Allergic airway disease is characterized by eosinophilic inflammation, mucus hypersecretion and increased airway resistance. Fungal antigens are ubiquitous within the environment and are well known triggers of allergic disease. Bacterial products are also frequently encountered within the environment and may alter the immune response to certain antigens. The consequence of simultaneous exposure to bacterial and fungal products on the lung adaptive immune response has not been explored. Here, we show that oropharyngeal aspiration of fungal lysates (Candida albicans, Aspergillus fumigatus) promotes airway eosinophilia, secretion of Th2 cytokines and mucus cell metaplasia. In contrast, oropharyngeal exposure to bacterial lysates (Pseudomonas aeruginosa) promotes airway inflammation characterized by neutrophils, Th1 cytokine secretion and no mucus production. More importantly, administration of bacterial lysates together with fungal lysates deviates the adaptive immune response to a Th1 type associated with neutrophilia and diminished mucus production. The immunomodulatory effect that bacterial lysates have on the response to fungi is TLR4 independent but MyD88 dependent. Thus, different types of microbial products within the airway can alter the host's adaptive immune response and potentially impact the development of allergic airway disease to environmental fungal antigens.Key words: Cytokines . Eosinophils . Immune responses . Lung inflammation . Th cells
IntroductionAllergic airway disease is characterized by eosinophilic inflammation, mucus hypersecretion and increased airway resistance (R n ) [1][2][3]. This response results from antigen-specific Th2 cell activation characterized by IL-4, IL-5 and IL-13 production [4]. IL-4 and IL-5 stimulate eosinophil maturation and activation while IL-13 is an important mediator of mucus production [4,5]. Among inhaled allergens that can trigger this type of immune response are a number of fungal species [6]. These agents can stimulate allergic inflammation without causing active infection in the immunocompetent host [6][7][8]. It is unclear why airway
776exposure to fungal antigens leads to a Th2 immune response but may result from specific antigenic determinants of the fungi that preferentially stimulate Th2 responses. However, CD4 T cells from mice with transgenic T-cell receptors specific for a particular Aspergillus antigen differentiate ex vivo into IFN-g-producing Th1 cells rather than Th2 cells [9]. Alternatively, it could be the lung environment with its costimulatory cytokine milieu that predisposes to a Th2 immune response to fungal antigens. Interestingly, not all individuals develop allergic airway inflammation in response to inhaled fungal allergens despite ubiquitous exposure [10]. The 'hygiene hypothesis' proposes that lung exposure to certain bacterial components (e.g. CpG DNA) could modulate the Th2immune response [11][12][13]. Thus, CD4 T cell immune response to specific protein antigens could be modulated by exposure to bacterial microbial products.We h...