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Table 2 Inflammatory events in asthma: Role of Cytokine-IgE Axis and Inflammatory Cells

From: Severe asthma and the omalizumab option

Event Cell types involved Mediators Cell type affected Net effect
Inflammation Antigen-presenting cell CSM T cells, B cells T cell activation Antibody synthesis
   TNF alpha Endothelium Cell adhesion, recruitment
  Mast cells IL-4 T cells Th2 cell polarization
   IL-4, IL-13 B cells IgE class switching
   IL-13 Goblet cell Mucus secretion CAM
   TNF-alpha Endothelium upregulation
   LTs Smooth muscles Contraction
   LTs, IL-5 Eosinophils Chemoattraction, survival
   Histamine Endothelium etc Edema, bronchospasm
  T cells IL-4, IL-13 B cells IgE class switching
   IL-5 Eosinophils Hematopoiesis, survival
   IL-9 Mast cells BHR, mast cell growth
  B cells IgE Mast cells,
Early phase
Mediator release
  Eosinophil MBP Epithelium, mast cells Injury, histamine release
   LTs Smooth muscle Contraction
   Cytokines Multiple types Inflammation
  1. CSM = Costimulatory molecule; LTs = leukotrienes; MBP = Major Basic Protein of Eosinophil; BHR = Bronchial hyperresponsiveness