In-Depth Review: Mast Cell Disease: Beyond Allergy and Mastocytosis| Volume 174, P5-22, August 2016

Interaction between allergic asthma and atherosclerosis

  • Cong-Lin Liu
    Department of Cardiology, Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
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  • Jin-Ying Zhang
    Department of Cardiology, Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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  • Guo-Ping Shi
    Reprint requests: Guo-Ping Shi, Cardiovascular Medicine, Brigham and Women's Hospital, 77 Avenue Louis Pasteur, NRB-7, Boston, MA 02115
    Department of Cardiology, Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
    Search for articles by this author
Published:October 06, 2015DOI:
      Prior studies have established an essential role of mast cells in allergic asthma and atherosclerosis. Mast cell deficiency or inactivation protects mice from allergen-induced airway hyper-responsiveness and diet-induced atherosclerosis, suggesting that mast cells share pathologic activities in both diseases. Allergic asthma and atherosclerosis are inflammatory diseases that contain similar sets of elevated numbers of inflammatory cells in addition to mast cells in the airway and arterial wall, such as macrophages, monocytes, T cells, eosinophils, and smooth muscle cells. Emerging evidence from experimental models and human studies points to a potential interaction between the 2 seemingly unrelated diseases. Patients or mice with allergic asthma have a high risk of developing atherosclerosis or vice versa, despite the fact that asthma is a T-helper (Th)2–oriented disease, whereas Th1 immunity promotes atherosclerosis. In addition to the preferred Th1/Th2 responses that may differentiate the 2 diseases, mast cells and many other inflammatory cells also contribute to their pathogenesis by more than just T cell immunity. Here, we summarize the different roles of airway and arterial wall inflammatory cells and vascular cells in asthma and atherosclerosis and propose an interaction between the 2 diseases, although limited investigations are available to delineate the molecular and cellular mechanisms by which 1 disease increases the risk of the other. Results from mouse allergic asthma and atherosclerosis models and from human population studies lead to the hypothesis that patients with atherosclerosis may benefit from antiasthmatic medications or that the therapeutic regimens targeting atherosclerosis may also alleviate allergic asthma.


      BAL (bronchoalveolar lavage), LDL (low-density lipoprotein), SMC (smooth muscle cell), TNF- (tumor necrosis factor-), LDLr (LDL receptor), Apoe (apolipoprotein E), OVA (ovalbumin), IMT (intima-media thickness), SMCs (smooth muscle cells), CI (confidence interval), OR (odds ratio), SUVmax (maximum standardized uptake value), MHC-I (major histocompatibility complex class-I), CHD (coronary heart disease), HDM (House dust mite), mMCP-6 (Mouse mast cell protease-6), MCP-1 (monocyte chemoattractant protein-1), PLA2 (phospholipase A2), COX-2 (cyclooxygenase-2), NF-B (nuclear factor-B), AP-1 (activator protein-1), RANTES (regulated on activation, normal T cell expressed and secreted), CCR2/CCL2 (chemokine (C-C Motif) Receptor 2/chemokine (C-C motif) ligand 2), PECAM-1 (platelet endothelial cell adhesion molecule-1), MCP-1 (monocyte chemoattractant protein-1), DRA (dust mite (Dermatophagoides farinae), ragweed, and Aspergillus sp.), LPS (lipopolysaccharide), GSK (glycogen synthase kinase), STAT-3 (signal transducer and Activator of transcription-3), CXCL4 (CXC chemokine ligand 4), ACT (asthma control test), SNPs (single nucleotide polymorphisms), GATA3 (GATA binding protein 3), Treg (regulatory T cell), CADs (coronary artery diseases), miRs (MicroRNAs), NOR-1 (neuronderived orphan receptor-1), 5-LO (5-lipoxygenase), LTA4 (leukotriene A4), GM-CSF (granulocyte-macrophage colony-stimulating factor), FLAP (5-LO–activating protein), HDL-C (high-density lipoprotein cholesterol), VLDL (very low-density lipoprotein)
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