help button home button
AJRCMB
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wen, F.-Q.
Right arrow Articles by Rennard, S. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wen, F.-Q.
Right arrow Articles by Rennard, S. I.
Am. J. Respir. Cell Mol. Biol., Volume 26, Number 4, April 2002 484-490

Interleukin-4- and Interleukin-13-Enhanced Transforming Growth Factor-beta 2 Production in Cultured Human Bronchial Epithelial Cells Is Attenuated by Interferon-gamma

Fu-Qiang Wen, Tadashi Kohyama, Xiangde Liu, Yun Kui Zhu, Hangjun Wang, Hui Jun Kim, Tetsu Kobayashi, Shinji Abe, John R. Spurzem, and Stephen I. Rennard

Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska; Department of Respiratory Diseases, Jincheng Hospital, Lanzhou, China; Mount Sinai Hospital, Toronto, Ontario, Canada; and Pulmonary Division, Department of Internal Medicine, Seoul Adventist Hospital, Seoul, Korea

    Abstract
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Cytokines derived from lymphocytes are believed to play key roles in a variety of diseases, including airway diseases such as asthma. The current study was designed to evaluate the hypothesis that cytokines derived from Th2 cells, interleukin (IL)-4 and IL-13, might contribute to tissue remodeling by modulating the production of transforming growth factor (TGF)-beta . In addition, the ability of interferon (IFN)-gamma , a cytokine derived from Th1 cells that can antagonize many effects of IL-4 and IL-13, was also assessed for its effects on TGF-beta production. IL-4 and IL-13 both stimulated production of TGF-beta 2 release from human bronchial epithelial cells in a time- and concentration-dependent manner. Both with and without acidification, TGF-beta 2 were detected. Neither TGF-beta 1 nor TGF-beta 3 was released. In contrast to the stimulatory effect on human bronchial epithelial cells, neither IL-4 nor IL-13 stimulated release of any TGF-beta isoform from human lung fibroblasts. IFN-gamma reduced both basal, IL-4-, and IL-13-stimulated release of TGF-beta 2 in human bronchial epithelial cells. The stimulatory effects of IL-4 and IL-13 and the inhibitory effect of IFN-gamma on TGF-beta 2 release were paralleled by mRNA levels, as assessed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). In summary, the Th2-derived cytokines, IL-4 and IL-13, can stimulate production of TGF-beta from airway epithelial cells but not from lung fibroblasts. IFN-gamma , in contrast, can inhibit TGF-beta 2 release both under basal conditions and following IL-4 or IL-13 stimulation. The ability of these cytokines to modulate TGF-beta release may contribute to both normal airway repair and to the development of subepithelial fibrosis in asthma.

    Introduction
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

The transforming growth factor-beta s (TGF-beta s) are a family of dimeric polypeptide growth factors consisting of three isoforms: TGF-beta 1, TGF-beta 2, and TGF-beta 3, which are expressed in many cell types including epithelial and mesenchymal cells (1). TGF-beta regulates cellular proliferation and differentiation in several settings, including embryonic development, wound healing, and angiogenesis (2). An increase or a decrease in the production of TGF-beta has been linked to several disease states, including atherosclerosis and fibrotic disease of the kidney, liver, and lung (6, 7). In asthma and chronic obstructive pulmonary diseases (COPD), chronic inflammation and injury of both the airways and the alveolar structures of the lung are observed and both peribronchiolar fibrosis and subepithelial fibrosis are also often seen (8). In addition, TGF-beta immunoreactivity is increased in epithelial cells and submucosa of those with asthma and bronchitis (11). TGF-beta has been suggested to function in the airway both as a mediator of normal repair processes and a contributor to the development of peribronchiolar fibrosis.

In asthma, cytokines produced by activated Th2 lymphocytes are believed to play critical roles in regulating the inflammatory process. Interleukin (IL)-4 and IL-13 in particular have been suggested to be key factors contributing to the chronic inflammatory state characterizing asthma (12, 13). These cytokines may also be involved in the connective tissue alterations that characterize airway remodeling in asthma. Both cytokines have been demonstrated to stimulate fibroblasts (14). Conversely, interferon (IFN)-gamma is a cytokine derived from a variety of cell types, including Th1 lymphocytes (15). This cytokine is believed to be deficient in asthma and is believed to antagonize some of the effects of IL-4 and IL-13 (16, 17).

The current study was designed to determine if the Th2 lymphocyte-derived cytokines, IL-4 and IL-13, might modulate airway remodeling by altering production of TGF-beta . In addition, the ability of IFN-gamma to interact with IL-4 and IL-13 was assessed. These studies demonstrate that IL-4 and IL-13 may have a profibrotic effect mediated by the stimulation of TGF-beta production by airway epithelial cells, an effect which is not observed with lung fibroblasts. IFN-gamma , in contrast, appears to downregulate TGF-beta production and to antagonize the IL-4 and IL-13 effect.

    Materials and Methods
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Recombinant human IL-4, IL-13, and IFN-gamma , recombinant human TGF-beta 1 and -beta 2, mouse anti-human TGF-beta 1 (clone: 9016-2) and -beta 2 (clone: 8,607.211), monoclonal antibodies (used for capture in enzyme-linked immunosorbent assay [ELISA]), and biotinylated anti-human TGF-beta 1 and -beta 2 antibodies (for detection) were purchased from R&D Systems Inc. (Minneapolis, MN). Tetramethylbenzidine was purchased from Sigma Chemical Co. (St. Louis, MO).

Cell Culture

Human bronchial epithelial cells. Adult human bronchial epithelial cells (HBECs) were obtained by the explant method (18). Briefly, bronchi obtained at autopsy were cut into 4- to 5-mm squares with a sterile scalpel. Individual explants were placed onto 35-mm culture dishes coated with Vitrogen 100 (Collagen, Palo Alto, CA) in serum-free medium comprised of a 1:1 mixture of Laboratory of Human Carcinogenesis (LHC)-9 and RPMI 1,640 (GIBCO Life Technologies, Grand Island, NY). LHC-9 containing LHC basal medium (Biofluids, Rockville, MD) was supplemented as previously described (19). Culture dishes containing explants were then incubated at 37°C in a humidified atmosphere of 5% CO2. After cells grew to confluence, cells were trypsinized and passaged onto Vitrogen-coated dishes in LHC-9/ RPMI. Third-passage cultures were stored in liquid N2. Cells of passages 4-8 were used for experiments. Cells were routinely checked with anti-human cytokeratin antibody (MAK-6; Triton, Alameda, CA) and anti-vimentin (DAKO, Santa Barbara, CA) for purity. All cells were found to be keratin positive and, in general, vimentin negative. Under some conditions, slight vimentin positivity could be observed. This was in marked contrast to the strong vimentin positivity and clear keratin negativity routinely observed with fibroblasts. Cell preparations, therefore, were free of fibroblast contamination to the limit of the immunohistochemical techniques.

Human fetal lung fibroblasts.Human fetal lung fibroblasts (HFL-1) were purchased from the American Type Culture Collection (Rockville, MD). The cells were cultured in 100-mm tissue culture dishes (FALCON) (Becton Dickinson Labware, Lincoln Park, NJ) in Dulbecco's modified Eagle's medium (DMEM) (GIBCO) supplemented with 10% fetal calf serum (FCS) (Biofluid), 50 U/ml penicillin G sodium, 50 µg/ml streptomycin sulfate (penicillin-streptomycin, GIBCO), and 1 µg/ml amphotericin B (Parma-Tek, Huntington, NY). The fibroblasts were passaged weekly by trypsinization (Trypsin-ethylenediaminetetraacetic acid; 0.05% trypsin, 0.53 mM EDTA-4Na). Passages 14-19 were used for experiments.

Experimental Protocol

To evaluate the effect of cytokines on the production of TGF-beta 2 by HBECs, 1 × 105 HBECs were seeded in LHC-9/RPMI in 12-well plates (FALCON) and grown for 3-4 d to reach confluence. After washing, fresh unsupplemented media, LHC-D/RPMI, containing various concentrations of IL-4, IL-13, or IFN-gamma were added and incubated for 24 h. To examine the effect of incubation time with cytokines on TGF-beta 2 production by HBECs, the cells were incubated with media containing 10 ng/ml of IL-4 or IL-13, 200 U/ml of IFN-gamma , or the combinations of IL-4 or IL-13 and IFN-gamma for up to 48 h. To examine the effect of IFN-gamma on the IL-4- or IL-13-induced production of TGF-beta 2 by HBECs, cells were incubated with 10 ng/ml of IL-4 or IL-13, together with various concentrations of IFN-gamma for 24 h.

For HFL-1 fibroblasts, cells were cultured to confluence in 10% FCS/DMEM in humidified 5% CO2/95% air at 37°C in 35 mm tissue culture dishes and growth-arrested in serum-deprived media for 24 h before experiments. Immediately before each experiment, fresh serum-free media containing IL-4, IL-13, IFN-gamma , or combinations of these cytokines were added and incubated for 48 h.

At the indicated times, all the culture media were harvested and stored at -80°C until ELISA for TGF-beta s was performed.

Measurement of TGF-beta s by ELISA

TGF-beta 1 and -beta 2 concentrations were determined by ELISA. Briefly, ELISA plates were coated overnight at 4°C with 100 µl of mouse anti-human TGF-beta -coating antibodies that had been diluted in 1× Voller's buffer (pH 9.6). For the assay of total TGF-beta s, samples to be tested were first activated by 1N HCl for 10 min and then neutralized by 1.2 N NaOH/0.5 M N-2-hydroxyethylpiperazine-N'-ethane sulfonic acid at room temperature. In addition, samples were directly assayed without acid activation. After rinsing, 100 µl of sequential dilutions of samples or standards containing known amounts of human TGF-beta s were added and incubated at room temperature for 2 h. Following this, 100 µl of biotinylated TGF-beta s antibodies diluted in phosphate-buffered saline (pH 7.4) containing 0.05% Tween 20 was added for 1 h. Next, 100 µl of streptavidin-horseradish peroxide (HRP) conjugate that had been diluted to 1:20,000 in dilution buffer was added for 1 h. Finally, 200 µl of the substrate buffer containing the HRP substrate tetramethylbenzidine and hydrogen peroxide in 0.05 M phosphate-citrate buffer (pH 5.0) was added for 30-60 min and color-developed in relation to the amount of TGF-beta s present. The reaction was stopped by adding 50 µl of stop solution (1 M sulfuric acid) and the degree of color that had been generated was determined by measuring the optical density at 450 nm in a Benchmark microplate reader (Bio-Rad, Hercules, CA). The standard curve was linearized and subjected to regression analysis. The concentration of TGF-beta s in unknown samples was estimated using this standard curve with commercially available software (MPM III-Vs 1.57, Bio Rad). The results are expressed as picograms per milliliter of culture medium and then corrected by the cell number. These assays are isoform-specific and detect an epitope expressed as the active TGF-beta forms, but are not a measure of bioactivity.

RNA Preparation

To determine whether changes in TGF-beta protein levels were related to mRNA levels, real-time reverse transcriptase/polymerase chain reaction (RT-PCR) was done. Cells were cultured until confluence and exposed to 10 ng/ml of IL-4 or IL-13 in the absence or presence of 200 U/ml of IFN-gamma for 24 h, as described previously. Total RNA was isolated by a single-step guanidinium-thiocyanate-phenol-chloroform extraction procedure described by Chomczynski (20) and treated with RNase free DNaseI. After denaturation of the freshly prepared RNA at 65°C for 10 min and 95°C for 5 min, a single-stranded cDNA was produced by reverse transcription described below.

Taqman Real-Time RT-PCR Assay

The PCR primers and Taqman probes for human TGF-beta 1, TGF-beta 2, and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a constitutively expressed gene, were a gift from Dr. Paula Belloni from Roche. The sequences used were: TGF-beta 1 primers, 5'-CGA GCC TGA GGC CGA CTA C-3' (forward) and 5'-AGA TTT CGT TGT GGG TTT CCA-3' (reverse); TGF-beta 2 primers, 5'-CCA TTA AGT GGA GCT GTA CGT-3' (forward) and 5'-GTG CCT ATT GCA TAG CAA TAC AGA A-3' (reverse); GAPDH primers, 5'-CCA GGA AAT GAG CTT GAG AAA GT-3'(forward) and 5'-CCC ACT CCT CCA CCT TTG AC-3'(reverse). Taqman probes were labeled with a reporter fluorescent dye, FAM (6-carboxyfluorescein), at the 5' end and a fluorescent dye quencher, TAMRA (6-carboxy-tetramethyll-rhodamine), at the 3' end. The probe sequence for TGF-beta 1 was FAM-CCA AGG AGG TCA CCC GCG TGC-TAMRA; for TGF-beta 2 was FAM-CCG TTC CTA TCC CGC GCC TCA CT-TAMRA; for GAPDH was FAM-CGT TGA GGG CAA TGC CAG CCC-TAMRA.

RT and PCR were performed using Taqman Reverse Transcription Reagents and a TaqMan Gold RT-PCR kit (Perkin-Elmer, Norwalk, CT) according to the manufacturer's specifications. A two-step RT-PCR was performed. The RT reaction was performed with 500 ng total RNA in a total volume of 40 µl containing 1× Taqman PCR buffer, 5.5 mM MgCl2, 500 µM of each deoxynucleotide triphosphate, 2.5 µM oligo d(T)16 primers, 0.4 U/µl RNase Inhibitor, and 1.25 U/µl MultiScribe Reverse Transcriptase. The RT reaction was performed at 25°C for 10 min, 48°C for 30 min, and 95°C for 10 min.

A thermal stable AmpliTaq Gold DNA polymerase was used for the second strand cDNA synthesis and DNA amplification. Real-time PCR was performed with 4 µl of RT products, 1× Taqman probe buffer A, 5.5 mM MgCl2, 200 µM dATP/dCTP/ dGTP, 400 µM dUTP, 300 nM primers (forward and reverse), 200 nM Taqman probe, 0.01 U/µl AmpErase, and 0.025 U/ml AmpliTaq Gold DNA Polymerase in a total volume of 50 µl. PCR was performed at 50°C for 2 min, 95°C for 10 min, and then run for 40 cycles at 95°C for 15 sec, 60°C for 1 min on the ABI PRISM 7,700 Detection System. Each sample was run in duplicate, and the Delta Rn (the ratio for the amount of reporter dye emission to the quenching dye emission) and threshold cycle (Ct) values were averaged from each reaction. Data were analyzed using a Sequence Detector V1.6 program (Perkin-Elmer).

Statistical Analysis

Each condition in every experiment included three replicate dishes and the data presented are the mean ± standard error of the mean of these triplicates. Each experiment was repeated on multiple occasions and each figure represents composite data from all experiments as indicated in the figure legends. Data were evaluated by one-way ANOVA in the experiments examining dose-dependent effect of cytokines unless indicated. If the overall F statistic was significant at the 0.05 level, subsequent inter-group significance testing was assessed post hoc by the Scheffe's F-test. In the experiments examining the effect of incubation time, two-way analysis of variance (ANOVA) was performed. A two-tailed unpaired Student's t test with the Bonferoni correction was also performed to compare paired samples.

    Results
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Time Course of IL-4, IL-13, and IFN-gamma on TGF-beta 2 Release by HBECs

Figure 1 shows TGF-beta 2 production by HBECs after incubation with 10 ng/ml of IL-4, IL-13, or 200 U/ml of IFN-gamma alone and with the combination of either IL-4 or IL-13 and IFN-gamma for various times. TGF-beta 2 release from IL-4- or IL-13- treated cells was significantly increased compared with control cells (P < 0.01). The stimulatory effect of IL-4 and IL-13 was observed at 12 h after the start of the incubation and continued for the 48 h-incubation period. The TGF-beta 2 release from IFN-gamma -treated HBECs was significantly suppressed compared with control cells (P < 0.01). The suppressive effect of IFN-gamma was observed at 24 h after the start of the incubation and continued for the 48 h-incubation period.


View larger version (38K):
[in this window]
[in a new window]
 
Figure 1.   Time course of IL-4, IL-13 and IFN-gamma on TGF-beta 2 release by HBECs. HBECs were incubated for times indicated with LHC-D/ RPMI in the absence or presence of 10 ng/ml IL-4, IL-13, or 200 U/ml IFN-gamma alone or the combination of either IL-4 or IL-13 with IFN-gamma . TGF-beta 2 levels in harvested media were determined by ELISA. Results are mean ± SEM of nine samples in three different experiments. Vertical axes: total TGF-beta 2 release (pg/106 cells). Horizontal axes: time. The effects of IL-4 or IL-13 alone were statistically significant relative to the control (P < 0.01, two-way ANOVA). *, # P < 0.01, Student t test, compared with control (*) or to IL-4 or IL-13 alone (#).

When HBECs were incubated in media containing either IL-4 or IL-13 together with IFN-gamma , the stimulatory effect of IL-4 and IL-13 on TGF-beta 2 production was significantly reduced (P < 0.01). A significant decrease in TGF-beta 2 production was observed at 24 h, at which time it was close to the control levels; after 48 h of incubation, it was lower than that of control.

Effect of IL-4, IL-13, and IFN-gamma on TGF-beta 2 Release by HBECs: Concentration Dependence

Figure 2 shows the release of TGF-beta 2 by HBECs treated with various concentrations of IL-4, IL-13, or IFN-gamma for 24 h. The concentration of total TGF-beta 2 released from control HBECs cultures was ~ 2,460 ± 210 pg/106 cells. IL-4 and IL-13 significantly increased the production of TGF-beta 2 by HBECs in a concentration-dependent manner (P < 0.01). IL-4 and IL-13 caused a 140%, 180%, and 250% increase of the control in the release of TGF-beta 2 from HBECs at 0.1, 1, and 10 ng/ml, respectively. IFN-gamma moderately but significantly suppressed the production of TGF-beta 2 by HBECs in a concentration-dependent manner (P < 0.01). IFN-gamma caused a 10%, 30%, and 40% decrease in the release of TGF-beta 2 from HBECs at 2, 20, and 200 U/ml, respectively.


View larger version (22K):
[in this window]
[in a new window]
 
Figure 2.   Effect of IL-4, IL-13, and IFN-gamma on TGF-beta 2 release by HBECs: concentration dependence. HBECs were incubated for 24 h with LHC-D/RPMI in the absence or presence of various concentrations of IL-4, IL-13, or IFN-gamma (A, B, and C, respectively). TGF-beta 2 levels in harvested media were determined by ELISA. Results are mean ± SEM of nine to 15 samples in three to five different experiments. Vertical axes: total TGF-beta 2 release (pg/106 cells). Horizontal axes: concentration of IL-4, IL-13, or IFN-gamma . *P < 0.05, Scheffe's F-test, compared with control.

Effect of IL-4, IL-13, and IFN-gamma on TGF-beta 1 Release from HFL-1 Fibroblasts

In contrast to HBECs, which released only TGF-beta 2, HFL-1 fibroblasts cultured for 48 h in serum-free DMEM released detectable amounts of both latent TGF-beta 1 and TGF-beta 2. The addition of IL-4, IL-13 or IFN-gamma alone or the combination of either IL-4 or IL-13 with IFN-gamma had little effect on the release of TGF-beta 1 compared with control. Similarly, the release of TGF-beta 2 by HFL-1 fibroblasts was not affected by the addition of IL-4, IL-13, or IFN-gamma alone, or the combination of these cytokines (Figure 3).


View larger version (23K):
[in this window]
[in a new window]
 
Figure 3.   Effect of IL-4, IL-13, and IFN-gamma on TGF-beta 1 and -beta 2 release by HFL-1 fibroblasts. HFL-1 fibroblasts were incubated for 48 h with serum-free DMEM in absence or presence of 10 ng/ml IL-4, IL-13, or 200 U/ml IFN-gamma alone, or the combination of either IL-4 or IL-13 with IFN-gamma . TGF-beta 1 (A) and TGF-beta 2 (B) levels in harvested media were determined by ELISA. Results are mean ± SEM of nine samples in three different experiments. Vertical axes: total TGF-beta s release (pg/106 cells). Horizontal axes: agents added.

Effect of IFN-gamma on TGF-beta 2 Release by HBECs Treated with IL-4 or IL-13: Concentration Dependence

IFN-gamma also inhibited the augmented TGF-beta 2 production in HBECs that were treated with either 10 ng/ml of IL-4 (Figure 4A), or IL-13 (Figure 4B) for 24 h. Addition of IFN-gamma to the medium containing IL-4 or IL-13 significantly suppressed the production of TGF-beta 2 from HBECs in a concentration-dependent manner in all cases (P < 0.01). As seen in Figure 4A, 200 U/ml of IFN-gamma reduced the concentration of TGF-beta 2 45% from 5,820 ± 370 to 3,210 ± 100 pg/ 106 cells in HBECs treated with IL-4. Similarly, as seen in Figure 4B, the concentration of TGF-beta 2 was reduced 57% from 6,080 ± 210 to 2,610 ± 440 in cells treated with IL-13.


View larger version (35K):
[in this window]
[in a new window]
 
Figure 4.   Effect of IFN-gamma on TGF-beta 2 release by HBECs treated with IL-4 or IL-13: concentration dependence. HBECs were incubated for 24 h with LHC-D/RPMI containing 10 ng/ml IL-4 (A) or IL-13 (B) in absence or presence of various concentrations of IFN-gamma . TGF-beta 2 levels in harvested media were determined by ELISA. Results are mean ± SEM of 9 to 12 samples in three to four different experiments. Vertical axes: total TGF-beta 2 release (pg/106 cells). Horizontal axes: concentration of IFN-gamma (U/ml). *P < 0.05, Scheffe's F-test, compared with control.

Effect of IL-4, IL-13, and IFN-gamma on TGF-beta 2 mRNA Expression

To determine whether IL-4, IL-13, or IFN-gamma regulated TGF-beta 2 production by altering mRNA expression, real time RT-PCR analysis was done (Figure 5). IL-4 or IL-13 treatment resulted in 4- to 5-fold increases in TGF-beta 2 mRNA expression in HBECs after 24-h-incubation (P < 0.01). IFN-gamma treatment significantly inhibited not only the spontaneous TGF-beta 2 mRNA expression but also the IL-4- or IL-13-stimulated TGF-beta 2 mRNA expression in HBECs (P < 0.01). The cytokines tested did not significantly change mRNA expression for TGF-beta 1 in HFL-1 fibroblasts; however, a slight, but significant increase in mRNA expression for TGF-beta 2 was noted in HFL-1 fibroblasts treated with IL-13. These results demonstrate that TGF-beta 2 production by HBECs regulated by IL-4, IL-13, and IFN-gamma is, at least in part, due to changes in mRNA levels.

    Discussion
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

The present study demonstrates that the Th2 cytokines IL-4 and IL-13 enhance the release of TGF-beta 2 by human bronchial epithelial cells, whereas the Th1 cytokine IFN-gamma suppresses this release. In combination, IFN-gamma suppresses the enhanced production of TGF-beta 2 induced by IL-4 or IL-13. The decrease in the production of TGF-beta 2 by HBECs treated with IFN-gamma together with IL-4 or IL-13 was more marked than that seen with IFN-gamma alone. Parallel changes were observed in TGF-beta 2 mRNA in HBECs. None of the cytokines affected HFL-1's release of TGF-beta 1 or TGF-beta 2. These results, therefore, suggest that IL-4, IL-13, and IFN-gamma can modulate the production of TGF-beta 2 by human airway epithelial cells.

TGF-beta is believed to play an important role in repair and remodeling processes in general (21, 22). In asthma, the airway epithelium is frequently subject to damage, and current concepts suggest that TGF-beta could play an important role in modulating repair of the airways in asthma (23, 24). Consistent with this, airway epithelial cells have been noted to increase TGF-beta by histochemical methods, and the airway wall in asthma has increased TGF-beta as well (11, 25). TGF-beta may contribute to epithelial repair by altering epithelial cell adhesion, modulating epithelial cell proliferation and differentiation, and by modulating epithelial cell production of other mediators (29, 30).

TGF-beta may also play a role in regulating mesenchymal cell repair in the airways (22, 31, 32). In this context, TGF-beta is a potent stimulus for fibroblast and myofibroblast production of the connective tissue matrix (33, 34). It is possible, therefore, that TGF-beta may modulate both restoration of a damaged epithelium in asthma and also contribute to the altered connective tissue that characterizes the asthmatic airway. In this context, epithelial cells can produce a number of mediators that can modulate mesenchymal cell recruitment, accumulation, and proliferation. Repair and remodeling processes in the airway, therefore, likely depend on a complex balance of a network of mediators in which TGF-beta may play a crucial role.

Among the cytokines that are believed to play a prominent role in the pathogenesis of asthma are IL-13 and IL-4 (12, 13). These cytokines are produced by several cell types including, prominently, Th2 lymphocytes (34). IL-13 and IL-4 are believed to contribute to the characteristic inflammatory response that is present in the asthmatic airway. These cytokines also can modulate the behavior of mesenchymal cells, including fibroblasts (14). In this regard, IL-4 has been demonstrated to stimulate fibroblast chemotaxis and proliferation (35, 36), and IL-13 and IL-4 have both been demonstrated to stimulate fibroblast-mediated contraction of extracellular matrix, a model of tissue remodeling characteristic of fibrotic lesions (37). The current study suggests that IL-4 and IL-13 may also contribute to mesenchymal cell participation in airway remodeling in asthma indirectly; that is, by stimulating TGF-beta production. Both IL-4 and IL-13 interact with specific receptors which are capable of activating several signal transduction pathways leading to altered gene expression (38). The current study demonstrates that IL-4- and IL-13-stimulated TGF-beta production is paralleled by an increase in mRNA expression, although the exact signal transduction pathways involved remain to be defined. The specific ELISA for TGF-beta used in the current study recognizes an epitope expressed only when TGF-beta is dissociated from the latency associated peptide. This is not a direct assay of TGF-beta activity. Some TGF-beta 2 was detected without acidification, and IL-4 and IL-13 increased this by ~2-fold (data not shown). This immunoassay suggests that some of the TGF-beta 2 produced by the airway epithelial cells may have been released in its active form, but bioassay would be needed to establish this.

Many cells are capable of releasing TGF-beta . Most of the TGF-beta released by cells, however, is inactive due to the presence of the latency-associated peptide (39). A number of mechanisms exist for activating TGF-beta , including proteolytic cleavage and nonproteolytic conformational changes (40). Moreover, TGF-beta is capable of stimulating its own production in a positive feedback loop (41). By virtue of the ability of IL-4 and IL-13 to stimulate the production of TGF-beta , IL-4 and IL-13 could initiate a TGF-beta -driven positive feedback cascade, thereby contributing to mesenchymal cell participation in airway remodeling. Several studies have reported that airway epithelial cells make TGF-beta 1 (11, 27, 42). Earlier work from this laboratory, however, demonstrated only TGF-beta 2 production by bovine bronchial epithelial cells (43). Using the mink lung cell bioassay, some of this TGF-beta was demonstrated to be released in its active form. A very recent study by Richter and colleagues has also reported that IL-4 and IL-13 increased TGF-beta 2 release from bronchial epithelial cells (44). The current study, therefore, is consistent both with earlier work from our laboratory and with the study of Richter.

In contrast to IL-13 and IL-4, IFN-gamma is a cytokine believed to be decreased in asthma (16, 17). It is produced by a number of cells, including Th1 lymphocytes (15), and it is thought that the balance between Th1 and Th2 cells in the airway actually depends on the balance between IFN-gamma and cytokines such as IL-13 and IL-4 (45). In the current study, IFN-gamma was found to antagonize the IL-4 and IL-13 effect of stimulating TGF-beta 2 release.

The current study is entirely an in vitro study. The demonstration that Th2 cytokines can "network" with TGF-beta raises the possibility that they can directly participate in remodeling events. Further evaluation of this hypothesis will require appropriate evaluation using in vivo models and clinical materials.

IFN-gamma is also known to have a number of other "antifibrotic" activities. It can inhibit fibroblast chemotaxis, proliferation, and production of extracellular matrix macromolecules (46). IFN-gamma can also directly antagonize TGF-beta effects. In this context, by stimulating STAT-1, IFN-gamma can lead to upregulation of the expression of SMAD-7 (49). SMAD-7 is a so-called inhibitory SMAD and is capable of binding to the TGF-beta receptor preventing activation of SMAD-2 and -3 which, when phosphorylated by the TGF-beta receptor, mediate TGF-beta effects (50). The current study extends the antagonistic effects of IFN-gamma on TGF-beta signaling by demonstrating that IFN-gamma can also suppress TGF-beta production, particularly in response to IL-4 and IL-13.

The full significance of altered airway structure in asthma remains to be determined. Some individuals with asthma appear to experience progressive loss of lung function, and altered structure may be a contributing factor. It is also reasonable that the altered airway structure creates a milieu suitable for the persistence of asthmatic inflammation. The mechanisms by which cytokines regulate tissue remodeling, therefore, may determine whether asthma is persistent or progressive. The current study provides evidence that the cytokines believed to regulate the inflammatory response in asthma can, by regulating TGF-beta production by airway epithelial cells, contribute to tissue remodeling in asthma as well.


View larger version (24K):
[in this window]
[in a new window]
 

    Footnotes

Address correspondence to: Stephen I. Rennard, M.D., Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, University of Nebraska Medical Center, 985125 Nebraska Medical Center, Omaha, Nebraska 68198-5125. E-mail: srennard{at}unmc.edu

(Received in original form November 21, 2001 and in revised form January 8, 2002).

Abbreviations: chronic obstructive pulmonary disease, COPD; Dulbecco's modified Eagle's medium, DMEM; fetal calf serum, FCS; human bronchial epithelial cell, HBEC; human fetal lung fibroblast, HFL-1; interferon gamma  , IFN-gamma ; interleukin, IL; reverse transcriptase-polymerase chain reaction, RT-PCR; transforming growth factor-beta , TGF-beta .

Acknowledgments: This work was supported by grant #HL64088-03 from National Heart Lung and Blood Institute. The authors greatly appreciate and acknowledge the assistance in manuscript preparation by Ms. Lillian Richards and Ms. Mary Tourek.
    References
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

1. Roberts, A. B., and M. B. Sporn. 1990. The transforming growth factor-b. In Handbook of Experimental Pharmacology: Peptide Growth Factors and Their Receptors, vol. 95. M. B. Sporn, and A. B. Roberts, editors. Springer-Verlag, New York. 419-472.

2. Blobe, G. C., W. P. Schiemann, and H. F. Lodish. 2000. Role of transforming growth factor beta in human disease. N. Engl. J. Med. 342: 1350-1358 [Free Full Text].

3. Roberts, A. B.. 1996. Transforming growth factor beta : activity and efficacy in animal models of wound healing. Wound Repair Regen. 3: 408-418 .

4. Singer, A. J., and R. A. F. Clark. 1999. Cutaneous wound healing. N. Engl. J. Med. 341: 738-746 [Free Full Text].

5. Sankar, S., N. Mahooti-Brooks, L. Bensen, T. L. McCarthy, M. Centrella, and J. A. Madri. 1996. Modulation of transforming growth factor beta  receptor levels on microvascular endothelial cells during in vitro angiogenesis. J. Clin. Invest. 97: 1436-1446 [Medline].

6. Grainger, D. J., P. R. Kemp, A. C. Liu, R. M. Lawn, and J. C. Metcalfe. 1994. Activation of transforming growth factor-beta is inhibited in transgenic apolipoprotein(a) mice. Nature 370: 460-462 [Medline].

7. Border, W. A., and N. A. Noble. 1994. Transforming growth factor beta in tissue fibrosis. N. Engl. J. Med. 331: 1286-1292 [Free Full Text].

8. Roche, W. R., R. Beasley, J. H. Williams, and S. T. Holgate. 1989. Subepithelial fibrosis in the bronchi of asthmatics. Lancet i: 520-524 .

9. Jeffery, P. K., A. J. Wardlaw, F. C. Nelson, J. V. Colins, and A. B. Kay. 1989. Bronchial biopsies in asthma. Am. Rev. Respir. Dis. 140: 1745-1753 [Medline].

10. Rennard, S., and A. Floreani. 1997. Pathophysiology of chronic obstructive pulmonary disease. In Asthma. P. J. Barnes, M. M. Grunstein, A. R. Leff, and A. J. Woolcock, editors. Lippincott-Raven Publishers, Philadelphia. 1375-1388.

11. Vignola, A. M., P. Chanez, G. Chiappara, A. M. Nerendino, E. Pace, A. Rizzo, A. M. la Rocca, V. Bellia, G. Bonsignore, and J. Bousquet. 1997. Transforming growth factor-beta expression in mucosal biopsies in asthma and chronic bronchitis. Am. J. Respir. Crit. Care Med. 156: 591-599 [Abstract/Free Full Text].

12. Wills-Karp, M., J. Luyimbazi, X. Xu, B. Schofield, T. Y. Neben, C. L. Karp, and D. D. Donaldson. 1998. Interleukin-13: central mediator of allergic asthma. Science 282: 2258-2261 [Abstract/Free Full Text].

13. Zhu, Z., R. J. Homer, Z. Wang, Q. Chen, G. P. Geba, J. Wang, Y. Zhang, and J. A. Elias. 1999. Pulmonary expression of interleukin-13 causes inflammation, mucus hypersecretion, subepithelial fibrosis, physiologic abnormalities, and eotaxin production. J. Clin. Invest. 103: 779-788 [Medline].

14. Doucet, C., D. Brouty-Boye, C. Pottin-Clemenceau, G. W. Canonica, C. Jasmin, and B. Azzarone. 1998. Interleukin (IL)4 and IL-13 act on human lung fibroblasts. J. Clin. Invest. 101: 2129-2139 [Medline].

15. Mosmann, T. R., and S. Sad. 1996. The expanding universe of T-cell subsets: Th1, Th2 and more. Immunol. Today 17: 138-146 [Medline].

16. Renzi, P. M., J. P. Turgeon, J. E. Marcotte, S. P. Drblik, D. Berube, M. F. Gagnon, and S. Spier. 1999. Reduced interferon-gamma production in infants with bronchiolitis and asthma. Am. J. Respir. Crit. Care Med. 159: 1417-1422 [Abstract/Free Full Text].

17. Cohn, L., C. Herrick, N. Niu, R. Homer, and K. Bottomly. 2000. IL-4 promotes airway eosinophilia by suppressing IFN-gamma production: defining a novel role for IFN-gamma in the regulation of allergic airway inflammation. J. Immunol. 166: 2760-2767 [Abstract/Free Full Text].

18. Gruenert, D. C., C. B. Basbaum, and J. H. Widdicombe. 1990. Long-term culture of normal and cystic fibrosis epithelial cells grown under serum-free conditions. In Vitro Cell. Dev. Biol. 26: 411-418 [Medline].

19. Beckmann, J. D., H. Takizawa, D. Romberger, M. Illig, L. Claassen, K. Rickard, and S. I. Rennard. 1992. Serum-free culture of fractionated bovine bronchial epithelial cells. In Vitro Cell. Dev. Biol. 28A:39-46.

20. Chomczynski, P., and N. Sacchi. 1987. Single-step method of RNA isolation by acid guanidine thiocyanate-phenol-chloroform extraction. Anal. Biochem. 162: 156-159 [Medline].

21. Tipton, D. A., and M. K. Dabbous. 1998. Autocrine transforming growth factor beta stimulation of extracellular matrix production by fibroblasts from fibrotic human gingiva. J. Periodontol. 69: 609-619 [Medline].

22. Pittet, J. F., M. J. Griffiths, T. Geiser, N. Kaminski, S. L. Dalton, X. Huang, L. A. Brown, P. J. Gotwals, V. E. Koteliansky, M. A. Matthay, and D. Sheppard. 2001. TGF-beta is a critical mediator of acute lung injury. J. Clin. Invest. 107: 1537-1544 [Medline].

23. Oddera, S., M. Silvestri, A. Balbo, B. O. Jovovich, R. Penna, E. Crimi, and G. A. Rossi. 1996. Airway eosinophilic inflammation, epithelial damage, and bronchial hyperresponsiveness in patients with mild-moderate, stable asthma. Allergy 51: 100-107 [Medline].

24. Holgate, S.. 2000. Epithelial damage and response. Clin. Exp. Allergy 30(Suppl.): 137-141 .

25. Redington, A. E., W. R. Roche, S. T. Holgate, and P. H. Howarth. 1998. Co-localization of immunoreactive transforming growth factor-beta 1 and decorin in bronchial biopsies from asthmatic and normal subjects. J. Pathol. 186: 410-415 [Medline].

26. Hoshino, M., Y. Nakamura, and J. J. Sim. 1998. Expression of growth factors and remodeling of the airway wall in bronchial asthma. Thorax 53: 21-27 [Abstract].

27. Aubert, J.-D., B. I. Dalal, T. R. Bai, C. R. Roberts, S. Hayashi, and J. C. Hogg. 1994. Transforming growth factor beta-1 gene expression in human airways. Thorax 49: 225-232 [Abstract].

28. Redington, A., J. Madden, A. J. Frew, R. Djukanovic, W. R. Roche, S. T. Holgate, and P. H. Howarth. 1997. Transforming Growth Factor-B1 in Asthma. Am. J. Respir. Crit. Care Med. 156: 642-647 [Abstract/Free Full Text].

29. Jetten, A. M., J. E. Shirley, and G. Stoner. 1986. Regulation of proliferation and differentiation of respiratory tract epithelial cells by TGF beta. Exp. Cell Res. 167: 539-549 [Medline].

30. Boland, S., E. Boisvieux-Ulrich, O. Houcine, A. Baeza-Squiban, M. Pouchelet, D. Schoevaert, and F. Marano. 1996. TGF beta 1 promotes actin cytoskeleton reorganization and migratory phenotype in epithelial tracheal cells in primary culture. J. Cell Sci. 109: 2207-2219 [Abstract].

31. Knight, D.. 2001. Epithelium-fibroblast interactions in response to airway inflammation. Immunol. Cell Biol. 79: 160-164 [Medline].

32. Holgate, S. T., D. E. Davies, P. M. Lackie, S. J. Wilson, S. M. Puddicombe, and J. L. Lordan. 2000. Epithelial-mesenchymal interactions in the pathogenesis of asthma. J. Allergy Clin. Immunol. 105: 193-204 [Medline].

33. Reed, M. J., R. B. Vernon, I. B. Abrass, and E. H. Sage. 1994. TGF-beta 1 induces the expression of type I collagen and SPARC, and enhances contraction of collagen gels, by fibroblasts from young and aged donors. J. Cell. Physiol. 158: 169-179 [Medline].

34. Abbas, A. K., K. M. Murphy, and A. Sher. 1996. Functional diversity of helper T lymphocytes. Nature 383: 787-793 [Medline].

35. Postlethwaite, A. E., and J. M. Seyer. 1991. Fibroblast chemotaxis induction by human recombinant interleukin-4. J. Clin. Invest. 87: 2147-2152 .

36. Kraft, M., C. Lewis, D. Pham, and H. W. Chu. 2001. IL-4, IL-13, and dexamethasone augment fibroblast proliferation in asthma. J. Allergy Clin. Immunol. 107: 602-606 [Medline].

37. Liu, X. D., Y. Zhu, K. H. Wang, T. Kohyama, F. Q. Wen, D. J. Romberger, and S. I. Rennard. 2000. Cytokine regulation of Type I collagen gel contraction mediated by human airway cells. Am. J. Respir. Crit. Care Med. 161: A440 .

38. Nelms, K., A. D. Keegan, J. Zamorano, J. J. Ryan, and W. E. Paul. 1999. The IL-4 receptor: signaling mechanisms and biologic functions. Annu. Rev. Immunol. 17: 701-738 [Medline].

39. Lawrence, D. A.. 2001. Latent-TGF-beta: an overview. Mol. Cell. Biochem. 219: 163-170 [Medline].

40. Massague, J.. 1998. TGF-beta signal transduction. Annu. Rev. Biochem. 67: 753-791 [Medline].

41. Wen, F. Q., T. Kohyama, C. M. Skold, Y. K. Zhu, R. Pineda, D. J. Romberger, and S. I. Rennard. 2001. Glucocorticoids modulate TGF-beta production by human fetal lung fibroblasts. Am. J. Respir. Crit. Care Med. 163: A911 .

42. Minshall, E. M., D. Y. M. Leung, R. J. Martin, Y. L. Song, L. Cameron, P. Ernst, and Q. Hamid. 1997. Eosinophil-associated TGF-beta 1 mRNA expression and airways fibrosis in bronchial asthma. Am. J. Respir. Cell Mol. Biol. 17: 326-333 [Abstract/Free Full Text].

43. Sacco, O., D. Romberger, A. Rizzino, J. Beckmann, S. I. Rennard, and J. R. Spurzem. 1992. Spontaneous production of transforming growth factor beta 2 by primary cultures of bronchial epithelial cells: effects on cell behavior in vitro. J. Clin. Invest. 90: 1379-1385 .

44. Richter, A., S. M. Puddicombe, J. L. Lordan, F. Bucchieri, S. J. Wilson, R. Djukanovic, G. Dent, S. T. Holgate, and D. E. Davies. 2001. The contribution of interleukin (IL)-4 and IL-13 to the epithelial-mesenchymal trophic unit in asthma. Am. J. Respir. Cell Mol. Biol. 25: 385-391 [Abstract/Free Full Text].

45. Ray, A., and L. Cohn. 2000. Altering the Th1/Th2 balance as a therapeutic strategy in asthmatic diseases. Curr. Opin. Investig. Drugs 1: 442-448 . [Medline]

46. Adelmann-Grill, B. C., R. Hein, F. Wach, and T. Krieg. 1987. Inhibition of fibroblast chemotaxis by recombinant human interferon gamma and interferon alpha. J. Cell. Physiol. 130: 270-275 [Medline].

47. Elias, J. A., S. A. Jimenez, and B. Freundlich. 1987. Recombinant gamma, alpha, and beta interferon regulation of human lung fibroblast proliferation. Am. Rev. Respir. Dis. 135: 62-65 [Medline].

48. Ghosh, A. K., W. Yuan, Y. Mori, S. Chen, and J. Varga. 2001. Antagonistic regulation of type I collagen gene expression by interferon-gamma and transforming growth factor-beta: integration at the level of p300/CBP transcriptional coactivators. J. Biol. Chem. 276: 11041-11048 [Abstract/Free Full Text].

49. Ulloa, L., J. Doody, and J. Massague. 1999. Inhibition of transforming growth factor-beta/SMAD signalling by the interferon-gamma/STAT pathway. Nature 397: 710-713 [Medline].

50. Nakao, A., S. Miike, M. Hatano, K. Okumura, T. Tokuhisa, C. Ra, and I. Iwamoto. 2000. Blockade of transforming growth factor beta/Smad signaling in T cells by overexpression of Smad7 enhances antigen-induced airway inflammation and airway reactivity. J. Exp. Med. 192: 151-158 [Abstract/Free Full Text].





This article has been cited by other articles:


Home page
EndocrinologyHome page
H. P. Gaide Chevronnay, P. B. Cornet, D. Delvaux, P. Lemoine, P. J. Courtoy, P. Henriet, and E. Marbaix
Opposite Regulation of Transforming Growth Factors-{beta}2 and -{beta}3 Expression in the Human Endometrium
Endocrinology, March 1, 2008; 149(3): 1015 - 1025.
[Abstract] [Full Text] [PDF]


Home page
Int ImmunolHome page
S.-Y. Nam, Y.-H. Kim, J.-S. Do, Y.-H. Choi, H.-J. Seo, H.-K. Yi, P.-H. Hwang, C.-H. Song, H.-K. Lee, J.-S. Kim, et al.
CD30 supports lung inflammation
Int. Immunol., February 1, 2008; 20(2): 177 - 184.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
H. W. J. Young, O. W. Williams, D. Chandra, L. K. Bellinghausen, G. Perez, A. Suarez, M. J. Tuvim, M. G. Roy, S. N. Alexander, S. J. Moghaddam, et al.
Central Role of Muc5ac Expression in Mucous Metaplasia and Its Regulation by Conserved 5' Elements
Am. J. Respir. Cell Mol. Biol., September 1, 2007; 37(3): 273 - 290.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
Q. Fang, X. Liu, M. Al-Mugotir, T. Kobayashi, S. Abe, T. Kohyama, and S. I. Rennard
Thrombin and TNF-{alpha}/IL-1beta Synergistically Induce Fibroblast-Mediated Collagen Gel Degradation
Am. J. Respir. Cell Mol. Biol., December 1, 2006; 35(6): 714 - 721.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
H. G. R. Thompson, J. D. Mih, T. B. Krasieva, B. J. Tromberg, and S. C. George
Epithelial-derived TGF-beta2 modulates basal and wound-healing subepithelial matrix homeostasis
Am J Physiol Lung Cell Mol Physiol, December 1, 2006; 291(6): L1277 - L1285.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
T. Kiwamoto, Y. Ishii, Y. Morishima, K. Yoh, A. Maeda, K. Ishizaki, T. Iizuka, A. E. Hegab, Y. Matsuno, S. Homma, et al.
Transcription Factors T-bet and GATA-3 Regulate Development of Airway Remodeling
Am. J. Respir. Crit. Care Med., July 15, 2006; 174(2): 142 - 151.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
C. Bergeron and L.-P. Boulet
Structural changes in airway diseases: characteristics, mechanisms, consequences, and pharmacologic modulation.
Chest, April 1, 2006; 129(4): 1068 - 1087.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Pathol.Home page
H. W. Chu, S. Balzar, G. J. Seedorf, J. Y. Westcott, J. B. Trudeau, P. Silkoff, and S. E. Wenzel
Transforming Growth Factor-{beta}2 Induces Bronchial Epithelial Mucin Expression in Asthma
Am. J. Pathol., October 1, 2004; 165(4): 1097 - 1106.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
T. Kikuchi, J. D. Shively, J. S. Foley, J. M. Drazen, and D. J. Tschumperlin
Differentiation-dependent responsiveness of bronchial epithelial cells to IL-4/13 stimulation
Am J Physiol Lung Cell Mol Physiol, July 1, 2004; 287(1): L119 - L126.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
F.-Q. Wen, X. Liu, T. Kobayashi, S. Abe, Q. Fang, T. Kohyama, R. Ertl, Y. Terasaki, L. Manouilova, and S. I. Rennard
Interferon-{gamma} Inhibits Transforming Growth Factor-{beta} Production in Human Airway Epithelial Cells by Targeting Smads
Am. J. Respir. Cell Mol. Biol., June 1, 2004; 30(6): 816 - 822.
[Abstract] [Full Text] [PDF]


Home page
Proc Am Thorac SocHome page
S. I. Rennard and S. G. Farmer
Exacerbations and Progression of Disease in Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, April 1, 2004; 1(2): 88 - 92.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
S. E. Evans, T. V. Colby, J. H. Ryu, and A. H. Limper
Transforming Growth Factor-{beta}1 and Extracellular Matrix-Associated Fibronectin Expression in Pulmonary Lymphangioleiomyomatosis
Chest, March 1, 2004; 125(3): 1063 - 1070.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
M. W. Wynes and D. W. H. Riches
Induction of Macrophage Insulin-Like Growth Factor-I Expression by the Th2 Cytokines IL-4 and IL-13
J. Immunol., October 1, 2003; 171(7): 3550 - 3559.
[Abstract] [Full Text] [PDF]


<
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager