SUMMARY:In experimental models of bronchial asthma with mice, airway inflammation and increase in airway hyperreactivity (AHR) are induced by a combination of systemic sensitization and airway challenge with allergens. In this report, we present another possibility: that systemic antigen-specific sensitization alone can induce AHR before the development of inflammation in the airway. Male BALB/c mice were sensitized with ovalbumin (OVA) by a combination of intraperitoneal injection and aerosol inhalation, and various parameters for airway inflammation and hyperreactivity were sequentially analyzed. Bronchial response measured by a noninvasive method (enhanced pause) and the eosinophil count and interleukin (IL)-5 concentration in bronchoalveolar lavage fluid (BALF) gradually increased following the sensitization, and significant increase was achieved after repeated OVA aerosol inhalation along with development of histologic changes of the airway. In contrast, AHR was already significantly increased by systemic sensitization alone, although airway inflammation hardly developed at that time point. BALF IL-4 concentration and the expression of IL-4 mRNA in the lung reached maximal values after the systemic sensitization, then subsequently decreased. Treatment of mice with anti-IL-4 neutralizing antibody during systemic sensitization significantly suppressed this early increase in AHR. In addition, IL-4 gene-targeted mice did not reveal this early increase in AHR by systemic sensitization. These results suggest that an immune response in the lung in an early stage of sensitization can induce airway hyperreactivity before development of an eosinophilic airway inflammation in BALB/c mice and that IL-4 plays an essential role in this process. If this early increase in AHR does occur in sensitized human infants, it could be another therapeutic target for early prevention of the future onset of asthma. (Lab Invest 2001, 81:1385-1396.A fter exposure to allergen(s), atopic bronchial asthma is characterized by airway inflammation and increased serum immunoglobulin (Ig) E levels together with increased airway hyperreactivity (AHR) in response to specific allergens and nonspecific stimuli (Burrows et al, 1989;Sears et al, 1991). In the process of airway inflammation, many kinds of inflammatory cells, such as mast cells (Ying et al, 1997), eosinophils (Lamkhioued et al, 1997), and T lymphocytes (Crimi et al, 1997;De Sanctis et al, 1997), are involved. In addition, various cytokines and growth factors produced by these cells, such as interleukin (IL)-4 (Leonard et al, 1997;Shi et al, 1998a), IL-5 (Shi et al, 1998b;Till et al, 1998), IL-10 (Borish et al, 1996;Robinson et al, 1996), IL-12 (Van Der Pouw Kraan et al, 1997), and IL-13 , may play important roles in the disease process. IL-5 and eosinophils have been recently specifically implicated as key contributors to the development of allergic airway inflammation.The predominance of Th2 phenotype of lymphocyte over Th1 phenotype from a very early stage of life has recently bee...