title: IL-17 in severe asthma. Where do we stand?
abstract: Asthma is a major chronic disease ranging from mild to severe refractory disease and is classified into various clinical phenotypes. Severe asthma is difficult to treat and frequently requires high doses of systemic steroids. In some cases, severe asthma even responds poorly to steroids. Several studies have suggested a central role of IL-17 (also called IL-17A) in severe asthma. Indeed, high levels of IL-17 are found in induced sputum and bronchial biopsies obtained from patients with severe asthma. The recent identification of a steroid-insensitive pathogenic Th17 pathway is therefore of major interest. In addition, IL-17A has been described in multiple aspects of asthma pathogenesis, including structural alterations of epithelial cells and smooth muscle contraction. In this perspective article, we frame the topic of IL-17A effects in severe asthma by reviewing updated information from human studies. We summarize and discuss the implications of IL-17 in the induction of neutrophilic airway inflammation, steroid insensitivity, the epithelial cell profile, and airway remodeling.
authors.affiliation: 1 Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR) 1087, l'Institut du Thorax, Nantes, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Chesné
authors.forename: Faouzi
authors.initials: F
authors.lastname: Braza
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mahay
authors.forename: Sophie
authors.initials: S
authors.lastname: Brouard
authors.forename: Marc
authors.initials: M
authors.lastname: Aronica
authors.forename: Antoine
authors.initials: A
authors.lastname: Magnan
mesh_terms: D056151:Airway Remodeling; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D004351:Drug Resistance; D004847:Epithelial Cells / Q000502:physiology; D006801:Humans; D020381:Interleukin-17 / Q000502:physiology*; D009504:Neutrophils / Q000502:physiology; D015398:Signal Transduction; D058504:Th17 Cells / Q000502:physiology
chemical_list: D018927:Anti-Asthmatic Agents; D020381:Interleukin-17
keywords: IL-17; Th17; neutrophilic asthma; severe asthma