Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling

Abstract Background Asthma is a heterogeneous disease with various inflammatory subtypes, including the type‐2 (T2) endotype associated with airway eosinophilia. Severe asthma is linked to reduced ventilatory function due to airway structural changes. This study compared the extent of airway remodel...

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Main Authors: Bogdan Jakiela, Karolina Górka, Iwona Gross‐Sondej, Sławomir Mikrut, Krzysztof Okoń, Piotr Sadowski, Anna Andrychiewicz, Hanna Plutecka, Tomasz Stachura, Grażyna Bochenek, Stanisława Bazan‐Socha, Krzysztof Sładek, Jerzy Soja
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Clinical and Translational Allergy
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Online Access:https://doi.org/10.1002/clt2.70060
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author Bogdan Jakiela
Karolina Górka
Iwona Gross‐Sondej
Sławomir Mikrut
Krzysztof Okoń
Piotr Sadowski
Anna Andrychiewicz
Hanna Plutecka
Tomasz Stachura
Grażyna Bochenek
Stanisława Bazan‐Socha
Krzysztof Sładek
Jerzy Soja
author_facet Bogdan Jakiela
Karolina Górka
Iwona Gross‐Sondej
Sławomir Mikrut
Krzysztof Okoń
Piotr Sadowski
Anna Andrychiewicz
Hanna Plutecka
Tomasz Stachura
Grażyna Bochenek
Stanisława Bazan‐Socha
Krzysztof Sładek
Jerzy Soja
author_sort Bogdan Jakiela
collection DOAJ
description Abstract Background Asthma is a heterogeneous disease with various inflammatory subtypes, including the type‐2 (T2) endotype associated with airway eosinophilia. Severe asthma is linked to reduced ventilatory function due to airway structural changes. This study compared the extent of airway remodeling in different immunological endotypes of asthma. Methods Severe asthma patients (n = 30) were stratified based on bronchial expression of T2 (e.g., CST1) and T3 (e.g., IL17A) immunity genes as T2‐high, T3‐high, or low‐inflammatory. We analyzed airway wall thickness using endobronchial ultrasound (EBUS), bronchial biopsy morphometry, and mRNA expression of remodeling genes. Bronchial epithelial cell cultures were used to assess cytokine responses. Results T2‐high asthma patients showed lower predicted FEV1 (59 vs. 74 % in low‐inflammatory variant, p = 0.049) and increased submucosa layer (L2) in EBUS (0.203 vs. 0.189 mm, p = 0.018). T2‐high asthma patients also had increased airway smooth muscle (ASM) mass (∼2‐fold, p = 0.018) and marginally thicker reticular basement membrane. T3‐high asthma showed only a trend toward thicker L2 (p = 0.055). Only patients with an eosinophilic signature in endobronchial biopsy demonstrated increased expression of remodeling genes, including TGFB1. A profibrotic profile was also induced in bronchial epithelium stimulated in vitro with IL‐13. Conclusion These data suggest that T2‐signature in severe asthma is associated with increased ASM mass and more pronounced airway obstruction. Overexpression of remodeling genes primarily occurred in patients with signs of eosinophilic infiltration in the bronchial mucosa, suggesting that remodeling may progress with uncontrolled airway inflammation.
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spelling doaj-art-14a4289e08474d709ac1c8eb3bda0fe72025-08-20T02:22:02ZengWileyClinical and Translational Allergy2045-70222025-06-01156n/an/a10.1002/clt2.70060Type 2 gene expression signature in severe asthma associates with more advanced airway remodelingBogdan Jakiela0Karolina Górka1Iwona Gross‐Sondej2Sławomir Mikrut3Krzysztof Okoń4Piotr Sadowski5Anna Andrychiewicz6Hanna Plutecka7Tomasz Stachura8Grażyna Bochenek9Stanisława Bazan‐Socha10Krzysztof Sładek11Jerzy Soja122nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków PolandFaculty of Mining Surveying and Environmental Engineering AGH University of Science and Technology Kraków PolandDepartment of Pathology Jagiellonian University Medical College Kraków PolandDepartment of Pathology Jagiellonian University Medical College Kraków PolandDepartment of Endoscopy University Hospital Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków Poland2nd Department of Internal Medicine Jagiellonian University Medical College Kraków PolandAbstract Background Asthma is a heterogeneous disease with various inflammatory subtypes, including the type‐2 (T2) endotype associated with airway eosinophilia. Severe asthma is linked to reduced ventilatory function due to airway structural changes. This study compared the extent of airway remodeling in different immunological endotypes of asthma. Methods Severe asthma patients (n = 30) were stratified based on bronchial expression of T2 (e.g., CST1) and T3 (e.g., IL17A) immunity genes as T2‐high, T3‐high, or low‐inflammatory. We analyzed airway wall thickness using endobronchial ultrasound (EBUS), bronchial biopsy morphometry, and mRNA expression of remodeling genes. Bronchial epithelial cell cultures were used to assess cytokine responses. Results T2‐high asthma patients showed lower predicted FEV1 (59 vs. 74 % in low‐inflammatory variant, p = 0.049) and increased submucosa layer (L2) in EBUS (0.203 vs. 0.189 mm, p = 0.018). T2‐high asthma patients also had increased airway smooth muscle (ASM) mass (∼2‐fold, p = 0.018) and marginally thicker reticular basement membrane. T3‐high asthma showed only a trend toward thicker L2 (p = 0.055). Only patients with an eosinophilic signature in endobronchial biopsy demonstrated increased expression of remodeling genes, including TGFB1. A profibrotic profile was also induced in bronchial epithelium stimulated in vitro with IL‐13. Conclusion These data suggest that T2‐signature in severe asthma is associated with increased ASM mass and more pronounced airway obstruction. Overexpression of remodeling genes primarily occurred in patients with signs of eosinophilic infiltration in the bronchial mucosa, suggesting that remodeling may progress with uncontrolled airway inflammation.https://doi.org/10.1002/clt2.70060airway remodelingasthma endotypesendobronchial ultrasoundsevere asthmatype 2 immunity
spellingShingle Bogdan Jakiela
Karolina Górka
Iwona Gross‐Sondej
Sławomir Mikrut
Krzysztof Okoń
Piotr Sadowski
Anna Andrychiewicz
Hanna Plutecka
Tomasz Stachura
Grażyna Bochenek
Stanisława Bazan‐Socha
Krzysztof Sładek
Jerzy Soja
Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
Clinical and Translational Allergy
airway remodeling
asthma endotypes
endobronchial ultrasound
severe asthma
type 2 immunity
title Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
title_full Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
title_fullStr Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
title_full_unstemmed Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
title_short Type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
title_sort type 2 gene expression signature in severe asthma associates with more advanced airway remodeling
topic airway remodeling
asthma endotypes
endobronchial ultrasound
severe asthma
type 2 immunity
url https://doi.org/10.1002/clt2.70060
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