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. 2008 Mar;121(3):685-91.
doi: 10.1016/j.jaci.2008.01.005.

Increased sputum and bronchial biopsy IL-13 expression in severe asthma

Shironjit K Saha  1 , Mike A Berry, Deborah Parker, Salman Siddiqui, Angela Morgan, Richard May, Phillip Monk, Peter Bradding, Andrew J Wardlaw, Ian D Pavord, Christopher E Brightling
Affiliations

Increased sputum and bronchial biopsy IL-13 expression in severe asthma

Shironjit K Saha et al. J Allergy Clin Immunol. 2008 Mar.

Abstract

Background: The importance of IL-13 in the asthma paradigm is supported by increased expression in human subjects, particularly in patients with mild-to-moderate asthma. However, the role of IL-13 in severe asthma needs to be further defined.

Objective: We sought to assess IL-13 expression in sputum and bronchial biopsy specimens from subjects with mild-to-severe asthma.

Methods: Sputum IL-13 concentrations were measured in 32 control subjects, 34 subjects with mild asthma, 21 subjects with moderate asthma, and 26 subjects with severe asthma. Enumeration of mast cells, eosinophils, and IL-13+ cells in the bronchial submucosa and airway smooth muscle (ASM) bundle was performed in 7 control subjects, 14 subjects with mild asthma, 7 subjects with moderate asthma, and 7 subjects with severe asthma.

Results: The proportion of subjects with measurable IL-13 in the sputum was increased in the mild asthma group (15/34) and severe asthma group (10/26) compared with that seen in the control group (4/32; P = .004). IL-13+ cells were increased within the submucosa in all asthma severity groups compared with control subjects (P = .006). The number of IL-13+ cells were increased within the ASM bundle in the severe asthma group compared with that seen in the other groups (P < .05). Asthma control questionnaire scores positively correlated with sputum IL-13 concentrations (R(s) = 0.35, P = .04) and mast cells in the ASM bundle (R(s) = 0.7, P = .007). IL-13+ cells within the submucosa and ASM correlated with sputum eosinophilia (R(s) = 0.4, P < or = .05).

Conclusions: IL-13 overexpression in sputum and bronchial biopsy specimens is a feature of severe asthma.

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Figures

FIG 1
FIG 1
Sputum IL-13 concentration. Δ, Sputum IL-13 concentration in the control group; ▼, mild asthma (GINA class 1); ◆, moderate asthma (GINA class 2-4); ■, severe asthma (GINA class 5) oral corticosteroid; ●, severe asthma (GINA class 5) intramuscular triamcinolone. Solid symbols indicate sputum eosinophilia greater than 3%. Horizontal bars represent median value. Values in parentheses represent subjects with measurable IL-13/total subjects in group. P = .012, Kruskal-Wallis test. P values on the figure are from the Mann-Whitney test.
FIG 2
FIG 2
Examples of IL-13+ cells in the submucosa and ASM bundle in subjects with asthma. Representative photomicrographs of bronchial biopsy sections from a subject with severe asthmatic illustrating isotype control (A; original magnification ×200), IL-13+ cells present in the bronchial submucosa and ASM bundle (B; original magnification ×200), and IL-13+ cells within the ASM bundle (C; original magnification ×400) are shown. IL-13+ cells are highlighted in the submucosa by arrows and in the ASM bundle by arrowheads.
FIG 3
FIG 3
The number of IL-13+ cells in the submucosa and ASM bundle in subjects with asthma. The number of mast cells in the ASM bundle (A), IL-13+ cells in the bronchial submucosa (B), and IL-13+ cells in the ASM bundle (C) are shown. Δ, Mild asthma (GINA class 1); ▼, moderate asthma (GINA class 2-3); ◆, severe asthma (GINA class 4-5); ■. Solid symbols represent sputum eosinophilia greater than 3%. Horizontal bars represent median value. Values in parentheses represent subjects with mast cells or IL-13+ cells present in ASM or submucosa/total subjects in group.
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