Innate immunity is a key factor for the resolution of inflammation in asthma

The resolution of inflammation is an integral and natural part of the physiological response to tissue injury, infection and allergens or other noxious stimuli. Resolution is now recognised as an active process with highly regulated cellular and biochemical events. Recent discoveries have highlighted that innate inflammatory cells have bimodal effector functions during the inflammatory response, including active roles during the resolution process. Several mediators displaying potent pro-resolving actions have recently been uncovered. Lipoxin A4, the lead member of this new class of pro-resolving mediators, has anti-inflammatory actions on type 2 innate lymphoid cells and pro-resolving actions through natural killer cells in asthma immunobiology. Eosinophils are also able to control crucial aspects of resolution through the generation of pro-resolving mediators. Uncontrolled asthma has been associated with a defect in thegeneration of specialised pro-resolving mediators, including lipoxin A4 and protectin D1. Thus, bioactive stable analogue mimetics of these mediators that can harness endogenous resolution mechanisms for inflammation may offer new therapeutic strategies for asthma and airway inflammation associated diseases

Continuous Rather Than Solely Early Farm Exposure Protects From Hay Fever Development

BACKGROUND: An important window of opportunity for early-life exposures has been proposed for the development of atopic eczema and asthma.OBJECTIVE: However, it is unknown whether hay fever with a peak incidence around late school age to adolescence is similarly determined very early in life.METHODS: In the Protection against Allergy-Study in Rural Environments (PASTURE) birth cohort potentially relevant exposures such as farm milk consumption and exposure to animal sheds were assessed at multiple time points from infancy to age 10.5 years and classified by repeated measure latent class analyses (n [ 769). Fecal samples at ages 2 and 12 months were sequenced by 16S rRNA. Hay fever was defined by parent -reported symptoms and/or physician's diagnosis of hay fever in the last 12 months using questionnaires at 10.5 years.RESULTS: Farm children had half the risk of hay fever at 10.5 years (adjusted odds ratio [aOR] 0.50; 95% CI 0.31-0.79) than that of nonfarm children. Whereas early life events such as gut microbiome richness at 12 months (aOR 0.66; 95% CI 0.46-0.96) and exposure to animal sheds in the first 3 years of life (aOR 0.26; 95% CI 0.06-1.15) were determinants of hay fever, the continuous consumption of farm milk from infancy up to school age was necessary to exert the protective effect (aOR 0.35; 95% CI 0.17-0.72).CONCLUSIONS: While early life events determine the risk of subsequent hay fever, continuous exposure is necessary to achieve protection. These findings argue against the notion that only early life exposures set long-lasting trajectories. (c) 2022 The Authors. Published by Elsevier IncPeer reviewe

An integrated molecular risk score early in life for subsequent childhood asthma risk.

BACKGROUND Numerous children present with early wheeze symptoms, yet solely a subgroup develops childhood asthma. Early identification of children at risk is key for clinical monitoring, timely patient-tailored treatment, and preventing chronic, severe sequelae. For early prediction of childhood asthma, we aimed to define an integrated risk score combining established risk factors with genome-wide molecular markers at birth, complemented by subsequent clinical symptoms/diagnoses (wheezing, atopic dermatitis, food allergy). METHODS Three longitudinal birth cohorts (PAULINA/PAULCHEN, n = 190 + 93 = 283, PASTURE, n = 1133) were used to predict childhood asthma (age 5-11) including epidemiological characteristics and molecular markers: genotype, DNA methylation and mRNA expression (RNASeq/NanoString). Apparent (ap) and optimism-corrected (oc) performance (AUC/R2) was assessed leveraging evidence from independent studies (Naïve-Bayes approach) combined with high-dimensional logistic regression models (LASSO). RESULTS Asthma prediction with epidemiological characteristics at birth (maternal asthma, sex, farm environment) yielded an ocAUC = 0.65. Inclusion of molecular markers as predictors resulted in an improvement in apparent prediction performance, however, for optimism-corrected performance only a moderate increase was observed (upto ocAUC = 0.68). The greatest discriminate power was reached by adding the first symptoms/diagnosis (up to ocAUC = 0.76; increase of 0.08, p = .002). Longitudinal analysis of selected mRNA expression in PASTURE (cord blood, 1, 4.5, 6 years) showed that expression at age six had the strongest association with asthma and correlation of genes getting larger over time (r = .59, p < .001, 4.5-6 years). CONCLUSION Applying epidemiological predictors alone showed moderate predictive abilities. Molecular markers from birth modestly improved prediction. Allergic symptoms/diagnoses enhanced the power of prediction, which is important for clinical practice and for the design of future studies with molecular markers

Circulating Human Eosinophils Share a Similar Transcriptional Profile in Asthma and Other Hypereosinophilic Disorders

Eosinophils are leukocytes that are released into the peripheral blood in a phenotypically mature state and are capable of being recruited into tissues in response to appropriate stimuli. Eosinophils, traditionally considered cytotoxic effector cells, are leukocytes recruited into the airways of asthma patients where they are believed to contribute to the development of many features of the disease. This perception, however, has been challenged by recent findings suggesting that eosinophils have also immunomodulatory functions and may be involved in tissue homeostasis and wound healing. Here we describe a transcriptome-based approach-in a limited number of patients and controls-to investigate the activation state of circulating human eosinophils isolated by flow cytometry. We provide an overview of the global expression pattern in eosinophils in various relevant conditions, e.g., eosinophilic asthma, hypereosinophilic dermatological diseases, parasitosis and pulmonary aspergillosis. Compared to healthy subjects, circulating eosinophils isolated from asthma patients differed in their gene expression profile which is marked by downregulation of transcripts involved in antigen presentation, pathogen recognition and mucosal innate immunity, whereas up-regulated genes were involved in response to non-specific stimulation, wounding and maintenance of homeostasis. Eosinophils from other hypereosinophilic disorders displayed a very similar transcriptional profile. Taken together, these observations seem to indicate that eosinophils exhibit non-specific immunomodulatory functions important for tissue repair and homeostasis and suggest new roles for these cells in asthma immunobiology

Role of eosinophils and innate lymphoid cells in asthma

Dans la première partie de cette thèse, nous avons cherché à déterminer le rôle de l’éosinophile circulant dans l’asthme par une approche transcriptomique. Nos résultats suggèrent que l’éosinophile recruté sur un site inflammatoire présente des fonctions immunomodulatrices, importantes dans la réparation tissulaire et le retour à l’homéostasie. Dans la deuxième partie de cette thèse, nous avons étudié le rôle des cellules NK et des cellules lymphoïdes innées de type 2 (ILC2) dans l’inflammation asthmatique. Les cellules NK circulantes sont fortement activées dans l’asthme sévère et ont la capacité d’induire l’apoptose d’éosinophiles autologues in vitro. La PGD2 induit la production d’IL-13 par les ILC2 en synergie avec les cytokines épithéliales IL-25 et IL-33. Enfin, ces fonctions sont régulées par la LXA4. En conclusion, notre travail de thèse met en lumière de nouveaux rôles pour l’éosinophile et les cellules lymphoïdes innées dans l’immunopathologie de l’asthme.In the first part of the thesis, we adopted a transcriptomic-based approach to investigate the activation state of circulating eosinophils in patients with asthma and other unrelated hypereosinophilic diseases. Taken together, our results, which suggest that esoinophils, recruited to inflammatory sites exhibit non-specific immunomodulatory functions important for tissue repair and homeostasis. In the second part of the thesis, we investigated the role of NK cells and type 2 innate lymphoid cells (ILC2) in asthma inflammation. Circulating NK cells are highly activated in severe asthma and promote apoptosis of autologous eosinophils in vitro. ILC2 generate interleukin-13 in response to prostaglandin D2 alone and in a synergistic manner with the airway epithelial cytokines IL-25 and IL-33. Finally, these functions are regulated by lipoxine A4. In conclusion, this thesis highlights new roles for eosinophils and innate lymphoid cells in asthma immunopathology

Role of eosinophils and innate lymphoid cells in asthma

Dans la première partie de cette thèse, nous avons cherché à déterminer le rôle de l’éosinophile circulant dans l’asthme par une approche transcriptomique. Nos résultats suggèrent que l’éosinophile recruté sur un site inflammatoire présente des fonctions immunomodulatrices, importantes dans la réparation tissulaire et le retour à l’homéostasie. Dans la deuxième partie de cette thèse, nous avons étudié le rôle des cellules NK et des cellules lymphoïdes innées de type 2 (ILC2) dans l’inflammation asthmatique. Les cellules NK circulantes sont fortement activées dans l’asthme sévère et ont la capacité d’induire l’apoptose d’éosinophiles autologues in vitro. La PGD2 induit la production d’IL-13 par les ILC2 en synergie avec les cytokines épithéliales IL-25 et IL-33. Enfin, ces fonctions sont régulées par la LXA4. En conclusion, notre travail de thèse met en lumière de nouveaux rôles pour l’éosinophile et les cellules lymphoïdes innées dans l’immunopathologie de l’asthme.In the first part of the thesis, we adopted a transcriptomic-based approach to investigate the activation state of circulating eosinophils in patients with asthma and other unrelated hypereosinophilic diseases. Taken together, our results, which suggest that esoinophils, recruited to inflammatory sites exhibit non-specific immunomodulatory functions important for tissue repair and homeostasis. In the second part of the thesis, we investigated the role of NK cells and type 2 innate lymphoid cells (ILC2) in asthma inflammation. Circulating NK cells are highly activated in severe asthma and promote apoptosis of autologous eosinophils in vitro. ILC2 generate interleukin-13 in response to prostaglandin D2 alone and in a synergistic manner with the airway epithelial cytokines IL-25 and IL-33. Finally, these functions are regulated by lipoxine A4. In conclusion, this thesis highlights new roles for eosinophils and innate lymphoid cells in asthma immunopathology

Facteurs prédictifs de la réponse bronchique lors de tests de provocation bronchique à l'allergène (comparaison entre allergènes de chat, d'acariens et de pollens de graminées.)

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

A new, faster, and safe nasal provocation test method for diagnosing mite allergic rhinitis.

Diagnosing house dust mite (HDM) allergic rhinitis is difficult. The nasal provocation test (NPT) has been shown to be the most pertinent, but several methods are available. According to guidelines, the NPT requires a skin end-point titration and an objective measurement of nasal patency. Hence, NPT is time consuming and its use is limited.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Evaluation of long-term sequelae by cardiopulmonary exercise testing 12 months after hospitalization for severe COVID-19

Abstract Background Cardiopulmonary exercise testing (CPET) is an important clinical tool that provides a global assessment of the respiratory, circulatory and metabolic responses to exercise which are not adequately reflected through the measurement of individual organ system function at rest. In the context of critical COVID-19, CPET is an ideal approach for assessing long term sequelae. Methods In this prospective single-center study, we performed CPET 12 months after symptom onset in 60 patients that had required intensive care unit treatment for a severe COVID-19 infection. Lung function at rest and chest computed tomography (CT) scan were also performed. Results Twelve months after severe COVID-19 pneumonia, dyspnea was the most frequently reported symptom although only a minority of patients had impaired respiratory function at rest. Mild ground-glass opacities, reticulations and bronchiectasis were the most common CT scan abnormalities. The majority of the patients (80%) had a peak O2 uptake (V′O2) considered within normal limits (median peak predicted O2 uptake (V′O2) of 98% [87.2–106.3]). Length of ICU stay remained an independent predictor of V′O2. More than half of the patients with a normal peak predicted V′O2 showed ventilatory inefficiency during exercise with an abnormal increase of physiological dead space ventilation (VD/Vt) (median VD/VT of 0.27 [0.21–0.32] at anaerobic threshold (AT) and 0.29 [0.25–0.34] at peak) and a widened median peak alveolar-arterial gradient for O2 (35.2 mmHg [31.2–44.8]. Peak PetCO2 was significantly lower in subjects with an abnormal increase of VD/Vt (p = 0.001). Impairments were more pronounced in patients with dyspnea. Peak VD/Vt values were positively correlated with peak D-Dimer plasma concentrations from blood samples collected during ICU stay (r2 = 0.12; p = 0.02) and to predicted diffusion capacity of the lung for carbon monoxide (DLCO) (r2 =  − 0.15; p = 0.01). Conclusions Twelve months after severe COVID-19 pneumonia, most of the patients had a peak V′O2 considered within normal limits but showed ventilatory inefficiency during exercise with increased dead space ventilation that was more pronounced in patients with persistent dyspnea. Trial registration: NCT04519320 (19/08/2020)