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IN THE CRIME OF SEVERE ASTHMA INFLAMMATION:

 

Our orders came from the epithelium

IgE, immunoglobulin E; IL, interleukin; TSLP, thymic stromal lymphopoietin  

Focusing on key epithelial cytokines

at the top of the inflammatory cascade (TSLP, IL-33 and IL-25) offers a different way to think about severe asthma.1-3

FOR SOME PEOPLE WITH SEVERE ASTHMA, THE EPITHELIUM IS THE STARTING POINT FOR AN OVERACTIVE IMMUNE RESPONSE TO VARIOUS INSULTS SUCH AS:1-3

Release of epithelial cytokines can result in pathologic inflammation, which can cause increased symptoms and asthma exacerbations.1-3,16

*The mechanisms underlying non-eosinophilic inflammation require further elucidation.

Watch the Mechanism of Disease Video

to learn more about the role of Epithelial Cytokines in severe asthma

Do you have any questions? AstraZeneca's medical experts will be happy to help.

References: 1.  Corren J. New Targeted Therapies for Uncontrolled Asthma. J Allergy Clin Immunol Pract. 2019;7(5):1394-1403.  2.  Lambrecht BN, Hammad H, Fahy JV. The Cytokines of Asthma. Immunity. 2019;50(4):975-991.  3.  Lambrecht BN, Hammad H. The immunology of asthma. Nat Immunol. 2015;16(1):45-56. 4.  Brusselle G, Bracke K. Targeting immune pathways for therapy in asthma and chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014;11 Suppl 5:S322-8. 5. Pelaia G, Vatrella A, Maselli R. The potential of biologics for the treatment of asthma. Nat Rev Drug Discov. 2012;11(12):958-72. 6. Pasha MA, Patel G, Hopp R, et al. Role of innate lymphoid cells in allergic diseases. Allergy Asthma Proc. 2019;40(3):138-145. 7. Brussellle G, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med. 2013;19(8):977-979. 8. Gauvreau GM, Sehmi R, Ambrose CS, et al. Thymic stromal lymphopoietin: its role and potential as a therapeutic target in asthma. Expert Opin Ther Targets. 2020;24(8):777-792. 9. Wu J, Liu F, Zhao J, et al. Thymic stromal lymphopoietin promotes asthmatic airway remodelling in human lung fibroblast cells through STAT3 signalling pathway. Cell Biochem Funct. 2013;31:496–503. 10. Divekar R, Kita H. Recent advances in epithelium-derived cytokines (IL-33, IL-25 and TSLP) and allergic inflammation. Curr Opin Allergy Clin Immunol. 2015 Feb;15(1):98-103. 11.  Hams E, Armstrong ME, Barlow JL, et al. IL-25 and type 2 innate lymphoid cells induce pulmonary fibrosis. PNAS. 2014 Jan7;111(1):367-372. 12. An G, Zhang X, Wang W, et al. The effects of interleukin‐33 on airways collagen deposition and matrix metalloproteinase expression in a murine surrogate of asthma. Immunology. 2018 Aug; 154(4): 637–650. 13. An G, Wang W, Zhang X, et al. Combined blockade of IL-25, IL-33 and TSLP mediates amplified inhibition of airway inflammation and remodelling in a murine model of asthma. Respirology. 2020 Jun;25(6):603-612. 14. Kaur D, Doe C, Woodman L, et al. Mast cell-airway smooth muscle crosstalk: the role of thymic stromal lymphopoietin. Chest. 2012 Jul;142(1):76-85. 15. Cao L, Liu F, Liu Y, et al. TSLP promotes asthmatic airway remodeling via p38-STAT3 signaling pathway in human lung fibroblast. Exp Lung Res. 2018 Aug;44(6):288-301. 16. Ying S, O'Connor B, Ratoff J, et al. Thymic stromal lymphopoietin expression is increased in asthmatic airways and correlates with expression of Th2-attracting chemokines and disease severity. J Immunol. 2005;174(12):8183-8190.