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MUHC scientists have discovered that our body's own defense mechanism causes some of the most serious asthma symptoms. The study by MUHC researchers Dr David Ramos-Barbón, Dr Elizabeth Fixman and Dr James Martin, published in a recent issue of Journal of Clinical Investigation (JCI), reveals that T lymphocytes — our body's defense cells — are responsible for the airway thickening, which increases the chances of a dangerous asthma attack. The discovery provides hope that new treatments might be developed to combat the disease, which currently has no cure.

Asthma symptoms are triggered by two factors: inflammation of the airways in the lungs, and thickening of airway muscle in the bronchi — an irreversible condition that doctors refer to as airway remodeling. Certain allergens — commonly dust and animal hair — can trigger inflammation, but the causes of airway remodeling (and the link between the two) have remained a mystery. MUHC researchers have now discovered that remodeling is actually caused by T lymphocytes — part of our body's own defense mechanism. "T lymphocytes are the traffic cops of the cellular world," says Dr Ramos-Barbón. Where antigens are present, T lymphocytes can be found directing the body's defense mechanism, which in the case of asthmatics results in airway remodeling. "This is a natural response designed to protect the body from disease," notes Dr Ramos-Barbón. "But in this case it actually promotes conditions that favour asthma, leading to increased symptoms such as coughing and difficulty breathing."

To make their discovery, researchers at the MUHC removed T lymphocytes from asthmatic rats, made them fluorescent by adding a jellyfish gene, and then transplanted them into non-asthmatic rats. "The fluorescence allowed us to track the movement of the T lymphocytes and determine their effect on the non-asthmatic rats," says Dr Ramos-Barbón. Researchers were surprised to discover that the T lymphocytes moved directly to — and infiltrated — the airway walls of the non-asthmatic rats, causing extensive remodeling. Moreover, researchers discovered that the T lymphocytes must be in direct contact with the cells of the airway wall in order to cause remodeling.

"The next step is to develop mechanisms to interrupt this process and combat asthma," says Dr Ramos-Barbón, who was presented the Eldon R. Smith Award for this research at the inaugural National Research Forum for Young Investigators in Circulatory and Respiratory Health, a major training and educational initiative of the CIHR Institute of Circulatory and Respiratory Health.

"This discovery is particularly exciting because it provides insight as to how the body's own CD4 T lymphocytes cause the thickening of the airway muscle, which increases the chances of a dangerous asthma attack. This research opens up new ways to prevent and treat asthma and its complications," said Dr Bhagirath Singh, Scientific Director of CIHR's Institute of Infection and Immunity. "Continued research is key to advancements and hope for new diagnostic tests and treatments."

The À¦°óSMÉçÇø Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at À¦°óSMÉçÇø — the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 institutes, provides leadership and support to close to 10,000 health researchers and trainees across Canada.