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      RhoA/Rho‐kinases in asthma: from pathogenesis to therapeutic targets

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          Abstract

          Asthma is a chronic and heterogeneous disease characterised by airway inflammation and intermittent airway narrowing. The key obstacle in the prevention and treatment of asthma has been our incomplete understanding of its aetiology and biological mechanisms. The ras homolog family member A (RhoA) of the Rho family GTPases has been considered to be one of the most promising and novel therapeutic targets for asthma. It is well known that RhoA/Rho‐kinases play an important role in the pathophysiology of asthma, including airway smooth muscle contraction, airway hyper‐responsiveness, β‐adrenergic desensitisation and airway remodelling. However, recent advances have suggested novel roles for RhoA in regulating allergic airway inflammation. Specifically, RhoA has been shown to regulate allergic airway inflammation through controlling Th2 or Th17 cell differentiation and to regulate airway remodelling through regulating mesenchymal stem cell (MSC) differentiation. In this review, we evaluate the literature regarding the recent advances in the activation of RhoA/Rho‐kinase, cytokine and epigenetic regulation of RhoA/Rho‐kinase, and the role of RhoA/Rho‐kinase in regulating major features of asthma, such as airway hyper‐responsiveness, remodelling and inflammation. We also discuss the importance of the newly identified role of RhoA/Rho‐kinase signalling in MSC differentiation and bronchial epithelial barrier dysfunction. These findings indicate the functional significance of the RhoA/Rho‐kinase pathway in the pathophysiology of asthma and suggest that RhoA/Rho‐kinase signalling may be a promising therapeutic target for the treatment of asthma.

          Abstract

          We evaluate recent advances in cytokine and epigenetic regulation of RhoA/Rho‐kinase and the role of RhoA/Rho‐kinase in regulating major clinical features of asthma, such as airway hyper‐responsiveness, remodelling and inflammation. The newly identified roles of RhoA/Rho‐kinase signalling in mesenchymal stem cell differentiation and bronchial epithelial barrier dysfunction are also discussed. We suggest that RhoA/Rho‐kinase signalling may be a promising therapeutic target for the treatment of asthma.

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          Most cited references107

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          T-helper type 2-driven inflammation defines major subphenotypes of asthma.

          T-helper type 2 (Th2) inflammation, mediated by IL-4, IL-5, and IL-13, is considered the central molecular mechanism underlying asthma, and Th2 cytokines are emerging therapeutic targets. However, clinical studies increasingly suggest that asthma is heterogeneous. To determine whether this clinical heterogeneity reflects heterogeneity in underlying molecular mechanisms related to Th2 inflammation. Using microarray and polymerase chain reaction analyses of airway epithelial brushings from 42 patients with mild-to-moderate asthma and 28 healthy control subjects, we classified subjects with asthma based on high or low expression of IL-13-inducible genes. We then validated this classification and investigated its clinical implications through analyses of cytokine expression in bronchial biopsies, markers of inflammation and remodeling, responsiveness to inhaled corticosteroids, and reproducibility on repeat examination. Gene expression analyses identified two evenly sized and distinct subgroups, "Th2-high" and "Th2-low" asthma (the latter indistinguishable from control subjects). These subgroups differed significantly in expression of IL-5 and IL-13 in bronchial biopsies and in airway hyperresponsiveness, serum IgE, blood and airway eosinophilia, subepithelial fibrosis, and airway mucin gene expression (all P < 0.03). The lung function improvements expected with inhaled corticosteroids were restricted to Th2-high asthma, and Th2 markers were reproducible on repeat evaluation. Asthma can be divided into at least two distinct molecular phenotypes defined by degree of Th2 inflammation. Th2 cytokines are likely to be a relevant therapeutic target in only a subset of patients with asthma. Furthermore, current models do not adequately explain non-Th2-driven asthma, which represents a significant proportion of patients and responds poorly to current therapies.
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            Type 2 inflammation in asthma--present in most, absent in many.

            John Fahy (2015)
            Asthma is one of the most common chronic immunological diseases in humans, affecting people from childhood to old age. Progress in treating asthma has been relatively slow and treatment guidelines have mostly recommended empirical approaches on the basis of clinical measures of disease severity rather than on the basis of the underlying mechanisms of pathogenesis. An important molecular mechanism of asthma is type 2 inflammation, which occurs in many but not all patients. In this Opinion article, I explore the role of type 2 inflammation in asthma, including lessons learnt from clinical trials of inhibitors of type 2 inflammation. I consider how dichotomizing asthma according to levels of type 2 inflammation--into 'T helper 2 (TH2)-high' and 'TH2-low' subtypes (endotypes)--has shaped our thinking about the pathobiology of asthma and has generated new interest in understanding the mechanisms of disease that are independent of type 2 inflammation.
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              Signaling from Rho to the actin cytoskeleton through protein kinases ROCK and LIM-kinase.

              The actin cytoskeleton undergoes extensive remodeling during cell morphogenesis and motility. The small guanosine triphosphatase Rho regulates such remodeling, but the underlying mechanisms of this regulation remain unclear. Cofilin exhibits actin-depolymerizing activity that is inhibited as a result of its phosphorylation by LIM-kinase. Cofilin was phosphorylated in N1E-115 neuroblastoma cells during lysophosphatidic acid-induced, Rho-mediated neurite retraction. This phosphorylation was sensitive to Y-27632, a specific inhibitor of the Rho-associated kinase ROCK. ROCK, which is a downstream effector of Rho, did not phosphorylate cofilin directly but phosphorylated LIM-kinase, which in turn was activated to phosphorylate cofilin. Overexpression of LIM-kinase in HeLa cells induced the formation of actin stress fibers in a Y-27632-sensitive manner. These results indicate that phosphorylation of LIM-kinase by ROCK and consequently increased phosphorylation of cofilin by LIM-kinase contribute to Rho-induced reorganization of the actin cytoskeleton.
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                Author and article information

                Contributors
                huchengp28@csu.edu.cn
                pgao1@jhmi.edu
                Journal
                Clin Transl Immunology
                Clin Transl Immunology
                10.1002/(ISSN)2050-0068
                CTI2
                Clinical & Translational Immunology
                John Wiley and Sons Inc. (Hoboken )
                2050-0068
                29 April 2020
                May 2020
                : 9
                : 5 ( doiID: 10.1002/cti2.v9.5 )
                : e01134
                Affiliations
                [ 1 ] Division of Allergy and Clinical Immunology Johns Hopkins University School of Medicine Baltimore MD USA
                [ 2 ] Department of Respiratory Medicine Xiangya Hospital Central South University Changsha China
                [ 3 ] Division of Pulmonary Critical Care and Sleep Medicine State University of New York at Buffalo Buffalo NY USA
                [ 4 ] Department of Otorhinolaryngology First Affiliated Hospital of Chongqing Medical University Chongqing China
                [ 5 ] Department of Respirology and Allergy Third Affiliated Hospital of Shenzhen University Shenzhen China
                Author notes
                [*] [* ] Correspondence

                Peisong Gao, The Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Room 3B.71, Baltimore, MD 21224, USA.

                E‐mail: pgao1@ 123456jhmi.edu

                Chengping Hu, Department of Respiratory Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.

                E‐mail: huchengp28@ 123456csu.edu.cn

                Author information
                https://orcid.org/0000-0002-7651-1339
                Article
                CTI21134
                10.1002/cti2.1134
                7190398
                32355562
                a5003c9a-fdf1-4607-aaeb-ec4fe9d801c9
                © 2020 The Authors. Clinical & Translational Immunology published by John Wiley & Sons Australia, Ltd on behalf of Australian and New Zealand Society for Immunology Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 January 2020
                : 08 April 2020
                : 08 April 2020
                Page count
                Figures: 5, Tables: 0, Pages: 16, Words: 9294
                Funding
                Funded by: US National Institutes of Health (NIH)
                Award ID: R56 AI143668
                Award ID: 2R56ES021739
                Award ID: R21 AI137547
                Award ID: R01AI141642
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                May 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.1 mode:remove_FC converted:29.04.2020

                airway inflammation,airway remodelling,asthma,rhoa,rho‐kinase,therapy

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