TH2 and TH17 inflammatory pathways are reciprocally regulated in asthma

DF Choy, KM Hart, LA Borthwick, A Shikotra… - Science translational …, 2015 - science.org
DF Choy, KM Hart, LA Borthwick, A Shikotra, DR Nagarkar, S Siddiqui, G Jia, CM Ohri…
Science translational medicine, 2015science.org
Increasing evidence suggests that asthma is a heterogeneous disorder regulated by distinct
molecular mechanisms. In a cross-sectional study of asthmatics of varying severity (n= 51),
endobronchial tissue gene expression analysis revealed three major patient clusters: TH2-
high, TH17-high, and TH2/17-low. TH2-high and TH17-high patterns were mutually
exclusive in individual patient samples, and their gene signatures were inversely correlated
and differentially regulated by interleukin-13 (IL-13) and IL-17A. To understand this …
Increasing evidence suggests that asthma is a heterogeneous disorder regulated by distinct molecular mechanisms. In a cross-sectional study of asthmatics of varying severity (n = 51), endobronchial tissue gene expression analysis revealed three major patient clusters: TH2-high, TH17-high, and TH2/17-low. TH2-high and TH17-high patterns were mutually exclusive in individual patient samples, and their gene signatures were inversely correlated and differentially regulated by interleukin-13 (IL-13) and IL-17A. To understand this dichotomous pattern of T helper 2 (TH2) and TH17 signatures, we investigated the potential of type 2 cytokine suppression in promoting TH17 responses in a preclinical model of allergen-induced asthma. Neutralization of IL-4 and/or IL-13 resulted in increased TH17 cells and neutrophilic inflammation in the lung. However, neutralization of IL-13 and IL-17 protected mice from eosinophilia, mucus hyperplasia, and airway hyperreactivity and abolished the neutrophilic inflammation, suggesting that combination therapies targeting both pathways may maximize therapeutic efficacy across a patient population comprising both TH2 and TH17 endotypes.
AAAS