Abstract

A subset of patients with stable asthma has prominent neutrophilic and reduced eosinophilic inflammation, which is associated with attenuated airways hyper-responsiveness (AHR). Haemophilus influenzae has been isolated from the airways of neutrophilic asthmatics; however, the nature of the association between infection and the development of neutrophilic asthma is not understood. Our aim was to investigate the effects of H. influenzae respiratory infection on the development of hallmark features of asthma in a mouse model of allergic airways disease (AAD). BALB/c mice were intraperitoneally sensitized to ovalbumin (OVA) and intranasally challenged with OVA 12–15 days later to induce AAD. Mice were infected with non-typeable H. influenzae during or 10 days after sensitization, and the effects of infection on the development of key features of AAD were assessed on day 16. T-helper 17 cells were enumerated by fluorescent-activated cell sorting and depleted with anti-IL-17 neutralizing antibody. We show that infection in AAD significantly reduced eosinophilic inflammation, OVA-induced IL-5, IL-13 and IFN-γ responses and AHR; however, infection increased airway neutrophil influx in response to OVA challenge. Augmented neutrophilic inflammation correlated with increased IL-17 responses and IL-17 expressing macrophages and neutrophils (early, innate) and T lymphocytes (late, adaptive) in the lung. Significantly, depletion of IL-17 completely abrogated infection-induced neutrophilic inflammation during AAD. In conclusion, H. influenzae infection synergizes with AAD to induce Th17 immune responses that drive the development of neutrophilic and suppress eosinophilic inflammation during AAD. This results in a phenotype that is similar to neutrophilic asthma. Infection-induced neutrophilic inflammation in AAD is mediated by IL-17 responses.

Highlights

  • Asthma is a complex disease of the airways that is generally characterized by symptoms of wheeze, cough, breathlessness and airway inflammation

  • How H. influenzae is associated with the pathogenesis of neutrophilic asthma is unknown

  • In this study we used mouse models to investigate the relationship between H. influenzae infection and allergic airways disease (AAD)

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Summary

Introduction

Asthma is a complex disease of the airways that is generally characterized by symptoms of wheeze, cough, breathlessness and airway inflammation. Further investigation of the non-eosinophilic subtype has identified a subgroup with an intense neutrophilic bronchitis [5,8] with increased interleukin (IL)-8 [4]. Neutrophilic asthmatics have reduced eosinophilic inflammation and AHR. They are frequently resistant to corticosteroid treatment, which results in a significant proportion of asthmarelated health care costs [5,8,9,10,11,12]. IL-17 is elevated in asthma and other obstructive airway diseases that are characterized by increased neutrophils [13,14,15,16]

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