Title: IL-4 and IL-6 in Bronchial Asthma Does IL-6 Plays More Important Role than IL-4? A Preliminary Study

Authors: Prof Usha, Dr Deepa Rani, Dr Hema Goyal, Dr Richa Katiyar, Kavyanjali, Shailja, Niladri, Dr Sajjan Kumar Meena, Ranjan Singh Rana

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.115

Abstract

Summary: Cytokines IL-4, 5, 6 and 13 plays an important role in the pathogenesis & chronicity of bronchial Asthma. Main purpose of the study was to see role of IL-4 & IL-6 in allergic disease.

Material & Method: Total 58 cases of bronchial asthma in which 10 cases were having allergic rhinitis and 07 had urticaria, along with 20 healthy controls were taken for study between period of November 13 to December 14.

Result: Among 58 patients of asthma, 10 had associated rhinitis and 07 cases had urticaria. Out of 58 cases 58.62% patients were male and 41.38% patients were females. Total 13 patients were children of age group 3-15 year in which males were 23.53% & females were 20.83% . Most common age group was 16-30 years in which 54.16 % were female and 47.05% were male. Total 42 cases (72.41%) were between 3 to 30 years. IL-4 was raised significantly in asthma cases in 25% cases. Similarly, IL-6 was significantly elevated in 48.27% patients of asthma. Thus our study concludes that IL-6 plays more role in pathogenesis of asthma than IL-4. Monoclonal antibody to IL-6 may be tried on this cases.

Keyword: Bronchial Asthma, Allergic rhinitis, urticaria, IL-4, IL-6, Cytokines.

References

1.      Nakanishi K, Basophils are potent antigen presenting cells that selectively induces Th2 cells, Eur. J. Immunol, 2010, 40: 1836-42.

2.      Amin K, The role of mast cells in allergic inflammation Respiratory Medicine 2012; 106(1): 9-14.

3.      Kumar V , Abbas AK , Aster JC: Robbins and Cotran Pathologic basis of diseases.9th edition(South Asia edition)Reed Elsevier India Private limited Vol1 2014,P201-205

4.      Bradding P, Roberts J.A., Britten KM, Montefort S, Djukanovic R, Mueller R, Heusser CH et al. Interleukin 4, 5, and 6 and tumour necrosis factor alpha in normal and asthmatic airways. Am. J Respir Cell Mol. Bial 1994; 10(5): 471-80.

5.      Canonica G W: Introduction to nasal and pulmonary allergy cascade. Allergy 2002; 57 (Supp75); 8-12

6.      Deo SS, Mistry K J, Kakade AM Niphadkar PV: Role played by Th2 type cytokines in IgE mediated allergy and asthma lung India 2010, 27(2);66-71

7.      Imada M, Simons FE, Jay FT, Hayglass KT, Antigen mediated and polyclonal stimulation of human cytokine production elict qualitatively different patterns of cytokine gene expression. Int. Immunol. 1995,7(2): 229-237.

8.      Ozol D1, Koca C, Mete E, Yigitoğlu R; Influence of atopy on asthma severity in adult female patients . J.Invest . Allergol Clin Immunol 2008, 18; 36-40

9.      Rincon M, Irvin CG: Role of IL-6 in Asthma and other inflammatory pulmonary disorder. Int. J. Bio. Sci. 2012; 8(9): 1281-1290

10.  Pene J, Rousset F, Briere F, et al: IgE production by normal human lymphocytes is induced by interleukin 4 and suppressed by interferon gamma and alpha and prostaglandin E2. Proc Natt. Acad. SCIUSA 1988; 85(18): 6880-6884

11.  Moser R, Fehr J, Bruijnzel PL, IL-4 controls the selective endothelium driven transmigration of eosinophils from allergic individuals, J. Immunol 1992; 149(4): 1432-1438

12.  Mahajan S, Mehta AA: role of Cytokines in Pathophysiology of Asthma. Iranian Journal of Pharmacology and therapeutics, 2006, 5: 1-14

13.  Papadopoulos J, Karpouzis A, Tentes J, Kouskoukis C et al.,: Assessment of Interleukins IL-4, IL-6, IL-8, IL 10 in acute urticaria. J. Clin. Med. Res. 2014, 6 (2), 133-137

14.  Wills -Karp M. Immunologic basis of antigen induced air way hyperresponsive key. Ann. Rev. Immunol, 1999,17,255-281

15.  Walter DM, Mcintire JJ, Berry G, Mckenzie A N,Donaoldson DD, Dkruyff RH et al. Critical role of IL-13 in the development of allergen-induced airway hyperreactivity, J Immunol 2001; 167(18): 4668-75

16.  Whittaker L, Niu N, Temann UA, Stoddard A, Flavell R A, Ray A et al. Interleukin 13 mediates a fundamental pathway for air way epithelial mucus induced by CD4 T Cells and IL-9. Am. J.Resper. Cell. Mol. Bio. 2002, 27(5), 593-602

17.  Kurowska-Stolarska M, Kerwin P, Murphy G,Russo RC Stolarski B, Garcia CC et al: IL-33 induces antigen Specific IL-5+T cells and promotes allergic induced airway inflammation independent of IL-4. J. Immunol. 2008, 181(7), 4780-90.

18.  Javad Ghaffari, Rafiei A.R., Ajami A, Mohdavi M, Hoshiar B; Serum interleukin 6 & 8  in mild and servere asthmatic patients Is it difference? Caspian J. Intern. Med. 2011; 2(2): 226-228

19.  Hirano T: Interleukin 6 and its receptor, ten years later. Intern. Rev. Immunol 1998; 16(3-4), 249-284

20.  Kasperska- Zalac A: Acute Phase response in chronic urticaria, DOI: 10.1111/J. 1468-3083, 2011. 04366. JEADV 2012; 26: 665-672.

21.  Peter J, Badrul C and Sergei A.K.; Pulmonary biomarkers is chronic obstru-ctive pulmonary disease, AM J Respire- Crit Care Med. 2006(1); 174: 6-14

22.  Broide D H, Lotz M, Cuomo AJ, Coburn DA, Federman EC, Wasserman S I; Cyto-kines in symptomatic asthma airways. J. Allergy clin Immunol 1992,89(15),958-96.

23.  Stadnyk AW. Cytokine productions by epithelial cells, Faseb J. 1994; 8: 1041-47

24.  Yokoyama A, Kohno N, Fujino S, Hamada H, Inoue Y, Fujioka S et al : Circulating interleukin 6 levels in patients with bronchial asthma. Am. J. Respir. crit. Care. Med. 1995; 151(5): 1354-1358.

25.  Kishimoto T: IL-6 from its discovery to clinical application. Int. Immunol 2010; 22(5): 347-352.

26.  Naveu WA, Allard JL., Raymond DM, Bourassa LM, Burns SM, Bunn JY et al., Elevation of IL-6 in the allergic asthmatic airway is independent of inflammation but associates with loss of control of  airway function. Respir. Res. 2010; 11: 28

27.  Rincon M, Anguinta J, Nakamura T, Fikrig E, Flavell R A: IL-6 directs the differentiation of IL-4 producing CD4 + T Cell J. Exp. Med. 1997, 185(3), 461-469

28.  Diehl s, Chow C W, Weiss L, Palmetshofer A, Twardzik T, Rounds L et al. Induction of NFAT -C2 expression by interleukin 6 promotes T helper Type 2 differentiation. J. Exp Med. 2002, 196(1), 39-49

29.  Tillie Leblond I, Pugin J, Marquett C H, Lamblin C, Saulnier F. Brichet A et al; Balance between proinflammatory cytokine and their inhibitors in bronchial lavage from patients with status asthmaticus. Ann. J. Respir, Crit. Care. Med. 1999; 159: 487-494

30.  Doganci A, Sauer K, Karwot R, Finotto S, Pathological role of IL-6 in the experimental allergic bronchial asthma in mice, Clin. Rev. Allergy Immunal 2005, 28(3) : 257-270

31.  Subrahmanyam R M, Srikantaill IC, Krishna P, Rayappa Wilma C, Silvia D, Thenrunavukkarasu S, Devi K, Rao M, Kamal V, Can bronchial asthma be classified based on the immunological status, Lung India, 2011, 28 (2) 110-113

32.  Song W, Zhao J, and Li Z. interleukin 6 in BAL fluid from patients with COPD Chin Med. J. 2001; 114 (11) : 1140-1142

33.  Stankiewicz W, Dabrowski MP, Chcialowski A, Plusa T: Cellular and cytokine immuno regulation in patients with chronic obstructive pulmonary disease and bronchial asthma. Mediators Inflamm 2002; 11(5), 307-312

34.  Alwakil IM, Alkabeer AM, Kabil TN, Abdelmonen AA: Serum interleukin 6 and interleukin 8 in bronchial asthma AAMJ, 2011; 9(3), Suppl.-1, 385-395.

Corresponding Author

Dr Deepa Rani