Severe asthma and the omalizumab option

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

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, basophil	Early phase response Mediator release
	Eosinophil	MBP	Epithelium, mast cells	Injury, histamine release
		LTs	Smooth muscle	Contraction
		Cytokines	Multiple types	Inflammation

CSM = Costimulatory molecule; LTs = leukotrienes; MBP = Major Basic Protein of Eosinophil; BHR = Bronchial hyperresponsiveness

ISSN: 1476-7961