RESUMEN
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is associated with high levels of cysteinyl leukotrienes, prostaglandin D2, and low levels of prostaglandin E2. Further, 15-hydroxyeicosatetraenoic acid (15-HETE) levels may have predictive value in therapeutic outcomes of aspirin desensitization. Accumulation of nasal group 2 innate lymphoid cells (ILC2s) has been demonstrated during COX-1 inhibition in AERD, although the relationships between tissue ILC2 accumulation, reaction symptom severity, and novel lipid biomarkers are unknown. OBJECTIVE: We sought to determine whether novel lipid mediators are predictive of nasal ILC2 accumulation and symptom scores during COX-1 inhibitor challenge in patients with AERD. METHODS: Blood and nasal scraping samples from patients with AERD were collected at baseline and COX-1 inhibitor reaction and then processed for flow cytometry for nasal ILC2s and serum for lipidomic analysis. RESULTS: Eight patients with AERD who were undergoing aspirin desensitization were recruited. Of the 161 eicosanoids tested, 42 serum mediators were detected. Baseline levels of 15-HETE were negatively correlated with the change in numbers of airway ILC2s (r = -0.6667; P = .0428). Docosahexaenoic acid epoxygenase metabolite 19,20-dihydroxy-4Z,7Z,10Z,13Z,16Z-docosapentaenoic acid (19,20-diHDPA) was positively correlated with both changes in airway ILC2s (r = 0.7143; P = .0305) and clinical symptom scores (r = 0.5000; P = .0081). CONCLUSION: Low levels of baseline 15-HETE predicted a greater accumulation of airway ILC2s in patients with AERD who were receiving COX-1 inhibition. Further, increases in the cytochrome P pathway metabolite 19,20-dihydroxy-4Z,7Z,10Z,13Z,16Z-docosapentaenoic acid (19,20-diHDPA) were associated with increased symptoms and nasal ILC2 accumulation. Future studies to assess how these mediators might control ILC2s may improve the understanding of AERD pathogenesis.
Asunto(s)
Asma Inducida por Aspirina , Pólipos Nasales , Sinusitis , Humanos , Inmunidad Innata , Linfocitos/metabolismo , Asma Inducida por Aspirina/tratamiento farmacológico , Ácidos Hidroxieicosatetraenoicos/uso terapéutico , Inhibidores de la Ciclooxigenasa/uso terapéutico , Sinusitis/tratamiento farmacológico , Mucosa Nasal/metabolismo , Prostaglandinas , Eicosanoides , Aspirina/efectos adversos , Pólipos Nasales/tratamiento farmacológicoRESUMEN
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is characterized by tissue eosinophilia and mast cell activation, including abundant production of prostaglandin D2 (PGD2). Group 2 innate lymphoid cells (ILC2s), which promote tissue eosinophilia and mast cell responses, undergo chemotaxis and cytokine production in response to PGD2, but it is unknown whether ILC2s are active in patients with AERD. OBJECTIVE: We sought to determine whether ILC2 numbers change in peripheral blood and the nasal mucosa during COX-1 inhibitor-induced reactions in patients with AERD. METHODS: Blood and nasal scrapings were collected at baseline, during reactions, and after completion of ketorolac/aspirin challenge/desensitization in 12 patients with AERD. ILC2s and eosinophils were quantitated by means of flow cytometry. Urine was also collected, and quantification of PGD2 metabolite and leukotriene E4 levels was done by using ELISA. Baseline and nonsteroidal anti-inflammatory drug reaction clinical data were correlated with cell changes. RESULTS: ILC2 numbers significantly increased in nasal mucosal samples and decreased in blood at the time of COX-1 inhibitor reactions in 12 patients with AERD. These changes were not observed in 2 patients without AERD. Furthermore, eosinophil numbers decreased in blood concurrently with significant increases in urinary PGD2 metabolite and leukotriene E4 levels. The magnitude of increases in nasal mucosal ILC2 numbers positively correlated with maximum symptom scores during challenges. Furthermore, blood ILC2 numbers during the reaction correlated with time for the reaction to resolve, possibly reflecting reaction severity. CONCLUSIONS: ILC2s are recruited to the nasal mucosa during COX-1 inhibitor-induced reactions in patients with AERD, correlating with enhanced production of prostaglandins and leukotrienes.
Asunto(s)
Asma Inducida por Aspirina/inmunología , Inhibidores de la Ciclooxigenasa/efectos adversos , Linfocitos/inmunología , Mucosa Nasal/inmunología , Adulto , Anciano , Asma Inducida por Aspirina/sangre , Asma Inducida por Aspirina/orina , Recuento de Células , Desensibilización Inmunológica , Dinoprost/orina , Femenino , Humanos , Ketorolaco/administración & dosificación , Leucotrieno E4/orina , Masculino , Persona de Mediana Edad , Mucosa Nasal/citologíaRESUMEN
The maintenance of the mesenchymal stem cell (MSC) phenotype in vivo is influenced by the precise orchestration of biochemical and biophysical signals in the stem cell "niche". However, when MSCs are removed from the body and expanded in vitro, there is a loss of multipotency. Here, we employ micropatterned hydrogels to explore how biophysical cues influence the retention of MSC multipotency marker expression. At the single-cell level, soft substrates and patterns that restrict spreading and cytoskeletal tension help maintain the expression of MSC markers. When MSCs are patterned in multicellular geometries, both high cell density and regions of low tension within the pattern are shown to assist the maintenance of multipotency. Combining experiment and simulation along with cytoskeleton disrupting agents reveals spatial patterns of cytoskeletal tension in multicellular architectures that guides the expression of markers associated with MSC multipotency. These findings uncover a relationship between multiple biophysical parameters in maintaining the MSC phenotype, which may shed light on the structure of the MSC "niche" and prove useful in guiding the selection of in vitro expansion materials for regenerative therapies.