Capital Medical University, Beijing, China
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Asthma III
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM
PURPOSE: The cytokines IL-33, thymic stromal lymphopoietin (TSLP) and IL-25 have been implicated in asthma pathogenesis owing to the ability to promote Th2-type cytokine synthesis, but their relative importance in “real-life” human asthma is unclear. In the present study, using bronchial alveolar lavage fluid (BALF) as window we aimed to examine airways concentrations of these mediators, along with those of Th1- and Th2-type cytokines in a large group asthmatics (n=70) and controls (n=30), and in the asthmatics compare their concentrations with those of Th1- and Th2-type cytokines, global IgE synthesis and lung function.
METHODS: Analytes were measured in BALF using Meso Scale Discovery (MSD) system and in house ELISA.
RESULTS: The median BALF concentrations of IL-33, TSLP, IL-4, IL-5, IL-13 and IL-12p70, but not IL-25, IL-2 and IFN-g were significantly greater in the asthmatics compared with the controls (p < 0.05). In the asthmatics, the median concentrations of BALF Th2 cytokines were significantly higher in those patients in the middle and upper tertiles of BALF IL-33 and TSLP concentrations compared with those in the lower tertile (p < 0.05). These tertiles of patients also had greater infiltration of BALF eosinophils and neutrophils (p < 0.05) and significantly higher median serum IgE concentrations and lower lung function (FEV1) compared with those in the lower tertile (p < 0.05).
CONCLUSIONS: The data implicate the Th2-promoting cytokines TSLP and IL-33 in a “high inflammation, high Th2, lower lung function and higher global IgE synthesis” endotype of asthma, highlighting them as potential key molecular targets for individualized asthma therapy.
CLINICAL IMPLICATIONS: These anomalies illustrate some of the challenges arising in studies attempting to define asthma “endotypes”, which might be helpful for personalized treatment in asthma.
DISCLOSURE: The following authors have nothing to disclose: Wei Wang, Yan Li, Zhe Lv, Yun Li, Yan Chen, Matt Edwards, Betty Shamji, Kewu Huang, Chris Corrigan, Sun Ying
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