Published ahead of print on November 20, 2003, doi:10.1164/rccm.200308-1156OC
Am. J. Respir. Crit. Care Med., Volume 169, Number 3, February 2004, 373-377
A more recent version of this article appeared on February 1, 2004
Submitted on August 20, 2003
Accepted on November 18, 2003
Increased thrombin activity following allergen challenge: a potential link to airway remodeling?
Masaki Terada1, Elizabeth A.B. Kelly1, and Nizar N Jarjour1*
1 Medicine, Pulmonary and Critical Care Section, University of Wisconsin, Madison, WI, USA
* To whom correspondence should be addressed. E-mail: nnj{at}medicine.wisc.edu.
In addition to its central role in hemostasis, thrombin may play a role in inflammation and remodeling. To investigate the contribution of thrombin to allergic airway inflammation in asthma, we used an enzymatic assay to determine thrombin activity in bronchoalveolar lavage fluid obtained from 19 atopic asthma subjects before (Day 0) and 48 hours after (Day 2) segmental bronchoprovocation with antigen. Thrombin activity increased from 0 (0, 2.9) to 41.1 (0.3, 75.6) units x 10-3/ml on Day 2 (p=0.002) and correlated with total protein levels in lavage fluid on Day 2 (r=0.885, p<0.001). After antigen challenge, thrombin activity also showed significant correlations with interleukin-5 (r=0.66, p=0.002), transforming growth factor-beta 1 (r=0.70, p<0.001), fibronectin (r=0.85, p<0.001) and tissue factor (r=0.55, p=0.03) levels in lavage fluid. Furthermore, Day 2, but not Day 0 lavage fluid, induced proliferation of human airway fibroblasts. This mitogenic effect was significantly reduced with hirudin, a specific thrombin inhibitor. Taken together, our findings suggest that allergen-driven airway inflammation in asthma is associated with enhanced potential for fibroblast proliferation that is related, at least in part, to increased thrombin activity. We propose that enhanced thrombin activity provides a potential link between allergic inflammation and initiation of airway remodeling.
Key words: asthma, bronchoalveolar lavage fluid, thrombin, fibroblasts
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