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C101-08 Discordant Airway Gene Expression of TSLP and Its Specific Receptor Subunit, CRLF2, Links CRLF2 to Mixed Granulocytic Inflammation and Lung Function Decline in SPIROMICS
Abstract   Peer reviewed

C101-08 Discordant Airway Gene Expression of TSLP and Its Specific Receptor Subunit, CRLF2, Links CRLF2 to Mixed Granulocytic Inflammation and Lung Function Decline in SPIROMICS

M E Kelly, K Komori, I Barjaktarevic, J L Curtis, E R Bleecker, R P Bowler, R G Barr, A P Comellas, C B Cooper, D Couper, …
American journal of respiratory and critical care medicine, Vol.212(Supplement_1), aamag1622027
05/01/2026
DOI: 10.1093/ajrccm/aamag162.2027

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Abstract

Rationale Thymic stromal lymphopoietin (TSLP) is an epithelial alarmin chiefly implicated in T2 airway inflammation, though it may also participate in broader (non-T2) inflammatory processes. The utility of airway epithelial gene expression of TSLP and its specific receptor subunit, cytokine receptor-like factor 2 (CRLF2), as biomarkers of downstream inflammation and clinical outcomes remains unclear. Methods We analyzed RNA sequencing data from bronchial airway brushing obtained in phase 1 of the SPIROMICS bronchoscopy sub-study (N = 161: 23 never-smokers, 67 ever-smokers with COPD, 71 ever-smokers without COPD). We related airway TSLP and CRLF2 expression to clinical, hematologic/sputum measures, and gene-expression signatures of T2/eosinophilic and neutrophilic inflammation, including to our published T2 signature and to eosinophil and neutrophil signatures derived from single-cell atlas data. Associations used Spearman correlations and linear models adjusted for age, sex, race/ethnicity, COPD status, smoking status, and pack-years. Results CRLF2 expression correlated with gene-expression evidence of both T2/eosinophilic and neutrophilic inflammation: T2 signature (ρ = 0.26, p < 0.001), eosinophil signature (ρ = 0.44, p < 0.001), and neutrophil signature (ρ = 0.39, p < 0.001). CRLF2 was positively associated with log sputum neutrophil count (ρ = 0.24, p = 0.024) and blood neutrophil count (ρ = 0.036, p < 0.001), but not with sputum or blood eosinophil counts. Higher CRLF2 related to worse baseline lung function, particularly among current smokers, (lower post-bronchodilator FEV1: ρ = −0.21, p = 0.008), as well as greater 5-year FEV1 decline across current and former smokers (ρ = −0.22, p = 0.007). Significant findings persisted after covariate adjustment. In contrast, TSLP expression, although strongly correlated with expression of the epithelial alarmin IL33 (ρ = 0.53, p < 0.001), was negatively correlated with CRLF2 (ρ = −0.24, p = 0.002) and with eosinophil and neutrophil gene-expression signatures (ρ = −0.26 and −0.33, both p < 0.001). TSLP expression showed no association with sputum or blood cell counts. Conclusions In bronchial epithelium from SPIROMICS, gene expression of CRLF2, but not of TSLP, tracked with downstream alarmin-relevant inflammatory programs, consistent with a regulatory role in TSLP signaling through TSLPR, as well as with clinically meaningful outcomes. CRLF2 expression was associated with evidence of both T2/eosinophilic and neutrophilic inflammation, and with lower baseline FEV1 and accelerated FEV1 decline, suggesting engagement of a broader, clinically relevant inflammatory milieu. By contrast, epithelial TSLP transcript levels mirrored IL33 gene expression but were not associated with cellular or transcriptomic inflammation. These findings position CRLF2, rather than TSLP expression itself, as a potential airway biomarker of TSLP-axis activity and disease impact with potential implications for patient stratification as well as strategic approaches for TSLP-pathway-targeted therapies. This abstract is funded by: SPIROMICS was supported by contracts from the NIH/NHLBI (HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C, 75N92024D00012), grants from the NIH/NHLBI (U01HL137880, U24HL141762, R01HL182622, R01HL144718, and R01HL093081), and supplemented by contributions made through the Foundation for the NIH and the COPD Foundation from Amgen; AstraZeneca/MedImmune; Bayer; Bellerophon Therapeutics; Boehringer-Ingelheim Pharmaceuticals, Inc.; Bristol Myers Squibb; Chiesi Farmaceutici S.p.A.; Forest Research Institute, Inc.; Genentech; GlaxoSmithKline; Grifols Therapeutics, Inc.; Ikaria, Inc.; MGC Diagnostics; Novartis Pharmaceuticals Corporation; Nycomed GmbH; Polarean; ProterixBio; Regeneron Pharmaceuticals, Inc.; Sanofi; Sunovion; Takeda Pharmaceutical Company; Theravance Biopharma; Verona; and Mylan/Viatris.
 Biomarkers Gene Expression Inflammation Blood Neutrophils Pharmaceutical industry

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