IL-33-dependent type 2 inflammation during rhinovirus-induced asthma exacerbations in vivo

• Published in: American journal of respiratory and critical care medicine Vol. 190; no. 12; pp. 1373 - 1382
• Main Authors: Jackson, David J, Makrinioti, Heidi, Rana, Batika M J, Shamji, Betty W H, Trujillo-Torralbo, Maria-Belen, Footitt, Joseph, Jerico Del-Rosario, Telcian, Aurica G, Nikonova, Alexandra, Zhu, Jie, Aniscenko, Julia, Gogsadze, Leila, Bakhsoliani, Eteri, Traub, Stephanie, Dhariwal, Jaideep, Porter, James, Hunt, Duncan, Hunt, Toby, Hunt, Trevor, Stanciu, Luminita A, Khaitov, Musa, Bartlett, Nathan W, Edwards, Michael R, Kon, Onn Min, Mallia, Patrick, Papadopoulos, Nikolaos G, Akdis, Cezmi A, Westwick, John, Edwards, Matthew J, Cousins, David J, Walton, Ross P, Johnston, Sebastian L
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 15.12.2014
• Subjects: Adult; Asthma - etiology; Asthma - physiopathology; Asthma - virology; Cells, Cultured; Female; Humans; Inflammation - etiology; Inflammation - physiopathology; Interleukin-13 - physiology; Interleukin-33; Interleukin-4 - physiology; Interleukin-5 - physiology; Interleukins - physiology; Lymphocyte Subsets - physiology; Male; Original; Picornaviridae Infections - complications; Picornaviridae Infections - physiopathology; Rhinovirus; Severity of Illness Index; T-Lymphocytes - physiology; Th2 Cells - physiology; Viral Load; ILC2; infection; virus; Th2
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.201406-1039OC

Rhinoviruses are the major cause of asthma exacerbations; however, its underlying mechanisms are poorly understood. We hypothesized that the epithelial cell-derived cytokine IL-33 plays a central role in exacerbation pathogenesis through augmentation of type 2 inflammation. To assess whether rhinovirus induces a type 2 inflammatory response in asthma in vivo and to define a role for IL-33 in this pathway. We used a human experimental model of rhinovirus infection and novel airway sampling techniques to measure IL-4, IL-5, IL-13, and IL-33 levels in the asthmatic and healthy airways during a rhinovirus infection. Additionally, we cultured human T cells and type 2 innate lymphoid cells (ILC2s) with the supernatants of rhinovirus-infected bronchial epithelial cells (BECs) to assess type 2 cytokine production in the presence or absence of IL-33 receptor blockade. IL-4, IL-5, IL-13, and IL-33 are all induced by rhinovirus in the asthmatic airway in vivo and relate to exacerbation severity. Further, induction of IL-33 correlates with viral load and IL-5 and IL-13 levels. Rhinovirus infection of human primary BECs induced IL-33, and culture of human T cells and ILC2s with supernatants of rhinovirus-infected BECs strongly induced type 2 cytokines. This induction was entirely dependent on IL-33. IL-33 and type 2 cytokines are induced during a rhinovirus-induced asthma exacerbation in vivo. Virus-induced IL-33 and IL-33-responsive T cells and ILC2s are key mechanistic links between viral infection and exacerbation of asthma. IL-33 inhibition is a novel therapeutic approach for asthma exacerbations.