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ABSTRACT: Background
The mechanism of TH2/TH17-predominant and TH2/TH17-low asthma is unknown.Objective
We sought to study the immune mechanism of TH2/TH17-predominant and TH2/TH17-low asthma.Methods
In a previously reported cohort of 60 asthmatic patients, 16 patients were immunophenotyped with TH2/TH17-predominant asthma and 22 patients with TH2/TH17-low asthma. We examined bronchoalveolar lavage (BAL) fluid leukocytes, cytokines, mediators, and epithelial cell function for these asthma subgroups.Results
Patients with TH2/TH17-predominant asthma had increased IL-1β, IL-6, IL-23, C3a, and serum amyloid A levels in BAL fluid, and these correlated with IL-1β and C3a levels. TH2/TH17 cells expressed higher levels of the IL-1 receptor and phospho-p38 mitogen-activated protein kinase. Anakinra, an IL-1 receptor antagonist protein, inhibited BAL TH2/TH17 cell counts. TH2/TH17-low asthma had 2 distinct subgroups: neutrophilic asthma (45%) and pauci-inflammatory asthma (55%). This contrasted with patients with TH2/TH17-predominant and TH2-predominant asthma, which included neutrophilic asthma in 6% and 0% of patients, respectively. BAL fluid neutrophils strongly correlated with BAL fluid myeloperoxidase, IL-8, IL-1α, IL-6, granulocyte colony-stimulating factor, and GM-CSF levels. Sixty percent of the patients with neutrophilic asthma had a pathogenic microorganism in BAL culture, which suggested a subclinical infection.Conclusion
We uncovered a critical role for the IL-1β pathway in patients with TH2/TH17-predminant asthma. A subgroup of patients with TH2/TH17-low asthma had neutrophilic asthma and increased BAL fluid IL-1α, IL-6, IL-8, granulocyte colony-stimulating factor, and GM-CSF levels. IL-1α was directly involved in IL-8 production and likely contributed to neutrophilic asthma. Sixty percent of neutrophilic patients had a subclinical infection.
SUBMITTER: Liu W
PROVIDER: S-EPMC5376378 | biostudies-literature | 2017 May
REPOSITORIES: biostudies-literature

Liu Weimin W Liu Sucai S Verma Mukesh M Zafar Iram I Good James T JT Rollins Donald D Groshong Stephen S Gorska Magdalena M MM Martin Richard J RJ Alam Rafeul R
The Journal of allergy and clinical immunology 20161001 5
<h4>Background</h4>The mechanism of T<sub>H</sub>2/T<sub>H</sub>17-predominant and T<sub>H</sub>2/T<sub>H</sub>17-low asthma is unknown.<h4>Objective</h4>We sought to study the immune mechanism of T<sub>H</sub>2/T<sub>H</sub>17-predominant and T<sub>H</sub>2/T<sub>H</sub>17-low asthma.<h4>Methods</h4>In a previously reported cohort of 60 asthmatic patients, 16 patients were immunophenotyped with T<sub>H</sub>2/T<sub>H</sub>17-predominant asthma and 22 patients with T<sub>H</sub>2/T<sub>H</sub>17 ...[more]