Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study

IntroductionAsthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) is a term used to describe a patient with coexisting clinical features of asthma and COPD. We have previously reported that epithelial to mesenchymal transition (EMT) is active in the lungs of patients with COPD howeve...

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Main Authors: Surajit Dey, Wenying Lu, Prabuddha S. Pathinayake, Maddison Waters, Greg Haug, Josie Larby, Heinrich C. Weber, Peter A. B. Wark, Mathew Suji Eapen, Sukhwinder Singh Sohal
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Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1531279/full
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author Surajit Dey
Wenying Lu
Prabuddha S. Pathinayake
Maddison Waters
Greg Haug
Josie Larby
Heinrich C. Weber
Peter A. B. Wark
Peter A. B. Wark
Mathew Suji Eapen
Sukhwinder Singh Sohal
author_facet Surajit Dey
Wenying Lu
Prabuddha S. Pathinayake
Maddison Waters
Greg Haug
Josie Larby
Heinrich C. Weber
Peter A. B. Wark
Peter A. B. Wark
Mathew Suji Eapen
Sukhwinder Singh Sohal
author_sort Surajit Dey
collection DOAJ
description IntroductionAsthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) is a term used to describe a patient with coexisting clinical features of asthma and COPD. We have previously reported that epithelial to mesenchymal transition (EMT) is active in the lungs of patients with COPD however, EMT in ACO remains an unexplored area. We hypothesize that EMT is an active process in ACO.MethodsIn this cross-sectional study, large airway endobronchial biopsy (EBB) tissues from patients with asthma (14), COPD (22), current (CS) and ex-smokers (ES), and ACO (12) were immunohistochemically stained for EMT markers (E and N cadherin, vimentin, S100A4, and Collagen IV) and compared with 12 current smokers with normal lung function (NLFS) and 10 non-smoking healthy control (HC) subjects. In addition, air-liquid interface (ALI) cell cultures were performed and cells from patients with ACO and HC were treated with TGF-β, IL-13 and cigarette smoke extract (CSE). Later cells from ALI cultures were lysed for Immunoblotting. Immunostained tissues were enumerated for percent expression of E and N-Cadherin in the epithelium, vimentin and S100A4 positive cells both in the epithelium and reticular basement membrane (RBM). Additionally, the degree of RBM fragmentation was evaluated, a key tissue structural marker of EMT.ResultsCompared to healthy controls and asthmatics, ACO had the greatest fragmentation of RBM (P < 0.01). ACO also had substantially decreased percentage expression of E-cadherin (P <0.01), increase percentage of N-cadherin expression, and higher vimentin and S100A4 positive basal cells, in comparison to healthy controls. In the RBM of ACO, S100A4 positive cells (P <0.05) and Vimentin-positive cells were markedly higher in comparison to HC. Similar changes were observed with western blots in response to Th-2 cytokine IL-13, CSE and EMT activator TGF-β.ConclusionsThese data are suggestive of active EMT in ACO. Additionally, 50% of the patients with ACO were on 800 mcg/day inhaled corticosteroid (ICS) treatment which may have abrogated some EMT activity; however, it suggests protective effects of ICS as we previously reported in COPD. Studies with larger cohorts are needed to further confirm ICS effects in ACO.
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spelling doaj-art-00744d2f989744d4bc814c40ebf03f5a2025-08-20T01:55:31ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15312791531279Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy studySurajit Dey0Wenying Lu1Prabuddha S. Pathinayake2Maddison Waters3Greg Haug4Josie Larby5Heinrich C. Weber6Peter A. B. Wark7Peter A. B. Wark8Mathew Suji Eapen9Sukhwinder Singh Sohal10Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, AustraliaRespiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, AustraliaImmune Health Program, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, AustraliaDepartment of Respiratory Medicine, Launceston General Hospital, Launceston, AustraliaDepartment of Respiratory Medicine, Launceston General Hospital, Launceston, AustraliaDepartment of Respiratory Medicine, Launceston General Hospital, Launceston, AustraliaDepartment of Respiratory Medicine, Tasmanian Health Services (THS), North-West Hospital, Burnie, TAS, AustraliaImmune Health Program, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, AustraliaDepartment of Respiratory Medicine, Monash University, Melbourne, AustraliaRespiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, AustraliaRespiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, AustraliaIntroductionAsthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) is a term used to describe a patient with coexisting clinical features of asthma and COPD. We have previously reported that epithelial to mesenchymal transition (EMT) is active in the lungs of patients with COPD however, EMT in ACO remains an unexplored area. We hypothesize that EMT is an active process in ACO.MethodsIn this cross-sectional study, large airway endobronchial biopsy (EBB) tissues from patients with asthma (14), COPD (22), current (CS) and ex-smokers (ES), and ACO (12) were immunohistochemically stained for EMT markers (E and N cadherin, vimentin, S100A4, and Collagen IV) and compared with 12 current smokers with normal lung function (NLFS) and 10 non-smoking healthy control (HC) subjects. In addition, air-liquid interface (ALI) cell cultures were performed and cells from patients with ACO and HC were treated with TGF-β, IL-13 and cigarette smoke extract (CSE). Later cells from ALI cultures were lysed for Immunoblotting. Immunostained tissues were enumerated for percent expression of E and N-Cadherin in the epithelium, vimentin and S100A4 positive cells both in the epithelium and reticular basement membrane (RBM). Additionally, the degree of RBM fragmentation was evaluated, a key tissue structural marker of EMT.ResultsCompared to healthy controls and asthmatics, ACO had the greatest fragmentation of RBM (P < 0.01). ACO also had substantially decreased percentage expression of E-cadherin (P <0.01), increase percentage of N-cadherin expression, and higher vimentin and S100A4 positive basal cells, in comparison to healthy controls. In the RBM of ACO, S100A4 positive cells (P <0.05) and Vimentin-positive cells were markedly higher in comparison to HC. Similar changes were observed with western blots in response to Th-2 cytokine IL-13, CSE and EMT activator TGF-β.ConclusionsThese data are suggestive of active EMT in ACO. Additionally, 50% of the patients with ACO were on 800 mcg/day inhaled corticosteroid (ICS) treatment which may have abrogated some EMT activity; however, it suggests protective effects of ICS as we previously reported in COPD. Studies with larger cohorts are needed to further confirm ICS effects in ACO.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1531279/fullasthma-COPD overlap (ACO)COPD - chronic obstructive pulmonary diseasesmokingfibrosisICS - inhaled corticosteroidshistopathology
spellingShingle Surajit Dey
Wenying Lu
Prabuddha S. Pathinayake
Maddison Waters
Greg Haug
Josie Larby
Heinrich C. Weber
Peter A. B. Wark
Peter A. B. Wark
Mathew Suji Eapen
Sukhwinder Singh Sohal
Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
Frontiers in Immunology
asthma-COPD overlap (ACO)
COPD - chronic obstructive pulmonary disease
smoking
fibrosis
ICS - inhaled corticosteroids
histopathology
title Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
title_full Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
title_fullStr Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
title_full_unstemmed Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
title_short Epithelial-to-mesenchymal transition is an active process in the large airways of patients with asthma-COPD overlap and partially abrogated by inhaled corticosteroid treatment: a bronchoscopy endobronchial biopsy study
title_sort epithelial to mesenchymal transition is an active process in the large airways of patients with asthma copd overlap and partially abrogated by inhaled corticosteroid treatment a bronchoscopy endobronchial biopsy study
topic asthma-COPD overlap (ACO)
COPD - chronic obstructive pulmonary disease
smoking
fibrosis
ICS - inhaled corticosteroids
histopathology
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1531279/full
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