Predominant T H2 -like Bronchoalveolar T-Lymphocyte Population in Atopic Asthma

Abstract

Background. In atopic asthma, activated T helper lymphocytes are present in bronchial-biopsy specimens and bronchoalveolar-lavage (BAL) fluid, and their production of cytokines may be important in the pathogenesis of this disorder. Different patterns of cytokine release are characteristic of certain subgroups of T helper cells, termed T H1 and T H2 , the former mediating delayed-type hypersensitivity and the latter mediating IgE synthesis and eosinophilia. The pattern of cytokine production in atopic asthma is unknown.Methods. We assessed cells obtained by BAL in subjects with mild atopic asthma and in normal control subjects for the expression of messenger RNA (mRNA) for interleukin-2, 3, 4, and 5, granulocytemacrophage colony-stimulating factor (GM-CSF), and interferon gamma by in situ hybridization with 32 P-labeled complementary RNA. Localization of mRNA to BAL T cells was assessed by simultaneous in situ hybridization and immunofluorescence and by in situ hybridization after immunomagnetic enrichment or depletion of T cells.Results. As compared with the control subjects, the subjects with asthma had more BAL cells per 1000 cells that were positive for mRNA for interleukin-2 (P < 0.05), 3 (P < 0.01), 4 (P < 0.001), and 5 (P < 0.001) and GM-CSF (P < 0.001). There was no significant difference between the two groups in the number of cells expressing mRNA for interferon gamma. In the subjects with asthma, mRNA for interleukin-4 and 5 was expressed predominantly by T lymphocytes.Conclusions. Atopic asthma is associated with activation in the bronchi of the interleukin-3, 4, and 5 and GM-CSF gene cluster, a pattern compatible with predominant activation of the T H2 -like T-cell population. (N Engl J Med 1992;326:298–304.). © 1992, Massachusetts Medical Society. All rights reserved.