Dynamics of helper CD4 T cells during acute and stable allergic asthma

Mucosal Immunol. 2018 Nov;11(6):1640-1652. doi: 10.1038/s41385-018-0057-9. Epub 2018 Aug 7.

Abstract

Asthma comprises heterogeneous clinical subtypes driven by diverse pathophysiological mechanisms. We characterized the modulation of the inflammatory environment with the phenotype, gene expression, and function of helper CD4 T cells among acutely exacerbated and stable asthma patients. Systemic Th2 immune deviation (IgE and Th2 cytokines) and inflammation (IL-6, CRP) were associated with increased Th17 cells during acute asthma. Th2/Th17 cell differentiation during acute asthma was regulated by the enhanced expression of transcription factors (c-MAF, IRF-4). The development of pathogenic Th2 cells during acute asthma was characterized by the secretion of inflammatory cytokines coupled with Th2 molecules and PPARγ expression. The acquisition of CD15S, CD39, CD101, and CCR4 contributed to the increased heterogeneity of Regulatory T cells during asthma. Two clusters were derived from above cytokines, CD4 T cell phenotypes, and clinical data. Cluster 1, characterized by high eosinophils, Th2 and ILC2 frequencies, and higher exacerbation rates, may represent Th2-high subtype. Cluster 2 represents a more complex subtype; it is constituted by higher neutrophils or Th17 frequencies, higher inhaled corticosteroids dose and poor asthma control. In conclusion, we characterized systematically and longitudinally Th2-high and non-Th2 asthma subtypes and the heterogeneity of CD4 T cells in stable and acute asthma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adaptor Proteins, Signal Transducing / genetics
  • Adaptor Proteins, Signal Transducing / metabolism
  • Adult
  • Asthma / immunology*
  • CD4 Antigens / metabolism
  • Cell Differentiation
  • Cells, Cultured
  • Cytokines / metabolism
  • Disease Progression
  • Female
  • Humans
  • Hypersensitivity / immunology*
  • Immunoglobulin E / blood
  • Immunomodulation
  • Interferon Regulatory Factors / genetics
  • Interferon Regulatory Factors / metabolism
  • Male
  • PPAR gamma / genetics
  • Th17 Cells / immunology*
  • Th2 Cells / immunology*
  • Young Adult

Substances

  • Adaptor Proteins, Signal Transducing
  • CD4 Antigens
  • CMIP protein, human
  • Cytokines
  • Interferon Regulatory Factors
  • PPAR gamma
  • interferon regulatory factor-4
  • Immunoglobulin E