G.J. Gleich

We have performed bronchoalveolar lavage (BAL) on 17 subjects with mild atopic asthma (9 symptomatic, 8 asymptomatic) and 14 nonasthmatic control subjects (6 hay fever, 8 nonatopic). There was a significant increase in the percentage of mast cells in both groups of asthmatics although the counts were no different from those previously reported for a number of other respiratory diseases. Asthmatics with airway hyperreactivity (PC20 less than 4 mg/ml) had significant increases in spontaneous histamine release. There was a significant elevation in the eosinophil count and the concentration of major basic protein (MBP) in BAL fluid in the symptomatic asthmatics. Furthermore, there was a significant correlation between the amounts of MBP recovered and the percentage of eosinophils in the BAL. These changes were even more marked when asthmatics with airway hyperreactivity were compared with subjects with normoreactive airways. In addition, there was a significant increase in the percentage of epithelial cells in the hyperreactive asthmatics. There was an inverse correlation between the PC20 and the percentage of mast cells (p less than 0.01), eosinophils (p less than 0.05), and epithelial cells (p less than 0.05) and amount of MBP in BAL (p less than 0.01). This study supports the hypothesis that bronchial hyperresponsiveness is secondary to epithelial cell damage mediated through eosinophil-derived granule products.

Human peripheral blood eosinophils released eosinophil survival-enhancing activity when stimulated with the calcium ionophore, ionomycin. The release of activity was detected as early as 3 h after stimulation and was inhibited by an immunomodulating agent, cyclosporin A. The survival-enhancing activity was completely abolished by treatment with anti-interleukin 3 (IL-3) and anti-granulocyte/macrophage colony-stimulating factor (GM-CSF) monoclonal antibodies. Moreover, IL-3 and GM-CSF were measurable in ionomycin-stimulated eosinophil supernatants by immunoassay. Eosinophils produced approximately one-half as much IL-3 and one-fifth as much GM-CSF as ionomycin-stimulated mononuclear cells. Neutrophils also produced IL-3 and GM-CSF, but the amounts were less than those produced by eosinophils. These observations suggest a novel role for eosinophils in pathophysiology of allergic inflammation and host defense mechanisms.

Eosinophils play a central role in the inflammatory response associated with bronchial asthma. We studied the involvement of eosinophils in the development of airway hyperresponsiveness (AHR) in a mouse model of allergic airway sensitization. Sensitization of BALB/c mice to OVA via the airways induced allergen-specific T-cell responses, IgE production, immediate cutaneous hypersensitivity (ICH), and increased airway reactivity. Airway sensitization was associated with eosinophil infiltration of the airways and increased production of interleukin-5 (IL-5) in cultures of peribronchial lymph node cells. Treatment of OVA-challenged animals with anti-IL-5 antibody during the sensitization protocol completely abolished the infiltration of eosinophils into the lung tissue and prevented the development of AHR without affecting levels of allergen-specific IgE, cutaneous hypersensitivity and allergen-specific T cell responses. These findings demonstrate that infiltration of lung tissue by eosinophils, triggered by increased IL-5 production, is a major factor in the development of AHR in this mouse model of airway sensitization.

Major basic protein (MBP), one of several cationic proteins associated with the eosinophil granule, is cytotoxic to respiratory epithelium and is present in the sputum of asthmatics and on damaged bronchial epithelium from patients dying of asthma. The present experiments were performed in order to determine the effects of MBP on the responsiveness of airway smooth muscle. Rings of guinea pig trachea, in some of which the epithelium had been gently removed by rubbing, were incubated for 5 h in modified Krebs-Ringer bicarbonate solution containing buffer or human MBP (100 micrograms/ml). The tracheal rings were then suspended for isometric tension recording in organ chambers filled with Krebs-Ringer solution containing indomethacin. MBP did not affect the reactivity of rings in which the epithelium had been removed, but significantly augmented that of unrubbed rings to acetylcholine and histamine. The results suggest that MBP, by inhibiting the function of epithelial but not smooth muscle cells, causes hyperreactivity of respiratory smooth muscle, which may contribute to the hyperreactivity observed in chronic respiratory disease.