15-induced IL-10 production. TL1a- and IL-15-mediated cytokine induction required the presence of IL-18, whereas induction of IL-5, IL-13, GM-CSF, and IL-22 was IL-12 independent. IL-18Rα(+)DR3(+)CD4(+) T cells with similar functionality were present in human skin, nasal polyps, and, in particular, the intestine, where in chronic inflammation they localized with IL-18-producing cells in lymphoid aggregates. Collectively, these results suggest that human memory IL-18Rα(+)DR3(+) CD4(+) T cells may contribute to antigen-independent innate responses at barrier surfaces.
Collapse
Affiliation(s)
- P Holmkvist
- Immunology Section, Lund University, Lund, Sweden
- Biopharmaceuticals Research Unit, Novo Nordisk A/S, Måløv, Denmark
| | - K Roepstorff
- Biopharmaceuticals Research Unit, Novo Nordisk A/S, Måløv, Denmark
| | | | - C Sandén
- Unit of Airway Inflammation and Immunology, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - S Gudjonsson
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - O Patschan
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - O Grip
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - J Marsal
- Department of Gastroenterology, Skåne University Hospital, Lund, Sweden
| | - A Schmidtchen
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
- LKC Medicine, Nanyang Technological University, Singapore, Singapore
| | - L Hornum
- Biopharmaceuticals Research Unit, Novo Nordisk A/S, Måløv, Denmark
| | - J S Erjefält
- Unit of Airway Inflammation and Immunology, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - K Håkansson
- Biopharmaceuticals Research Unit, Novo Nordisk A/S, Måløv, Denmark
| | - W W Agace
- Immunology Section, Lund University, Lund, Sweden
- Section of Immunology and Vaccinology, National Veterinary Institute, Technical University of Denmark, Frederiksberg, Denmark
| |
Collapse
|
42
|
Chu DK, Jimenez-Saiz R, Verschoor CP, Walker TD, Goncharova S, Llop-Guevara A, Shen P, Gordon ME, Barra NG, Bassett JD, Kong J, Fattouh R, McCoy KD, Bowdish DM, Erjefält JS, Pabst O, Humbles AA, Kolbeck R, Waserman S, Jordana M. Indigenous enteric eosinophils control DCs to initiate a primary Th2 immune response in vivo. ACTA ACUST UNITED AC 2014; 211:1657-72. [PMID: 25071163 PMCID: PMC4113937 DOI: 10.1084/jem.20131800] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Eosinophils natively inhabit the small intestine, but a functional role for them there has remained elusive. Here, we show that eosinophil-deficient mice were protected from induction of Th2-mediated peanut food allergy and anaphylaxis, and Th2 priming was restored by reconstitution with il4(+/+) or il4(-/-) eosinophils. Eosinophils controlled CD103(+) dendritic cell (DC) activation and migration from the intestine to draining lymph nodes, events necessary for Th2 priming. Eosinophil activation in vitro and in vivo led to degranulation of eosinophil peroxidase, a granule protein whose enzymatic activity promoted DC activation in mice and humans in vitro, and intestinal and extraintestinal mouse DC activation and mobilization to lymph nodes in vivo. Further, eosinophil peroxidase enhanced responses to ovalbumin seen after immunization. Thus, eosinophils can be critical contributors to the intestinal immune system, and granule-mediated shaping of DC responses can promote both intestinal and extraintestinal adaptive immunity.
Collapse
Affiliation(s)
- Derek K Chu
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Rodrigo Jimenez-Saiz
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Christopher P Verschoor
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Tina D Walker
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Susanna Goncharova
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Alba Llop-Guevara
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Pamela Shen
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Melissa E Gordon
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Nicole G Barra
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Jennifer D Bassett
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Joshua Kong
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Ramzi Fattouh
- Clinical Microbiology, Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario M5S 1A8, Canada
| | - Kathy D McCoy
- Maurice Müller Laboratories, Universitätsklinik für Viszerale Chirurgie und Medizin (UVCM), University of Bern, 3008 Bern, Switzerland
| | - Dawn M Bowdish
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Jonas S Erjefält
- Department of Experimental Medical Science, Lund University, SE-22184 Lund, Sweden Department of Respiratory Medicine and Allergology, Lund University Hospital, SE-22185 Lund, Sweden
| | - Oliver Pabst
- Institute of Molecular Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Alison A Humbles
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune LLC, Gaithersburg, MA 20878
| | - Roland Kolbeck
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune LLC, Gaithersburg, MA 20878
| | - Susan Waserman
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Manel Jordana
- McMaster Immunology Research Centre (MIRC), Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| |
Collapse
|
43
|
Shikhagaie MM, Andersson CK, Mori M, Kortekaas Krohn I, Bergqvist A, Dahl R, Ekblad E, Hoffmann HJ, Bjermer L, Erjefält JS. Mapping of TLR5 and TLR7 in central and distal human airways and identification of reduced TLR expression in severe asthma. Clin Exp Allergy 2014; 44:184-96. [PMID: 24447081 DOI: 10.1111/cea.12176] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 06/30/2013] [Accepted: 07/02/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND The toll-like receptors, TLR5 and TLR7, have recently been proposed in asthma immunopathogenesis. While supporting data come from animal or in vitro studies, little is known about TLR5 and TLR7 expression in human asthmatic airways. METHODS Advanced immunohistochemical mapping of TLR5 and TLR7 was performed on bronchial and transbronchial biopsies from healthy individuals and patients with moderate and severe asthma. RESULTS TLR5 was identified in multiple structural cells; bronchial epithelium, alveolar type II pneumocytes, plasma cells, macrophages and neutrophils. Contrary to bronchial TLR5, which had a basolateral expression, alveolar TLR5 had polarized apical localization. Patients with severe asthma had decreased total and epithelial TLR5 expression compared to controls and moderate asthmatics (P < 0.001). TLR7 expression was found in several structural cells and asthma-related immune cells. Whereas TLR7 expression was decreased in severe asthmatics (P < 0.001), nerve-associated TLR7 increased (P = 0.035). Within the asthma groups, both TLR5 and TLR7 expression correlated with multiple lung function parameters. CONCLUSIONS Our results reveal broad expression patterns of TLR5 and TLR7 in the lung and that the expression is decreased in severe asthma. Hence, severe asthmatics may suffer from insufficient TLR signalling during viral or bacterial infections leading to poor and impaired defence mechanisms.
Collapse
Affiliation(s)
- M M Shikhagaie
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Skogvall S, Erjefält JS, Olin AI, Ankerst J, Bjermer L. Oral iodinated activated charcoal improves lung function in patients with COPD. Respir Med 2014; 108:905-9. [PMID: 24742364 DOI: 10.1016/j.rmed.2014.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 12/01/2022]
Abstract
The effect of 8 weeks treatment with oral iodinated activated charcoal (IAC) on lung function of patients with moderate chronic obstructive pulmonary disease (COPD) was examined in a double blind randomized placebo controlled parallel group study with 40 patients. In the IAC group, patients showed a statistically significant improvement of FEV1 baseline by 130 ml compared to placebo, corresponding to 8.2% improvement (p = 0.031*). Correlation statistics revealed that the improvement of FEV1 baseline was significantly correlated both to FEV1 post-bronchodilator (p = 0.0020**) and FEV1 post-exercise (0.033*) values. This demonstrates that the improved baseline lung function by IAC did not inhibit a further beta2-adrenoceptor relaxation, and thus that patients did not reach a limit for maximal improvement of the lung function after IAC treatment. Eight patients in the IAC group developed abnormal thyroid hormone levels transiently during the treatment. This side effect was not correlated to improvement of lung function (p = 0.82). No serious adverse effects directly related to the treatment were recorded. In summary, this study demonstrates that iodinated activated charcoal surprisingly and significantly improved lung function of patients with moderate COPD. The underlying mechanism of action is unclear, but is likely to be different from the drugs used today. The immediate conclusion is that further studies are now justified in order to determine clinical efficacy of IAC in COPD and explore possible mechanisms of action.
Collapse
Affiliation(s)
| | - Jonas S Erjefält
- Dept of Exp Med Science, Lund University, Sweden; Dept of Allergology and Respiratory Medicine, Lund University, Sweden
| | - Anders I Olin
- Dept of Allergology and Respiratory Medicine, Lund University, Sweden
| | - Jaro Ankerst
- Dept of Allergology and Respiratory Medicine, Lund University, Sweden
| | - Leif Bjermer
- Dept of Allergology and Respiratory Medicine, Lund University, Sweden
| |
Collapse
|
45
|
Roos AB, Mori M, Grönneberg R, Österlund C, Claesson HE, Wahlström J, Grunewald J, Eklund A, Erjefält JS, Lundberg JO, Nord M. Elevated exhaled nitric oxide in allergen-provoked asthma is associated with airway epithelial iNOS. PLoS One 2014; 9:e90018. [PMID: 24587191 PMCID: PMC3938593 DOI: 10.1371/journal.pone.0090018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 12/03/2013] [Indexed: 01/01/2023] Open
Abstract
Background Fractional exhaled nitric oxide is elevated in allergen-provoked asthma. The cellular and molecular source of the elevated fractional exhaled nitric oxide is, however, uncertain. Objective To investigate whether fractional exhaled nitric oxide is associated with increased airway epithelial inducible nitric oxide synthase (iNOS) in allergen-provoked asthma. Methods Fractional exhaled nitric oxide was measured in healthy controls (n = 14) and allergic asthmatics (n = 12), before and after bronchial provocation to birch pollen out of season. Bronchoscopy was performed before and 24 hours after allergen provocation. Bronchial biopsies and brush biopsies were processed for nitric oxide synthase activity staining with nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d), iNOS immunostaining, or gene expression analysis of iNOS by real-time PCR. NADPH-d and iNOS staining were quantified using automated morphometric analysis. Results Fractional exhaled nitric oxide and expression of iNOS mRNA were significantly higher in un-provoked asthmatics, compared to healthy controls. Allergic asthmatics exhibited a significant elevation of fractional exhaled nitric oxide after allergen provocation, as well as an accumulation of airway eosinophils. Moreover, nitric oxide synthase activity and expression of iNOS was significantly increased in the bronchial epithelium of asthmatics following allergen provocation. Fractional exhaled nitric oxide correlated with eosinophils and iNOS expression. Conclusion Higher fractional exhaled nitric oxide concentration among asthmatics is associated with elevated iNOS mRNA in the bronchial epithelium. Furthermore, our data demonstrates for the first time increased expression and activity of iNOS in the bronchial epithelium after allergen provocation, and thus provide a mechanistic explanation for elevated fractional exhaled nitric oxide in allergen-provoked asthma.
Collapse
Affiliation(s)
- Abraham B. Roos
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- * E-mail:
| | - Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Reidar Grönneberg
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Christina Österlund
- Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Erik Claesson
- Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden
| | - Jan Wahlström
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Johan Grunewald
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Anders Eklund
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Jonas S. Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Jon O. Lundberg
- Department of Physiology and Pharmacology, Section of Pharmacological Nitric Oxide Research, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Nord
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
- Safety Science, Global Regulatory Affairs & Patient Safety, AstraZeneca Global Medicines Development, Mölndal, Sweden
| |
Collapse
|
46
|
Bergqvist A, Andersson CK, Hoffmann HJ, Mori M, Shikhagaie M, Krohn IK, Dahl R, Bjermer L, Erjefält JS. Marked epithelial cell pathology and leukocyte paucity in persistently symptomatic severe asthma. Am J Respir Crit Care Med 2014; 188:1475-7. [PMID: 24328780 DOI: 10.1164/rccm.201308-1444le] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
47
|
Krohn IK, Sverrild A, Lund G, Dahl R, Erjefält JS, Backer V, Hoffmann HJ. Cultured mast cells from patients with asthma and controls respond with similar sensitivity to recombinant Der p2-induced, IgE-mediated activation. Scand J Immunol 2013; 78:352-6. [PMID: 23790102 DOI: 10.1111/sji.12085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 06/14/2013] [Indexed: 12/01/2022]
Abstract
The function of cultured mast cells may depend on genetic or environmental influence on the stem cell donor. This study investigates whether asthma or atopy in the donor influenced the growth and sensitivity of mast cells cultured from patients with asthma and healthy controls under identical conditions. Mast cells were cultured from peripheral blood from twelve patients with an objectively confirmed asthma diagnosis and eight healthy subjects. During the last 2 weeks of culture, mast cells were incubated with IL-4 and 80 kU/l recombinant human IgE containing two clones (7% + 7%) specific for mite allergen Der p2. The sensitivity of IgE-mediated activation of mast cells was investigated as FcεRI-mediated upregulation of CD63. Ten subjects were atopic, defined as a positive skin prick test (>3 mm) to at least one of ten common allergens. After activation with recombinant Der p2, the maximum CD63 median fluorescence intensity was 20 456 ± 1640 (SE) for patients with asthma and 22,275 ± 1971 (SE) for controls (ns). The fraction of CD63 positive cells was 54.4% in patients with asthma and 48.4% in controls (ns). The allergen concentration inducing 50% of the maximal CD63 response was similar in patients with asthma [-0.4795 log ng/ml ± 0.092 (SE)] and controls (-0.6351 log ng/ml ± 0.083, ns) and in atopic and non-atopic subjects. When cultured, sensitized and activated under identical conditions, mast cells from allergic asthmatics and healthy controls respond similar. Activation of cultured mast cells appears to depend on culture conditions (IL-4, IgE) rather than on donor status as atopy and asthma.
Collapse
Affiliation(s)
- I K Krohn
- Department of Pulmonary Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | | | | | | |
Collapse
|
48
|
Mori M, Andersson CK, Graham GJ, Löfdahl CG, Erjefält JS. Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD. Respir Res 2013; 14:65. [PMID: 23758732 PMCID: PMC3728038 DOI: 10.1186/1465-9921-14-65] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 06/05/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND De novo lymphatic vessel formation has recently been observed in lungs of patients with moderate chronic obstructive pulmonary disease (COPD). However, the distribution of lymphatic vessel changes among the anatomical compartments of diseased lungs is unknown. Furthermore, information regarding the nature of lymphatic vessel alterations across different stages of COPD is missing. This study performs a detailed morphometric characterization of lymphatic vessels in major peripheral lung compartments of patients with different severities of COPD and investigates the lymphatic expression of molecules involved in immune cell trafficking. METHODS Peripheral lung resection samples obtained from patients with mild (GOLD stage I), moderate-severe (GOLD stage II-III), and very severe (GOLD stage IV) COPD were investigated for podoplanin-immunopositive lymphatic vessels in distinct peripheral lung compartments: bronchioles, pulmonary blood vessels and alveolar walls. Control subjects with normal lung function were divided into never smokers and smokers. Lymphatics were analysed by multiple morphological parameters, as well as for their expression of CCL21 and the chemokine scavenger receptor D6. RESULTS The number of lymphatics increased by 133% in the alveolar parenchyma in patients with advanced COPD compared with never-smoking controls (p < 0.05). In patchy fibrotic lesions the number of alveolar lymphatics increased 20-fold from non-fibrotic parenchyma in the same COPD patients. The absolute number of lymphatics per bronchiole and artery was increased in advanced COPD, but numbers were not different after normalization to tissue area. Increased numbers of CCL21- and D6-positive lymphatics were observed in the alveolar parenchyma in advanced COPD compared with controls (p < 0.01). Lymphatic vessels also displayed increased mean levels of immunoreactivity for CCL21 in the wall of bronchioles (p < 0.01) and bronchiole-associated arteries (p < 0.05), as well as the alveolar parenchyma (p < 0.001) in patients with advanced COPD compared with never-smoking controls. A similar increase in lymphatic D6 immunoreactivity was observed in bronchioles (p < 0.05) and alveolar parenchyma (p < 0.01). CONCLUSIONS This study shows that severe stages of COPD is associated with increased numbers of alveolar lymphatic vessels and a change in lymphatic vessel phenotype in major peripheral lung compartments. This novel histopathological feature is suggested to have important implications for distal lung immune cell traffic in advanced COPD.
Collapse
Affiliation(s)
- Michiko Mori
- Unit of Airway Inflammation and Immunology, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Cecilia K Andersson
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Gerard J Graham
- Institute of Infection, Immunity and Inflammation, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, UK
| | - Claes-Göran Löfdahl
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jonas S Erjefält
- Unit of Airway Inflammation and Immunology, Department of Experimental Medical Sciences, Lund University, Lund, Sweden
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| |
Collapse
|
49
|
Swärd K, Sadegh MK, Mori M, Erjefält JS, Rippe C. Elevated pulmonary arterial pressure and altered expression of Ddah1 and Arg1 in mice lacking cavin-1/PTRF. Physiol Rep 2013; 1:e00008. [PMID: 24303100 PMCID: PMC3831936 DOI: 10.1002/phy2.8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 12/15/2022] Open
Abstract
Caveolae are invaginations in the plasma membrane that depend on caveolins and cavins for maturation. Here, we investigated the pulmonary phenotype in mice lacking cavin-1. Bright field and electron-microscopy showed that the cavin-1-deficient mice lacked caveolae in the lung, had an increased lung tissue density, and exhibited hypertrophic remodeling of pulmonary arteries. The right ventricle of the heart moreover had an increased mass and the right ventricular pressure was elevated. A microarray analysis revealed upregulation of Arg1 and downregulation of Ddah1, molecules whose altered expression has previously been associated with pulmonary arterial hypertension. Taken together, this work demonstrates vascular remodeling and increased pulmonary blood pressure in cavin-1 deficient mice and associates this phenotype with altered expression of Arg1 and Ddah1.
Collapse
Affiliation(s)
- Karl Swärd
- Department of Experimental Medical Science, Biomedical Centre, Lund University BMC D12, SE-221 84, Lund, Sweden
| | | | | | | | | |
Collapse
|
50
|
Swärd K, Sadegh MK, Mori M, Erjefält JS, Rippe C. Elevated pulmonary arterial pressure and altered expression of Ddah1 and Arg1 in mice lacking cavin-1/PTRF. Physiol Rep 2013. [PMID: 24303100 PMCID: PMC3831936 DOI: 10.1002/phy2.8,] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Caveolae are invaginations in the plasma membrane that depend on caveolins and cavins for maturation. Here, we investigated the pulmonary phenotype in mice lacking cavin-1. Bright field and electron-microscopy showed that the cavin-1-deficient mice lacked caveolae in the lung, had an increased lung tissue density, and exhibited hypertrophic remodeling of pulmonary arteries. The right ventricle of the heart moreover had an increased mass and the right ventricular pressure was elevated. A microarray analysis revealed upregulation of Arg1 and downregulation of Ddah1, molecules whose altered expression has previously been associated with pulmonary arterial hypertension. Taken together, this work demonstrates vascular remodeling and increased pulmonary blood pressure in cavin-1 deficient mice and associates this phenotype with altered expression of Arg1 and Ddah1.
Collapse
Affiliation(s)
- Karl Swärd
- Department of Experimental Medical Science, Biomedical Centre, Lund University BMC D12, SE-221 84, Lund, Sweden
| | | | | | | | | |
Collapse
|