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IMPAIRED IMMUNOREGULATORY NETWORK OF THE CD4 T LYMPHOCYTES IN REFRACTORY ASTHMA
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Abstract
The immunopathogenesis of severe asthma has been associated with an inefficient regulatory response. There are a few studies about the CD4 T cells profile among individuals with severe asthma refractory to treatment. Objective: To evaluate the CD4 T lymphocyte profile from individuals with severe
asthma according to their response to treatment, relating to their atopy status and
age of asthma onset.
Methods: We evaluated nineteen individuals with severe asthma refractory to treatment
(SAR), 21 with well‐controlled or partly controlled severe asthma (CSA) and 23
with mild‐to‐moderate asthma (MMA). Lymphocytes were obtained from PBMC, and
the frequency of expression of different molecules in this population was assessed
using the flow cytometry.
Results: We observed the frequency of CD4+IFN‐γ+T cells was higher in atopic individuals
with SAR than with CSA. In addition, among the atopic and early‐onset
asthma (EOA), the frequency of CD4+CTLA‐4+T cells was lower in the SAR group
than the CSA group. In relation to non‐atopic and late‐onset asthma (LOA) phenotypes,
we noted the frequency of CD4+FoxP3+T cells was lower in individuals with
SAR than with CSA. We also observed among the LOA patients, the frequency of
CD4+TGF‐β+ T cells was decreased in SAR group than the in CSA group.
Conclusion and Clinical Relevance: Our data suggest that refractoriness to treatment
in asthma is associated with a lower expression of distinct regulatory molecules
by CD4 T cells between those who are atopic and have EOA and those who
are non‐atopic and have LOA. Thus, these results may contribute to the identification
of new regulatory strategies to treat asthma according to their phenotypes.
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