It has already been demonstrated that the degree of bronchial reactivity to histamine or metacholine correlates with asthma severity measured as symptom scores, treatment required

to control symptoms and diurnal variability of lung function parameters [21, 22]. Interestingly, it has been demonstrated that CD14++ CD16+ cells are potent producers of many pro-inflammatory cytokines while stimulated with viral nucleic acids indicating their possible role in regulation of the inflammatory response [9] Surprisingly, however, we have not been able to demonstrate any direct correlation between the number of CD14++ CD16+ cells and any of the conventional click here parameters reflecting intensity of airway inflammation such as FeNO or peripheral blood eosinophilia. Therefore, we cannot provide evidence that CD14++ CD16+ monocytes significantly affect the intensity of allergic inflammation in response to allergen challenge. However, it cannot be excluded that in asthmatic patients, those cells may affect AHR through modulation of inflammatory response to respiratory infections including viral infections. Dysfunction of the airways seen in asthmatic patients depends not only on airway inflammation but also on structural changes in the airways referred to as remodelling. Although airway inflammation leads to development

of bronchial reactivity, in asthmatic patients, successful therapy with inhaled corticosteroids has only selleck chemical mild effect on AHR [23, 24]. Anti-inflammatory effects of corticosteroids in asthma are Carbohydrate associated with dramatic depletion of inflammatory cells, mainly eosinophils and lymphocytes from the airway tissues [24]. However, some structural changes in the airways are resistant to corticosteroid therapy [24]. It has been recently demonstrated that the degree of bronchial responsiveness to histamine but not to metacholine correlates with airway remodelling [25]. It is therefore tempting to speculate that the disequilibrium between individual PBM subsets may

participate in the development of airway remodelling and AHR. The CD16+ monocytes play a role in tissue remodelling and angiogenesis [8, 10, 26]. Analysis of transcriptomes demonstrated that among all PBM subsets, the CD14++ CD16+ cells are characterized by the greatest expression of genes involved in tissue remodelling and angiogenesis such as TGFB1 or CD105 [10]. Moreover, the Th-2 type cytokines such as IL-4 and IL-13, which are abundantly produced in allergic asthmatics, induce differentiation of monocytes into profibrotic and angiogenic macrophages, which in turn play a crucial role in remodelling of the lungs leading to pathological fibrosis [27]. Further insights into the potential role of individual PBM subsets in asthma are provided by analysis of their kinetics after allergen challenge. Decrease in the number of CD14++ CD16+ PBMs after allergen challenge may reflect different chemotactic potential of those subsets.