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Mechanisms of Mucus Induction in Asthma

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Allergy Frontiers: Clinical Manifestations

Part of the book series: Allergy Frontiers ((ALLERGY,volume 3))

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Abstract

Mucus hypersecretion is a defining feature of asthma and contributes significantly to airway obstruction. The mechanisms by which a normal airway epithelium is converted to a mucus-producing epithelium in asthma are complex. Inflammation in asthma promotes metaplasia of ciliated and Clara cells into goblet cells after both EGFR activation and the effects of IL-13 on Stat6 activation. Recently identified transcription factors and proteins highlight critical steps in the pathway that leads to the transition to a mucus-secreting airway epithelium.

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References

  1. Osler W (1901) Principles and Practice of Medicine. New York: D. Appleton. pp. 628–629.

    Google Scholar 

  2. Huber HC, and Kossler, KK (1922) The pathology of bronchial asthma. Arch Int Med 30:689–760.

    Google Scholar 

  3. Hogg JC, Macklem, PT, and Thurlbeck, WM (1968) Site and nature of airway obstruction in chronic obstructive lung disease. N Engl J Med 278:1355–1360.

    PubMed  CAS  Google Scholar 

  4. Moreno RH, Hogg, JC, and Pare, PD (1986) Mechanics of airway narrowing. Am Rev Respir Dis 133:1171–1180.

    PubMed  CAS  Google Scholar 

  5. James A, and Carroll, N (1995) Theoretical effects of mucus gland discharge on airway resistance in asthma. Chest 107:110S.

    Article  PubMed  Google Scholar 

  6. Rose MC, and Voynow, JA (2006) Respiratory tract mucin genes and mucin glycoproteins in health and disease. Physiol Rev 86:245–278.

    Article  PubMed  CAS  Google Scholar 

  7. Perez-Vilar J (2007) Mucin granule intraluminal organization. Am J Respir Cell Mol Biol 36:183–190.

    Article  PubMed  CAS  Google Scholar 

  8. Groneberg DA, Eynott, PR, Lim, S, Oates, T, Wu, R, Carlstedt, I, Roberts, P, McCann, B, Nicholson, AG, Harrison, BD, et al. (2002) Expression of respiratory mucins in fatal status asthmaticus and mild asthma. Histopathology 40:367–373.

    Article  PubMed  CAS  Google Scholar 

  9. Ordonez CL, Khashayar, R, Wong, HH, Ferrando, R, Wu, R, Hyde, DM, Hotchkiss, JA, Zhang, Y, Novikov, A, Dolganov, G, et al. (2001) Mild and moderate asthma is associated with airway goblet cell hyperplasia and abnormalities in mucin gene expression. Am J Respir Crit Care Med 163:517–523.

    PubMed  CAS  Google Scholar 

  10. Rogers DF (2004) Airway mucus hypersecretion in asthma an undervalued pathology? Curr Opin Pharmacol 4:241– 250.

    Article  PubMed  CAS  Google Scholar 

  11. Martin LD, Rochelle, LG, Fischer, BM, Krunkosky, TM, and Adler, KB (1997) Airway epithelium as an effector of inflammation: molecular regulation of secondary mediators. Eur Respir J 10:2139–2146.

    Article  PubMed  CAS  Google Scholar 

  12. Li Y, Martin, LD, Spizz, G, and Adler, KB (2001) MARCKS protein is a key molecule regulating mucin secretion by human airway epithelial cells in vitro. J Biol Chem 276:40982–40990.

    Article  PubMed  CAS  Google Scholar 

  13. Singer M, Martin, LD, Vargaftig, BB, Park, J, Gruber, AD, Li, Y, and Adler, KB (2004) A MARCKS-related peptide blocks mucus hypersecretion in a mouse model of asthma. Nat Med 10:193–196.

    Article  PubMed  CAS  Google Scholar 

  14. Shimura S, Andoh, Y, Haraguchi, M, and Shirato, K (1996) Continuity of airway goblet cells and intraluminal mucus in the airways of patients with bronchial asthma. Eur Respir J 9:1395–1401.

    Article  PubMed  CAS  Google Scholar 

  15. Aikawa T, Shimura, S, Sasaki, H, Ebina, M, and Takishima, T (1992) Marked goblet cell hyperplasia with mucus accumulation in the airways of patients who died of severe acute asthma attack. Chest 101:916–921.

    Article  PubMed  CAS  Google Scholar 

  16. Carroll NG, Mutavdzic, S, and James, AL (2002) Increased mast cells and neutrophils in submucosal mucous glands and mucus plugging in patients with asthma. Thorax 57:677–682.

    Article  PubMed  CAS  Google Scholar 

  17. Reader JR, Tepper, JS, Schelegle, ES, Aldrich, MC, Putney, LF, Pfeiffer, JW, and Hyde, DM (2003) Pathogenesis of mucous cell metaplasia in a murine asthma model. Am J Pathol 162:2069–2078.

    PubMed  Google Scholar 

  18. Tyner JW, Kim, EY, Ide, K, Pelletier, MR, Roswit, WT, Morton, JD, Bataile, JT, Patel, AC, Patterson, A, Castro, M, et al. (2006) Blocking airway mucous cell metaplasia by inhibiting EGFR anti-apoptosis and IL-13 transdifferentiation signals. J Clin Invest 116:309–321.

    Article  PubMed  CAS  Google Scholar 

  19. Evans CM, Williams, OW, Tuvim, MJ, Nigam, R, Mixides, GP, Blackburn, MR, DeMayo, FJ, Burns, AR, Smith, C, Reynolds, SD, et al. (2004) Mucin is produced by clara cells in the proximal airways of antigen-challenged mice. Am J Respir Cell Mol Biol 31:382–394.

    Article  PubMed  CAS  Google Scholar 

  20. Hayashi T, Ishii, A, Nakai, S, and Hasegawa, K (2004) Ultrastructure of goblet-cell metaplasia from Clara cell in the allergic asthmatic airway inflammation in a mouse model of asthma in vivo. Virchows Arch 444:66–73.

    Article  PubMed  Google Scholar 

  21. Ollerenshaw S, and Woolcock, AJ (1992) Characteristics of the inflammation in biopsies from large airways of subjects with asthma and subjects with chronic airflow limitation. Am Rev Respir Dis 145:922–927.

    PubMed  CAS  Google Scholar 

  22. Bentley AM, Meng, Q, Robinson, DS, Hamid, Q, Kay, AB, and Durham, SR (1993) Increases in activated T lymphocytes, eosinophils, and cytokine mRNA expression for interleukin-5 and granulocyte/macrophage colony-stimulating factor in bronchial biopsies after allergen inhalation challenge in atopic asthmatics. Am J Respir Cell Mol Biol 8:35–42.

    PubMed  CAS  Google Scholar 

  23. Robinson DS, Hamid, Q, Ying, S, Tsicopoulos, A, Barkans, J, Bentley, AM, Corrigan, C, Durham, SR, and Kay, AB (1992) Predominant TH2-like bronchoalveolar T-lymphocyte population in atopic asthma. New Engl J Med 326:298–304.

    Article  PubMed  CAS  Google Scholar 

  24. Cohn L, Elias, JA, and Chupp, GL (2004) Asthma: mechanisms of disease persistence and progression. Annu Rev Immunol 22:789–815.

    Article  PubMed  CAS  Google Scholar 

  25. Bradley BL, Azzawi, M, Jacobson, M, Assoufi, B, Collins, JV, Irani, AM, Schwartz, LB, Durham, SR, Jeffery, PK, and Kay, AB (1991) Eosinophils, T-lymphocytes, mast cells, neutrophils, and macrophages in bronchial biopsy specimens from atopic subjects with asthma: comparison with biopsy specimens from atopic subjects without asthma and normal control subjects and relationship to bronchial hyperresponsiveness. J Allergy Clin Immunol 88:661–674.

    Article  PubMed  CAS  Google Scholar 

  26. Tanizaki Y, Kitani, H, Okazaki, M, Mifune, T, Mitsunobu, F, and Kimura, I (1993) Mucus hypersecretion and eosinophils in bronchoalveolar lavage fluid in adult patients with bronchial asthma. J Asthma 30:257–262.

    Article  PubMed  CAS  Google Scholar 

  27. Cohn L, Homer, RJ, Marinov, A, Rankin, J, and Bottomly, K (1997) Induction of airway mucus production By T helper 2 (Th2) cells: a critical role for interleukin 4 in cell recruitment but not mucus production. J Exp Med 186:1737–1747.

    Article  PubMed  CAS  Google Scholar 

  28. Corry DB, Folkesson, HG, Warnock, ML, Erle, DJ, Matthay, MA, Wiener-Kronish, JP, and Locksley, RM (1996) Interleukin 4, but not interleukin 5 or eosinophils, is required in a murine model of acute airway hyperreactivity [see comments] [published erratum appears in J Exp Med 1997 May 5;185(9):1715]. J Exp Med 183:109–117.

    Article  PubMed  CAS  Google Scholar 

  29. Gavett SH, Chen, X, Finkelman, F, and Wills-Karp, M (1994) Depletion of murine CD4 + T lymphocytes prevents antigen-induced airway hyperreactivity and pulmonary eosinophilia. Am J Respir Cell Mol Biol 10:587–593.

    PubMed  CAS  Google Scholar 

  30. Lee JJ, McGarry, MP, Farmer, SC, Denzler, KL, Larson, KA, Carrigan, PE, Brenneise, IE, Horton, MA, Haczku, A, Gelfand, EW, et al. (1997) Interleukin-5 expression in the lung epithelium of transgenic mice leads to pulmonary changes pathognomonic of asthma. J Exp Med 185:2143–2156.

    Article  PubMed  CAS  Google Scholar 

  31. Rankin JA, Picarella, DE, Geba, GP, Temann, A, Prasad, B, DiCosimo, B, Tarallo, A, Stripp, B, Whitsett, J, and Flavell, RA (1996) Phenotypic and physiologic characterization of transgenic mice expressing interleukin 4 in the lung: lymphocytic and eosinophilic inflammation without airway hyperreactivity. Proc Nat Acad Sci U S A 93:7821–7825.

    Article  CAS  Google Scholar 

  32. Zhu Z, Homer, R, Wang, Z, Chen, Q, Geba, G, Wang, J, Zhang, Y, and Elias, J (1999) Transgenic expression of IL-13 in murine lung causes airway inflammation, mucus hypersecretion, subendothelial fibrosis, eotaxin production and airways hyperresponsiveness to methacholine. J Clin Invest 103:779–788.

    Article  PubMed  CAS  Google Scholar 

  33. Temann UA, Prasad, B, Gallup, MW, Basbaum, C, Ho, SB, Flavell, RA, and Rankin, JA (1997) A novel role for murine IL-4 in vivo: induction of MUC5AC gene expression and mucin hypersecretion. Am J Respir Cell Mol Biol 16:471–478.

    PubMed  CAS  Google Scholar 

  34. Humbles AA, Lloyd, CM, McMillan, SJ, Friend, DS, Xanthou, G, McKenna, EE, Ghiran, S, Gerard, NP, Yu, C, Orkin, SH, et al. (2004) A critical role for eosinophils in allergic airways remodeling. Science 305:1776–1779.

    Article  PubMed  CAS  Google Scholar 

  35. Lee JJ, Dimina, D, Macias, MP, Ochkur, SI, McGarry, MP, O'Neill, KR, Protheroe, C, Pero, R, Nguyen, T, Cormier, SA, et al. (2004) Defining a link with asthma in mice congenitally deficient in eosinophils. Science 305:1773–1776.

    Article  PubMed  CAS  Google Scholar 

  36. Cohn L, Homer, RJ, MacLeod, H, Mohrs, M, Brombacher, F, and Bottomly, K (1999) Th2induced airway mucus production is dependent on IL-4Ralpha, but not on eosinophils. J Immunol 162:6178–6183.

    PubMed  CAS  Google Scholar 

  37. Grunig G, Warnock, M, Wakil, AE, Venkayya, R, Brombacher, F, Rennick, DM, Sheppard, D, Mohrs, M, Donaldson, DD, Locksley, RM, et al. (1998) Requirement for IL-13 independently of IL-4 in experimental asthma [see comments]. Science 282:2261–2263.

    Article  PubMed  CAS  Google Scholar 

  38. Wills-Karp M, Luyimbazi, J, Xu, X, Schofield, B, Neben, TY, Karp, CL, and Donaldson, DD (1998) Interleukin-13: central mediator of allergic asthma. Science 282:2258–2261.

    Article  PubMed  CAS  Google Scholar 

  39. Whittaker L, Niu, N, Temann, UA, Stoddard, A, Flavell, RA, Ray, A, Homer, RJ, and Cohn, L (2002) Interleukin-13 mediates a fundamental pathway for airway epithelial mucus induced by CD4 T cells and interleukin-9. Am J Respir Cell Mol Biol 27:593–602.

    PubMed  CAS  Google Scholar 

  40. Mattes J, Yang, M, Siqueira, A, Clark, K, MacKenzie, J, McKenzie, AN, Webb, DC, Matthaei, KI, and Foster, PS (2001) IL-13 induces airways hyperreactivity independently of the IL-4R alpha chain in the allergic lung. J Immunol 167:1683–1692.

    PubMed  CAS  Google Scholar 

  41. Walter DM, McIntire, JJ, Berry, G, McKenzie, AN, Donaldson, DD, DeKruyff, RH, and Umetsu, DT (2001) Critical role for IL-13 in the development of allergen-induced airway hyperreactivity. J Immunol 167:4668–4675.

    PubMed  CAS  Google Scholar 

  42. Justice JP, Crosby, J, Borchers, MT, Tomkinson, A, Lee, JJ, and Lee, NA (2002) CD4(+) T cell-dependent airway mucus production occurs in response to IL-5 expression in lung. Am J Physiol Lung Cell Mol Physiol 282:L1066–L1074.

    PubMed  CAS  Google Scholar 

  43. Temann UA, Ray, P, and Flavell, RA (2002) Pulmonary overexpression of IL-9 induces Th2 cytokine expression, leading to immune pathology. J Clin Invest 109:29–39.

    PubMed  CAS  Google Scholar 

  44. Temann UA, Laouar, Y, Eynon, EE, Homer, R, and Flavell, RA (2007) IL9 leads to airway inflammation by inducing IL13 expression in airway epithelial cells. Int Immunol 19:1–10.

    Article  PubMed  CAS  Google Scholar 

  45. Kuperman DA, Huang, X, Nguyenvu, L, Holscher, C, Brombacher, F, and Erle, DJ (2005) IL-4 receptor signaling in Clara cells is required for allergen-induced mucus production. J Immunol 175:3746–3752.

    PubMed  CAS  Google Scholar 

  46. Kuperman DA, Huang, X, Koth, LL, Chang, GH, Dolganov, GM, Zhu, Z, Elias, JA, Sheppard, D, and Erle, DJ (2002) Direct effects of interleukin-13 on epithelial cells cause airway hyperreactivity and mucus overproduction in asthma. Nat Med 8:885–889.

    PubMed  CAS  Google Scholar 

  47. Atherton HC, Jones, G, and Danahay, H (2003) IL-13-induced changes in the goblet cell density of human bronchial epithelial cell cultures: MAP kinase and phosphatidylinositol 3-kinase regulation. Am J Physiol Lung Cell Mol Physiol 285:L730–L739.

    PubMed  CAS  Google Scholar 

  48. Dabbagh K, Takeyama, K, Lee, HM, Ueki, IF, Lausier, JA, and Nadel, JA (1999) IL-4 induces mucin gene expression and goblet cell metaplasia In vitro and In vivo [in process citation]. J Immunol 162:6233–6237.

    PubMed  CAS  Google Scholar 

  49. Kondo M, Tamaoki, J, Takeyama, K, Isono, K, Kawatani, K, Izumo, T, and Nagai, A (2006) Elimination of IL-13 reverses established goblet cell metaplasia into ciliated epithelia in airway epithelial cell culture. Allergol Int 55:329–336.

    Article  PubMed  CAS  Google Scholar 

  50. Hackel PO, Zwick, E, Prenzel, N, and Ullrich, A (1999) Epidermal growth factor receptors: critical mediators of multiple receptor pathways. Curr Opin Cell Biol 11:184–189.

    Article  PubMed  CAS  Google Scholar 

  51. Burgel PR, and Nadel, JA (2004) Roles of epidermal growth factor receptor activation in epithelial cell repair and mucin production in airway epithelium. Thorax 59:992–996.

    Article  PubMed  Google Scholar 

  52. Takeyama K, Dabbagh, K, Jeong Shim, J, Dao-Pick, T, Ueki, IF, and Nadel, JA (2000) Oxidative stress causes mucin synthesis via transactivation of epidermal growth factor receptor: role of neutrophils. J Immunol 164:1546–1552.

    PubMed  CAS  Google Scholar 

  53. Takeyama K, Dabbagh, K, Lee, HM, Agusti, C, Lausier, JA, Ueki, IF, Grattan, KM, and Nadel, JA (1999) Epidermal growth factor system regulates mucin production in airways. Proc Natl Acad Sci U S A 96:3081–3086.

    Article  PubMed  CAS  Google Scholar 

  54. Takeyama K, Fahy, JV, and Nadel, JA (2001) Relationship of epidermal growth factor receptors to goblet cell production in human bronchi. Am J Respir Crit Care Med 163:511–516.

    PubMed  CAS  Google Scholar 

  55. Zhen G, Park, SW, Nguyenvu, LT, Rodriguez, MW, Barbeau, R, Paquet, AC, and Erle, DJ (2007) IL-13 and epidermal growth factor receptor have critical but distinct roles in epithelial cell mucin production. Am J Respir Cell Mol Biol 36:244–253.

    Article  PubMed  CAS  Google Scholar 

  56. Danahay H, Atherton, H, Jones, G, Bridges, RJ, and Poll, CT (2002) Interleukin-13 induces a hypersecretory ion transport phenotype in human bronchial epithelial cells. Am J Physiol Lung Cell Mol Physiol 282:L226–L236.

    PubMed  CAS  Google Scholar 

  57. Kouznetsova I, Chwieralski, CE, Balder, R, Hinz, M, Braun, A, Krug, N, and Hoffmann, W (2007) Induced trefoil factor family 1 expression by trans-differentiating Clara cells in a murine asthma model. Am J Respir Cell Mol Biol 36:286–295.

    Article  PubMed  CAS  Google Scholar 

  58. Yasuo M, Fujimoto, K, Tanabe, T, Yaegashi, H, Tsushima, K, Takasuna, K, Koike, T, Yamaya, M, and Nikaido, T (2006) Relationship between calcium-activated chloride channel 1 and MUC5AC in goblet cell hyperplasia induced by interleukin-13 in human bronchial epithelial cells. Respiration 73:347–359.

    Article  PubMed  CAS  Google Scholar 

  59. Shim JJ, Dabbagh, K, Ueki, IF, Dao-Pick, T, Burgel, PR, Takeyama, K, Tam, DC, and Nadel, JA (2001) IL-13 induces mucin production by stimulating epidermal growth factor receptors and by activating neutrophils. Am J Physiol Lung Cell Mol Physiol 280:L134–L140.

    PubMed  CAS  Google Scholar 

  60. Wan H, Kaestner, KH, Ang, SL, Ikegami, M, Finkelman, FD, Stahlman, MT, Fulkerson, PC, Rothenberg, ME, and Whitsett, JA (2004) Foxa2 regulates alveolarization and goblet cell hyperplasia. Development 131:953–964.

    Article  PubMed  CAS  Google Scholar 

  61. Wan H, Xu, Y, Ikegami, M, Stahlman, MT, Kaestner, KH, Ang, SL, and Whitsett, JA (2004) Foxa2 is required for transition to air breathing at birth. Proc Natl Acad Sci U S A 101:14449–14454.

    Article  PubMed  CAS  Google Scholar 

  62. Homer RJ, Zhu, Z, Cohn, L, Lee, CG, White, WI, Chen, S, and Elias, JA (2006) Differential expression of chitinases identify subsets of murine airway epithelial cells in allergic inflammation. Am J Physiol Lung Cell Mol Physiol 291:L502–L511.

    Article  PubMed  CAS  Google Scholar 

  63. Park KS, Korfhagen, TR, Bruno, MD, Kitzmiller, JA, Wan, H, Wert, SE, Khurana Hershey, GK, Chen, G, and Whitsett, JA (2007) SPDEF regulates goblet cell hyperplasia in the airway epithelium. J Clin Invest 117:978–988.

    Article  PubMed  CAS  Google Scholar 

  64. Whiting PJ (2003) The GABAA receptor gene family: new opportunities for drug development. Curr Opin Drug Discov Devel 6:648–657.

    PubMed  CAS  Google Scholar 

  65. Xiang YY, Wang, S, Liu, M, Hirota, JA, Li, J, Ju, W, Fan, Y, Kelly, MM, Ye, B, Orser, B, et al. (2007) A GABAergic system in airway epithelium is essential for mucus overproduction in asthma. Nat Med 13:862–867.

    Article  PubMed  CAS  Google Scholar 

  66. Young HW, Williams, OW, Chandra, D, Bellinghausen, LK, Perez, G, Suarez, A, Tuvim, MJ, Roy, MG, Alexander, SN, Moghaddam, SJ, et al. (2007) Central role of Muc5ac expression in mucous metaplasia and its regulation by conserved 5' elements. Am J Respir Cell Mol Biol 37:273–290.

    Article  PubMed  CAS  Google Scholar 

  67. Cohn L, Homer, RJ, Niu, N, and Bottomly, K (1999) T helper 1 cells and interferon gamma regulate allergic airway inflammation and mucus production. J Exp Med 190:1309–1318.

    Article  PubMed  CAS  Google Scholar 

  68. Heller NM, Matsukura, S, Georas, SN, Boothby, MR, Rothman, PB, Stellato, C, and Schleimer, RP (2004) Interferon-gamma inhibits STAT6 signal transduction and gene expression in human airway epithelial cells. Am J Respir Cell Mol Biol 31:573–582.

    Article  PubMed  CAS  Google Scholar 

  69. Shi ZO, Fischer, MJ, De Sanctis, GT, Schuyler, MR, and Tesfaigzi, Y (2002) IFN-gamma, but not Fas, mediates reduction of allergen-induced mucous cell metaplasia by inducing apoptosis. J Immunol 168:4764–4771.

    PubMed  CAS  Google Scholar 

  70. Tesfaigzi Y, Fischer, MJ, Daheshia, M, Green, FH, De Sanctis, GT, and Wilder, JA (2002) Bax is crucial for IFN-gamma-induced resolution of allergen-induced mucus cell metaplasia. J Immunol 169:5919–5925.

    PubMed  CAS  Google Scholar 

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Cohn, L. (2009). Mechanisms of Mucus Induction in Asthma. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Clinical Manifestations. Allergy Frontiers, vol 3. Springer, Tokyo. https://doi.org/10.1007/978-4-431-88317-3_11

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