T helper 2 Inflammation & Severe Muscularization of Arteries in the Lungs.

描述（由申请人提供）：T辅助细胞2炎症和肺中动脉的严重肌化项目摘要/摘要肺动脉重塑，其特征在于严重的肌化，通常见于在肺动脉中度过部分生命周期的蠕虫寄生虫（例如，犬恶丝虫）感染。这些寄生虫诱导辅助性T细胞2（Th 2）应答。这种相同类型的病变也见于哮喘的支气管动脉中，哮喘是另一种Th 2反应相关疾病，特别是在患有长期哮喘的个体中或哮喘吸烟者中。这些相关性表明肺动脉或支气管动脉的严重肌化可能是Th 2驱动的炎症的结果。典型的肺动脉高压（PAH）中描述了严重的肺动脉肌化。在PAH中怀疑免疫病理学与自身免疫性疾病（如系统性硬皮病、病毒或寄生虫病）相关。在初步的实验中，我们已经表明，Th 2反应可溶性抗原单独足以诱导严重的肺动脉肌化和增加右心室收缩压急性缺氧后。这是在免疫的C57 BL/6小鼠中诱导的，所述小鼠在延长的时间段内用两种不同抗原中的任一种给予间歇性气道激发。CD 4 + T细胞和白细胞介素（IL）-4（IL-13）是肺动脉肌化发展所必需的，一种重要的Th 2细胞因子IL-13的短暂耗竭降低了病变的严重程度。单独的IL-13是不够的，表明复杂的Th 2启动的过程诱导严重的动脉肌化。Th 2应答的哪些成分直接导致动脉肌化以及Th 2应答成分如何相互作用是尚待回答的重要问题。为了解决这些问题，提出了三个具体的目标，以确定T细胞和树突状细胞（DC）和可溶性免疫介质（IL-17，IL-33）的作用，在此期间发生动脉肌化的效应阶段。提出了在肺中发生动脉损伤和重塑的时间段内耗尽或过继转移T细胞、树突状细胞和可溶性免疫介质的实验。使用在我的实验室中安全建立的技术，待测试的假设是T细胞和DC控制IL-17和IL-33的产生，从而直接决定肺动脉肌化和右心室功能的程度。这项工作的长期目标是利用我实验室开发的小鼠模型来确定炎症相关PAH（如硬皮病患者中观察到的PAH）的诊断、预后和管理目标。这是独特的和重要的，因为大量的临床数据已经怀疑免疫反应的参与，但尚未解剖免疫反应和肺动脉严重肌化之间的因果关系。 公共卫生相关性：肺动脉肌化是肺动脉高压（PAH）患者常见的组织学病变。严重的动脉肌化也是与辅助性T细胞2（Th 2）免疫应答相关的疾病的典型特征：蠕虫寄生虫感染、影响肺动脉的自身免疫疾病和影响支气管动脉的哮喘。基于我们先前开发Th 2免疫应答诱导的严重肺动脉肌化小鼠模型的工作，该提议寻求鉴定T细胞应答控制的细胞和介质，其是用于管理与例如由自身免疫引起的严重炎症性疾病相关的肺动脉高压的新靶点。

DESCRIPTION (provided by applicant): T helper 2 Inflammation & Severe Muscularization of Arteries in the Lungs Project Summary / Abstract Pulmonary arterial remodeling, characterized by severe muscularization, is commonly seen in infections with helminth parasites that spend part of their life cycle in the pulmonary artery (e.g. Dirofilaria immitis). These parasites induce a T helper 2 (Th2) response. This same type of lesion is also seen in the bronchial artery in asthma, another Th2-response associated disease, particularly in individuals with asthma of long duration, or in asthmatic cigarette smokers. These associations indicate that severe muscularization of the pulmonary or bronchial arteries might be a consequence of a Th2 driven inflammation. Classically, severe pulmonary arterial muscularization has been described in pulmonary arterial hypertension (PAH). An immune-pathology has been suspected in PAH associated with autoimmune diseases such as systemic scleroderma, viral, or parasitic diseases. In preliminary experiments, we have shown that the Th2 response to soluble antigen alone is sufficient to induce severe pulmonary arterial muscularization and increased right ventricular systolic pressures following acute hypoxia. This was induced in immunized C57BL/6 mice that were given intermittent airway challenges over a prolonged period of time with either of two different antigens. CD4+ T cells and Interleukin (IL)-4 were necessary for the development of pulmonary arterial muscularization and transient depletion of an important Th2 cytokine, IL-13, decreased the severity of the lesion. IL-13 alone was not sufficient indicating that a complex Th2 - initiated process induced severe arterial muscularization. Which components of the Th2 response directly cause the arterial muscularization and how the Th2 response components interact are important questions yet to be answered. To address these questions, three specific aims are proposed to identify the roles of T cells and dendritic cells (DCs) and soluble immune mediators (IL-17, IL-33) for the effector phase during which arterial muscularization occurs. Experiments are proposed to deplete or to adoptively transfer T cells, dendritic cells, and soluble immune mediators during the time periods that arterial injury and remodeling occur in the lungs. Using techniques that are securely established in my laboratory, the hypothesis to be tested is that T cells and DCs control the production of IL-17 and IL-33 thereby directly determining the degree of pulmonary arterial muscularization and right ventricular function. The long range goal of this work takes advantage of the mouse model developed in my laboratory to identify targets for the diagnosis, prognosis and management for inflammation associated PAH, such as PAH seen in scleroderma patients. This is unique and significant because a large body of clinical data has suspected the involvement of the immune response, but has not yet dissected the causal relationship between the immune response and severe muscularization of arteries in the lungs. PUBLIC HEALTH RELEVANCE: T helper 2 inflammation & severe muscularization of arteries in the lungs Project Narrative Pulmonary arterial muscularization is a frequent histological lesion seen in pulmonary arterial hypertension (PAH). Severe arterial muscularization is also typical for diseases associated with T helper 2 (Th2) immune responses: helminth parasite infections, auto-immune diseases affecting pulmonary arteries and asthma affecting bronchial arteries. Building on our previous work developing Th2-immune-response induced mouse models of severe pulmonary arterial muscularization, this proposal seeks to identify T cell response controlled cells and mediators that are new targets for the management of pulmonary hypertension associated with severe inflammatory diseases caused for example by auto-immunity.