Abstract

Obese and overweight patients with asthma are challenging to treat optimally, and many suffer from poor control of their asthma. ILCs are central players in both the hemostatic regulation of adipose tissue and yet are important in the development of airway inflammation.  Herein, we describe the phenotypic landscape of circulating ILCs in relation to CD4+ and CD8+ T cells comparing obese and overweight with asthma to lean groups with or without asthma. Blood samples were collected as part of the BAMSE birth cohort study and analyzed using 18-colour flow cytometry (n=87). Using both supervised and unsupervised approaches, we examined ILC phenotype and memory status in comparison to their adaptive T cell counterparts. Analysis of circulatory lymphocyte populations by flow cytometry revealed that the proportion of Th2 cells were only significantly elevated in the blood of lean asthmatic individuals when compared to non-asthmatic controls. In contrast, the overweight and obese asthmatic individuals were characterized by an increased frequency of innate-like terminally differentiated effector memory (TEMRA) CD8+ T cells and CD45RO expressing ILC2. An association with BMI or body fat percentage was found for a range of markers, including IL-7R, CD200R and CD117, in the overweight and obese groups amongst these cell types. We also show that steroid exposure can restore IL-7R expression on naïve ILC2 during alarmin induced activation. In summary, our studies demonstrate that alterations in the CD8+ TEMRA cell and ILC2 compartments in overweight and obese individuals with asthma serves to immunologically distinguish these groups from their lean counterparts.