Understanding the pathophysiology of severe asthma to generate new therapeutic opportunities  Stephen T. Holgate, MD, FMedSci, John Holloway, PhD, Susan.

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Understanding the pathophysiology of severe asthma to generate new therapeutic opportunities  Stephen T. Holgate, MD, FMedSci, John Holloway, PhD, Susan Wilson, PhD, Peter H. Howarth, MD, FRCP, Hans Michael Haitchi, MD, Suresh Babu, MD, Donna E. Davies, PhD  Journal of Allergy and Clinical Immunology  Volume 117, Issue 3, Pages 496-506 (March 2006) DOI: 10.1016/j.jaci.2006.01.039 Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 1 Effect of entanercept administered for 12 weeks on symptoms (A) and methacholine hyperresponsiveness measured as PC20 (B) in patients with severe corticosteroid-refractory asthma. Reproduced with permission from BMJ Publishing Group from Howarth et al.60 Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 2 Domain structure of ADAM33 in relation to function. Each exon of the ADAM33 gene is identified by letters A through V (top). EGF, epidermal growth factor; UTR, untranslated region. Reprinted by permission from Macmillan Publishers Ltd: Van Eerdewegh et al.91 Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 3 Localization of ADAM33 protein to airways smooth muscle (SM) in a bronchial biopsy specimen from a patient with severe asthma. Reprinted with permission from Haitchi et al.116 Official Journal of the American Thoracic Society. © American Thoracic Society. Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 4 Alternatively spliced variants of ADAM33 in human fibroblasts identified by means of PCR. EGF, Epidermal growth factor; TM, transmembrane. Reprinted with permission from Powell et al.97 Official Journal of the American Thoracic Society. © American Thoracic Society. Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 5 Three-dimensional structure of ADAM33 determined by means of crystallography in complex with the inhibitor Marimastat (shown as the stick and ball construct). The substrate binding site contains unique features that are specific for ADAM33, suggesting that it has a limited substrate specificity. C, C-terminal end; N, N-terminal end. Reprinted with permission from Orth et al.98 Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 6 Immunolocalization of ADAM33 in 8- to 12-week human fetal lung tissue. ADAM33 immunoreactivity is mostly found around bronchial tubes in primitive mesenchymal cells but also in airways smooth muscle. αSMA, α Smooth muscle actin. Reprinted with permission from Haitchi et al.116 Official Journal of the American Thoracic Society. © American Thoracic Society. Journal of Allergy and Clinical Immunology 2006 117, 496-506DOI: (10.1016/j.jaci.2006.01.039) Copyright © 2006 American Academy of Allergy, Asthma and Immunology Terms and Conditions