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Inhalation of the fungus Alternaria alternata is associated with an increased risk of allergic asthma development and exacerbations. Recent work in acute exposure animal models suggests that A. alternata-induced asthma symptoms, which include inflammation, mucus overproduction and airway hyperresponsiveness, are due to A. alternata proteases that act via protease-activated receptor-2 (PAR2). However, because other active components present in A. alternata may be contributing to asthma pathophysiology through alternative signaling, the specific role PAR2 plays in asthma initiation and maintenance remains undefined. Airway epithelial cells provide the first encounter with A. alternata and are thought to play an important role in initiating the physiologic response. To better understand the role for PAR2 airway epithelial signaling we created a PAR2-deficient human bronchial epithelial cell line (16HBEPAR - /- ) from a model bronchial parental line (16HBE14o-). Comparison of in vitro physiologic responses in these cell lines demonstrated a complete loss of PAR2 agonist (2at-LIGRL-NH 2 ) response and significantly attenuated protease (trypsin and elastase) and A. alternata responses in the 16HBEPAR - grown at air-liquid interface demonstrated rapid, PAR2-dependent and independent, inflammatory cytokine, chemokine and growth factor basolateral release. In conclusion, the novel human PAR2-deficient cell line allows for direct in vitro examination of the role(s) for PAR2 in allergen challenge with polarized human airway epithelial cells./- line. Apical application of A. alternata to 16HBE14o- and 16HBEPAR2 -/- grown at air-liquid interface demonstrated rapid, PAR2-dependent and independent, inflammatory cytokine, chemokine and growth factor basolateral release. In conclusion, the novel human PAR2-deficient cell line allows for direct in vitro examination of the role(s) for PAR2 in allergen challenge with polarized human airway epithelial cells., Competing Interests: Declaration of Competing Interest Drs. Kathryn A DeFea, Theodore J. Price, Gregory Dussor, Josef Vagner and Scott Boitano are all involved in PARMedics, a company that specializes in the development of protease-activated receptor-2 ligands. None of the work in this manuscript originated from the company nor is protected by the company. On behalf of my colleagues, I am stating that there is no conflict of interest in the creation and eventual publication of this manuscript., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Purpose: Asthma is a heterogenous disease strongly associated with inflammation that has many different causes and triggers. Current asthma treatments target symptoms such as bronchoconstriction and airway inflammation. Despite recent advances in biological therapies, there remains a need for new classes of therapeutic agents with novel, upstream targets. The proteinase‐activated receptor‐2 (PAR2) has long been implicated in allergic airway inflammation and asthma and it remains an intriguing target for novel therapies. Here, we describe the actions of C781, a newly developed low MW PAR2 biased antagonist, in vitro and in vivo in the context of acute allergen exposure. Experimental Approach: A human bronchial epithelial cell line expressing PAR2 (16HBE14o‐ cells) was used to evaluate the modulation in vitro, by C781, of physiological responses to PAR2 activation and downstream β‐arrestin/MAPK and Gq/Ca2+ signalling. Acute Alternaria alternata sensitized and challenged mice were used to evaluate C781 as a prophylactically administered modulator of airway hyperresponsiveness, inflammation and mucus overproduction in vivo. Key Results: C781 reduced in vitro physiological signalling in response to ligand and proteinase activation. C781 effectively antagonized β‐arrestin/MAPK signalling without significant effect on Gq/Ca2+ signalling in vitro. Given prophylactically, C781 modulated airway hyperresponsiveness, airway inflammation and mucus overproduction of the small airways in an acute allergen‐challenged mouse model. Conclusion and Implications: Our work demonstrates the first biased PAR2 antagonist for β‐arrestin/MAPK signalling. C781 is efficacious as a prophylactic treatment for allergen‐induced airway hyperresponsiveness and inflammation in mice. It exemplifies a key pharmacophore for PAR2 that can be optimized for clinical development. [ABSTRACT FROM AUTHOR]