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Jakwerth CA, Weckmann M, Illi S, Charles H, Zissler UM, Oelsner M, Guerth F, Omony J, Nemani SSP, Grychtol R, Dittrich AM, Skevaki C, Foth S, Weber S, Alejandre Alcazar MA, van Koningsbruggen-Rietschel S, Brock R, Blau S, Hansen G, Bahmer T, Rabe KF, Brinkmann F, Kopp MV, Chaker AM, Schaub B, von Mutius E, Schmidt-Weber CB. 17q21 Variants Disturb Mucosal Host Defense in Childhood Asthma. Am J Respir Crit Care Med 2024; 209:947-959. [PMID: 38064241 DOI: 10.1164/rccm.202305-0934oc] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/07/2023] [Indexed: 03/13/2024] Open
Abstract
Rationale: The strongest genetic risk factor for childhood-onset asthma, the 17q21 locus, is associated with increased viral susceptibility and disease-promoting processes.Objectives: To identify biological targets underlying the escalated viral susceptibility associated with the clinical phenotype mediated by the 17q21 locus.Methods: Genome-wide transcriptome analysis of nasal brush samples from 261 children (78 healthy, 79 with wheezing at preschool age, 104 asthmatic) within the ALLIANCE (All-Age-Asthma) cohort, with a median age of 10.0 (range, 1.0-20.0) years, was conducted to explore the impact of their 17q21 genotype (SNP rs72163891). Concurrently, nasal secretions from the same patients and visits were collected, and high-sensitivity mesoscale technology was employed to measure IFN protein levels.Measurements and Main Results: This study revealed that the 17q21 risk allele induces a genotype- and asthma/wheeze phenotype-dependent enhancement of mucosal GSDMB expression as the only relevant 17q21-encoded gene in children with preschool wheeze. Increased GSDMB expression correlated with the activation of a type-1 proinflammatory, cell-lytic immune, and natural killer signature, encompassing key genes linked to an IFN type-2-signature (IFNG, CXCL9, CXCL10, KLRC1, CD8A, GZMA). Conversely, there was a reduction in IFN type 1 and type 3 expression signatures at the mRNA and protein levels.Conclusions: This study demonstrates a novel disease-driving mechanism induced by the 17q21 risk allele. Increased mucosal GSDMB expression is associated with a cell-lytic immune response coupled with compromised airway immunocompetence. These findings suggest that GSDMB-related airway cell death and perturbations in the mucosal IFN signature account for the increased vulnerability of 17q21 risk allele carriers to respiratory viral infections during early life, opening new options for future biological interventions.The All-Age-Asthma (ALLIANCE) cohort is registered at www.clinicaltrials.gov (pediatric arm, NCT02496468).
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Affiliation(s)
- Constanze A Jakwerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Markus Weckmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Sabina Illi
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Helen Charles
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ulrich M Zissler
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Madlen Oelsner
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ferdinand Guerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Jimmy Omony
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Sai Sneha Priya Nemani
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Ruth Grychtol
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Anna-Maria Dittrich
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Chrysanthi Skevaki
- Member of the German Center for Lung Research (DZL), Germany
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics and
| | - Svenja Foth
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Stefanie Weber
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Miguel A Alejandre Alcazar
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Lung Health and Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, Giessen, Germany
- Translational Experimental Pediatrics, Experimental Pulmonology, Department of Pediatrics
- Center for Molecular Medicine Cologne and Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases, and
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Silke van Koningsbruggen-Rietschel
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Robert Brock
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Samira Blau
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Gesine Hansen
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
- Cluster of Excellence 2115 (RESIST), Hannover Medical School, Hanover, Germany
| | - Thomas Bahmer
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- Internal Medicine Department I, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Klaus F Rabe
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- LungenClinic Grosshansdorf GmbH and Medical Clinics, Christian Albrechts University, Kiel, Germany
| | - Folke Brinkmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Matthias Volkmar Kopp
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Adam M Chaker
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, Technical University of Munich, Munich, Germany
| | - Bianca Schaub
- Member of the German Center for Lung Research (DZL), Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Erika von Mutius
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
| | - Carsten B Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
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2
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Shahrokny P, Maison N, Riemann L, Ehrmann M, DeLuca D, Schuchardt S, Thiele D, Weckmann M, Dittrich AM, Schaub B, Brinkmann F, Hansen G, Kopp MV, von Mutius E, Rabe KF, Bahmer T, Hohlfeld JM, Grychtol R, Holz O. Increased breath naphthalene in children with asthma and wheeze of the All Age Asthma Cohort (ALLIANCE). J Breath Res 2023; 18:016003. [PMID: 37604132 DOI: 10.1088/1752-7163/acf23e] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/21/2023] [Indexed: 08/23/2023]
Abstract
Exhaled breath contains numerous volatile organic compounds (VOCs) known to be related to lung disease like asthma. Its collection is non-invasive, simple to perform and therefore an attractive method for the use even in young children. We analysed breath in children of the multicenter All Age Asthma Cohort (ALLIANCE) to evaluate if 'breathomics' have the potential to phenotype patients with asthma and wheeze, and to identify extrinsic risk factors for underlying disease mechanisms. A breath sample was collected from 142 children (asthma: 51, pre-school wheezers: 55, healthy controls: 36) and analysed using gas chromatography-mass spectrometry (GC/MS). Children were diagnosed according to Global Initiative for Asthma guidelines and comprehensively examined each year over up to seven years. Forty children repeated the breath collection after 24 or 48 months. Most breath VOCs differing between groups reflect the exposome of the children. We observed lower levels of lifestyle-related VOCs and higher levels of the environmental pollutants, especially naphthalene, in children with asthma or wheeze. Naphthalene was also higher in symptomatic patients and in wheezers with recent inhaled corticosteroid use. No relationships with lung function or TH2 inflammation were detected. Increased levels of naphthalene in asthmatics and wheezers and the relationship to disease severity could indicate a role of environmental or indoor air pollution for the development or progress of asthma. Breath VOCs might help to elucidate the role of the exposome for the development of asthma. The study was registered at ClinicalTrials.gov (NCT02496468).
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Affiliation(s)
- P Shahrokny
- Fraunhofer ITEM, Department of Clinical Airway Research, German Center for Lung Research (BREATH, DZL), Hannover, Germany
| | - N Maison
- Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Germany German Center for Lung Research (CPC-M, DZL), Munich, Germany
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - L Riemann
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Center for Lung Research (BREATH, DZL), Hannover, Germany
- Clinician Scientist Program TITUS, Else-Kröner-Fresenius-Stiftung, Hannover Medical School, Hannover, Germany
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - M Ehrmann
- Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Germany German Center for Lung Research (CPC-M, DZL), Munich, Germany
| | - D DeLuca
- German Center for Lung Research (BREATH, DZL), Hannover, Germany
| | - S Schuchardt
- Fraunhofer ITEM, Bio- and Environmental Analytics, Hannover, Germany
| | - D Thiele
- Division of Pediatric Pulmonology and Allergology, University Children's Hospital, German Center for Lung Research (ARCN, DZL), Luebeck, Germany
- Institute of Medical Biometry and Statistics (IMBS), University Medical Center Schleswig-Holstein, Luebeck, Germany
| | - M Weckmann
- Division of Pediatric Pulmonology and Allergology, University Children's Hospital, German Center for Lung Research (ARCN, DZL), Luebeck, Germany
- Epigenetics of Chronic Lung Disease, Priority Research Area Chronic Lung Diseases, Leibniz Lung Research Center Borstel, Borstel, Germany
| | - A M Dittrich
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Center for Lung Research (BREATH, DZL), Hannover, Germany
| | - B Schaub
- Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Germany German Center for Lung Research (CPC-M, DZL), Munich, Germany
| | - F Brinkmann
- Division of Pediatric Pulmonology and Allergology, University Children's Hospital, German Center for Lung Research (ARCN, DZL), Luebeck, Germany
| | - G Hansen
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Center for Lung Research (BREATH, DZL), Hannover, Germany
| | - M V Kopp
- Division of Pediatric Pulmonology and Allergology, University Children's Hospital, German Center for Lung Research (ARCN, DZL), Luebeck, Germany
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - E von Mutius
- Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Germany German Center for Lung Research (CPC-M, DZL), Munich, Germany
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - K F Rabe
- LungenClinic Grosshansdorf and Department of Medicine, Christian-Albrechts-University Kiel, German Center for Lung Research (ARCN, DZL), Grosshansdorf, Germany
| | - T Bahmer
- LungenClinic Grosshansdorf and Department of Medicine, Christian-Albrechts-University Kiel, German Center for Lung Research (ARCN, DZL), Grosshansdorf, Germany
- Internal Medicine Department I, University Hospital Schleswig-Holstein, UKSH - Campus Kiel, German Center for Lung Research (ARCN, DZL), Kiel, Germany
| | - J M Hohlfeld
- Fraunhofer ITEM, Department of Clinical Airway Research, German Center for Lung Research (BREATH, DZL), Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - R Grychtol
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Center for Lung Research (BREATH, DZL), Hannover, Germany
| | - O Holz
- Fraunhofer ITEM, Department of Clinical Airway Research, German Center for Lung Research (BREATH, DZL), Hannover, Germany
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3
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Jirmo AC, Grychtol R, Gaedcke S, Liu B, DeStefano S, Happle C, Halle O, Monteiro JT, Habener A, Breiholz OD, DeLuca D, Hansen G. Single cell RNA sequencing reveals distinct clusters of Irf8-expressing pulmonary conventional dendritic cells. Front Immunol 2023; 14:1127485. [PMID: 37251386 PMCID: PMC10213693 DOI: 10.3389/fimmu.2023.1127485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
A single population of interferon-regulatory factor 8 (Irf8)-dependent conventional dendritic cell (cDC type1) is considered to be responsible for both immunogenic and tolerogenic responses depending on the surrounding cytokine milieu. Here, we challenge this concept of an omnipotent single Irf8-dependent cDC1 cluster through analysis of pulmonary cDCs at single cell resolution. We report existence of a pulmonary cDC1 cluster lacking Xcr1 with an immunogenic signature that clearly differs from the Xcr1 positive cDC1 cluster. The Irf8+Batf3+Xcr1- cluster expresses high levels of pro-inflammatory genes associated with antigen presentation, migration and co-stimulation such as Ccr7, Cd74, MHC-II, Ccl5, Il12b and Relb while, the Xcr1+ cDC1 cluster expresses genes corresponding to immune tolerance mechanisms like Clec9a, Pbx1, Cadm1, Btla and Clec12a. In concordance with their pro-inflammatory gene expression profile, the ratio of Xcr1- cDC1s but not Xcr1+cDC1 is increased in the lungs of allergen-treated mice compared to the control group, in which both cDC1 clusters are present in comparable ratios. The existence of two distinct Xcr1+ and Xcr1- cDC1 clusters is furthermore supported by velocity analysis showing markedly different temporal patterns of Xcr1- and Xcr1+cDC1s. In summary, we present evidence for the existence of two different cDC1 clusters with distinct immunogenic profiles in vivo. Our findings have important implications for DC-targeting immunomodulatory therapies.
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Affiliation(s)
- Adan Chari Jirmo
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Svenja Gaedcke
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Bin Liu
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Stephanie DeStefano
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Olga Halle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Joao T. Monteiro
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Excellence Cluster Resolving Infection Susceptibility RESIST (EXC 2155), Deutsche Forschungsgemeinschaft, Hannover Medical School, Hannover, Germany
| | - Anika Habener
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Oliver D. Breiholz
- Research Core Unit Genomics (RCUG), Hannover Medical School, Hannover, Germany
| | - David DeLuca
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
- Excellence Cluster Resolving Infection Susceptibility RESIST (EXC 2155), Deutsche Forschungsgemeinschaft, Hannover Medical School, Hannover, Germany
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4
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Böschen E, Wendt A, Müller-Stöver S, Piechnik L, Fuchs H, Lund M, Steindor M, Große-Onnebrink J, Keßler C, Grychtol R, Rothoeft T, Bieli C, van Egmond-Fröhlich A, Stehling F. Tracheostomy decannulation in children: a proposal for a structured approach on behalf of the working group chronic respiratory insufficiency within the German-speaking society of pediatric pulmonology. Eur J Pediatr 2023:10.1007/s00431-023-04966-6. [PMID: 37121990 DOI: 10.1007/s00431-023-04966-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 05/02/2023]
Abstract
The number of children with tracheostomies with and without home mechanical ventilation has grown continuously in recent years. For some of these children, the need for tracheostomy resolves and the child can be weaned from the tracheal cannula. Choosing the optimal time point for decannulation after elaborated prior diagnostic work-up needs careful consideration. The decannulation process requires an interdisciplinary team; however, these specialized structures for the experienced care of these children with tracheostomy are not available in all areas. The Working Group on Chronic Respiratory Insufficiency in the German Speaking Pediatric Pneumology Society (GPP) developed these recommendations to guide through a decannulation process. Initial evaluation of decannulation feasibility starts in the outpatient clinic with a detailed history, examination, and a speaking valve trial and is followed by an inpatient workup including sleep study, airway endoscopy and possibly modifications of the tracheal cannula. Downsizing the tracheal cannula allows a stepwise controlled weaning prior to removal of the tracheal cannula. After shrinking of the tracheostomy, the final surgical closure is performed. Conclusion: An algorithm with diagnostic and therapeutic procedures for a safe and successful decannulation process is proposed. What is Known: • In children tracheostomy decannulation is a complex process that requires careful preparation and surveillance. What is New: • This statement of the German speaking society of pediatric pulmonology provides an expert practice guidance on the decannulation procedure and the value of one-way speaking valves.
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Affiliation(s)
- Eicke Böschen
- Department of Respiratory Care, Pediatric Pulmonology and Sleep Medicine, Childrens Hospital, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany.
| | - Anke Wendt
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité, Berlin, Germany
| | - Sarah Müller-Stöver
- Department of Respiratory Care, Pediatric Pulmonology and Sleep Medicine, Childrens Hospital, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany
| | - Lydia Piechnik
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité, Berlin, Germany
| | - Hans Fuchs
- Center for Pediatrics, Department of Neonatology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Madeleine Lund
- Department of Respiratory Care, Pediatric Pulmonology and Sleep Medicine, Childrens Hospital, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany
| | - Mathis Steindor
- Department of Pediatric Pulmonology and Sleep Medicine, Childrens Hospital, University of Duisburg-Essen, Essen, Germany
| | | | - Christina Keßler
- Department of General Pediatrics, University Hospital Munster, Munster, Germany
| | - Ruth Grychtol
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Tobias Rothoeft
- Department of Neonatology and Pediatric Intensive Care, University Childrens Hospital, Ruhr-University, Bochum, Germany
| | - Christian Bieli
- Department of Paediatric Pulmonology, University Childrens Hospital, Zurich, Switzerland
| | | | - Florian Stehling
- Department of Pediatric Pulmonology and Sleep Medicine, Childrens Hospital, University of Duisburg-Essen, Essen, Germany
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5
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Lemmel S, Weckmann M, Wohlers A, Jirmo AC, Grychtol R, Ricklefs I, Nissen G, Bachmann A, Singh S, Caicedo J, Bahmer T, Hansen G, Von Mutius E, Rabe KF, Fuchs O, Dittrich AM, Schaub B, Happle C, Carpenter AE, Kopp MV, Becker T. In vitro neutrophil migration is associated with inhaled corticosteroid treatment and serum cytokines in pediatric asthma. Front Pharmacol 2022; 13:1021317. [PMID: 36304163 PMCID: PMC9593213 DOI: 10.3389/fphar.2022.1021317] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/17/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Different asthma phenotypes are driven by molecular endotypes. A Th1-high phenotype is linked to severe, therapy-refractory asthma, subclinical infections and neutrophil inflammation. Previously, we found neutrophil granulocytes (NGs) from asthmatics exhibit decreased chemotaxis towards leukotriene B4 (LTB4), a chemoattractant involved in inflammation response. We hypothesized that this pattern is driven by asthma in general and aggravated in a Th1-high phenotype. Methods: NGs from asthmatic nd healthy children were stimulated with 10 nM LTB4/100 nM N-formylmethionine-leucyl-phenylalanine and neutrophil migration was documented following our prior SiMA (simplified migration assay) workflow, capturing morphologic and dynamic parameters from single-cell tracking in the images. Demographic, clinical and serum cytokine data were determined in the ALLIANCE cohort. Results: A reduced chemotactic response towards LTB4 was confirmed in asthmatic donors regardless of inhaled corticosteroid (ICS) treatment. By contrast, only NGs from ICS-treated asthmatic children migrate similarly to controls with the exception of Th1-high donors, whose NGs presented a reduced and less directed migration towards the chemokines. ICS-treated and Th1-high asthmatic donors present an altered surface receptor profile, which partly correlates with migration. Conclusions: Neutrophil migration in vitro may be affected by ICS-therapy or a Th1-high phenotype. This may be explained by alteration of receptor expression and could be used as a tool to monitor asthma treatment.
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Affiliation(s)
- Solveig Lemmel
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
| | - Markus Weckmann
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- Priority Research Area Chronic Lung Diseases Leibniz Lung Research Center Borstel, Epigenetics of Chronic Lung Disease, Großhansdorf, Germany
- Airway Research Center North, Member of the German Center of Lung Research (DZL), Lübeck, Germany
- *Correspondence: Markus Weckmann,
| | - Anna Wohlers
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
| | - Adan Chari Jirmo
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center of Lung Research (DZL), Hannover, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center of Lung Research (DZL), Hannover, Germany
| | - Isabell Ricklefs
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- Airway Research Center North, Member of the German Center of Lung Research (DZL), Lübeck, Germany
| | - Gyde Nissen
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- Airway Research Center North, Member of the German Center of Lung Research (DZL), Lübeck, Germany
| | - Anna Bachmann
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
| | - Shantanu Singh
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, CA, United States
| | - Juan Caicedo
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, CA, United States
| | - Thomas Bahmer
- Department of Pneumology, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
- University Hospital Schleswig-Holstein Campus Kiel, Department for Internal Medicine I, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Kiel, Germany
| | - Gesine Hansen
- Airway Research Center North, Member of the German Center of Lung Research (DZL), Lübeck, Germany
| | - Erika Von Mutius
- University Children’s Hospital, Ludwig Maximilian’s University, German Research Center for Environmental Health (CPC-M), Member of the German Center of Lung Research (DZL), Munich, Germany
| | - Klaus F. Rabe
- Department of Pneumology, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Oliver Fuchs
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- University Children’s Hospital, Ludwig Maximilian’s University, German Research Center for Environmental Health (CPC-M), Member of the German Center of Lung Research (DZL), Munich, Germany
- Department of Paediatric Respiratory Medicine, Inselspital, University Children’s Hospital of Bern, University of Bern, Bern, Switzerland
| | - Anna-Maria Dittrich
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center of Lung Research (DZL), Hannover, Germany
| | - Bianca Schaub
- University Children’s Hospital, Ludwig Maximilian’s University, German Research Center for Environmental Health (CPC-M), Member of the German Center of Lung Research (DZL), Munich, Germany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center of Lung Research (DZL), Hannover, Germany
| | - Anne E. Carpenter
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, CA, United States
| | - Matthias Volkmar Kopp
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- Airway Research Center North, Member of the German Center of Lung Research (DZL), Lübeck, Germany
- Department of Paediatric Respiratory Medicine, Inselspital, University Children’s Hospital of Bern, University of Bern, Bern, Switzerland
| | - Tim Becker
- Department of Paediatric Pneumology and Allergology, University Children’s Hospital, Lübeck, Schleswig-Holstein, Germany
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, CA, United States
- IAV GmbH, Gifhorn, Germany
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6
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Maison N, Omony J, Illi S, Thiele D, Skevaki C, Dittrich AM, Bahmer T, Rabe KF, Weckmann M, Happle C, Schaub B, Meyer M, Foth S, Rietschel E, Renz H, Kopp MV, Hansen G, von Mutius E, Grychtol R. T2-high asthma across all ages – comparative analysis in
children and adults from the ALLIANCE cohort. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N Maison
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - J Omony
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - S Illi
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - D Thiele
- University Medical Center Schleswig-Holstein, Institute of Medical
Biometry and Statistics (IMBS), Luebeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
| | - C Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry,
Philipps-University Marburg, Molecular Diagnostics, Marburg,
Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - A-M Dittrich
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - T Bahmer
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Grosshansdorf, Germany
- University Hospital Schleswig-Holstein, Campus Kiel, Internal Medicine
Department I, Pneumology, Kiel, Germany
| | - KF Rabe
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Grosshansdorf, Germany
| | - M Weckmann
- University Medical Center Schleswig-Holstein, Division of Paediatric
Pneumology and Allergology, Luebeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
| | - C Happle
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - B Schaub
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - M Meyer
- University Children's Hospital, University of Cologne, Cologne,
Germany
| | - S Foth
- University Children’s Hospital Marburg, University of Marburg,
Marburg, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - E Rietschel
- University Children's Hospital, University of Cologne, Cologne,
Germany
| | - H Renz
- Institute of Laboratory Medicine and Pathobiochemistry,
Philipps-University Marburg, Molecular Diagnostics, Marburg,
Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - MV Kopp
- University Children's Hospital, University of Bern, Department
of Paediatric Respiratory Medicine, Bern, Switzerland
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
- University Medical Center Schleswig-Holstein, Division of Paediatric
Pneumology and Allergology, Luebeck, Germany
| | - G Hansen
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - E von Mutius
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - R Grychtol
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
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7
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DeStefano S, Jirmo AC, Habener A, Tereno-Monteiro J, Funken D, Happle C, Urner K, Schaub B, Grychtol R, Hansen G. Impaired perinatal tolerance development in
NLRP3-/-mice. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S DeStefano
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Member of Childhood Allergy and Tolerance – bioMarkers and
Predictors Consortium (CHAMP), Hannover, Germany
| | - AC Jirmo
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover
(BREATH), Hannover, Germany
| | - A Habener
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover
(BREATH), Hannover, Germany
| | - J Tereno-Monteiro
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Member of German Center for Lung Research Hannover; Cluster of
Excellence RESIST (EXC 2155), Hannover, Germany
| | - D Funken
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
| | - C Happle
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover
(BREATH), Hannover, Germany
| | - K Urner
- LMU Munich, Department of Pediatrics, Dr von Hauner Children's
Hospital, Munich, Germany
- Member of Childhood Allergy and Tolerance – bioMarkers and
Predictors Consortium (CHAMP), Hannover, Germany
| | - B Schaub
- LMU Munich, Department of Pediatrics, Dr von Hauner Children's
Hospital, Munich, Germany
- Member of Childhood Allergy and Tolerance – bioMarkers and
Predictors Consortium (CHAMP), Hannover, Germany
- Member of the German Center for Lung Research (DZL), Comprehensive
Pneumology Center – LMU Munich, Munich, Germany
| | - R Grychtol
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover
(BREATH), Hannover, Germany
| | - G Hansen
- Hannover Medical School, Pediatric Pneumology, Allergology and
Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover
(BREATH), Hannover, Germany
- Member of Childhood Allergy and Tolerance – bioMarkers and
Predictors Consortium (CHAMP), Hannover, Germany
- Member of German Center for Lung Research Hannover; Cluster of
Excellence RESIST (EXC 2155), Hannover, Germany
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8
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Habener A, Grychtol R, Gaedcke S, DeLuca D, Dittrich AM, Happle C, Abdo M, Watz H, Pedersen F, König IR, Thiele D, Kopp MV, von Mutius E, Bahmer T, Rabe KF, Meyer-Bahlburg A, Hansen G. IgA + memory B cells are significantly increased in patients with asthma and small airways dysfunction. Eur Respir J 2022; 60:13993003.02130-2021. [PMID: 35595320 DOI: 10.1183/13993003.02130-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Comprehensive studies investigated the role of T cells in asthma leading to personalised treatment options targeting severe eosinophilic asthma. However, little is known about the contribution of B cells to this chronic inflammatory disease. In this study, we investigated the contribution of various B cell populations to specific clinical features in asthma. METHODS In the All Age Asthma Cohort (ALLIANCE) a subgroup of 154 adult asthma patients and 28 healthy controls were included for B cell characterisation by flow cytometry. Questionnaires, lung function measurements, blood differential counts and allergy testing of participants were analysed together with comprehensive data on B cells via association studies and multivariate linear models. RESULTS Patients with severe asthma showed decreased immature B cell populations while memory B cells were significantly increased compared to both mild-moderate asthma patients and healthy controls. Furthermore, increased frequencies of immunoglobulin A positive (IgA+) memory B cells were associated with impaired lung function and specifically with parameters indicative for augmented resistance in the peripheral airways. Accordingly, asthma patients with small airway dysfunction (SAD) defined by impulse oscillometry showed increased frequencies of IgA+ memory B cells, particularly in patients with mild to moderate asthma. Additionally, IgA+ memory B cells significantly correlated with clinical features of SAD such as exacerbations. CONCLUSIONS With this study we demonstrate for the first time a significant association of increased IgA+ memory B cells with asthma and SAD, pointing towards future options for B cell-directed strategies in preventing and treating asthma.
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Affiliation(s)
- Anika Habener
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.,These authors contributed equally to this work
| | - Ruth Grychtol
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.,These authors contributed equally to this work
| | - Svenja Gaedcke
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - David DeLuca
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Anna Maria Dittrich
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Christine Happle
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Mustafa Abdo
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Henrik Watz
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Frauke Pedersen
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,LungenClinic Grosshansdorf, Grosshansdorf, Germany.,Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Inke Regina König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Dominik Thiele
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Matthias Volkmar Kopp
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Section for Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Campus Centrum Lübeck, Germany.,Department of Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Erika von Mutius
- Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.,Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Thomas Bahmer
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,LungenClinic Grosshansdorf, Grosshansdorf, Germany.,University Hospital Schleswig-Holstein, Campus Kiel, Internal Medicine I, Pneumology, Kiel, Germany
| | - Klaus Friedrich Rabe
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.,LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | | | - Gesine Hansen
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany .,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), German Research Foundation (DFG), Hannover Medical School, Hannover, Germany
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9
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Maison N, Omony J, Illi S, Thiele D, Skevaki C, Dittrich AM, Bahmer T, Rabe KF, Weckmann M, Happle C, Schaub B, Meier M, Foth S, Rietschel E, Renz H, Hansen G, Kopp MV, von Mutius E, Grychtol R. T-high asthma phenotypes across life span. Eur Respir J 2022; 60:13993003.02288-2021. [PMID: 35210326 DOI: 10.1183/13993003.02288-2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/04/2022] [Indexed: 11/05/2022]
Abstract
RATIONALE In adults, personalised asthma treatment targets patients with T2-high and eosinophilic asthma phenotypes. It is unclear whether such classification is achievable in children. OBJECTIVES To define T2-high asthma with easily accessible biomarkers and compare resulting phenotypes across all ages. METHODS In the multicenter clinical ALL Age Asthma Cohort (ALLIANCE), 1125 participants (n=776 asthmatics, n=349 controls) were recruited and followed for 2 years (1 year in adults). Extensive clinical characterisation (questionnaires, blood differential count, allergy testing, lung function and sputum induction (in adults) was performed at baseline and follow-ups. Interleukin (IL)-4, IL-5 and IL-13 were measured after stimulation of whole blood with LPS or anti-CD3/CD28. MEASUREMENTS AND MAIN RESULTS Based on blood eosinophil counts and allergen-specific serum IgE antibodies (sIgE), patients were categorised into four mutually exclusive phenotypes: "Atopy-only", "Eosinophils-only", "T2-high" (eosinophilia+atopy) and "T2-low" (neither eosinophilia nor atopy). The T2-high phenotype was found across all ages, even in very young children in whom it persisted to a large degree even after 2 years of follow-up. T2-high asthma in adults was associated with childhood onset suggesting early origins of this asthma phenotype. In both children and adults, the T2-high phenotype was characterised by excessive production of specific IgE to allergens (p<0.0001) and, from school age onwards, by increased production of IL-5 after anti-CD3/CD28 stimulation of whole blood. CONCLUSIONS Using easily accessible biomarkers, patients with T2-high asthma can be identified across all ages delineating a distinct phenotype. These patients may benefit from therapy with biologicals even at younger age.
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Affiliation(s)
- Nicole Maison
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Jimmy Omony
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Sabina Illi
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Dominik Thiele
- Institute of Medical Biometry and Statistics (IMBS), University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany
| | - Anna-Maria Dittrich
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Thomas Bahmer
- University Hospital Schleswig-Holstein, Campus Kiel, Internal Medicine Department I, Pneumology, Kiel, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Klaus Friedrich Rabe
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Markus Weckmann
- Division of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Bianca Schaub
- Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Meike Meier
- Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany
| | - Svenja Foth
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Ernst Rietschel
- Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.,Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Matthias Volkmar Kopp
- Division of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany.,Department of Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Erika von Mutius
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany .,Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
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10
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Maison N, Herbrüggen H, Schaub B, Schauberger C, Foth S, Grychtol R, Abdo M, Watz H, Nikolaizik W, Rabe KF, Kopp MV, Hansen G, von Mutius E, Bahmer T, Omony J. Impact of imposed social isolation and use of face masks on asthma course and mental health in pediatric and adult patients with recurrent wheeze and asthma. Allergy Asthma Clin Immunol 2021; 17:93. [PMID: 34530911 PMCID: PMC8444172 DOI: 10.1186/s13223-021-00592-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/21/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background There is currently a dramatic increase in the number of COVID-19 cases worldwide, and further drastic restrictions in our daily life will be necessary to contain this pandemic. The implications of restrictive measures like social-distancing and mouth-nose protection on patients with chronic respiratory diseases have hardly been investigated. Methods Our survey, was conducted within the All Age Asthma Cohort (ALLIANCE), a multicenter longitudinal observational study. We assessed the effects of COVID-19 imposed social isolation and use of facial masks, on asthma course and mental health in patients with asthma and wheezing. Results We observed a high rate of problems associated with using facemasks and a significant reduction in the use of routine medical care. In addition to unsettling impacts, such as an increase in depression symptoms in adults, an astonishing and pleasing effect was striking: preschool children experienced an improvement in disease condition during the lockdown. This improvement can be attributed to a significant reduction in exposure to viral infections. Conclusion Long-term observation of this side effect may help improve our understanding of the influence of viral infections on asthma in early childhood.
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Affiliation(s)
- Nicole Maison
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany. .,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany. .,German Center for Lung Research (DZL), Munich, Germany. .,Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany.
| | - Heidrun Herbrüggen
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Bianca Schaub
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany
| | - Christina Schauberger
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany
| | - Svenja Foth
- German Center for Lung Research (DZL), Munich, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany.,University of Giessen Marburg Lung Center (UGMLC), Giessen, Germany
| | - Ruth Grychtol
- German Center for Lung Research (DZL), Munich, Germany.,Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Mustafa Abdo
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Henrik Watz
- German Center for Lung Research (DZL), Munich, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Wilfried Nikolaizik
- German Center for Lung Research (DZL), Munich, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany.,University of Giessen Marburg Lung Center (UGMLC), Giessen, Germany
| | - Klaus F Rabe
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Matthias V Kopp
- German Center for Lung Research (DZL), Munich, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Institute for Medical Biometry and Statistics, University Luebeck, University Medical Centre Schleswig-Holstein, Campus, Luebeck, Germany
| | - Gesine Hansen
- German Center for Lung Research (DZL), Munich, Germany.,Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Erika von Mutius
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany.,Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany
| | - Thomas Bahmer
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Internal Medicine Department I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jimmy Omony
- Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany
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11
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Habener A, Happle C, Grychtol R, Skuljec J, Busse M, Dalüge K, Obernolte H, Sewald K, Braun A, Meyer-Bahlburg A, Hansen G. Regulatory B cells control airway hyperreactivity and lung remodeling in a murine asthma model. J Allergy Clin Immunol 2020; 147:2281-2294.e7. [PMID: 33249168 DOI: 10.1016/j.jaci.2020.09.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 06/05/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Asthma is a widespread, multifactorial chronic airway disease. The influence of regulatory B cells on airway hyperreactivity (AHR) and remodeling in asthma is poorly understood. OBJECTIVE Our aim was to analyze the role of B cells in a house dust mite (HDM)-based murine asthma model. METHODS The influence of B cells on lung function, tissue remodeling, and the immune response were analyzed by using wild-type and B-cell-deficient (μMT) mice and transfer of IL-10-proficient and IL-10-deficient B cells to μMT mice. RESULTS After HDM-sensitization, both wild-type and μMT mice developed AHR, but the AHR was significantly stronger in μMT mice, as confirmed by 2 independent techniques: invasive lung function measurement in vivo and examination of precision-cut lung slices ex vivo. Moreover, airway remodeling was significantly increased in allergic μMT mice, as shown by enhanced collagen deposition in the airways, whereas the numbers of FoxP3+ and FoxP3- IL-10-secreting regulatory T cells were reduced. Adoptive transfer of IL-10-proficient but not IL-10-deficient B cells into μMT mice before HDM-sensitization attenuated AHR and lung remodeling. In contrast, FoxP3+ regulatory T cells were equally upregulated by transfer of IL-10-proficient and IL-10-deficient B cells. CONCLUSION Our data in a murine asthma model illustrate a central role of regulatory B cells in the control of lung function and airway remodeling and may support future concepts for B-cell-targeted prevention and treatment strategies for allergic asthma.
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Affiliation(s)
- Anika Habener
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Christine Happle
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Ruth Grychtol
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Jelena Skuljec
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Department of Neurology, University Medicine Essen, Essen, Germany
| | - Mandy Busse
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
| | - Kathleen Dalüge
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Helena Obernolte
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Katherina Sewald
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Armin Braun
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Almut Meyer-Bahlburg
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany; Department of Pediatrics, University Medicine Greifswald, Greifswald, Germany
| | - Gesine Hansen
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany.
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12
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Hansen G, Grychtol R, Schuster A. Medikamentöse Langzeittherapie des Asthma bronchiale bei Kindern und Jugendlichen – neue Aspekte. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-01022-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Jirmo AC, Rossdam C, Grychtol R, Happle C, Gerardy‐Schahn R, Buettner FFR, Hansen G. Differential expression patterns of glycosphingolipids and C-type lectin receptors on immune cells in absence of functional regulatory T cells. Immun Inflamm Dis 2020; 8:512-522. [PMID: 32737949 PMCID: PMC7654419 DOI: 10.1002/iid3.334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/03/2020] [Accepted: 07/20/2020] [Indexed: 02/05/2023]
Abstract
Background Glycosylation is a common and complex type of protein posttranslational modification. Altered glycosylation of immunoglobulins in autoimmune diseases has led to the “altered glycan hypothesis” postulating existence of a unique glycan signature on immune cells and extracellular proteins characterized by site‐specific relative abundances of individual glycan structures and glycosylation patterns. However, it is not clear how glycosylation on leukocyte subpopulations differ between states of health or inflammation. Hypothesis Glycosphingolipid patterns on immune cells of forkhead‐box‐P3‐deficient scurfy mice differs from those on wild‐type immune cells. Methods T cells and dendritic cells were isolated from spleens of either wild‐type or age‐matched scurfy mice. Glycosphingolipids of CD4+ T cells and splenic dendritic cells from wild‐type and scurfy mice were then analyzed by multiplexed capillary gel electrophoresis coupled to laser‐induced fluorescence detection (xCGE‐LIF). In addition, flow cytometry and ChipCytometry were used to access expression patterns of various C‐type lectin receptors on antigen‐presenting cells from various organs of both wild‐type and scurfy mice. Results We, hereby report differential expression of glycosphingolipids in health and under inflammatory conditions as reflected in wild‐type and scurfy mice. Furthermore, we observed that the absence of functional regulatory T cells correlated with elevated expression of CLEC‐7A and CD205 but a reduction in levels of CLEC12A and CD206 on antigen‐presenting cells. Conclusion We hereby show that the absence of functional regulatory T cells affects expression pattern and quantities of glycosphingolipids on immune cells. Thus, glycosphingolipids could serve as biomarkers for mapping genetical and homeostatic perturbances such as those resulting from a diseased condition.
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Affiliation(s)
- Adan C. Jirmo
- Department of Pediatric Pneumology, Allergology and NeonatologyHannover Medical SchoolHannoverGermany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)German Center for Lung Research (DZL)HannoverGermany
| | - Charlotte Rossdam
- Institute of Clinical BiochemistryHannover Medical SchoolHannoverGermany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and NeonatologyHannover Medical SchoolHannoverGermany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)German Center for Lung Research (DZL)HannoverGermany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and NeonatologyHannover Medical SchoolHannoverGermany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)German Center for Lung Research (DZL)HannoverGermany
| | - Rita Gerardy‐Schahn
- Institute of Clinical BiochemistryHannover Medical SchoolHannoverGermany
- Excellence Cluster RESIST (EXC 2155)Hannover Medical SchoolHannoverGermany
| | | | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and NeonatologyHannover Medical SchoolHannoverGermany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)German Center for Lung Research (DZL)HannoverGermany
- Excellence Cluster RESIST (EXC 2155)Hannover Medical SchoolHannoverGermany
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14
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Jirmo AC, Busse M, Happle C, Skuljec J, Dalüge K, Habener A, Grychtol R, DeLuca DS, Breiholz OD, Prinz I, Hansen G. IL-17 regulates DC migration to the peribronchial LNs and allergen presentation in experimental allergic asthma. Eur J Immunol 2020; 50:1019-1033. [PMID: 32142593 DOI: 10.1002/eji.201948409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/30/2020] [Accepted: 03/05/2020] [Indexed: 01/04/2023]
Abstract
IL-17 is associated with different phenotypes of asthma, however, it is not fully elucidated how it influences induction and maintenance of asthma and allergy. In order to determine the role of IL-17 in development of allergic asthma, we used IL-17A/F double KO (IL-17A/F KO) and WT mice with or without neutralization of IL-17 in an experimental allergic asthma model and analyzed airway hyperresponsiveness, lung inflammation, T helper cell polarization, and DCs influx and activation. We report that the absence of IL-17 reduced influx of DCs into lungs and lung draining LNs. Compared to WT mice, IL-17A/F KO mice or WT mice after neutralization of IL-17A showed reduced airway hyperresponsiveness, eosinophilia, mucus hypersecretion, and IgE levels. DCs from draining LNs of allergen-challenged IL-17A/F KO mice showed a reduction in expression of migratory and costimulatory molecules CCR7, CCR2, MHC-II, and CD40 compared to WT DCs. Moreover, in vivo stimulation of adoptively transferred antigen-specific cells was attenuated in lung-draining LNs in the absence of IL-17. Thus, we report that IL-17 enhances airway DC activation, migration, and function. Consequently, lack of IL-17 leads to reduced antigen-specific T cell priming and impaired development of experimental allergic asthma.
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Affiliation(s)
- Adan Chari Jirmo
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Mandy Busse
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Jelena Skuljec
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Kathleen Dalüge
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Anika Habener
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - David S DeLuca
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Oliver D Breiholz
- Research Core Unit Genomics (RCUG), Hannover Medical School, Hannover, Germany
| | - Immo Prinz
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.,Excellence Cluster RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
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15
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Gingele S, Pul R, Sardari M, Borbor M, Henkel F, Moellenkamp TM, Gudi V, Happle C, Grychtol R, Habener A, Hansen G, Hermann DM, Stangel M, Kleinschnitz C, Skuljec J. FoxP3 deficiency causes no inflammation or neurodegeneration in the murine brain. J Neuroimmunol 2020; 342:577216. [PMID: 32199198 DOI: 10.1016/j.jneuroim.2020.577216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/17/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/20/2022]
Abstract
Regulatory T cells (Treg) maintain immunological self-tolerance and their functional or numerical deficits are associated with progression of several neurological diseases. We examined the effects of Treg absence on the structure and integrity of the unchallenged murine brain. When compared to control, Treg-deficient FoxP3sf mutant mice showed no differences in brain size, myelin amount and oligodendrocyte numbers. FoxP3sf strain displayed no variations in quantity of neurons and astrocytes, whereas microglia numbers were slightly reduced. We demonstrate lack of neuroinflammation and parenchymal responses in the brains of Treg-deficient mice, suggesting a minor Treg role in absence of blood-brain barrier breakdown.
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Affiliation(s)
- Stefan Gingele
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Refik Pul
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Maryam Sardari
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Mina Borbor
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Florian Henkel
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Thiemo M Moellenkamp
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Viktoria Gudi
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - Anika Habener
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - Dirk M Hermann
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Martin Stangel
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Christoph Kleinschnitz
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Jelena Skuljec
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
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16
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Saglani S, Gregory LG, Manghera AK, Branchett WJ, Uwadiae F, Entwistle LJ, Oliver RA, Vasiliou JE, Sherburn R, Lui S, Puttur F, Vöhringer D, Walker SA, Buckley J, Grychtol R, Fainardi V, Denney L, Byrne A, von Mutius E, Bush A, Lloyd CM. Inception of early-life allergen-induced airway hyperresponsiveness is reliant on IL-13 +CD4 + T cells. Sci Immunol 2019; 3:3/27/eaan4128. [PMID: 30194239 DOI: 10.1126/sciimmunol.aan4128] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Abstract
Airway hyperresponsiveness (AHR) is a critical feature of wheezing and asthma in children, but the initiating immune mechanisms remain unconfirmed. We demonstrate that both recombinant interleukin-33 (rIL-33) and allergen [house dust mite (HDM) or Alternaria alternata] exposure from day 3 of life resulted in significantly increased pulmonary IL-13+CD4+ T cells, which were indispensable for the development of AHR. In contrast, adult mice had a predominance of pulmonary LinnegCD45+CD90+IL-13+ type 2 innate lymphoid cells (ILC2s) after administration of rIL-33. HDM exposure of neonatal IL-33 knockout (KO) mice still resulted in AHR. However, neonatal CD4creIL-13 KO mice (lacking IL-13+CD4+ T cells) exposed to allergen from day 3 of life were protected from AHR despite persistent pulmonary eosinophilia, elevated IL-33 levels, and IL-13+ ILCs. Moreover, neonatal mice were protected from AHR when inhaled Acinetobacter lwoffii (an environmental bacterial isolate found in cattle farms, which is known to protect from childhood asthma) was administered concurrent with HDM. A. lwoffii blocked the expansion of pulmonary IL-13+CD4+ T cells, whereas IL-13+ ILCs and IL-33 remained elevated. Administration of A. lwoffii mirrored the findings from the CD4creIL-13 KO mice, providing a translational approach for disease protection in early life. These data demonstrate that IL-13+CD4+ T cells, rather than IL-13+ ILCs or IL-33, are critical for inception of allergic AHR in early life.
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Affiliation(s)
- Sejal Saglani
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK. .,Respiratory Paediatrics, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK
| | - Lisa G Gregory
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Avneet K Manghera
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - William J Branchett
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Faith Uwadiae
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Lewis J Entwistle
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - R A Oliver
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jessica E Vasiliou
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Rebekah Sherburn
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Stephen Lui
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - F Puttur
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - David Vöhringer
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg Wasserturmstrasse 3-5, 91054 Erlangen, Germany
| | - Simone A Walker
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - James Buckley
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Ruth Grychtol
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Valentina Fainardi
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Laura Denney
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Adam Byrne
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Erika von Mutius
- Dr Von Hauner Childrens Hospital of Ludwig-Maximilians-Universitaet of Munich and Helmholtz Zentrum Munchen-German Research Center for Environmental Health, Institute for Asthma and Allergy Prevention, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
| | - Andrew Bush
- Respiratory Paediatrics, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK
| | - Clare M Lloyd
- Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.
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17
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Abstract
Patients with cerebral palsy (CP), especially those at the severe end of the spectrum (Gross Motor Function Classification System levels IV-V equivalent), frequently suffer from sleep disturbance and sleep-disordered breathing (SDB). Non-invasive ventilation (NIV) is increasingly used in this patient group, albeit with little published evidence of its effectiveness in CP. This article aims to review the current evidence in the use of NIV in children with CP, highlighting areas of uncertainties, as well as the balance of potential risks, challenges and benefits. We would also share our experience and practical considerations in using NIV to manage SDB in this group of patients. Between January 2010 and December 2016, 21 patients (median age 11.1 (range 1.7-16.1) years) with CP were initiated on NIV at Great Ormond Street Hospital for Children following diagnosis of moderate to severe SDB on cardiorespiratory polygraphy. Over half of our patients with CP (n=11) failed to establish on NIV either due to intolerance of mask and/or ventilation pressure at the initial trial in hospital, or poor adherence during follow-up, in contrast to the overall failure rate of 8.7% among total patient population commenced on NIV. Children with CP constitute a relatively small but challenging group of patients. Decision to undertake NIV should be individualised, based on benefit outweighing the risk and burden of the treatment.
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Affiliation(s)
- Ruth Grychtol
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Elaine Y Chan
- Respiratory Unit, Great Ormond St Hospital for Children, London, UK
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18
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Skuljec J, Jirmo AC, Habener A, Talbot SR, Pul R, Grychtol R, Aydin M, Kleinschnitz C, Happle C, Hansen G. Absence of Regulatory T Cells Causes Phenotypic and Functional Switch in Murine Peritoneal Macrophages. Front Immunol 2018; 9:2458. [PMID: 30429849 PMCID: PMC6220442 DOI: 10.3389/fimmu.2018.02458] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/14/2018] [Accepted: 10/04/2018] [Indexed: 01/05/2023] Open
Abstract
Tissue macrophages are important components of tissue homeostasis and inflammatory pathologies. In the peritoneal cavity, resident macrophages interact with a variety of immune cells and can exhibit broad range of phenotypes and functions. Forkhead-box-P3 (FOXP3)+ regulatory T cells (Tregs) play an indispensable role in maintaining immunological tolerance, yet whether, and how the pathological condition that results from the lack of functional Tregs affects peritoneal macrophages (PM) is largely unknown. We used FOXP3-deficient scurfy (Sf) mice to investigate PM behavior in terms of the missing crosstalk with Tregs. Here, we report that Treg deficiency induced a marked increase in PM numbers, which was reversed after adoptive transfer of CD4+ T cells or neutralization of macrophage colony-stimulating factor. Ex vivo assays demonstrated a pro-inflammatory state of PM from Sf mice and signs of excessive activation and exhaustion. In-depth immunophenotyping of Sf PM using single-cell chipcytometry and transcriptome analysis revealed upregulation of molecules involved in the initiation of innate and adaptive immune responses. Moreover, upon transfer to non-inflammatory environment or after injection of CD4+ T cells, PM from Sf mice reprogramed their functional phenotype, indicating remarkable plasticity. Interestingly, frequencies, and immune polarization of large and small PM subsets were dramatically changed in the FOXP3-deficient mice, suggesting distinct origin and specialized function of these subsets in inflammatory conditions. Our findings demonstrate the significant impact of Tregs in shaping PM identity and dynamics. A better understanding of PM function in the Sf mouse model may have clinical implication for the treatment of immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, and other forms of immune-mediated enteropathies.
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Affiliation(s)
- Jelena Skuljec
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Department of Neurology, Essen University Hospital, Essen, Germany
| | - Adan Chari Jirmo
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Anika Habener
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Steven R Talbot
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover, Germany
| | - Refik Pul
- Department of Neurology, Essen University Hospital, Essen, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Malik Aydin
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,HELIOS Medical Center Wuppertal, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research, Witten/Herdecke University, Wuppertal, Germany
| | | | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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Grychtol R, Abel F, Fitzgerald DA. The role of sleep diagnostics and non-invasive ventilation in children with spinal muscular atrophy. Paediatr Respir Rev 2018; 28:18-25. [PMID: 30396824 DOI: 10.1016/j.prrv.2018.07.006] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 01/13/2023]
Abstract
Spinal muscular atrophy (SMA) is a degenerative motor neurone disorder causing progressive muscular weakness. Without assisted ventilation or novel therapies, most children with SMA type 1 die before the second year of life due to respiratory failure as the respiratory muscles and bulbar function are severely affected. Active respiratory treatment (mechanically assisted cough, invasive or non-invasive ventilation) has improved survival significantly in recent decades, but often at the cost of becoming ventilator dependent. The advent of a new oligonucleotide based therapy (Nusinersen) has created new optimism for improving motor function. However, the long-term effect on respiratory function is unclear and non-invasive respiratory support will remain an important part of medical management in patients with SMA. This review summarises the existing knowledge about sleep-disordered breathing and respiratory failure in patients with SMA, especially type 1, as well as the evidence of improved outcome and survival in patients treated with non-invasive or invasive ventilation. Practical considerations and ethical concerns are delineated with discussion on how these may be affected by the advent of new therapies such as Nusinersen.
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Affiliation(s)
- Ruth Grychtol
- Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Francois Abel
- Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | - Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Happle C, Meyer-Decking L, Dreier A, Wetzke M, Gläsener S, Grychtol R, Braubach P, Jablonka A, Haid S, Jirmo AC, Habener A, Skuljec J, Hansen G. Improved protocol for simultaneous analysis of leukocyte subsets and epithelial cells from murine and human lung. Exp Lung Res 2018; 44:127-136. [PMID: 29677457 DOI: 10.1080/01902148.2018.1432721] [Citation(s) in RCA: 3] [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: 10/17/2022]
Abstract
PURPOSE To study and isolate lung cells by flow cytometry, enzymatic digestion and generation of single cell suspensions is required. This significantly influences expression of cellular epitopes and protocols need to be adapted for the best isolation and subsequent analysis of specific cellular subsets. MATERIALS AND METHODS We optimized protocols for the simultaneous isolation and characterization of specific human and murine lung cell types. For alveolar epithelial cells (AEC), a primarily dispase based digestion method and for leukocytes, a primarily collagenase based technique was adapted. Protocols were applied in parallel in either single experimental mice or human lung specimens. RESULTS Optimized dispase/DNase digestion yielded a high percentage of Epcam+CD45-CD31- AEC as assessed by flow cytometry. Epcam+CD45-CD3-CD11b-CD11c-CD16/32-CD19-CD31-F4/80- AEC were readily sortable with high purity and typical morphology and function upon in vitro stimulation with lipopolysaccharide or respiratory-syncytial-virus (RSV) infection. To analyze lung leukocytes, specimens were digested with an adapted collagenase/DNase protocol yielding high percentages of viable leukocytes with typical morphology, function, and preserved subset specific leukocyte markers. Both protocols could be applied simultaneously in a single experimental mouse post mortem. Application of both digestion methods in primary human lung specimens yielded similar results with high proportions of Epcam+CD45- human AEC after dispase/DNase digestion and preservation of human T cell epitopes after collagenase/DNase digestion. CONCLUSION The here described protocols were optimized for the simple and efficient isolation of murine and human lung cells. In contrast to previously described techniques, they permit simultaneous in-depth characterization of pulmonary epithelial cells and leukocyte subsets such as T helper, cytotoxic T, and B cells from one sample. As such, they may help to comprehensively and sustainably characterize murine and human lung specimens and facilitate studies on the role of lung immune cells in different respiratory pathologies.
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Affiliation(s)
- Christine Happle
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Lena Meyer-Decking
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany
| | - Anika Dreier
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Martin Wetzke
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany
| | - Stephanie Gläsener
- b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Ruth Grychtol
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Peter Braubach
- b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany.,c Department of Pathology , Hannover Medical School , Hannover , Germany
| | - Alexandra Jablonka
- d Department of Clinical Immunology and Rheumatology , Hannover Medical School , Hannover , Germany.,e German Center for Infection Research (DZIF) , Standort Hannover-Braunschweig , Germany
| | - Sibylle Haid
- f Experimental Virology and TWINCORE , a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research , Hannover , Germany
| | - Adan Chari Jirmo
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Anika Habener
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
| | - Jelena Skuljec
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany
| | - Gesine Hansen
- a Department of Pediatrics, Allergology, and Neonatology , Hannover Medical School , Hannover , Germany.,b German Center for Lung Research , Biomedical Research in End Stage and Obstructive Lung Disease/ BREATH Hannover , Germany
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Elgizouli M, Logan C, Grychtol R, Rothenbacher D, Nieters A, Heinzmann A. Reduced PRF1 enhancer methylation in children with a history of severe RSV bronchiolitis in infancy: an association study. BMC Pediatr 2017; 17:65. [PMID: 28253869 PMCID: PMC5335730 DOI: 10.1186/s12887-017-0817-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 02/21/2017] [Indexed: 01/09/2023] Open
Abstract
Background Acute lower respiratory tract infection is the commonest disease affecting children under five worldwide. Respiratory syncytial virus (RSV) is among the most common causative pathogens. Epidemiological data suggest an association between severe viral respiratory infections in infancy and increased incidence of childhood wheeze and asthma. DNA methylation is involved in immune cell differentiation and identity. It provides an avenue for environmental influences on the genome and therefore has potential as a marker for sustained effects of infectious insults. In this study we investigated the association between DNA methylation patterns in the perforin gene (PRF1) in childhood and a history of hospitalisation for severe RSV disease in the first two years of life. Methods In this retrospective study, we explored patterns of whole blood DNA methylation at a methylation sensitive region of the proximal PRF1 enhancer in a group of children with a record of hospitalisation for severe RSV disease during infancy (n = 43) compared to healthy controls matched for age and sex with no similar hospitalisation history, no allergy and no persistent wheeze (n = 43). Univariate and bivariate conditional logistic regression analyses were conducted to test the association between PRF1 enhancer methylation and record of hospitalisation for RSV disease. Results Children with a record of hospitalisation for severe RSV bronchiolitis demonstrated markedly lower levels of DNA methylation at two cytosine-phosphate-guanine dinucleotide (CpG) loci of the PRF1 proximal enhancer, corresponding to a signal transducer and activator of transcription 5 (STAT5) responsive element, compared to controls, adjusted odds ratios of 0.82 (95% confidence interval [CI] 0.71, 0.94) and 0.73 (95% CI 0.58, 0.92) for each 1% increase in DNA methylation. Smoking in the household showed a significant influence on DNA methylation at the assayed positions. Conclusions Our findings support an association between childhood DNA methylation patterns in PRF1 and a record of severe RSV infection in infancy. Longitudinal studies are required to establish the utility of PRF1 methylation as a marker of severe RSV disease.
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Affiliation(s)
- Magdeldin Elgizouli
- Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 115 4, Freiburg, D-79106, Germany
| | - Chad Logan
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Ruth Grychtol
- Department of Pediatrics and Adolescent Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Alexandra Nieters
- Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 115 4, Freiburg, D-79106, Germany.
| | - Andrea Heinzmann
- Department of Pediatrics and Adolescent Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Castanhinha S, Sherburn R, Walker S, Gupta A, Bossley CJ, Buckley J, Ullmann N, Grychtol R, Campbell G, Maglione M, Koo S, Fleming L, Gregory L, Snelgrove RJ, Bush A, Lloyd CM, Saglani S. Pediatric severe asthma with fungal sensitization is mediated by steroid-resistant IL-33. J Allergy Clin Immunol 2015; 136:312-22.e7. [PMID: 25746970 PMCID: PMC4534777 DOI: 10.1016/j.jaci.2015.01.016] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [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: 08/13/2014] [Revised: 12/24/2014] [Accepted: 01/05/2015] [Indexed: 11/16/2022]
Abstract
Background The mechanism underlying severe asthma with fungal sensitization (SAFS) is unknown. IL-33 is important in fungus-induced asthma exacerbations, but its role in fungal sensitization is unexplored. Objective We sought to determine whether fungal sensitization in children with severe therapy-resistant asthma is mediated by IL-33. Methods Eighty-two children (median age, 11.7 years; 63% male) with severe therapy-resistant asthma were included. SAFS (n = 38) was defined as specific IgE or skin prick test response positivity to Aspergillus fumigatus, Alternaria alternata, or Cladosporium herbarum. Clinical features and airway immunopathology were assessed. Chronic exposure to house dust mite and A alternata were compared in a neonatal mouse model. Results Children with SAFS had earlier symptom onset (0.5 vs 1.5 years, P = .006), higher total IgE levels (637 vs 177 IU/mL, P = .002), and nonfungal inhalant allergen-specific IgE. Significantly more children with SAFS were prescribed maintenance oral steroids (42% vs 14%, P = .02). SAFS was associated with higher airway IL-33 levels. In neonatal mice A alternata exposure induced higher serum IgE levels, pulmonary IL-33 levels, and IL-13+ innate lymphoid cell (ILC) and TH2 cell numbers but similar airway hyperresponsiveness (AHR) compared with those after house dust mite exposure. Lung IL-33 levels, IL-13+ ILC numbers, TH2 cell numbers, IL-13 levels, and AHR remained increased with inhaled budesonide during A alternata exposure, but all features were significantly reduced in ST2−/− mice lacking a functional receptor for IL-33. Conclusion Pediatric SAFS was associated with more oral steroid therapy and higher IL-33 levels. A alternata exposure resulted in increased IL-33–mediated ILC2 numbers, TH2 cell numbers, and steroid-resistant AHR. IL-33 might be a novel therapeutic target for SAFS.
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Affiliation(s)
- Susana Castanhinha
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom
| | - Rebekah Sherburn
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Simone Walker
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Atul Gupta
- Department of Respiratory Paediatrics, Kings College Hospital, London, United Kingdom
| | - Cara J Bossley
- Department of Respiratory Paediatrics, Kings College Hospital, London, United Kingdom
| | - James Buckley
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Nicola Ullmann
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom
| | - Ruth Grychtol
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Gaynor Campbell
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Marco Maglione
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom
| | - Sergio Koo
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom
| | - Louise Fleming
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom; Airways Disease, NHLI, Imperial College London, London, United Kingdom
| | - Lisa Gregory
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Robert J Snelgrove
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Andrew Bush
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom; Airways Disease, NHLI, Imperial College London, London, United Kingdom
| | - Clare M Lloyd
- Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom
| | - Sejal Saglani
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, United Kingdom; Leukocyte Biology, NHLI, Imperial College London, London, United Kingdom.
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Kubiak C, de Andres-Trelles F, Kuchinke W, Huemer KH, Thirstrup S, Whitfield K, Libersa C, Barraud B, Grählert X, Dreier G, Grychtol R, Temesvari Z, Blasko G, Kardos G, O'Brien T, Cooney M, Gaynor S, Schieppati A, Sanz N, Hernandez R, Asker-Hagelberg C, Johansson H, Bourne S, Byrne J, Asghar A, Husson JM, Gluud C, Demotes-Mainard J. Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN). Trials 2009; 10:95. [PMID: 19835581 PMCID: PMC2768680 DOI: 10.1186/1745-6215-10-95] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 10/16/2009] [Indexed: 12/03/2022] Open
Abstract
Background Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. Methods In order to summarise the current situation in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN) developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching an agreement on a common classification was the initial step in the development of the survey. Results The ECRIN transnational working group on regulation, composed of experts in the field of clinical research from ten European countries, defined seven major categories of clinical research that seem relevant from both the regulatory and the scientific points of view, and correspond to congruent definitions in all countries: clinical trials on medicinal products; clinical trials on medical devices; other therapeutic trials (including surgery trials, transplantation trials, transfusion trials, trials with cell therapy, etc.); diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.); and epidemiology studies. Our classification was essential to develop a survey focused on protocol submission to ethics committees and competent authorities, procedures for amendments, requirements for sponsor and insurance, and adverse event reporting following five main phases: drafting, consensus, data collection, validation, and finalising. Conclusion The list of clinical research categories as used for the survey could serve as a contribution to the, much needed, task of harmonisation and simplification of the regulatory requirements for clinical research in Europe.
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Affiliation(s)
- Christine Kubiak
- Institut Thématique Santé Publique, Institut National de la Santé et de la Recherche Médicale (Inserm), Paris, France.
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Mailaparambil B, Grychtol R, Heinzmann A. Respiratory syncytial virus bronchiolitis and asthma - insights from recent studies and implications for therapy. ACTA ACUST UNITED AC 2009; 8:202-7. [PMID: 19601880 DOI: 10.2174/187152809788681056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Infection with respiratory syncytial virus (RSV) is a leading cause of upper and lower respiratory tract infection in infants. It is accompanied by a considerably disease burden and a hospitalisation rate of up to 3% in infected infants. Besides, it is still a matter of intensive discussion whether severe RSV infection in early infancy causes the development of asthma later in live or whether RSV bronchiolitis just chronologically precedes asthma in children who are susceptible to asthma. The latter could be due to a common genetic background of both diseases predisposing to an exaggerated inflammatory response of the lungs to allergens and pathogens. Genetic studies might help to elucidate the mechanisms leading to both diseases and to highlight common as well as diverse pathways. The results of such investigations will influence the current understanding of the diseases and might even change our therapeutical approaches to both disorders. This review summarizes current findings in the genetics of bronchial asthma and severe RSV bronchiolitis. The question whether a relationship exists between severe RSV bronchiolitis in infancy and childhood asthma will also be discussed by taking recent epidemiological studies in account. A special focus is laid on the implications of these findings for a targeted drug therapy of both diseases.
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Affiliation(s)
- Beena Mailaparambil
- Centre for Pediatrics and Adolescent Medicine, University of Freiburg, D-79106 Freiburg, Germany
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Grychtol R. ["Little hedgehogs of doubts"--success and discourse of insulin shock therapy in the 1930s to 1950s]. Praxis (Bern 1994) 2008; 97:835-839. [PMID: 18754336 DOI: 10.1024/1661-8157.97.15.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Insulin shock therapy was one of the major somatic treatments in psychiatry in the 1930s. Even though this treatment was risky, expensive and completely empirical, it spread all over the industrialised world within few years. The development of several centres for this new treatment contributed to this success story, mainly the Viennese Psychiatric-neurological clinic and the Swiss asylum Münsingen. Visiting psychiatrists in these clinics and Jewish émigrés became important advocates of the new therapy in other countries. The success of insulin coma therapy was also based on the hope of many psychiatrists in the 1930s for a more somatic approach for mental illness- thereby promising to catch up with biologically defined 20th century medicine. However the discussion shows that the basic concepts of psychiatric treatment first changed with the discovery of new drugs in the 1950s.
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Affiliation(s)
- R Grychtol
- Institut für Ethik und Geschichte der Medizin der Albert-Ludwigs-Universität, Freiburg i. Br.
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