Two different pathways lead to eosinophilic airway inflammation in asthma. Two different pathways lead to eosinophilic airway inflammation in asthma. In.

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Two different pathways lead to eosinophilic airway inflammation in asthma. Two different pathways lead to eosinophilic airway inflammation in asthma. In allergic asthma, dendritic cells present allergens to CD4+ T-cells, inducing T-helper (Th)2 cells, which produce interleukin (IL)-4, IL-5 and IL-13, and leading to IgE switching in B-cells, airway eosinophilia and mucous hypersecretion. In nonallergic eosinophilic asthma, air pollutants, microbes and glycolipids induce the release of epithelium-derived cytokines, including IL-33, IL-25 and thymic stromal lymphopoietin (TSLP), which activate innate lymphoid cells (ILCs) in an antigen-independent manner via their respective receptors (IL-17 receptor B (IL-17RB), ST2 and TSLP receptor (TSLPR)). Activated ILC2s produce high amounts of IL-5 and IL-13, leading to eosinophilia, mucus hypersecretion and airway hyperreactivity. CRTH2: chemoattractant receptor homologous molecule expressed on Th2 cells; ALX/FPR2: receptor for lipoxin A4; FcεRI: high-affinity receptor for IgE; GATA3: GATA-binding protein 3; PG: prostaglandin; ROR: retinoic acid receptor-related orphan receptor; NK: natural killer; MHC: major histocompatibility complex; TCR: T-cell receptor. Reproduced from [51] with permission from the publisher. Jantina C. de Groot et al. ERJ Open Res 2015;1:00024-2015 ©2015 by European Respiratory Society