The leaky lung test: a pilot study using inhaled mannitol to measure airway barrier function in asthma

Georas, Steve N.; Ransom, Nicole; Hillman, Sara; Eliseeva, Sophia; Veazey, Janelle; Smyth, Timothy; Lê, Kim-Anne; Meddings, Jon

doi:10.1080/02770903.2018.1536145

Cited by 7 publications

(10 citation statements)

References 32 publications

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“…108 Mannitol is well tolerated, migrates paracellularly across the epithelial barrier, and is not extensively metabolized. Recently, Georas et al 109 used inhaled mannitol for the evaluation of barrier function in asthma. Healthy controls and patients with mild asthma inhaled mannitol and serum levels of mannitol were determined afterwards.…”

Section: How To Measure Epithelial Permeabilitymentioning

confidence: 99%

Epithelial barriers in allergy and asthma

Hellings

Steelant

2020

Journal of Allergy and Clinical Immunology

216

180

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The respiratory epithelium provides a physical, functional, and immunologic barrier to protect the host from the potential harming effects of inhaled environmental particles and to guarantee maintenance of a healthy state of the host. When compromised, activation of immune/inflammatory responses against exogenous allergens, microbial substances, and pollutants might occur, rendering individuals prone to develop chronic inflammation as seen in allergic rhinitis, chronic rhinosinusitis, and asthma. The airway epithelium in asthma and upper airway diseases is dysfunctional due to disturbed tight junction formation. By putting the epithelial barrier to the forefront of the pathophysiology of airway inflammation, different approaches to diagnose and target epithelial barrier defects are currently being developed. Using single-cell transcriptomics, novel epithelial cell types are being unraveled that might play a role in chronicity of respiratory diseases. We here review and discuss the current understandings of epithelial barrier defects in type 2-driven chronic inflammation of the upper and lower airways, the estimated contribution of these novel identified epithelial cells to disease, and the current clinical challenges in relation to diagnosis and treatment of allergic rhinitis, chronic rhinosinusitis, and asthma.

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Section: How To Measure Epithelial Permeabilitymentioning

confidence: 99%

Epithelial barriers in allergy and asthma

Hellings

Steelant

2020

Journal of Allergy and Clinical Immunology

216

180

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“…e-mail: Carl.persson@med.lu.se sputum 5,6 . However, it has been repeatedly demonstrated that absorption of inhaled tracers is not increased in individuals with asthma 5,[7][8][9] .…”

Section: Carl Persson Department Of Laboratory Medicine Universitymentioning

confidence: 99%

‘Bedside’ observations challenge aspects of the ‘epithelial barrier hypothesis’

Persson

2021

Nat Rev Immunol

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“…Mannitol, rarely metabolized and without radioactivity, was used in animal studies to evaluate the airway epithelial permeability [53] . However, a recent study showed no difference in serum mannitol levels between subjects with mild asthma and healthy controls after inhalation of mannitol [54] . Biomarkers for evaluating the epithelial barrier function are gaining research interest.…”

Section: Assessment Of Epithelial Barrier Functionmentioning

confidence: 99%

Involvement and therapeutic implications of airway epithelial barrier dysfunction in type 2 inflammation of asthma

Ding

Zhang

Öğülür

et al. 2022

Chinese Medical Journal

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Type 2 inflammation is a complex immune response and primary mechanism for several common allergic diseases including allergic rhinitis, allergic asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. It is the predominant type of immune response against helminths to prevent their tissue infiltration and induce their expulsion. Recent studies suggest that epithelial barrier dysfunction contributes to the development of type 2 inflammation in asthma, which may partly explain the increasing prevalence of asthma in China and around the globe. The epithelial barrier hypothesis has recently been proposed and has received great interest from the scientific community. The development of leaky epithelial barriers leads to microbial dysbiosis and the translocation of bacteria to inter- and sub-epithelial areas and the development of epithelial tissue inflammation. Accordingly, preventing the impairment and promoting the restoration of a deteriorated airway epithelial barrier represents a promising strategy for the treatment of asthma. This review introduces the interaction between type 2 inflammation and the airway epithelial barrier in asthma, the structure and molecular composition of the airway epithelial barrier, and the assessment of epithelial barrier integrity. The role of airway epithelial barrier disruption in the pathogenesis of asthma will be discussed. In addition, the possible mechanisms underlying the airway epithelial barrier dysfunction induced by allergens and environmental pollutants, and current treatments to restore the airway epithelial barrier are reviewed.

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The leaky lung test: a pilot study using inhaled mannitol to measure airway barrier function in asthma

Cited by 7 publications

References 32 publications

Epithelial barriers in allergy and asthma

Epithelial barriers in allergy and asthma

‘Bedside’ observations challenge aspects of the ‘epithelial barrier hypothesis’

Involvement and therapeutic implications of airway epithelial barrier dysfunction in type 2 inflammation of asthma

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