Central role of immunoglobulin (Ig) E in the induction of lung eosinophil infiltration and T helper 2 cell cytokine production: inhibition by a non-anaphylactogenic anti-IgE antibody

Elevated levels of immunoglobulin (Ig) E are associated with bronchial asthma, a disease characterized by eosinophilic inflammation of the airways. Activation of antigen-specific T helper (Th) 2 cells in the lung with the subsequent release of interleukin (IL) 4 and IL-5 is believed to play an important role in the pathogenesis of this disease. In this study, we have used a non-anaphylactogenic anti-mouse-IgE antibody to investigate the relationship between IgE, airway eosinophil infiltration, and the production of Th2 cytokines. Immunization of mice with house dust mite antigen increased serum levels of IgE and IgG. Antigen challenge of immunized but not control mice induced an infiltration of eosinophils in the bronchoalveolar lavage associated with the production of IL-4 and IL-5 from lung purified Thy1.2+ cells activated through the CD3-T cell receptor complex. Administration of the anti-IgE monoclonal antibody (mAb) 6h before antigen challenge neutralized serum IgE but not IgG and inhibited the recruitment of eosinophils into the lungs and the production of IL-4 and IL-5 but not interferon gamma. Studies performed using an anti-CD23 mAb, CD23 deficient and mast cell deficient mice suggest that anti-IgE mAb suppresses eosinophil infiltration and Th2 cytokine production by inhibiting IgE-CD23-facilitated antigen presentation to T cells. Our results demonstrate that IgE-dependent mechanisms are important in the induction of a Th2 immune response and the subsequent infiltration of eosinophils into the airways. Neutralization of IgE, for example, non- anaphylactogenic anti-IgE mAbs may provide a novel therapeutic approach to the treatment of allergic airway disease.     

支气管哮喘患儿诱导痰中炎性细胞类型及炎症相关细胞因子的临床价值研究

目的 探讨支气管哮喘患儿诱导痰中炎性细胞类型及炎症相关细胞因子的临床价值.方法 选取支气管哮喘患儿54例(研究组)作为研究对象,根据哮喘发作期严重程度将研究组分为轻度哮喘组、中度哮喘组和重度哮喘组.另选取性别和年龄相当的支气管肺炎(不合并哮喘)患儿42例作为对照组,检测对照组和研究组治疗前、后诱导痰中炎性细胞类型、T淋...     

重组鼠白细胞介素-12腺病毒载体对哮喘小鼠模型IL-4、IFN-γ表达的影响

目的探讨重组鼠白细胞介素-12(IL-12)基因的腺病毒载体(AdCMVIL-12)对小鼠支气管哮喘模型IL-4、IFN-γ表达的影响。方法雌性BALB/c小鼠50只,按数字随机表法分为5组,每组10只:哮喘模型组、AdCMVIL-12组、AdCMVLacZ组、激素治疗组和正常对照组。并于第20天分别鼻内吸入50μL生理盐水和5×108 PFU AdC-MVIL-12。第28天收集各组小鼠的支气管肺泡灌洗液(BALF),检测IL-4、IFN-γ的变化,RT-PCR方法检测各组肺组织中IL-4、IFN-γmRNA的表达水平。结果哮喘模型组与对照组、AdCMVIL-12组相比较,BALF中的IL-4表达水平明显升高,而IFN-γ在AdCMVIL-12组中的表达水平显著上升。RT-PCR结果显示,哮喘模型组小鼠肺组织IL-4mRNA的表达与AdCMVIL-12组、激素治疗组及正常对照组相比较明显升高;而IFN-γmRNA的表达水平明显下降。结论 AdCMVIL-12对哮喘小鼠的气道及肺组织内的IL-4表达有明显的抑制作用,其机制可能与AdCMVIL-12阻断IL-4的表达,调节Th1/Th2类细胞因子的平衡有关。     

特异性免疫治疗对支气管哮喘患儿Th1／Th2细胞因子表达及呼吸力学的影响

目的探讨特异性免疫治疗（SIT）对支气管哮喘患儿Th1／Th2细胞因子表达及呼吸力学的影响。方法87例支气管哮喘患儿按随机数字法分为2组,对照组（n=42例）采用对症支持疗法,观察组（n=45例）在对症支持治疗基础上加用SIT。比较两组治疗前后Th1／Th2细胞因子、IgE表达及呼吸力学的变化。结果治疗后观察组总有效率、血清IFN-γ表达水平及IFN-γ／／IL-4明显高于对照组（P〈0．05）,而血清IL-4及IgE表达水平明显低于对照组（P〈0．05）,差异均有统计学意义。结论对症支持的基础上加用SIT治疗小儿支气管哮喘能显著提高疗效,促进Th2细胞反应转移到Th1细胞反应,保持Th1／Th2平衡状态,进而改善呼吸力学参数。     

白细胞介素-25与支气管哮喘小鼠发病的关系

目的探讨IL-25与支气管哮喘发病的关系。方法将30只健康雌性Balb/c小鼠随机分为3组：分别为卵白蛋白（OVA）致敏并激发的哮喘模型组（A组）,OVA）致敏、激发并予糖皮质激素治疗组（B组）及正常对照组（C组）,每组10只。于末次激发后24h后各组小鼠摘眼球取血,ELISA法检测其血清IL-25、IFN-γ及IL-4水平。收集支气管肺泡灌洗液（BALF）,行嗜酸性粒细胞（EOS）计数,HE染色观察各组肺组织病理改变。RT-PCR法检测各组肺组织IL-25mRNA和IL-4mRNA表达。结果 1、B组多数小鼠未见明显行为学异常反应,肺组织病理损害较A组明显减轻,BALF中EOS计数（126.2±10.8）×103/L亦显著低于A组（324.7±13.6）×103/L（P〈0.01）。2、A组小鼠血清IL-25、IL-4水平[（80.66±3.06）pg/ml,（124.7±4.13）pg/m]均高于C组[（46.25±1.90）pg/ml,（32.73±2.20）pg/ml],IFN-γ水平[（45.25±5.34）pg/ml]低于C组[（80.56±2.49）pg/ml]其差异均有统计学意义（P〈0.01）。3、A组小鼠肺组织IL-25mRNA和IL-4mRNA表达均高于C组（P〈0.01）,B组小鼠肺组织IL-25mRNA和IL-4mRNA表达均低于A组（P〈0.01）。A组小鼠肺组织IL-25mRNA表达量与BALF中EOS计数呈正相关（r=0.901,P〈0.01）。结论 IL-25参与了哮喘小鼠的发病,在哮喘的发病中起促炎作用,其促进哮喘发病的作用可以被激素抑制。     

Effects of Ecklonia cava ethanolic extracts on airway hyperresponsiveness and inflammation in a murine asthma model: role of suppressor of cytokine signaling.

Ecklonia cava (EC) is a brown alga that evidences radical scavenging activity, bactericidal activity, tyrosinase inhibitory activity, and protease inhibitory activity. However, its anti-allergic effects remain poorly understood. In the current study, we attempted to determine whether pretreatment with EC induces a significant inhibition of asthmatic reactions in a mouse asthma model. Mice sensitized and challenged with ovalbumin (OVA) evidenced typical asthmatic reactions, as follows: an increase in the number of eosinophils in bronchoalveolar lavage fluid; a marked influx of inflammatory cells into the lung around blood vessels and airways, and airway luminal narrowing; the development of airway hyperresponsiveness; the detection of tumor necrosis factor-alpha (TNF-alpha) and Th2 cytokines, including IL-4 and IL-5 in the bronchoalveolar lavage (BAL) fluid; and the detection of allergen-specific immunoglobulin E (IgE) in the serum. However, the administration of EC extract prior to the final airway OVA challenge resulted in a significant inhibition of all asthmatic reactions. We also demonstrated that EC extracts treatment resulted in significant reductions on matrix metalloproteinase-9 (MMP-9) and Suppressor of cytokine signaling-3 (SOCS-3) expression and a reduction in the increased eosinophil peroxidase (EPO) activity. The treatment of animals with EC extracts resulted in a significant reduction in the concentrations of the Th2 cytokine (IL-4 and IL-5) in the airways, without any concomitant increase in the concentration of Th1 cytokines. These findings indicate that EC extracts may prove useful as an adjuvant therapy for allergic airway reactions via the inhibition of the Th2 response. Accordingly, this study may provide evidence that EC extract performs a critical function in the amelioration of the pathogenetic process of asthma in mice.     

血必净注射液对卵蛋白致敏小鼠气道MUC5AC及Th1／Th2细胞因子表达的影响

目的研究血必净注射液对卵蛋白（OVA）致敏小鼠气道MUC5AC及Th1/Th2细胞因子表达的影响,探讨干预气道黏液高分泌的机制。方法卵蛋白腹腔注射致敏小鼠,32只小鼠随机分组为：对照组、哮喘组、地塞米松治疗组和血必净治疗组,每组8只,酶联免疫吸附试验（ELISA）检测小鼠肺泡灌洗液（BALF）中IL-4、IFN-γ的水平变化,实时RT-PCR检测小鼠肺组织MUC5AC mRNA表达变化。结果 （1）与对照组小鼠气道MUC5A mRNA表达（0.377±0.021）相比,哮喘组（1.103±0.087）明显增多（P〈0.01）;地塞米松治疗组（0.403±0.038）及血必净治疗组（0.437±0.031）小鼠气道MUC5A mRNA表达较哮喘组明显降低（P〈0.01）;（2）与对照组小鼠BALF表达IL-4[（22.812±1.978）ng/L]及IFN-γ[（101.232±9.664）ng/L]比较,哮喘组BALF表达IL-4[（87.234±6.901）ng/L]水平升高（P〈0.01）,而IFN-γ表达[（47.231±3.887）ng/L]明显降低（P〈0.01）;与哮喘组比较,地塞米松治疗组（[36.289±3.012）ng/L]及血必净治疗组IL-4水平[（38.112±2.761）ng/L]均显著降低（P〈0.01）;结论血必净注射液降低IL-4和MUC5AC的表达,提示在抑制气道黏液高分泌及控制哮喘方面具有意义。     

针刺对过敏性哮喘大鼠肺肠组织SP-AmRNA表达的影响

目的探讨针刺对过敏性哮喘(哮喘)大鼠肺肠组织表面蛋白A(SP-A)mRNA表达的影响。方法将40只SD大鼠随机分为空白组、哮喘模型组、针刺肺组、针刺肠组、针刺肺肠组,每组各8只。除空白组外,余4组采用腹腔注射卵蛋白致敏,2周后尾静脉注射卵蛋白激发哮喘发作进行造模。空白组、哮喘模型组不针刺,针刺肺组针刺尺泽、孔最、列缺、肺俞穴,针刺肠组针刺曲池、合谷、天枢、上巨虚穴,针刺肺肠组针刺孔最、列缺、曲池、天枢穴。检测并比较各组大鼠针刺后肺肠等组织中SP-A mRNA的表达。结果哮喘模型组肺、大肠及小肠组织中SP-A mRNA的表达均较空白组高(P0.01);针刺肺组、针刺肠组、针刺肺肠组的肺、大肠及针刺肺肠组小肠组织中SP-A mRNA的表达均较哮喘模型组高(P0.05);针刺肺组、针刺肠组的小肠组织中SP-A mRNA的表达与哮喘模型组比较无明显差异(P均0.05)。结论哮喘大鼠肺肠组织SP-A mRNA表达均发生异常,其中肺与大肠生物学相关性最为密切。     

Beta 2-microglobulin-dependent T cells are dispensable for allergen- induced T helper 2 responses

CD4+ and CD8+ alpha/beta+ T cells of the T helper cell (Th)2 phenotype produce the cytokines IL-4, IL-5, and IL-13 that promote IgE production and eosinophilic inflammation. IL-4 may play an important role in mediating the differentiation of antigenically naive alpha/beta+ T cells into Th2 cells. Murine NK1.1+ (CD4+ or CD4-CD8-) alpha/beta+ T cells comprise a beta 2-microglobulin (beta 2m)-dependent cell population that rapidly produces IL-4 after cell activation in vitro and in vivo and has been proposed as a source of IL-4 for Th2 cell differentiation. alpha/beta+ CD8+ T cells, most of which require beta 2m for their development, have also been proposed as positive regulators of allergen-induced Th2 responses. We tested whether beta 2m- dependent T cells were essential for Th2 cell-mediated allergic reactions by treating wild-type, beta 2m-deficient (beta 2m -/-), and IL-4-deficient (IL-4 -/-) mice of the C57BL/6 genetic background with ovalbumin (OVA), using a protocol that induces robust allergic pulmonary disease in wild-type mice. OVA-treated beta 2m -/- mice had circulating levels of total and OVA-specific IgE, pulmonary eosinophilia, and expression of IL-4, IL-5, and IL-13 mRNA in bronchial lymph node tissue similar to that of OVA-treated wild-type mice. In contrast, these responses in OVA-treated IL-4 -/- mice were all either undetectable or markedly reduced compared with wild-type mice, confirming that IL-4 was required in this allergic model. These results indicate that the NK1.1+ alpha/beta+ T cell population, as well as other beta 2m-dependent populations, such as most peripheral alpha/beta+ CD8+ T cells, are dispensable for the Th2 pulmonary response to protein allergens.     

Inflammatory cytokines (IL-4, IL-5 and IL-13)]

The polarized Th2 cells play an important role in the pathogenesis of atopic asthma as well as in the induction of airway inflammation. Th2 cytokines, such as IL-4, IL-5 and IL-13, are pivotal in regulating the allergic phenotype, the IgE response or the inflammatory cell-mediated function. Selective inhibition of Th2 cytokines by pharmacologic agents, including anti-cytokine blocking antibody, cytokine mutant and soluble cytokine receptor, will contribute to asthma therapy. Strategies based on blocking key signaling cytokines are also discussed.     

CD8+ T cells in asthma: friend or foe?

While it is well established that CD4(+) T lymphocytes play a crucial role in the initiation, progression and persistence of asthma, the role of CD8(+) T cells is less understood. CD8(+) T cells form functionally similar subsets which exhibit similar cytokine profiles as Th1 and Th2 cells, known as Tc1 and Tc2. Evidence from animal studies suggest that CD8(+) T cells are capable of regulating IgE production through the induction of IL-12 and IL-18 production in dendritic cells, and that CD8(+) T cells may act to moderate Th2 polarisation within the localised lymph nodes during allergic sensitisation. Such findings have led to the suggestion that Th1 polarising, CD8(+) T cell-inducing vaccines would inhibit the development of airway hyperresponsiveness (AHR) and Th2 cell infiltration. Despite these positive findings, the role of CD8(+) T cells within the lung remains poorly understood. While CD8(+) T cells, particularly those expressing the Tc1 phenotype, are capable of moderating inflammation and suppressing AHR, it has been postulated that Tc2 CD8(+) T cells predominate within established asthma and may act to amplify the inappropriate immune response which defines the condition. Within the clinic, the association between CD8(+) T cells and asthma is almost universally defined as injurious, further suggesting a prejudicial role for these cells within the established disease. CD8(+) T cells may be a valuable potential target for therapeutic intervention, either by potentiating their regulatory effects prior to the development of sensitisation, or through suppressing their pro-inflammatory properties within established atopy.     

In vivo depletion of lung CD11c+ dendritic cells during allergen challenge abrogates the characteristic features of asthma

Although dendritic cells (DCs) play an important role in sensitization to inhaled allergens, their function in ongoing T helper (Th)2 cell-mediated eosinophilic airway inflammation underlying bronchial asthma is currently unknown. Here, we show in an ovalbumin (OVA)-driven murine asthma model that airway DCs acquire a mature phenotype and interact with CD4(+) T cells within sites of peribronchial and perivascular inflammation. To study whether DCs contributed to inflammation, we depleted DCs from the airways of CD11c-diphtheria toxin (DT) receptor transgenic mice during the OVA aerosol challenge. Airway administration of DT depleted CD11c(+) DCs and alveolar macrophages and abolished the characteristic features of asthma, including eosinophilic inflammation, goblet cell hyperplasia, and bronchial hyperreactivity. In the absence of CD11c(+) cells, endogenous or adoptively transferred CD4(+) Th2 cells did not produce interleukin (IL)-4, IL-5, and IL-13 in response to OVA aerosol. In CD11c-depleted mice, eosinophilic inflammation and Th2 cytokine secretion were restored by adoptive transfer of CD11c(+) DCs, but not alveolar macrophages. These findings identify lung DCs as key proinflammatory cells that are necessary and sufficient for Th2 cell stimulation during ongoing airway inflammation.     

支气管哮喘气道炎症表型与Th1/Th2和IgE的相关研究

目的 分析不同气道炎症表型的支气管哮喘患者的循环血辅助性T细胞1/2(Th1/Th2)和IgE水平与临床特征的关系。方法 选择2017年6月至2018年12月于该院诊断为支气管哮喘患者共180例,根据诱导痰液中性粒细胞(Neu)和嗜酸粒细胞(Eos)百分比分为Neu组、Eos组、混合组和寡细胞组,检测循环血Th1/Th2和IgE水平,Th1细胞分泌细胞因子血清干扰素-γ(IFN-)γ和Th2细胞分泌白细胞介素-4(IL-4),比较各组患者的临床特征。结果 Eos组和混合组的Th1/Th2(0.56±0.12、0.59±0.15)明显低于Neu组(0.77±0.23)和寡细胞组(0.72±0.19),但IgE水平[(12.3±4.5)、(11.9±4.3)mg/L],比Neu组和寡细胞组[(7.6±3.2)、(7.2±3.1)mg/L]增加,IFN-γ[(32.6±9.5)、(30.5±8.6)mg/L比(21.2±6.8)、(20.9±5.7)mg/L]和IL-4[(25.7±6.8)、(23.3±6.5)mg/L比(12.4±4.3)、(11.5±4.2)mg/L]水平升高,差异有统计学意义(P<0.05)。Neu组和混合组患者哮喘病程和严重程度明显大于其他两组,吸烟和气道感染率增加;Eos组和混合组患者过敏性鼻炎和皮肤点刺试验阳性率高于其他两组,差异有统计学意义(P<0.05)。4种炎症表型组患者的肺功能包括第1秒用力呼气容积(FEV1)及与用力肺活量的比值(FEV1/FVC)、用力呼气中段流量(MMEF%)、50%用力呼气流量(FEF 50%)和75%用力呼气流量(FEF 75%)比较差异无统计学意义(P>0.05)。结论 支气管哮喘患者具有不同的炎症细胞表型,与循环血Th1/Th2和IgE水平以及临床特征有密切联系。     

外周血淋巴细胞亚群、细胞因子在未足月胎膜早破孕妇中水平变化及与绒毛膜羊膜炎发生的相关性研究

目的 探究外周血T淋巴细胞亚群、B淋巴细胞亚群及细胞因子在未足月胎膜早破(preterm premature rupture of membrane,PPROM)孕妇中水平变化及与绒毛膜羊膜炎发生的相关性.方法 选取2018年1月—2019年12月于本院就诊的PPROM孕妇50例作为研究组,以同期未发生胎膜早破孕妇5...     

特异性脱敏治疗对哮喘Th1/Th2类细胞因子表达的调控

目的探讨特异性脱敏治疗对支气管哮喘T淋巴细胞表达Th1/Th2类细胞因子白细胞介素2(IL-2)和IL-4的调控作用.方法选择30例缓解期哮喘患者和32例健康者,哮喘患者根据特异性皮肤试验结果进行特异性脱敏治疗(SIT),治疗前后采用放射免疫方法检测血清中的IL-2、IL-4和总IgE,同时检测32例正常对照者.结果哮喘患者在SIT前血清Th2类细胞因子IL-4和IgE水平显著性增高,Th1类细胞因子IL-2显著性降低,与对照组比较差异均有统计学意义(均P<0.001);经过特异性脱敏治疗1年以后,哮喘患者血清中IL-2水平明显增高,而IL-4及IgE的水平明显降低,治疗前后比较差异均有统计学意义(均P<0.05);血清中IL-4与IgE水平之间存在显著正相关(r=0.65,P<0.01).结论特异性脱敏治疗使变应原特异性应答从Th2转移到Th1,从而调节哮喘患者Th1/Th2细胞之间的平衡.     

Changes in immune responses to antigen applied to tape-stripped skin with CpG-oligodeoxynucleotide in mice.

CpG-oligodeoxynucleotide (CpG-ODN) plays a critical role in immunity via the augmentation of Th1 and suppression of Th2 responses. We examined here the effect of CpG-ODN on the immune response to an antigen applied to tape-stripped mouse skin by evaluating the production of cytokines and Ig isotypes. Confocal laser scanning microscopy revealed that the model antigen, OVA, and CpG-ODN easily penetrated the tape-stripped skin. Co-administration of CpG-ODN and OVA to the disrupted skin elicited an antigen-specific Th1-predominant immune response and enhanced the production of Th1-type cytokines, IL-12 and IFN-gamma. On the other hand, the production of a Th2-type cytokine, IL-4, was drastically suppressed. Cytokine production was supported by the expression of mRNA in the draining lymph node. In terms of antigen-specific antibody production, the level of IgG2a which is regulated by IFN-gamma was increased by CpG-ODN, but IgE production regulated by IL-4 was suppressed. Furthermore, administration of CpG-ODN via the skin drastically attenuated the production of IgE in mice undergoing IgE-type immune response. Administration of CpG-ODN through the skin may shift the immune response from Th2 to Th1-like response. These results suggested that administration of CpG-ODN via skin is a simple strategy for patients with diseases like AD, which is characterized by Th2-dominated inflammation.     

支气管哮喘患者外周血PD-1，IFN-γ，IL-4与Th细胞及T细胞亚群水平表达的临床意义研究

目的　探讨支气管哮喘患者外周程序性死亡受体1（programmend cell death protein l, PD-1）、干扰素-γ（intorferon-γ,IFN-γ）、白细胞介素-4（interleukin-4,IL-4）与辅助性T细胞（helper-T cell, Th细胞）及T细胞亚群水平表达的临床意义。方法　选取2019年9月～2020年9月就诊于西安国际医学中心医院的80例哮喘患者为研究组,另以同期在该院体检的80例健康成人为对照组,采用肺功能仪检测两组研究对象的肺功能指标;ELISA法检测两组研究对象血清PD-1,IFN-γ和IL-4水平;单克隆抗体间接免疫荧光法检测两组研究对象外周血Th细胞和T淋巴细胞亚群占比,比较两组以上指标差异并分析其临床意义。结果　与对照组相比,研究组肺功能指标FEV1和FEV1/预计值百分比（fevl%pred）、血清PD-1和IFN-γ水平、外周血Th1细胞占比、Th1/Th2比值、CD8+水平以及CD4+/CD8+比值均显著降低,血清IL-4表达水平和外周血Th2细胞及CD4+水平占比均显著升高,差异均有统计学意义（t=3.221~19.847,均P＜0.01）,而两组CD3+水平无显著差异（t=1.132,P=0.259）。结论　支气管哮喘发作伴随着患者血清PD-1水平降低以及IL-4水平增高,从而抑制了Th1细胞产生IFN-γ,并使得Th1/Th2和CD4+/ CD8+平衡状态破坏,各细胞及细胞因子相互制约、相互调节,构成复杂的调节网络,对哮喘的诊断治疗有重要意义。