Ankaflavin, a novel Nrf-2 activator for attenuating allergic airway inflammation

The role of inflammation-induced oxidative stress in the pathogenesis and progression of chronic inflammatory airways diseases has received increasing attention in recent years. Nuclear factor-erythroid 2 related factor 2 (Nrf-2) is the primary transcription factor that regulates the expression of antioxidant and detoxifying enzymes. In this study, yellow pigment ankaflavin (AK), derived from Monascus-fermented products, elevated nuclear Nrf-2 protein translocation in both the A549 lung cell line and the lungs of ovalbumin (OVA)-challenged mice. Furthermore, AK increased the mRNA expression of antioxidant enzymes regulated by Nrf-2, leading to a reduction in allergen-driven airway inflammation, mucus cell hyperplasia, and eosinophilia in OVA-challenged mice. Additionally, AK prevented T-cell infiltration and Th2 cytokines including interleukin (IL)-4, IL-5, and IL-13 generation in bronchial alveolar lavage fluid. The adhesion molecules ICAM-1, VCAM-1, and eotaxin were substantially reduced by AK treatment. Importantly, the inhibitory effect of AK on adhesion molecule production and immune cell infiltration was abolished by Nrf-2 small interfering RNA. This is the first study to illustrate that AK acts as a novel Nrf-2 activator for modulating the oxidative stress pathway to improve the lung injury and ameliorate the development of airway inflammation.

Fetal origins of asthma

There is convincing evidence that asthma has its origins in early life. We review the epidemiological and biological evidence for fetal exposures that may have a causal role in asthma development. However, those factors that provoke asthma exacerbations are not necessarily the same as those associated with disease induction. Epidemiological studies have identified many potential exposures linked to asthma but these do not confirm causality and have not been replicated by experiment. Asthma is a heterogeneous disease and there are developmental influences on at least two pathways, airway structure and airway inflammation. The fetus is not immunologically naive and intrauterine exposures can act directly to invoke immunological sensitisation leading postnatally to airway inflammation. Other potential mechanisms include indirect effects on airway and lung growth through fetal nutrition and epigenetic modifications of DNA expression by environmental exposures. Identifying the causal factors will provide the targets for interventions to prevent disease.

Prevention and treatment of DNA vaccine encoding cockroach allergen Bla g 1 in a mouse model of allergic airway inflammation

BACKGROUND

One-fourth of the US population is sensitized to the German cockroach. Primary German cockroach allergen Bla g 1 is detected in 63% of homes and 52% of childcare facilities in the United States. No effective treatment or vaccination strategies are yet available.

OBJECTIVES

We evaluated the prophylactic and therapeutic efficacy of a plasmid DNA-mediated vaccination using the Bla g 1 gene in a mouse model of allergic inflammatory airway disease.

METHODS

A plasmid DNA vector coding for the Bla g 1 allergen controlled by cytomegalovirus promoter was constructed. To estimate the protective efficacy, BALB/c mice were given three injections of plasmid DNA-Bla g 1 prior to sensitization with two priming doses of recombinant Bla g 1 (rBla g 1) antigens, followed by nebulized rBla g 1 challenge. In the therapeutic approach, sensitization was followed by administering Bla g 1 DNA vaccine.

RESULTS

Bla g 1 vaccination significantly reduced allergen-induced airway inflammation, even after mice were presensitized and a Th2-dominant response was established. The Bla g 1 vaccination significantly reduced total inflammatory cell infiltrate, eosinophilia, secretion of Th2 cytokines IL-4 and IL-5 in bronchoalveolar lavage fluid, allergen-induced inflammatory infiltrates in the lungs, and Bla g 1-specific IgE in serum upon challenge with rBla g 1. Importantly, Bla g 1 DNA vaccination was able to induce IL-10-secreting regulatory T cells that could suppress the allergen-specific Th2 cells.

CONCLUSION

DNA vaccination showed protective and therapeutic efficacy against a clinically relevant allergen Bla g 1.

[Effect of large-scale repair work on indoor formaldehyde levels upon and subjective symptoms in, medical students during gross anatomy dissection course]

OBJECTIVES

To examine the effect of large-scale repair work on indoor formaldehyde (FA) levels and subjective symptoms in medical students during a gross anatomy dissection course.

METHODS

We measured the indoor FA levels, room air temperature, and room humidity during a gross anatomy dissection course. In addition, the prevalence of subjective symptoms, keeping allergy state, and wearing personal protective equipment were surveyed in two groups of students using a self-administered questionnaire.

RESULTS

The mean indoor FA levels before and after repair work were 1.22 ppm and 0.14 ppm, respectively. The mean indoor FA level significantly decreased after repair work. The prevalences of most subjective symptoms before the anatomy practice were similar before and after the repair work. However, the prevalences of most subjective symptoms during the anatomy practice were lower after the repair work.

CONCLUSIONS

The mean indoor FA levels and prevalences of subjective symptoms decreased after the repair work. We have to continuously monitor indoor FA levels, carry out private countermeasures to minimize exposure to FA, and maintain equipment for ventilation to be able to conduct practice in a comfortable environment.

[Harmful biological agents at museum workposts]

BACKGROUND

The aim of the studies was to determine the level and kind of microbiological contamination of air and surfaces in museum premises with various collection specificities. In addition, the criteria for selecting indicators of contamination with harmful biological agents at museum workposts are proposed.

MATERIAL AND METHODS

The analysis of microbial contamination was carried out in 14 museum premises (storehouses, restoration workshops, exhibition hall). Microbiological air purity was measured with a MAS-100 Eco Air Sampler. Surface samples were collected using contact plates RODAC Envirocheck. Biochemical API tests were used to identify bacteria and yeasts. Fungi were diagnosed with taxonomic keys, based on macro- and microscopic mycelia assessment.

RESULTS

The levels of microbiological contamination in museums varied and ranged from 2.1 x 10(2) to 7.0 x 10(3) cfu/m3 in the air and from 1.4 x 10(2) to 1.7 x 10(4) cfu/100 cm2 on surfaces. The dominant microorganisms were fungi, which accounted respectively for 18-98% and 23-100% of all isolates from tested sites and surfaces. It was found that the amount of fungi in the indoor air of the Museum of Archeology and Ethnography and the Museum of Independence Traditions equaled respectively 4.2 x 10(2) cfu/m3 and 1.4 x 10(4) cfu/m3, which means that they exceeded the recommended reference value of 2.0 x 10(2) cfu/m3.

CONCLUSIONS

Having analyzed the frequency of strain isolation, the source of microorganisms and the hazard to human health, 10 fungal species were isolated, which may be regarded as indicators of contamination with harmful biological agents at museum workposts. They are: Aspergillus (A. niger, A. versicolor), Cladosporium (C. herbarum, C. macrocarpum), Penicillium (P. carneum, P. digitatum, P. italicum, P. paneum, P. polonicum), Rhizopus nigricans.

Fungal aerosol in the process of poultry breeding--quantitative and qualitative analysis

BACKGROUND

The aim of this study was to assess fungal air contamination in the processes associated with poultry breeding depending on the season. The evaluation was based on the determined concentrations of fungi and qualitative identification of isolated microorganisms.

MATERIALS AND METHODS

The study covered 2 hatcheries and 3 hen buildings. The air was sampled in spring, summer and autumn directly onto a filter using air aspirator. For the quantitative analysis of fungi, the medium MEA with chloramphenicol and streptomycin was used. The qualitative identification of fungi was carried out based on macro- and microscopic analysis.

RESULTS

The concentrations of total airborne mesophilic fungi in breeding facilities ranged from 1.22 x 10(3) to 5.87 x 10(5) cfu/m3 with the arithmetic mean value 1.60 x 10(5) cfu/m5. In 45% of the taken samples, these levels exceeded the reference value recommended in Poland for occupational environment exposure. The fungi concentration in the air of poultry houses was significantly modified by season (p = 0.04). A higher concentration of fungi occurred in autumn (p = 0.05). The dominant fungal microflora in the air was composed of molds (88%), with the most prevalent genus Acremonium. Yeasts constituted another 10% of bioaerosol and were mainly represented by genus Candida. The fungal aerosol contained two species qualified to the 2 group of risk--Aspergillus fumigatus and Candida tropicalis.

CONCLUSIONS

Facilities of poultry farms are contaminated with high concentrations of fungal aerosols, especially in a colder season, often exceeding the recommended limits. Among the fungi, there are also present pathogenic microorganisms that may pose a risk to farm workers' health.

EAACI position paper: prevention of work-related respiratory allergies among pre-apprentices or apprentices and young workers

Apprenticeship is a period of increased risk of developing work-related respiratory allergic diseases. There is a need for documents to provide appropriate professional advice to young adults aiming to reduce unsuitable job choices and prevent impairment from their careers. The present document is the result of a consensus reached by a panel of experts from European and non-European countries addressed to allergologists, pneumologists, occupational physicians, primary care physicians, and other specialists interested in this field, which aims to reduce work-related respiratory allergies (rhinoconjunctivitis and asthma) among allergic or nonallergic apprentices and other young adults entering the workforce. The main objective of the document is to issue consensus suggestions for good clinical practice based on existing scientific evidence and the expertise of a panel of physicians.

Prevention of house dust mite induced allergic airways disease in mice through immune tolerance

Allergic airways disease is a consequence of a Th2 response to an allergen leading to a series of manifestations such as production of allergen-specific IgE, inflammatory infiltrates in the airways, and airway hyper-reactivity (AHR). Several strategies have been reported for tolerance induction to allergens leading to protection from allergic airways disease. We now show that CD4 blockade at the time of house dust mite sensitization induces antigen-specific tolerance in mice. Tolerance induction is robust enough to be effective in pre-sensitized animals, even in those where AHR was pre-established. Tolerant mice are protected from airways eosinophilia, Th2 lung infiltration, and AHR. Furthermore, anti-CD4 treated mice remain immune competent to mount immune responses, including Th2, to unrelated antigens. Our findings, therefore, describe a strategy for tolerance induction potentially applicable to other immunogenic proteins besides allergens.

Panax ginseng ameliorates airway inflammation in an ovalbumin-sensitized mouse allergic asthma model

ETHNOPHARMACOLOGICAL RELEVANCE

Panax ginseng (PG) is a medicinal herb that has been used to treat various immune diseases including asthma and COPD. In this study, we investigated the inhibitory mechanism of PG on asthma parameters in mice.

MATERIALS AND METHODS

BALB/c mice were sensitized with 20 μg/200 μl OVA adsorbed on 1.0mg/50 μl aluminum hydroxide gel adjuvant by i.p. injection on days 0 and 14. Mice were then challenged with 5% OVA in PBS to the nose for 30 min once a day for 3 days, from day 20 until day 22, using a nebulizer. PG (20mg/kg) or vehicle was administrated by i.p. injection once a day 10 min before every OVA challenge for 3 days. The recruitment of inflammatory cells into bronchoalveolar lavage fluid or lung tissues was measured. The expression of EMBP, Muc5ac, CD40, and CD40 ligand (CD40L) in lung tissues was investigated. In addition, the cytokines and mitogen activated protein (MAP) kinases were measured by RT-PCR and Western blot.

RESULTS AND CONCLUSIONS

PG restored the expression of EMBP, Muc5ac, CD40, and CD40L, as well as the mRNA and protein levels of interleukin (IL)-1β, IL-4, IL-5, and tumor necrosis factor (TNF)-α. In addition, PG inhibited the numbers of goblet cells and further small G proteins and MAP kinases in bronchoalveolar lavage cells and lung tissues increased in ovalbumin-induced allergic asthma in mice. These results suggest that PG may be used as a therapeutic agent in asthma, based on reductions of various allergic responses.

[The Bergamo experience of health surveillance in the bakery sector]

The purpose of this study is to analyse the various risk factors present in the artisan and semi industrial bread making technological cycle as well as verify the kind of illnesses and ailments encountered amongst the workforce. The objective being to identify a preventive action programme together with the necessary Health support measures. Our case study, drew upon a sample of 428 workers (252 bread makers and 176 sales staff). Each of them was asked to complete a questionnaire about the production process, the kind of exposure to wheat flour particles, smoking habits, present or past common allergy pathologies, the symptoms connected to the work, both in the allergic and osteomuscular field. Those positive respondents were subjected to various medical tests so as to ascertain a definitive diagnosis of their ailments. As was easy to predict, the most common pathology (ailment), found amongst bread makers, related to the respiratory system--16.7% of the population. In particular, 7.5% was affected by eye rhinitis, 2.8% by allergic bronchial asthma, 3.2% indicated a mix between rhinitis and bronchial asthma and 3.2% by BPCO. Skin ailments affected 2% of workers and WMSDs more than 2.8%.

[Evaluation of occupational allergic diseases of the respiratory tract]

The paper presents the basic etiological and pathogenetic aspects of occupational allergic diseases of the respiratory tract, discusses the clinical course, diagnosis, and priorities of the prevention of allergic diseases of the upper airways and bronchopulmonary apparatus from the action of industrial allergens.

[Etiology, determinants, diagnostics and prophylaxis of occupational allergic respiratory diseases in hairdressers]

Hairdressers are occupationally exposed to many substances both, allergizing and irritating. The continuous development of hairdressing services brings about new risks. The most important allergens are: persulfates (ammonium and potassium), paraphenylenediamine, and latex. A growing number of occupational allergens in the work environment of hairdresses, providing that most of them are low weight allergens, may cause some diagnostic problems. Health risks related with haidressing occupation, have prompted the researchers to pay more attention to risk factors of occupational allergy. Owing to the fact, that first morbid symptoms may occur very early, even during the apprenticeship in a hairdressing school, it is very important to indentify health risks, which can be useful in predicting the onset of occupational allergy and in developing effective prevention methods. The most common allergens at the hairdressers' workplace, risk factors, diagnostics of occupational asthma and rhinitis, as well as the prevention of these diseases are reviewed in this publication.

Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study

BACKGROUND

Data on the long-term effects of sublingual immunotherapy (SLIT) are sparse, and the optimal duration of treatment is a matter of debate.

OBJECTIVE

We sought to prospectively evaluate the long-term effect of SLIT given for 3, 4, or 5 years and to compare the effect of those different durations.

METHODS

In this prospective open controlled study we followed up patients with respiratory allergy who were monosensitized to mites for 15 years. The subjects were divided in 4 groups receiving drug therapy alone or SLIT for 3, 4, or 5 years. Clinical scores, skin sensitizations, methacholine reactivity, and nasal eosinophil counts were evaluated every year during the winter months. The clinical effect was considered to persist until clinical scores remained at less than 50% of the baseline value, and then patients underwent another course of SLIT.

RESULTS

Seventy-eight patients were enrolled, and 59 completed the study. In the 12 control subjects no relevant change in clinical scores was seen throughout the study. In the patients receiving SLIT for 3 years, the clinical benefit persisted for 7 years. In those receiving immunotherapy for 4 or 5 years, the clinical benefit persisted for 8 years. New sensitizations occurred in all the control subjects over 15 years and in less than a quarter of the patients receiving SLIT (21%, 12%, and 11%, respectively). The second course of vaccination induced a benefit more rapidly than the first course. The behavior of bronchial hyperreactivity and nasal eosinophils paralleled the clinical score.

CONCLUSION

Under the present conditions, it can be suggested that a 4-year duration of SLIT is the optimal choice because it induces a long-lasting clinical improvement similar to that seen with a 5-year course and greater than that of a 3-year vaccination.

Montelukast during primary infection prevents airway hyperresponsiveness and inflammation after reinfection with respiratory syncytial virus

RATIONALE

Respiratory syncytial virus (RSV) bronchiolitis in infants may be followed by the development of asthma-like symptoms. Age at first infection dictates consequences upon reinfection. Reinfection of mice initially exposed as neonates to RSV enhanced development of airway hyperresponsiveness (AHR), eosinophilic inflammation, and mucus hyperproduction. RSV lower respiratory tract disease is associated with activation of the leukotriene pathway.

OBJECTIVES

To determine the effects of montelukast (MK), a cysteinyl leukotriene (cysLT) receptor antagonist, in primary and secondary RSV-infected newborn and adult mice.

METHODS

BALB/c mice were infected with RSV at 1 week (neonate) or 6 to 8 weeks (adult) of age and reinfected 5 weeks later. MK was administered 1 day before the initial infection and through Day 6 after infection. Seven days after primary or secondary infection, airway function was assessed by lung resistance to increasing doses of inhaled methacholine; lung inflammation, goblet cell metaplasia, and cytokine levels in bronchoalveolar lavage fluid were monitored.

MEASUREMENTS AND MAIN RESULTS

RSV infection induced cysLT release in bronchoalveolar lavage fluid. MK decreased RSV-induced AHR, airway inflammation, and increased IFN-gamma production in primary infected adult and neonatal mice. MK, administered during initial infection of neonates but not during secondary infection, prevented subsequent enhancement of AHR, airway eosinophilia, and mucus hyperproduction upon reinfection.

CONCLUSIONS

MK attenuated the initial responses to primary RSV infection in both age groups and altered the consequences of RSV reinfection in mice initially infected as neonates. These data support an important role for cysLT in RSV-induced AHR and inflammation.

Effect of ozone on response to ovalbumin & its modulation by vitamins C & E in sensitized guinea pigs

BACKGROUND & OBJECTIVES

Exposure to ozone and asthma are both associated with increased oxidative stress. Exposure to ozone therefore, may potentiate the airway response to allergens. We undertook this study to investigate the effect of ozone exposure on airway response to ovalbumin in sensitized guinea pigs and its modulation by dietary supplementation with antioxidant vitamins C and E.

METHODS

After in vivo measurements of specific airways conductance (SGaw) and airway hyperresponsiveness (AHR) to inhaled histamine, guinea pigs were sensitized to ovalbumin and divided into three groups: (i) sensitized; (ii) sensitized and exposed daily to ozone; and (iii) sensitized, exposed daily to ozone and given dietary supplementation with vitamin C, 2 mg/kg body wt and E, 7 IU/kg body wt. A control group of nonsensitized animals was included. After 4 wk, AHR was measured again and animals were challenged with inhaled ovalbumin. Changes in SGaw were followed for early and late airway bronchoconstrictive responses. The following measurements were obtained: (i) parameters of oxidative stress--plasma malonaldehyde (MDA) as marker of lipid peroxidation and superoxide anion generation by leukocytes and bronchoalveolar lavage (BAL) cells; (ii) antioxidant status: red cell superoxide dismutase (SOD); and (iii) glutathione peroxidase (GPx). BAL cytology was studied.

RESULTS

Ozone exposure resulted in an increase in AHR and early and late bronchoconstrictive responses after ovalbumin challenge, greater superoxide anion generation in BAL cells, higher plasma MDA levels and decrease in red cell SOD activity. Dietary supplementation with vitamin C and E prevented or ameliorated these responses.

INTERPRETATION & CONCLUSIONS

Exposure to ozone at concentrations of 0.12 ppm for 2 h daily for 4 wk enhances the airway response to allergens in sensitized guinea pigs. Dietary supplementation with antioxidant vitamins E and C, affords variable degree of protection against this enhancement.