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Pattern recognition pathways leading to a Th2 cytokine bias in ABPA patients.
[allergic bronchopulmonary aspergillosis]
Allergic
bronchopulmonary
aspergillosis
(
ABPA
)
is
characterized
by
an
exaggerated
Th
2
response
to
Aspergillus
fumigatus
,
but
the
immunological
pathways
responsible
for
this
effect
are
unknown
.
The
aim
of
this
study
was
to
decipher
the
pattern
recognition
receptors
(
PRRs
)
and
cytokines
involved
in
the
Aspergillus-
specific
Th
2
response
,
and
to
study
Aspergillus-induced
responses
in
healthy
controls
and
ABPA
patients
.
Peripheral
blood
mononuclear
cells
(
PBMCs
)
were
stimulated
with
heat-killed
Aspergillus
conidia
,
various
other
pathogens
,
or
PRR-ligands
.
PRRs
and
cytokine
pathways
were
blocked
with
PRR-blocking
reagents
,
anti-
TNF
(
Etanercept
or
Adalimumab
)
,
IL
-
1
Ra
(
Anakinra
)
,
or
IFN
γ
(
IFN-gamma
)
.
ELISA
and
FACS
were
used
to
analyze
cytokine
responses
.
Aspergillus
was
the
only
pathogen
that
stimulated
the
Th
2
cytokines
IL
-
5
and
IL
-
13
,
while
Gram
-negative
bacteria
,
Gram
-
positive
bacteria
,
Candida
albicans
,
chitin
,
β-glucan
,
or
Toll
like
receptors
(
TLR
)
ligands
did
not
.
Depletion
of
CD
4
(
+
)
cells
abolished
IL
-
13
production
.
Blocking
complement
receptor
3
(
CR
3
)
significantly
reduced
IL
-
5
and
IL
-
13
,
while
blocking
TLR
2
,
TLR
4
or
dectin-
1
had
no
effect
.
ABPA
patients
displayed
increased
Aspergillus-induced
IL
-
5
and
IL
-
13
,
and
decreased
IFN
γ
production
compared
to
healthy
controls
.
All
biological
agents
tested
showed
the
capability
to
inhibit
Th
2
responses
,
but
also
decreased
Aspergillus-induced
IFN
γ
.
Aspergillus
conidia
are
unique
in
triggering
Th
2
responses
in
human
PBMCs
,
through
a
CR
3
-
dependent
pathway
.
ABPA
patients
display
a
significantly
increased
Aspergillus-induced
Th
2
/
Th
1
-
ratio
that
can
be
modulated
by
biologicals
.
These
data
provide
a
rationale
to
explore
IFN
γ
therapy
in
ABPA
as
a
corticosteroid-sparing
treatment
option
,
by
dampening
Th
2
responses
and
supplementing
the
IFN
γ-
deficiency
at
the
same
time
.
This
article
is
protected
by
copyright
.
All
rights
reserved
.
Diseases
Validation
Diseases presenting
"peripheral blood mononuclear cells"
symptom
acute rheumatic fever
allergic bronchopulmonary aspergillosis
cohen syndrome
liposarcoma
malignant atrophic papulosis
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