The Toll‐like receptor 7/8‐ligand resiquimod (R‐848) primes human neutrophils for leukotriene B4, prostaglandin E2and platelet‐activating factor biosynthesis

Toll-like receptor modulation: a novel therapeutic strategy in cardiovascular disease?

BACKGROUND

Toll-like receptors (TLRs) have been recently recognised as primary receptors in the innate immune system. Apart from initiating a prompt immune response against invading pathogens, TLRs are also considered to be an important link between innate immunity, inflammation and a variety of clinical disorders, including cardiovascular diseases. TLR signalling manipulation with novel drugs could offer important opportunities for cardiovascular disease modification.

OBJECTIVE

To present the latest knowledge supporting the involvement of TLRs in the pathogenesis and progress of cardiovascular diseases and explore the role of TLRs as potential targets for therapeutic intervention in cardiovascular territory.

METHODS

A review of the literature documenting implication of TLR signalling in cardiovascular disorders. Current progress in TLR-targeting drug development and the potential role of such a treatment strategy in cardiovascular disorders are discussed.

CONCLUSIONS

A growing body of evidence supports a role for TLRs in cardiovascular disease initiation and progression. Altering TLR signalling with novel drugs could be a beneficial therapeutic strategy for patients with cardiovascular disorders.

Toll-like receptor-mediated activation of neutrophils by influenza A virus

Influenza virus infection of the respiratory tract is characterized by a neutrophil infiltrate accompanied by inflammatory cytokine and chemokine production. We and others have reported that Toll-like receptor (TLR) proteins are present on human neutrophils and that granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment enhances IL-8 (CXCL8) secretion in response to stimulation with TLR ligands. We demonstrate that influenza virus can induce IL-8 and other inflammatory cytokines from GM-CSF-primed human neutrophils. Using heat inactivation of influenza virus, we show that viral entry but not replication is required for cytokine induction. Furthermore, endosomal acidification and viral uncoating are necessary. Finally, using single-cell analysis of intracellular cytokine accumulation in neutrophils from knockout mice, we prove that TLR7 is essential for influenza viral recognition and inflammatory cytokine production by murine neutrophils. These studies demonstrate neutrophil activation by influenza virus and highlight the importance of TLR7 and TLR8 in that response.

Toll-like receptors and airway inflammation

The respiratory tract opens to the external environment at the oral side edge, and the other edge of the respiratory tract connects to the closed space (alveoli), and so to preserve the sterility in the terminal respiratory tract is critical for protection against pathogens. The recognition machinery for the invasion of microbes is indispensable for the preservation of the sterility in the lungs. Our general understanding of how microbes are recognized by the innate immune system has increased considerably over the past several years, and the contribution of Toll-Like Receptors (TLRs) to innate immunity is now well documented. In the meantime, it has come to understand that many inflammatory processes may depend on TLR signaling, it has been considered to be involved in the pathogenesis of airway inflammatory diseases such as airway infections, bronchial asthma, and occupational airway diseases. In this review, we focus on physiological roles of TLRs in defense mechanisms of the airways, and pathophysiological roles on airway diseases.

Resiquimod and other immune response modifiers as vaccine adjuvants

Synthetic immune response modifiers, such as resiquimod, are Toll-like receptor 7 and 8 agonists that act as vaccine adjuvants, enhancing antigen-specific antibody production and skewing immunity towards a Th1 response. These compounds stimulate dendritic cells to secrete cytokines, upregulate costimulatory molecule expression and enhance antigen presentation to T cells. The compounds have demonstrated vaccine adjuvant properties in a number of animal models. The adjuvant effects can be enhanced by measures that allow the drug to stay localized with the vaccine without quickly entering the systemic circulation. Clinical studies demonstrate that topical application of resiquimod and analogs is safe and effective at activating the local immune response. For injection, resiquimod or a similar compound may need to be formulated to allow for local immune activation without induction of systemic cytokines.