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Thesis

Multiomic phenotyping of the airways in health and disease at single-cell resolution to discover molecular mechanisms of asthma

Abstract:

Asthma is a heterogenous disease of the airways showing phenotypic diversity across patients, requiring varied approaches to treatment. However, the underlying pathophysiological processes which drive the differences have not been comprehensively studied.


To profile the varied molecular pathways involved in its pathogenesis, I present a collection of single cell and spatial transcriptomic datasets, together spanning over 400,000 cells captured from upper and lower airway tissue sites from 62 individuals (asthma patients and healthy controls) across multiple molecular modalities (transcriptome, immune repertoire, protein expression). In addition to profiling the cell surface proteome, I developed a technique to interrogate antigen binding in allergic asthma with house dust-mite sensitisation. This rich omics data resource is accompanied by detailed clinical phenotyping, thereby providing the largest single-cell atlas of asthma and its key phenotypes.


Analysis of this resource reveals that in patients with allergic sensitisation, contrary to past concepts of allergic asthma pathogenesis, IgE-producing plasma cells were not found in the lung. However, IgE-binding cells were detected (e.g. basophils and mast cells), suggesting that IgE may be entering from the periphery. Notably, the allergens thought to cause IgE secretion were found to bind to immune cells, including antigen-presenting cells, suggesting the IgE secretion may be localised to lymphoid tissues. Profiling the differences between asthmatic and healthy individuals in the spatial context reveals probable mast cell - plasma cell and CD4+ - B cell niches, which may contribute to disease mechanism.


Differential abundance and gene expression analyses between the whole asthma cohort and healthy individuals showed features predominantly related to type 2 eosinophilic inflammation. Those changes correlated with clinical variables describing lung function, such as FEV1 and FVC. In contrast, comparisons between the asthma phenotypes allowed identification of features associated with neutrophilic inflammation. These features included IL-1 signalling, antibacterial defence, and inflammasome activation.


My findings underscore critical importance of careful phenotyping to uncover underlying molecular changes in asthma, as well as providing a rich resource to study it further.

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Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
NDM Experimental Medicine
Oxford college:
Wolfson College
Role:
Author
ORCID:
0000-0002-1036-6108

Contributors

Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Sub department:
Kennedy Institute for Rheumatology
Role:
Supervisor
ORCID:
0000-0003-1179-4021
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
NDM Experimental Medicine
Role:
Supervisor
ORCID:
0000-0003-0699-2373
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Centre for Human Genetics
Role:
Supervisor
ORCID:
0000-0002-0377-5536
Institution:
University of Oxford
Division:
MSD
Department:
RDM
Sub department:
Weatherall Inst of Molecular Medicine
Role:
Examiner
ORCID:
0000-0002-9019-2215
Institution:
GSK
Role:
Examiner
ORCID:
0000-0001-5906-1498


More from this funder
Funder identifier:
https://ror.org/03x94j517
Funding agency for:
Hinks, T
Grant:
MR/R015708/1
Programme:
MRC DTP iCASE Programme


DOI:
Type of award:
DPhil
Level of award:
Doctoral
Awarding institution:
University of Oxford

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