Emerging roles of innate lymphoid cells in inflammatory diseases: Clinical implications.

Innate lymphoid cells (ILC) represent a group of lymphocytes that lack specific antigen receptors and are relatively rare as compared to adaptive lymphocytes. ILCs play important roles in allergic and nonallergic inflammatory diseases due to their location at barrier surfaces within the airways, gut, and skin, and they respond to cytokines produced by activated cells in their local environment. Innate lymphoid cells contribute to the immune response by the release of cytokines and other mediators, forming a link between innate and adaptive immunity. In recent years, these cells have been extensively characterized and their role in animal models of disease has been investigated. Data to translate the relevance of ILCs in human pathology, and the potential role of ILCs in diagnosis, as biomarkers and/or as future treatment targets are also emerging. This review, produced by a task force of the Immunology Section of the European Academy of Allergy and Clinical Immunology (EAACI), encompassing clinicians and researchers, highlights the role of ILCs in human allergic and nonallergic diseases in the airways, gastrointestinal tract, and skin, with a focus on new insights into clinical implications, therapeutic options, and future research opportunities.

An early innate response underlies severe influenza-induced exacerbations of asthma in a novel steroid-insensitive and anti-IL-5-responsive mouse model.

BACKGROUND: Acute worsening of asthma symptoms (exacerbation) is predominantly triggered by respiratory viruses, with influenza causing the most severe exacerbations. The lack of an adequate animal model hampers mechanistic insight and the development of new therapeutics. AIM: We developed and characterized a robust, consistent, and reproducible mouse model of severe exacerbation of chronic allergic asthma. METHODS: Chronic allergic airway inflammation was induced following a house dust mite (HDM) sensitization protocol. HDM-sensitized mice and controls were infected with influenza virus A/X31 H3N2 and either or not treated with inhaled fluticasone propionate (FP), systemic corticosteroids (Pred), or anti-IL-5. Mice were killed at different time points after infection: Cellular accumulation and cytokines levels in the airways, PenH as a measure of airway hyper-responsiveness (AHR), and lung histology and viral replication were assessed. RESULTS: Infection with low-dose A/X31 H3N2 led to prolonged deterioration of lung function, aggravated mucus production, peri-vascular, peri-bronchial, and allergic inflammation that was unresponsive to inhaled corticosteroids, but responsive to systemic corticosteroids. The exacerbation was preceded at 14 h after virus exposure by a marked innate, but no Th2 and Th1 response subsequently followed by enhanced numbers of eosinophils, neutrophils, dendritic, and T cells into the lung lumen, parenchyma, and draining lymph nodes in HDM-sensitized mice. Anti-IL-5 treatment attenuated eosinophils and prevented the X31-induced exacerbation. CONCLUSIONS: Together, these findings indicate that an early innate response that involves eosinophils underlies the exacerbation. This model recapitulates all major features of severe asthma exacerbations and can serve to discern driving mechanisms and promote the development of novel therapeutics.

Improved piercing of microneedle arrays in dermatomed human skin by an impact insertion method.

An electrical applicator was designed, which can pierce short microneedles into the skin with a predefined velocity. Three different shapes of microneedles were used, namely 300 mum assembled hollow metal microneedle arrays, 300 mum solid metal microneedle arrays and 245 mum hollow silicon microneedle arrays. The latter are available as 4x4, 6x6 and 9x9 arrays. When using a velocity of 1 or 3 m/s reproducible piercing of dermatomed and full thickness human skin was evident from the appearance of blue spots on the dermal side of the skin after Trypan Blue treatment and the presence of fluorescently labeled particles in dermatomed skin. Manual piercing did not result in the appearance of blue spots. Transport studies revealed that i) piercing of microneedles with a predefined velocity into human skin resulted in a drastic enhancement of the Cascade Blue (CB, Mw 538) transport, ii) A higher piercing velocity resulted in a higher CB transport rate, iii) The CB transport rate was also dependent on the shape of the microneedles and iv) no difference in transport rate was observed between 4x4, 6x6 and 9x9 hollow silicon microneedle arrays.

Assembled microneedle arrays enhance the transport of compounds varying over a large range of molecular weight across human dermatomed skin.

In this study, we demonstrate the feasibility to use microneedle arrays manufactured from commercially available 30G hypodermal needles to enhance the transport of compounds up to a molecular weight of 72 kDa. Piercing of human dermatomed skin with microneedle arrays was studied by Trypan Blue staining on the SC side of the skin and transepidermal water loss measurements (TEWL). Passive transport studies were conducted with Cascade Blue (CB, Mw 538), Dextran-Cascade Blue (DCB, Mw 10 kDa), and FITC coupled Dextran (FITC-Dex, Mw 72 kDa). Microneedle arrays with needle lengths of 900, 700 and 550 micro m are able to pierce dermatomed human skin as evident from (a) the appearance of blue spots on the dermal side of the skin after Trypan Blue treatment and (b) elevated TEWL levels after piercing compared to non-treated human dermatomed skin. Microneedles with a length of 300 micro m did not pierce human skin in vitro. Transport studies performed with model compounds ranging from 538 Da to 72 kDa revealed that pretreatment with microneedle arrays enhanced the transport across dermatomed human skin. However, some degradation was also observed for FITC-Dex and DCB. We conclude that assembled microneedle arrays can be used to deliver compounds through the skin up to a molecular weight of at least 72 kDa.