• Jaideep Dhariwal, Aoife Cameron, Maria-Belen Trujillo-Torralbo, Ajerico Del Rosario, Eteri Bakhsoliani, Malte Paulsen, David J Jackson, Michael R Edwards, Rana Batika M J BMJ 5 Department of Respiratory Medicine & Allergy, King's College London, London, United Kingdom; and., David J Cousins, Trevor T Hansel, Sebastian L Johnston, Ross P Walton, and MRC-GSK Strategic Alliance Consortium.
• 1 Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom.
• Am. J. Respir. Crit. Care Med. 2017 Jun 15; 195 (12): 1586-1596.

RationaleNewly characterized type 2 innate lymphoid cells (ILC2s) display potent type 2 effector functionality; however, their contribution to allergic airways inflammation and asthma is poorly understood. Mucosal biopsy used to characterize the airway mucosa is invasive, poorly tolerated, and does not allow for sequential sampling.ObjectivesTo assess the role of ILC2s during nasal allergen challenge in subjects with allergic rhinitis using novel noninvasive methodology.MethodsWe used a human experimental allergen challenge model, with flow cytometric analysis of nasal curettage samples, to assess the recruitment of ILC2s and granulocytes to the upper airways of subjects with atopy and healthy subjects after allergen provocation. Soluble mediators in the nasal lining fluid were measured using nasosorption.Measurements And Main ResultsAfter an allergen challenge, subjects with atopy displayed rapid induction of upper airway symptoms, an enrichment of ILC2s, eosinophils, and neutrophils, along with increased production of IL-5, prostaglandin D2, and eosinophil and T-helper type 2 cell chemokines compared with healthy subjects. The most pronounced ILC2 recruitment was observed in subjects with elevated serum IgE and airway eosinophilia.ConclusionsThe rapid recruitment of ILC2s to the upper airways of allergic patients with rhinitis, and their association with key type 2 mediators, highlights their likely important role in the early allergic response to aeroallergens in the airways. The novel methodology described herein enables the analysis of rare cell populations from noninvasive serial tissue sampling.

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