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Campbell HK, Salvi AM, O'Brien T, Superfine R, DeMali KA. PAK2 links cell survival to mechanotransduction and metabolism. J Cell Biol 2019; 218:1958-1971. [PMID: 30940647 PMCID: PMC6548143 DOI: 10.1083/jcb.201807152] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/29/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022] Open
Abstract
Campbell et al. show that force stimulates PAK2 activation at cell–cell junctions, where it protects cells under force from death and plays a key role in linking force-induced mechanotransduction, metabolism, and cell survival. Too little or too much force can trigger cell death, yet factors that ensure the survival of cells remain largely unknown. Here, we demonstrate that E-cadherin responds to force by recruiting and activating p21-activated protein kinase 2 (PAK2) to allow cells to stiffen, metabolize, and survive. Interestingly, PAK2 activation and its control of the apoptotic response are specific for the amplitude of force applied. Specifically, under low amplitudes of physiological force, PAK2 is protected from proteolysis, thereby ensuring cell survival. In contrast, under higher amplitudes of physiological force, PAK2 is left unprotected and stimulates apoptosis, an effect that is prevented by cleavage-resistant forms of the protein. Finally, we demonstrate that PAK2 protection is conferred by direct binding of AMPK. Thus, PAK2 mediates the survival of cells under force. These findings reveal an unexpected paradigm for how mechanotransduction, metabolism, and cell survival are linked.
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Affiliation(s)
- Hannah K Campbell
- Department of Biochemistry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Alicia M Salvi
- Department of Biochemistry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Timothy O'Brien
- Department of Physics, University of North Carolina, Chapel Hill, NC
| | - Richard Superfine
- Department of Physics, University of North Carolina, Chapel Hill, NC
| | - Kris A DeMali
- Department of Biochemistry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
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52
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Huang H, Lu H, Liang L, Zhi Y, Huo B, Wu L, Xu L, Shen Z. MicroRNA-744 Inhibits Proliferation of Bronchial Epithelial Cells by Regulating Smad3 Pathway via Targeting Transforming Growth Factor-β1 (TGF-β1) in Severe Asthma. Med Sci Monit 2019; 25:2159-2168. [PMID: 30903795 PMCID: PMC6441316 DOI: 10.12659/msm.912412] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Bronchial epithelial cells proliferation plays a pivotal role in airway remodeling in children with severe asthma. MicroRNAs (miRNAs) have gained great attention for many diseases, including asthma. The purpose of this study was to explore the mechanisms that underlie miR-744 modulating bronchial epithelial cells proliferation in severe asthma in children. MATERIAL AND METHODS Bronchial epithelial cells were isolated from bronchial biopsies of normal controls and asthmatic subjects. miR-744 and transforming growth factor-ß1 (TGF-ß1) expressions were measured by quantitative reverse transcription PCR (qRT-PCR). Proliferating cell nuclear antigen (PCNA), phosphorylation or total of mothers against decapentaplegic homolog3 (Smad3) and production of Smad anchor for receptor activation (SARA) were measured via Western blot analysis. A link between miR-744 and TGF-ß1 was probed by luciferase activity and RNA immunoprecipitation. Cell proliferation was evaluated using the Cell Proliferation Assay Kit. RESULTS Severe asthma showed a significantly elevated cell proliferation rate and reduced abundance of miR-744, which in turn inhibited cell proliferation of bronchial epithelial cells. In particular, TGF-ß1 might be a candidate target of miR-744, and enrichment of miR-744 lowered the expression of TGF-ß1 at mRNA and protein levels. Indeed, overexpression of miR-744 lowered the proliferation rate of bronchial epithelial cells via driving TGF-ß1. Moreover, addition of miR-744 limited phosphorylation of Smad3 but reversed SARA protein abundance by regulating TGF-ß1. CONCLUSIONS The presence of miR-744 repressed bronchial epithelial cells proliferation through mediating the Smad3 pathway by modulating TGF-ß1, providing a promising therapeutic approach for epithelial function in severe asthma.
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Affiliation(s)
- Han Huang
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Hongxia Lu
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Lihong Liang
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Yueli Zhi
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Beibei Huo
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Linlin Wu
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Liping Xu
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Zhaobo Shen
- Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China (mainland)
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53
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Zastrzeżyńska W, Przybyszowski M, Bazan-Socha S, Gawlewicz-Mroczka A, Sadowski P, Okoń K, Jakieła B, Plutecka H, Ćmiel A, Sładek K, Musiał J, Soja J. Omalizumab may decrease the thickness of the reticular basement membrane and fibronectin deposit in the bronchial mucosa of severe allergic asthmatics. J Asthma 2019; 57:468-477. [PMID: 30905217 DOI: 10.1080/02770903.2019.1585872] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction: Immunoglobulin E is an important modulator of the inflammatory reaction in allergic asthma. It also contributes to airway remodeling in the course of the disease. The authors evaluated airway structural changes in severe allergic asthma during the omalizumab therapy. Patients and methods: The study included 13 patients with severe allergic asthma treated with omalizumab for at least one year. In each patient clinical, laboratory, and spirometry parameters were evaluated before and after the treatment. In addition, bronchoscopy with bronchial mucosa biopsy and bronchoalveolar lavage was performed. The basal lamina thickness, inflammatory cell infiltration, fibronectin, as well as type I and III collagen accumulation were assessed in bronchial mucosa specimens, together with the assessment of bronchoalveolar lavage cellularity. Results: The omalizumab therapy led to a decrease in the basal lamina thickness (p = 0.002), and to a reduction in fibronectin (p = 0.02), but not collagen deposits in the bronchial mucosa. The decrease in fibronectin accumulation was associated with an improvement in asthma control and quality of life (p = 0.01, both), and a diminished dose of systemic corticosteroids (p = 0.001). It was also associated with a tendency towards reduction of the eosinophil count in the peripheral blood, bronchoalveolar lavage fluid, and bronchial mucosa specimens. Conclusion: Our study has shown that omalizumab, effective in the treatment of severe allergic asthma, may also decrease unfavorable structural airway changes in allergic asthmatics, at least with respect to the fibronectin deposit and an increased thickness of the basal lamina. However, more extensive observational studies are needed to verify the above hypothesis.
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Affiliation(s)
| | - Marek Przybyszowski
- Department of Pulmonology, University Hospital, Krakow, Poland.,Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisława Bazan-Socha
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Gawlewicz-Mroczka
- Department of Pulmonology, University Hospital, Krakow, Poland.,Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Sadowski
- Department of Pathology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Okoń
- Department of Pathology, Jagiellonian University Medical College, Krakow, Poland
| | - Bogdan Jakieła
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Hanna Plutecka
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Adam Ćmiel
- Faculty of Applied Mathematics, AGH University of Science and Technology, Kraków, Poland
| | - Krzysztof Sładek
- Department of Pulmonology, University Hospital, Krakow, Poland.,Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Musiał
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy Soja
- Department of Pulmonology, University Hospital, Krakow, Poland.,Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
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54
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Evasovic JM, Singer CA. Regulation of IL-17A and implications for TGF-β1 comodulation of airway smooth muscle remodeling in severe asthma. Am J Physiol Lung Cell Mol Physiol 2019; 316:L843-L868. [PMID: 30810068 PMCID: PMC6589583 DOI: 10.1152/ajplung.00416.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Severe asthma develops as a result of heightened, persistent symptoms that generally coincide with pronounced neutrophilic airway inflammation. In individuals with severe asthma, symptoms are poorly controlled by high-dose inhaled glucocorticoids and often lead to elevated morbidity and mortality rates that underscore the necessity for novel drug target identification that overcomes limitations in disease management. Many incidences of severe asthma are mechanistically associated with T helper 17 (TH17) cell-derived cytokines and immune factors that mediate neutrophilic influx to the airways. TH17-secreted interleukin-17A (IL-17A) is an independent risk factor for severe asthma that impacts airway smooth muscle (ASM) remodeling. TH17-derived cytokines and diverse immune mediators further interact with structural cells of the airway to induce pathophysiological processes that impact ASM functionality. Transforming growth factor-β1 (TGF-β1) is a pivotal mediator involved in airway remodeling that correlates with enhanced TH17 activity in individuals with severe asthma and is essential to TH17 differentiation and IL-17A production. IL-17A can also reciprocally enhance activation of TGF-β1 signaling pathways, whereas combined TH1/TH17 or TH2/TH17 immune responses may additively impact asthma severity. This review seeks to provide a comprehensive summary of cytokine-driven T cell fate determination and TH17-mediated airway inflammation. It will further review the evidence demonstrating the extent to which IL-17A interacts with various immune factors, specifically TGF-β1, to contribute to ASM remodeling and altered function in TH17-driven endotypes of severe asthma.
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Affiliation(s)
- Jon M Evasovic
- Department of Pharmacology, School of Medicine, University of Nevada , Reno, Nevada
| | - Cherie A Singer
- Department of Pharmacology, School of Medicine, University of Nevada , Reno, Nevada
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55
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Tint D, Stabler CT, Hanifi A, Yousefi F, Linkov G, Hy K, Soliman AMS, Pleshko N. Spectroscopic Analysis of Human Tracheal Tissue during Decellularization. Otolaryngol Head Neck Surg 2019; 160:302-309. [PMID: 30325714 DOI: 10.1177/0194599818806271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To use mid-infrared (IR) spectroscopy to assess changes in the cartilaginous framework of human trachea during decellularization. STUDY DESIGN Laboratory-based study. SETTING Research laboratory. METHODS Six cadaveric human tracheas were decellularized using a detergent enzymatic method (DEM). Tissue samples were obtained from each specimen after 0, 1, 10, and 25 DEM cycles for histologic and spectroscopic analysis. Decellularization was confirmed using hematoxylin and eosin (H&E) and 2-(4-amidinophenyl)-1H-indole-6-carboxamidine (DAPI) staining. Changes in cartilaginous framework were examined using Fourier transform infrared imaging spectroscopy (FT-IRIS) and an attenuated total reflectance (ATR) probe in the mid-IR frequencies. Results were statistically analyzed using 1-way analysis of variance (ANOVA) and principal component analysis (PCA). RESULTS Six decellularized tracheal scaffolds were successfully created using a DEM protocol. Histologic examination showed near-complete nuclear loss following 25 DEM cycles. As observed with FT-IRIS analysis, the collagen absorbance signal (1336 cm-1) was predominantly in the perichondria and remained stable after 25 DEM cycles ( P = .132), while the absorbance from sugar rings in proteoglycans and nucleic acids in hyaline cartilage (1080 cm-1) showed a significant decrease after 1 DEM cycle ( P = .0007). Examination of the luminal surface of the trachea with an ATR probe showed raw mid-IR spectra consistent with cartilage. PCA showed significant separation of spectra corresponding to treatment cycle along the principal components 1 and 2. CONCLUSION Mid-IR spectroscopy is a viable method of monitoring changes in extracellular matrix components during the decellularization of human trachea.
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Affiliation(s)
- Derrick Tint
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Collin T Stabler
- 2 Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 3 Penn Center for Pulmonary Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 4 Penn Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 5 Penn Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arash Hanifi
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Farzad Yousefi
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Gary Linkov
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Kenneth Hy
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Ahmed M S Soliman
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Nancy Pleshko
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
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56
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Vasconcelos LHC, Silva MDCC, Costa AC, de Oliveira GA, de Souza ILL, Queiroga FR, Araujo LCDC, Cardoso GA, Righetti RF, Silva AS, da Silva PM, Carvalho CRDO, Vieira GC, Tibério IDFLC, Cavalcante FDA, da Silva BA. A Guinea Pig Model of Airway Smooth Muscle Hyperreactivity Induced by Chronic Allergic Lung Inflammation: Contribution of Epithelium and Oxidative Stress. Front Pharmacol 2019; 9:1547. [PMID: 30814952 PMCID: PMC6353839 DOI: 10.3389/fphar.2018.01547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022] Open
Abstract
Asthma is a heterogeneous disease of the airways characterized by chronic inflammation associated with bronchial and smooth muscle hyperresponsiveness. Currently, different murine models for the study of asthma show poor bronchial hyperresponsiveness due to a scarcity of smooth muscle and large airways, resulting in a failure to reproduce smooth muscle hyperreactivity. Thus, we aimed to standardize a guinea pig model of chronic allergic lung inflammation mimicking airway smooth muscle hyperreactivity observed in asthmatics (Asth). Animals were randomly divided into a control group (Ctrl), which received saline (0.9% NaCl), and the Asth group, subjected to in vivo sensitization with ovalbumin (OVA) nebulization. Morphological analysis was performed by hematoxylin-eosin staining. Bronchial hyperresponsiveness was evaluated by nebulization time in the fifth, sixth, and seventh inhalations (NT5-7) and tracheal isometric contractions were assessed by force transducer. Total antioxidant capacity was measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method and protein expression by Western blot. Histologically, the Asth group developed peribronchial cellular infiltrate, epithelial hyperplasia and smooth muscle thickening. After the fourth nebulization, the Asth group developed bronchial hyperreactivity. The trachea from the Asth group contracted after in vitro stimulation with OVA, differing from the Ctrl group, which showed no response. Additionally, airway smooth muscle hyperreactivity to carbachol and histamine was observed in the Asth group only in intact epithelium preparations, but not to KCl, and this effect was associated with an augmented production of reactive oxygen species. Moreover, lung inflammation impaired the relaxant potency of isoproterenol only in intact epithelium preparations, without interfering with nifedipine, and it was found to be produced by transforming growth factor-β negative modulation of β adrenergic receptors and, furthermore, big-conductance Ca2+-sensitive K+ channels. These effects were also associated with increased levels of phosphatidylinositol 3-kinases but not extracellular signal-regulated kinases 1/2 or phosphorylation, and augmented α-actin content as well, explaining the increased smooth muscle mass. Furthermore, pulmonary antioxidant capacity was impaired in the Asth group. Therefore, we developed a standardized and easy-to-use, reproducible guinea pig model of lung inflammation that mimics airway smooth muscle hypercontractility, facilitating the investigation of the mechanisms of bronchial hyperresponsiveness in asthma and new therapeutic alternatives.
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Affiliation(s)
- Luiz Henrique César Vasconcelos
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Maria da Conceição Correia Silva
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Alana Cristina Costa
- Graduação em Farmácia, Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Giuliana Amanda de Oliveira
- Graduação em Farmácia, Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Iara Leão Luna de Souza
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Fernando Ramos Queiroga
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Layanne Cabral da Cunha Araujo
- Programa de Pós graduação em Ciências (Fisiologia Humana), Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, Brazil
| | - Glêbia Alexa Cardoso
- Programa Associado de Pós graduação em Educação Física, Universidade Federal da Paraíba/Universidade do Pernambuco, João Pessoa, Brazil
| | - Renato Fraga Righetti
- Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Hospital Sírio Libanês, São Paulo, Brazil
| | - Alexandre Sérgio Silva
- Programa Associado de Pós graduação em Educação Física, Universidade Federal da Paraíba/Universidade do Pernambuco, João Pessoa, Brazil
- Departamento de Educação Física, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Patrícia Mirella da Silva
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
- Departamento de Biologia Molecular, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Carla Roberta de Oliveira Carvalho
- Programa de Pós graduação em Ciências (Fisiologia Humana), Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Biofísica e Fisiologia, Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, Brazil
| | - Giciane Carvalho Vieira
- Departamento de Morfologia/Centro de Ciências da Saúde/Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | - Fabiana de Andrade Cavalcante
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
- Departamento de Fisiologia e Patologia/Centro de Ciências da Saúde/Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Bagnólia Araújo da Silva
- Programa de Pós graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil
- Departamento de Ciências Farmacêuticas/Centro de Ciências da Saúde/Universidade Federal da Paraíba, João Pessoa, Brazil
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The anatomic substrate of irreversible airway obstruction and barotrauma in a case of hurricane-triggered fatal status asthmaticus during puerperium: Lessons from an autopsy. Respir Med Case Rep 2018; 26:136-141. [PMID: 30603604 PMCID: PMC6306954 DOI: 10.1016/j.rmcr.2018.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 01/27/2023] Open
Abstract
Non-fully reversible airway obstruction in fatal asthma is often seen in association with profound structural changes of the bronchial wall, termed airway remodeling. Evidence suggests that heavy precipitation events can trigger epidemics of severe asthma. We present a case of fatal asthma in a young woman with no prior near-fatal exacerbations and postulate that the patient's extensive airway remodeling and puerperal state (susceptibility factors), in combination with a massive allergen challenge during a hurricane landfall (triggering factor), played a central role in her death. The autopsy revealed diffuse obstruction of proximal and distal bronchi by mucous plugs together with transmural chronic inflammation, tissue eosinophilia, extensive goblet cell hyperplasia with MUC-5 expression and airway smooth muscle (ASM) thickening. The observed distribution of airway remodeling was heterogeneous with sparing of the lingula, which exhibited hyperinflation and expansion of perivascular spaces indicative of dissecting air. The massive stagnation of mucus and significant inter-airway structural heterogeneity created an anatomical substrate for unequal airflow distribution facilitating the development of barotrauma. Although not considered conventional risk factors for fatal asthma, we believe that in this case, the patient's puerperal state in conjunction with an extreme environmental event dispersing aeroallergens were major contributors to the development of a fatal asthma attack. Our autopsy findings suggest that effective strategies to evacuate stagnated mucus and induce relaxation of thickened ASM are crucial in the management of life-threatening asthma exacerbations.
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Lin J, Yang D, Huang M, Zhang Y, Chen P, Cai S, Liu C, Wu C, Yin K, Wang C, Zhou X, Su N. Chinese expert consensus on diagnosis and management of severe asthma. J Thorac Dis 2018; 10:7020-7044. [PMID: 30746249 PMCID: PMC6344700 DOI: 10.21037/jtd.2018.11.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 11/25/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Jiangtao Lin
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Dong Yang
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Mao Huang
- Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yongming Zhang
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Ping Chen
- Department of Respiratory Medicine, General Hospital of Shenyang Military Region, Shenyang 110015, China
| | - Shaoxi Cai
- Department of Respiratory Medicine, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - Chuntao Liu
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Changgui Wu
- Department of Respiratory Medicine, Xijing Hospital of Fourth Military Medical University, Xi’an 710032, China
| | - Kaisheng Yin
- Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Changzheng Wang
- Department of Respiratory Medicine, Xinqiao Hospital of Third Military Medical University, Chongqing 400037, China
| | - Xin Zhou
- Department of Respiratory Medicine, First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Nan Su
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
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Abstract
Regulated cell death is a major mechanism to eliminate damaged, infected, or superfluous cells. Previously, apoptosis was thought to be the only regulated cell death mechanism; however, new modalities of caspase-independent regulated cell death have been identified, including necroptosis, pyroptosis, and autophagic cell death. As an understanding of the cellular mechanisms that mediate regulated cell death continues to grow, there is increasing evidence that these pathways are implicated in the pathogenesis of many pulmonary disorders. This review summarizes our understanding of regulated cell death as it pertains to the pathogenesis of chronic obstructive pulmonary disease, asthma, idiopathic pulmonary fibrosis, acute respiratory distress syndrome, and pulmonary arterial hypertension.
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Affiliation(s)
- Maor Sauler
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut 06520, USA;
| | - Isabel S Bazan
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut 06520, USA;
| | - Patty J Lee
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut 06520, USA;
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Facciolongo N, Polese G, Romani S, Corbetta L. Competence in bronchial thermoplasty. Panminerva Med 2018; 61:422-428. [PMID: 30486619 DOI: 10.23736/s0031-0808.18.03582-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bronchial thermoplasty (BT) is an innovative non-pharmacological endoscopic treatment for patients with severe persistent asthma based on controlled heat release with a device called Alair™ Catheter (Boston Scientific, Natick, MA, USA). The Alair™ system is the first device that works by delivering radiofrequency or thermal energy to selectively reduce the amount of airway smooth muscle (ASM) in bronchi. Literature showed significant improvement in clinical outcomes such as symptom control, severe exacerbation rate, hospitalization, quality of life, and number of working or school days lost for asthma. Besides smooth muscle effects changes in inflammatory pattern after BT have been documented. Bronchial thermoplasty requires an experienced physician who had a proficiency training in bronchoscopy and had rigor, dexterity and a thorough knowledge of the airway anatomy. Furthermore, right selection of severe asthma patient is crucial in order to have best response after BT. This article reviews BT device description and how to perform the procedure. Criteria for right selection and management of patient before and after BT will be discussed.
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Affiliation(s)
| | - Guido Polese
- Azienda ULSS 22 Bussolengo, Regione Veneto, Verona, Italy
| | - Sofia Romani
- A.O.U Careggi, SOD of Intervention Pneumology, Florence, Italy
| | - Lorenzo Corbetta
- Operative Unit of Interventional Pneumology, University of Florence, Florence, Italy
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61
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Fibroblast gene expression following asthmatic bronchial epithelial cell conditioning correlates with epithelial donor lung function and exacerbation history. Sci Rep 2018; 8:15768. [PMID: 30361541 PMCID: PMC6202408 DOI: 10.1038/s41598-018-34021-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/06/2018] [Indexed: 11/08/2022] Open
Abstract
Airway remodeling may contribute to decreased lung function in asthmatic children. Bronchial epithelial cells (BECs) may regulate fibroblast expression of extracellular matrix (ECM) constituents and fibroblast-to-myofibroblast transition (FMT). Our objective was to determine if human lung fibroblast (HLF) expression of collagen I (COL1A1), hyaluronan synthase 2 (HAS2), and the FMT marker alpha-smooth muscle actin (α-SMA) by HLFs conditioned by BECs from asthmatic and healthy children correlate with lung function measures and exacerbation history among BEC donors. BECs from asthmatic (n = 23) and healthy children (n = 15) were differentiated at an air-liquid interface (ALI) and then co-cultured with HLFs for 96 hours. Expression of COL1A1, HAS2, and α-SMA by HLFs was determined by quantitative polymerase chain reaction (qPCR). FMT was quantified by measuring HLF cytoskeletal α-SMA by flow cytometry. Pro-collagen Iα1, hyaluronan (HA), and PGE2 were measured in BEC-HLF supernatant. Correlations between lung function measures of BEC donors, and COL1A1, HAS2, and α-SMA gene expression, as well as supernatant concentrations of HA, pro-collagen Iα1, hyaluronan (HA), and PGE2 were assessed. We observed that expression of α-SMA and COL1A1 by HLFs co-cultured with asthmatic BECs was negatively correlated with BEC donor lung function. BEC-HLF supernatant concentrations of pro-collagen Iα1 were negatively correlated, and PGE2 concentrations positively correlated, with asthmatic BEC donor lung function. Expression of HAS2, but not α-SMA or COL1A1, was greater by HLFs co-cultured with asthmatic BECs from donors with a history of severe exacerbations than by HLFs co-cultured with BECs from donors who lacked a history of severe exacerbations. In conclusion, α-SMA and COL1A1 expression by HLFs co-cultured with BECs from asthmatic children were negatively correlated with lung function measures, supporting our hypothesis that epithelial regulation of HLFs and airway deposition of ECM constituents by HLFs contributes to lung function deficits among asthmatic children. Furthermore, epithelial regulation of airway HAS2 may influence the susceptibility of children with asthma to experience severe exacerbations. Finally, epithelial-derived PGE2 is a potential regulator of airway FMT and HLF production of collagen I that should be investigated further in future studies.
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Panda L, Mabalirajan U. Recent Updates on Corticosteroid Resistance in Asthma. EUROPEAN MEDICAL JOURNAL 2018. [DOI: 10.33590/emj/10311987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Corticosteroids are one of the most effective medications available for a wide variety of inflammatory diseases, including rheumatoid arthritis, inflammatory bowel disease, autoimmune diseases, and chronic lung diseases such as asthma; however, 5–10% of asthma patients respond poorly to corticosteroids and require high doses, secondary immunosuppressants, such as calcineurin inhibitors and methotrexate, or disease-modifying biologics that can be toxic and/or expensive. Though steroid-resistant asthma affects a small percentage of patients, it consumes significant health resources and contributes to substantial morbidity and mortality. In addition, the side effects caused by excessive use of steroids dramatically impact patients’ quality of life. Recognition of patients who respond poorly to steroid therapy is important due to the persistent and considerable problems they face in managing their conditions, which bears a significant socioeconomic burden. Along with the recognition of such patients, elucidation of the molecular mechanisms of steroid resistance is equally important, so that administration of a high dosage of steroids, and the consequent adverse effects, can be avoided. This review provides an update on the mechanisms of steroid function and the possible new therapeutic modalities to treat steroid-resistant asthma.
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Affiliation(s)
- Lipsa Panda
- Molecular Pathobiology of Respiratory Diseases, Council of Scientific & Industrial Research (CSIR), Institute of Genomics and Integrative Biology, Delhi, India
| | - Ulaganathan Mabalirajan
- Molecular Pathobiology of Respiratory Diseases, Council of Scientific & Industrial Research (CSIR), Institute of Genomics and Integrative Biology, Delhi, India
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63
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Moheimani F, Koops J, Williams T, Reid AT, Hansbro PM, Wark PA, Knight DA. Influenza A virus infection dysregulates the expression of microRNA-22 and its targets; CD147 and HDAC4, in epithelium of asthmatics. Respir Res 2018; 19:145. [PMID: 30068332 PMCID: PMC6090696 DOI: 10.1186/s12931-018-0851-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/25/2018] [Indexed: 02/07/2023] Open
Abstract
Background Specific microRNAs (miRNAs) play essential roles in airway remodeling in asthma. Infection with influenza A virus (IAV) may also magnify pre-existing airway remodeling leading to asthma exacerbation. However, these events remain to be fully defined. We investigated the expression of miRNAs with diverse functions including proliferation (miR-20a), differentiation (miR-22) or innate/adaptive immune responses (miR-132) in primary bronchial epithelial cells (pBECs) of asthmatics following infection with the H1N1 strain of IAV. Methods pBECs from subjects (n = 5) with severe asthma and non-asthmatics were cultured as submerged monolayers or at the air-liquid-interface (ALI) conditions and incubated with IAV H1N1 (MOI 5) for up to 24 h. Isolated miRNAs were subjected to Taqman miRNAs assays. We confirmed miRNA targets using a specific mimic and antagomir. Taqman mRNAs assays and immunoblotting were used to assess expression of target genes and proteins, respectively. Results At baseline, these miRNAs were expressed at the same level in pBECs of asthmatics and non-asthmatics. After 24 h of infection, miR-22 expression increased significantly which was associated with the suppression of CD147 mRNA and HDAC4 mRNA and protein expression in pBECs from non-asthmatics, cultured in ALI. In contrast, miR-22 remained unchanged while CD147 expression increased and HDAC4 remained unaffected in cells from asthmatics. IAV H1N1 mediated increases in SP1 and c-Myc transcription factors may underpin the induction of CD147 in asthmatics. Conclusion The different profile of miR-22 expression in differentiated epithelial cells from non-asthmatics may indicate a self-defense mechanism against aberrant epithelial responses through suppressing CD147 and HDAC4, which is compromised in epithelial cells of asthmatics. Electronic supplementary material The online version of this article (10.1186/s12931-018-0851-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fatemeh Moheimani
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.
| | - Jorinke Koops
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Department of Molecular Pharmacology, University of Groningen, Groningen, Netherlands
| | - Teresa Williams
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Andrew T Reid
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
| | - Philip M Hansbro
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
| | - Peter A Wark
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Darryl A Knight
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, HMRI building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
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64
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Curcumin Attenuates Airway Inflammation and Airway Remolding by Inhibiting NF-κB Signaling and COX-2 in Cigarette Smoke-Induced COPD Mice. Inflammation 2018; 41:1804-1814. [DOI: 10.1007/s10753-018-0823-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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65
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Patel DF, Snelgrove RJ. The multifaceted roles of the matrikine Pro-Gly-Pro in pulmonary health and disease. Eur Respir Rev 2018; 27:180017. [PMID: 29950303 PMCID: PMC9488800 DOI: 10.1183/16000617.0017-2018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/08/2018] [Indexed: 02/06/2023] Open
Abstract
Matrikines are bioactive fragments of the extracellular matrix (ECM) that are fundamental in regulating a diverse array of physiological processes. The tripeptide Proline-Glycine-Proline (PGP) is a collagen-derived matrikine that has classically been described as a neutrophil chemoattractant. In this article, we describe our current understanding of the pathways that generate, degrade and modify PGP to dictate its bioavailability and stability. Additionally, we discuss our expanding appreciation of the capacity of PGP to regulate diverse cell types and biological processes, independent of its activity on neutrophils, including a putative role in wound repair. We argue that PGP functions as a primitive and conserved damage-associated molecular pattern, which is generated during infection or injury and subsequently acts to shape ensuing inflammatory and repair processes. As a fragment of the ECM that accumulates at the epicentre of the action, PGP is perfectly positioned to focus neutrophils to the exact site required and direct a localised repair response. However, it is essential that PGP is efficiently degraded, as if this matrikine is allowed to persist then pathology can ensue. Accordingly, we discuss how this pathway is subverted in chronic lung diseases giving rise to persistent inflammation and pathological tissue remodelling.
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Affiliation(s)
- Dhiren F Patel
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Robert J Snelgrove
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Imperial College London, London, UK
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66
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Hansbro PM, Kim RY, Starkey MR, Donovan C, Dua K, Mayall JR, Liu G, Hansbro NG, Simpson JL, Wood LG, Hirota JA, Knight DA, Foster PS, Horvat JC. Mechanisms and treatments for severe, steroid-resistant allergic airway disease and asthma. Immunol Rev 2018; 278:41-62. [PMID: 28658552 DOI: 10.1111/imr.12543] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Severe, steroid-resistant asthma is clinically and economically important since affected individuals do not respond to mainstay corticosteroid treatments for asthma. Patients with this disease experience more frequent exacerbations of asthma, are more likely to be hospitalized, and have a poorer quality of life. Effective therapies are urgently required, however, their development has been hampered by a lack of understanding of the pathological processes that underpin disease. A major obstacle to understanding the processes that drive severe, steroid-resistant asthma is that the several endotypes of the disease have been described that are characterized by different inflammatory and immunological phenotypes. This heterogeneity makes pinpointing processes that drive disease difficult in humans. Clinical studies strongly associate specific respiratory infections with severe, steroid-resistant asthma. In this review, we discuss key findings from our studies where we describe the development of representative experimental models to improve our understanding of the links between infection and severe, steroid-resistant forms of this disease. We also discuss their use in elucidating the mechanisms, and their potential for developing effective therapeutic strategies, for severe, steroid-resistant asthma. Finally, we highlight how the immune mechanisms and therapeutic targets we have identified may be applicable to obesity-or pollution-associated asthma.
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Affiliation(s)
- Philip M Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Richard Y Kim
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Malcolm R Starkey
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Chantal Donovan
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Kamal Dua
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jemma R Mayall
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Gang Liu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Nicole G Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jodie L Simpson
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jeremy A Hirota
- James Hogg Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Darryl A Knight
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Paul S Foster
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jay C Horvat
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
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67
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Xie B, Laxman B, Hashemifar S, Stern R, Gilliam TC, Maltsev N, White SR. Chemokine expression in the early response to injury in human airway epithelial cells. PLoS One 2018; 13:e0193334. [PMID: 29534074 PMCID: PMC5849294 DOI: 10.1371/journal.pone.0193334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/08/2018] [Indexed: 12/22/2022] Open
Abstract
Basal airway epithelial cells (AEC) constitute stem/progenitor cells within the central airways and respond to mucosal injury in an ordered sequence of spreading, migration, proliferation, and differentiation to needed cell types. However, dynamic gene transcription in the early events after mucosal injury has not been studied in AEC. We examined gene expression using microarrays following mechanical injury (MI) in primary human AEC grown in submersion culture to generate basal cells and in the air-liquid interface to generate differentiated AEC (dAEC) that include goblet and ciliated cells. A select group of ~150 genes was in differential expression (DE) within 2-24 hr after MI, and enrichment analysis of these genes showed over-representation of functional categories related to inflammatory cytokines and chemokines. Network-based gene prioritization and network reconstruction using the PINTA heat kernel diffusion algorithm demonstrated highly connected networks that were richer in differentiated AEC compared to basal cells. Similar experiments done in basal AEC collected from asthmatic donor lungs demonstrated substantial changes in DE genes and functional categories related to inflammation compared to basal AEC from normal donors. In dAEC, similar but more modest differences were observed. We demonstrate that the AEC transcription signature after MI identifies genes and pathways that are important to the initiation and perpetuation of airway mucosal inflammation. Gene expression occurs quickly after injury and is more profound in differentiated AEC, and is altered in AEC from asthmatic airways. Our data suggest that the early response to injury is substantially different in asthmatic airways, particularly in basal airway epithelial cells.
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Affiliation(s)
- Bingqing Xie
- Department of Human Genetics, University of Chicago, Chicago, IL, United States of America
- Illinois Institute of Technology, Chicago, IL, United States of America
| | - Bharathi Laxman
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
| | - Somaye Hashemifar
- Department of Human Genetics, University of Chicago, Chicago, IL, United States of America
- Toyota Technological Institute at Chicago, Chicago, IL, United States of America
| | - Randi Stern
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
| | - T. Conrad Gilliam
- Department of Human Genetics, University of Chicago, Chicago, IL, United States of America
| | - Natalia Maltsev
- Department of Human Genetics, University of Chicago, Chicago, IL, United States of America
| | - Steven R. White
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
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Arafah MA, Raddaoui E, Kassimi FA, Alhamad EH, Alboukai AA, Alshedoukhy AA, Ouban A. Endobronchial biopsy in the final diagnosis of chronic obstructive pulmonary disease and asthma: a clinicopathological study. Ann Saudi Med 2018; 38:118-124. [PMID: 29620545 PMCID: PMC6074367 DOI: 10.5144/0256-4947.2018.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Asthma and chronic obstructive pulmonary disease (COPD) are chronic conditions with an increasing prevalence in developing countries. The evaluation of endobronchial biopsies has emerged as a tool to differentiate between both conditions via the measurement of the reticular basement membrane (RBM) thickness with various conclusions drawn from different studies. OBJECTIVES Compare the thickness of the RBM between asthma and COPD and evaluate other histomorphological features in both groups. DESIGN Prospective, descriptive and analytical. SETTING University teaching hospital. PATIENTS AND METHODS The study included patients with COPD and irreversible and reversible asthma with diagnosis based on clinical assessment, pulmonary function tests and high-resolution computed tomography scans. Endobronchial biopsies were obtained from all patients and, using a light microscope and a computerized image analyzer, the thickness of the reticular basement membrane was calculated in all patients. We also made a qualitative assessment of other histo-morphological features. MAIN OUTCOME MEASURES Mean RBM thickness. SAMPLE SIZE Thirty male patients. RESULTS The mean RBM thickness in asthmatic patients was 8.9 (2.4) micro m. The mean RBM thickness in COPD patients was 5.3 (1.1) micro m. However, there was no thickening of the RBM in patients with reversible asthma. The RBM was significantly thicker in patients with irreversible asthma than in patients with COPD or reversible asthma. There were no significant differences in epithelial desquamation or metaplasia, mucosal or submucosal inflammation, the presence of eosinophils, submucosal glandular hyperplasia or submucosal smooth muscle hyperplasia between groups. CONCLUSIONS The thickness of the RBM is the only reproducible histopathological feature to differentiate COPD from irreversible asthma. LIMITATIONS The study included a limited number of patients. A qualitative approach was used to compare epithelial cell injury, inflammation, submucosal glandular and muscular hyperplasia. CONFLICT OF INTEREST None.
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Affiliation(s)
- Maria Abdulrahim Arafah
- Dr. Maria Abdulrahman Arafah, Department of Pathology,, College of Medicine, King Saud University,, PO Box 2925, Riyadh 11461,, Saudi Arabia, M: +966555214611, marafah83@ gmail.com, ORCID: http://orcid. org/0000-0002-6847-5884
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69
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Ferreira DS, Carvalho-Pinto RM, Gregório MG, Annoni R, Teles AM, Buttignol M, Araújo-Paulino BB, Katayama EH, Oliveira BL, Del Frari HS, Cukier A, Dolhnikoff M, Stelmach R, Rabe KF, Mauad T. Airway pathology in severe asthma is related to airflow obstruction but not symptom control. Allergy 2018; 73:635-643. [PMID: 28960335 DOI: 10.1111/all.13323] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients with asthma present structural and inflammatory alterations that are believed to play a role in disease severity. However, airway remodeling and inflammation have not been extensively investigated in relation to both symptom control and airflow obstruction in severe asthmatics. We aimed to investigate several inflammatory and structural pathological features in bronchial biopsies of severe asthmatics that could be related to symptom control and airflow obstruction after standardized treatment. METHODS Fifty severe asthmatics received prednisone 40 mg/d for 2 weeks and maintenance therapy with budesonide/formoterol 400/12 μg twice daily + budesonide/formoterol 200/6 μg as needed for 12 weeks. Endobronchial biopsies were performed at the end of 12 weeks. We performed extensive immunopathological analyses of airway tissue inflammation and remodeling features in patients stratified by asthma symptom control and by airflow obstruction. RESULTS Airway tissue inflammation and remodeling were not associated with symptom control. Asthmatics with persistent airflow obstruction had greater airway smooth muscle (Asm) area with decreased periostin and transforming growth factor beta-positive cells within Asm bundles, in addition to lower numbers of chymase-positive mast cells in the submucosa compared to patients with nonpersistent obstruction. CONCLUSIONS Symptom control in severe asthmatics was not associated with airway tissue inflammation and remodeling, although persistent airflow obstruction in these patients was associated with bronchial inflammation and airway structural changes.
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Affiliation(s)
- D. S. Ferreira
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - R. M. Carvalho-Pinto
- Pulmonary Division; Heart Institute (InCor); University of São Paulo Medical School; São Paulo Brazil
| | - M. G. Gregório
- Pulmonary Division; Heart Institute (InCor); University of São Paulo Medical School; São Paulo Brazil
| | - R. Annoni
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - A. M. Teles
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - M. Buttignol
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - B. B. Araújo-Paulino
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - E. H. Katayama
- University of São Paulo Medical School; São Paulo Brazil
| | - B. L. Oliveira
- University of São Paulo Medical School; São Paulo Brazil
| | | | - A. Cukier
- Pulmonary Division; Heart Institute (InCor); University of São Paulo Medical School; São Paulo Brazil
| | - M. Dolhnikoff
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
| | - R. Stelmach
- Pulmonary Division; Heart Institute (InCor); University of São Paulo Medical School; São Paulo Brazil
| | - K. F. Rabe
- LungenClinic Grosshansdorf; Grosshansdorf Germany
- Airway Research Center North in the German Center for Lung Research (DZL)
| | - T. Mauad
- Department of Pathology; University of São Paulo Medical School; São Paulo Brazil
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70
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Pathinayake PS, Hsu ACY, Waters DW, Hansbro PM, Wood LG, Wark PAB. Understanding the Unfolded Protein Response in the Pathogenesis of Asthma. Front Immunol 2018; 9:175. [PMID: 29472925 PMCID: PMC5810258 DOI: 10.3389/fimmu.2018.00175] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/19/2018] [Indexed: 01/14/2023] Open
Abstract
Asthma is a heterogeneous, chronic inflammatory disease of the airways. It is a complex disease with different clinical phenotypes and results in a substantial socioeconomic burden globally. Poor understanding of pathogenic mechanisms of the disease hinders the investigation into novel therapeutics. Emerging evidence of the unfolded protein response (UPR) in the endoplasmic reticulum (ER) has demonstrated previously unknown functions of this response in asthma development. A worsening of asthmatic condition can be brought on by stimuli such as oxidative stress, pathogenic infections, and allergen exposure. All of which can induce ER stress and activate UPR leading to activation of different inflammatory responses and dysregulate the innate immune functions in the airways. The UPR as a central regulator of asthma pathogenesis may explain several unknown mechanism of the disease onset, which leads us in new directions for future asthma treatments. In this review, we summarize and discuss the causes and impact of ER–UPR in driving the pathogenesis of asthma and highlight its importance in clinical implications.
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Affiliation(s)
- Prabuddha S Pathinayake
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Alan C-Y Hsu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - David W Waters
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Peter A B Wark
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
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71
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Abstract
Bronchial thermoplasty is an innovative treatment for patients with severe asthma and chronic airflow obstruction with an established long-term efficacy and safety profile. This review focuses on the role of bronchial thermoplasty in severe asthma, its mechanism of action, appropriate patient selection, current evidence, and recent developments of this therapy.
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72
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Kuo CHS, Pavlidis S, Loza M, Baribaud F, Rowe A, Pandis I, Hoda U, Rossios C, Sousa A, Wilson SJ, Howarth P, Dahlen B, Dahlen SE, Chanez P, Shaw D, Krug N, Sandstrӧm T, De Meulder B, Lefaudeux D, Fowler S, Fleming L, Corfield J, Auffray C, Sterk PJ, Djukanovic R, Guo Y, Adcock IM, Chung KF. A Transcriptome-driven Analysis of Epithelial Brushings and Bronchial Biopsies to Define Asthma Phenotypes in U-BIOPRED. Am J Respir Crit Care Med 2017; 195:443-455. [PMID: 27580351 DOI: 10.1164/rccm.201512-2452oc] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
RATIONALE Asthma is a heterogeneous disease driven by diverse immunologic and inflammatory mechanisms. OBJECTIVES Using transcriptomic profiling of airway tissues, we sought to define the molecular phenotypes of severe asthma. METHODS The transcriptome derived from bronchial biopsies and epithelial brushings of 107 subjects with moderate to severe asthma were annotated by gene set variation analysis using 42 gene signatures relevant to asthma, inflammation, and immune function. Topological data analysis of clinical and histologic data was performed to derive clusters, and the nearest shrunken centroid algorithm was used for signature refinement. MEASUREMENTS AND MAIN RESULTS Nine gene set variation analysis signatures expressed in bronchial biopsies and airway epithelial brushings distinguished two distinct asthma subtypes associated with high expression of T-helper cell type 2 cytokines and lack of corticosteroid response (group 1 and group 3). Group 1 had the highest submucosal eosinophils, as well as high fractional exhaled nitric oxide levels, exacerbation rates, and oral corticosteroid use, whereas group 3 patients showed the highest levels of sputum eosinophils and had a high body mass index. In contrast, group 2 and group 4 patients had an 86% and 64% probability, respectively, of having noneosinophilic inflammation. Using machine learning tools, we describe an inference scheme using the currently available inflammatory biomarkers sputum eosinophilia and fractional exhaled nitric oxide levels, along with oral corticosteroid use, that could predict the subtypes of gene expression within bronchial biopsies and epithelial cells with good sensitivity and specificity. CONCLUSIONS This analysis demonstrates the usefulness of a transcriptomics-driven approach to phenotyping that segments patients who may benefit the most from specific agents that target T-helper cell type 2-mediated inflammation and/or corticosteroid insensitivity.
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Affiliation(s)
- Chih-Hsi Scott Kuo
- 1 Department of Computing.,2 Data Science Institute, and.,3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Stelios Pavlidis
- 1 Department of Computing.,2 Data Science Institute, and.,4 Janssen Research and Development, High Wycombe, United Kingdom
| | - Matthew Loza
- 4 Janssen Research and Development, High Wycombe, United Kingdom
| | - Fred Baribaud
- 4 Janssen Research and Development, High Wycombe, United Kingdom
| | - Anthony Rowe
- 4 Janssen Research and Development, High Wycombe, United Kingdom
| | - Ioannis Pandis
- 1 Department of Computing.,2 Data Science Institute, and
| | - Uruj Hoda
- 3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.,5 Biomedical Research Unit, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
| | - Christos Rossios
- 3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ana Sousa
- 6 Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, United Kingdom
| | - Susan J Wilson
- 7 Faculty of Medicine, Southampton University, Southampton, United Kingdom
| | - Peter Howarth
- 7 Faculty of Medicine, Southampton University, Southampton, United Kingdom
| | - Barbro Dahlen
- 8 Centre for Allergy Research, Karolinska Institute, Stockholm, Sweden
| | - Sven-Erik Dahlen
- 8 Centre for Allergy Research, Karolinska Institute, Stockholm, Sweden
| | | | - Dominick Shaw
- 10 Centre for Respiratory Research, University of Nottingham, Nottingham, United Kingdom
| | - Norbert Krug
- 11 Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
| | - Thomas Sandstrӧm
- 12 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertrand De Meulder
- 13 European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL, University of Lyon, Lyon, France
| | - Diane Lefaudeux
- 13 European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL, University of Lyon, Lyon, France
| | - Stephen Fowler
- 14 Centre for Respiratory Medicine and Allergy, University of Manchester, Manchester, United Kingdom
| | - Louise Fleming
- 3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.,5 Biomedical Research Unit, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
| | - Julie Corfield
- 15 AstraZeneca R&D, Molndal, Sweden.,16 Areteva R&D, Nottingham, United Kingdom; and
| | - Charles Auffray
- 13 European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL, University of Lyon, Lyon, France
| | - Peter J Sterk
- 17 Faculty of Medicine, University of Amsterdam, Amsterdam, the Netherlands
| | - Ratko Djukanovic
- 7 Faculty of Medicine, Southampton University, Southampton, United Kingdom
| | - Yike Guo
- 1 Department of Computing.,2 Data Science Institute, and
| | - Ian M Adcock
- 3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.,5 Biomedical Research Unit, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
| | - Kian Fan Chung
- 3 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.,5 Biomedical Research Unit, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
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73
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Royce SG, Rele S, Broughton BRS, Kelly K, Samuel CS. Intranasal administration of mesenchymoangioblast-derived mesenchymal stem cells abrogates airway fibrosis and airway hyperresponsiveness associated with chronic allergic airways disease. FASEB J 2017. [PMID: 28626025 DOI: 10.1096/fj.201700178r] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Structural changes known as airway remodeling (AWR) characterize chronic/severe asthma and contribute to lung dysfunction. Thus, we assessed the in vivo efficacy of induced pluripotent stem cell and mesenchymoangioblast-derived mesenchymal stem cells (MCA-MSCs) on AWR in a murine model of chronic allergic airways disease (AAD)/asthma. Female Balb/c mice were subjected to a 9-wk model of ovalbumin (Ova)-induced chronic AAD and treated intravenously or intranasally with MCA-MSCs from weeks 9 to 11. Changes in airway inflammation (AI), AWR, and airway hyperresponsiveness (AHR) were assessed. Ova-injured mice presented with AI, goblet cell metaplasia, epithelial thickening, increased airway TGF-β1 levels, subepithelial myofibroblast and collagen accumulation, total lung collagen concentration, and AHR (all P < 0.001 vs. uninjured control group). Apart from epithelial thickness, all other parameters measured were significantly, although not totally, decreased by intravenous delivery of MCA-MSCs to Ova-injured mice. In comparison, intranasal delivery of MCA-MSCs to Ova-injured mice significantly decreased all parameters measured (all P < 0.05 vs. Ova group) and, most notably, normalized aberrant airway TGF-β1 levels, airway/lung fibrosis, and AHR to values measured in uninjured animals. MCA-MSCs also increased collagen-degrading gelatinase levels. Hence, direct delivery of MCA-MSCs offers great therapeutic benefit for the AWR and AHR associated with chronic AAD.-Royce, S. G., Rele, S., Broughton, B. R. S., Kelly, K., Samuel, C. S. Intranasal administration of mesenchymoangioblast-derived mesenchymal stem cells abrogates airway fibrosis and airway hyperresponsiveness associated with chronic allergic airways disease.
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Affiliation(s)
- Simon G Royce
- Fibrosis Laboratory, Monash University, Clayton, Victoria, Australia; .,Department of Medicine, Central Clinical School, Monash University, Prahran, Victoria, Australia; and
| | - Siddharth Rele
- Fibrosis Laboratory, Monash University, Clayton, Victoria, Australia
| | - Brad R S Broughton
- Cardiovascular and Pulmonary Pharmacology Group, Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton, Victoria, Australia
| | - Kilian Kelly
- Cynata Therapeutics, Armadale, Victoria, Australia
| | - Chrishan S Samuel
- Fibrosis Laboratory, Monash University, Clayton, Victoria, Australia;
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74
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Zhao L, Li YY, Li CW, Chao SS, Liu J, Nam HN, Dung NTN, Shi L, Wang DY. Increase of poorly proliferated p63 + /Ki67 + basal cells forming multiple layers in the aberrant remodeled epithelium in nasal polyps. Allergy 2017; 72:975-984. [PMID: 27807867 DOI: 10.1111/all.13074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Aberrant epithelial remodeling with the ectopic expression of p63 (basal cell markers) is an important pathologic phenomenon seen in chronically inflamed airway epithelium such as in nasal polyps (NPs). METHODS Biopsies were obtained from 55 NP patients and 18 healthy controls (inferior turbinate). Among NP patients, 15 were treated with oral and nasal steroids, so that two sets of NP biopsies were taken before and after the treatments. p63, Ki67, type IV β-tubulin, and cell cycle markers were investigated in these specimens. RESULTS The number of p63+ cells is significantly higher in both hyperplastic (1.53-fold, P < 0.0001) and squamous metaplastic (2.02-fold, P < 0.0001) epithelium from NPs than from healthy controls. There are three types of proliferative basal cells (p63+ /Ki67+ ) which are in different phases of the cell cycle, such as G1 phase (type I cells), S to G2 phase (type II cells), and mitosis (type III cells). Of importance, some type I cells may arrest after proliferation although they may still be p63+ /Ki67+ . In healthy epithelium, the ratio of the type I and II cells is almost 50:50. However, less type II cells are found in hyperplastic epithelium (34.85%, P = 0.012) and in squamous metaplastic epithelium (30.77%, P = 0.02) together with the presence of type III cells (3.45%, P = 0.01). These findings were not changed after steroid treatments. CONCLUSIONS An increase of poorly proliferated basal cells forming multiple layers, which may stain for basal cell markers but does not form a proper epidermal barrier, is an important histopathologic phenomenon in aberrant remodeled epithelium of NPs.
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Affiliation(s)
- L. Zhao
- Department of Otolaryngology; The Second Hospital of Shandong University; Shandong University; Jinan China
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Y. Y. Li
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - C. W. Li
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - S. S. Chao
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - J. Liu
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - H. N. Nam
- Department of Otolaryngology; Pham Ngoc Thach University of Medicine; Ho Chi Minh City Vietnam
| | - N. T. N. Dung
- Department of Otolaryngology; Pham Ngoc Thach University of Medicine; Ho Chi Minh City Vietnam
| | - L. Shi
- Department of Otolaryngology; The Second Hospital of Shandong University; Shandong University; Jinan China
| | - D. Y. Wang
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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75
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Jiao D, Wong CK, Tsang MSM, Chu IMT, Liu D, Zhu J, Chu M, Lam CWK. Activation of Eosinophils Interacting with Bronchial Epithelial Cells by Antimicrobial Peptide LL-37: Implications in Allergic Asthma. Sci Rep 2017; 7:1848. [PMID: 28500314 PMCID: PMC5431911 DOI: 10.1038/s41598-017-02085-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 04/05/2017] [Indexed: 01/21/2023] Open
Abstract
The role of antimicrobial peptide LL-37 in asthma exacerbation is unclear. Microbial infection, which is the most common inducer of asthma exacerbation, is accompanied by elevated LL-37. The present study found that co-culture of eosinophils and bronchial epithelial cell line BEAS-2B significantly enhanced intercellular adhesion molecule-1 on both cells and CD18 expression on eosinophils upon LL-37 stimulation. IL-6, CXCL8 and CCL4 were substantially released in co-culture in the presence of LL-37. LL-37 triggered the activation of eosinophils interacting with BEAS-2B cells in a P2X purinoceptor 7/epidermal growth factor receptor-dependent manner. Eosinophils and BEAS-2B cells differentially contribute to the expression of cytokines/chemokines in co-culture, while soluble mediators were sufficient to mediate the intercellular interactions. Intracellular p38-mitogen-activated protein kinase, extracellular signal-regulated kinase and NF-κB signaling pathways were essential for LL-37-mediated activation of eosinophils and BEAS-2B cells. By using the ovalbumin-induced asthmatic model, intranasal administration of mCRAMP (mouse ortholog of LL-37) in combination with ovalbumin during the allergen challenge stage significantly enhanced airway hyperresponsiveness and airway inflammation in sensitized mice, thereby implicating a deteriorating role of LL-37 in allergic asthma. This study provides evidence of LL-37 in triggering asthma exacerbation via the activation of eosinophils interacting with bronchial epithelial cells in inflammatory airway.
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Affiliation(s)
- Delong Jiao
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Chun-Kwok Wong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China. .,Institute of Chinese Medicine and State Key Laboratory of Phytochemistry and Plant Resources in West China, the Chinese University of Hong Kong, Hong Kong, China. .,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
| | - Miranda Sin-Man Tsang
- Institute of Chinese Medicine and State Key Laboratory of Phytochemistry and Plant Resources in West China, the Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Ida Miu-Ting Chu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Dehua Liu
- Institute of Chinese Medicine and State Key Laboratory of Phytochemistry and Plant Resources in West China, the Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Jing Zhu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Man Chu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Christopher Wai-Kei Lam
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau, China
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76
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Berair R, Hartley R, Mistry V, Sheshadri A, Gupta S, Singapuri A, Gonem S, Marshall RP, Sousa AR, Shikotra A, Kay R, Wardlaw A, Bradding P, Siddiqui S, Castro M, Brightling CE. Associations in asthma between quantitative computed tomography and bronchial biopsy-derived airway remodelling. Eur Respir J 2017; 49:49/5/1601507. [PMID: 28461289 DOI: 10.1183/13993003.01507-2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/20/2017] [Indexed: 12/19/2022]
Abstract
Airway remodelling in asthma remains poorly understood. This study aimed to determine the association of airway remodelling measured on bronchial biopsies with 1) lung function impairment and 2) thoracic quantitative computed tomography (QCT)-derived morphometry and densitometry measures of proximal airway remodelling and air trapping.Subjects were recruited from a single centre. Bronchial biopsy remodelling features that were the strongest predictors of lung function impairment and QCT-derived proximal airway morphometry and air trapping markers were determined by stepwise multiple regression. The best predictor of air trapping was validated in an independent replication group.Airway smooth muscle % was the only predictor of post-bronchodilator forced expiratory volume in 1 s (FEV1) % pred, while both airway smooth muscle % and vascularity were predictors of FEV1/forced vital capacity. Epithelial thickness and airway smooth muscle % were predictors of mean segmental bronchial luminal area (R2=0.12; p=0.02 and R2=0.12; p=0.015), whereas epithelial thickness was the only predictor of wall area % (R2=0.13; p=0.018). Vascularity was the only significant predictor of air trapping (R2=0.24; p=0.001), which was validated in the replication group (R2=0.19; p=0.031).In asthma, airway smooth muscle content and vascularity were both associated with airflow obstruction. QCT-derived proximal airway morphometry was most strongly associated with epithelial thickness and airway smooth muscle content, whereas air trapping was related to vascularity.
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Affiliation(s)
- Rachid Berair
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.,These authors contributed equally to this work
| | - Ruth Hartley
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.,These authors contributed equally to this work
| | - Vijay Mistry
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Ajay Sheshadri
- Dept of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Sumit Gupta
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Sherif Gonem
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | | | | | - Aarti Shikotra
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Richard Kay
- Novartis Pharmaceuticals, Basel, Switzerland.,Medpace (UK) Ltd, Stirling, UK
| | - Andrew Wardlaw
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Peter Bradding
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Salman Siddiqui
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Mario Castro
- Dept of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher E Brightling
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
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77
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Yang M, Wang HY, Chen JC, Zhao J. Regulation of airway inflammation and remodeling in asthmatic mice by TLR3/TRIF signal pathway. Mol Immunol 2017; 85:265-272. [PMID: 28342933 DOI: 10.1016/j.molimm.2017.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/02/2017] [Accepted: 03/04/2017] [Indexed: 12/17/2022]
Abstract
This paper aims to investigate the effect of Toll-like receptors 3 (TLR3)/TIR-domain-containing adapter-inducing interferon-β (TRIF) signal pathway on the airway inflammation and remodeling in asthmatic mice. C57BL/6 and TLR3-/- mice were randomly divided into three groups (10 mice per group), including Control group (mice inhaled phosphate buffer saline (PBS)), Asthma group (mice inhaled ovalbumin (OVA)) and polyriboinosinic-ribocytidylic acid (poly (I: C)) group (asthmatic mice were injected intraperitoneally with TLR3 agonist poly (I: C)). Hematoxylin-eosin (HE) staining, Wright-Giemsa staining, Enzyme-linked immunosorbent assay (ELISA), Immunohistochemistry, Hydroxyproline assay, quantitative real time polymerase chain reaction (qRT-PCR) and Western blot were used to assess for the indices of airway inflammation and remodeling. In terms of WT mice, all asthma groups with or without the addition of poly (I: C) showed exaggerated inflammation and remodeling in the airways as compared to Control group, which were more seriously in poly (I: C) group than Asthma group. Furthermore, we observed the significant inhibition of airway inflammation and remodeling in the TLR3-/- mice in both Asthma no matter with or without addition of poly (I: C) than the WT mice. TLR3 knockout could obviously relieve the airway inflammation and remodeling in asthma through inhibiting TLR3/TRIF signaling pathway.
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Affiliation(s)
- Mei Yang
- Department of critical care medicine, The Third People's Hospital of Jinan, Jinan 250132, Shandong, PR China.
| | - Hao-Ying Wang
- Department of critical care medicine, The Third People's Hospital of Jinan, Jinan 250132, Shandong, PR China
| | - Jian-Chang Chen
- Department of emergency, Shandong Provincial Western Hospital, Jinan 250021, Shandong, PR China
| | - Jing Zhao
- Department of cardiology, Qilu Hospital Affiliated to Shandong University, Jinan 250012, PR China
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78
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Shikotra A, Choy DF, Siddiqui S, Arthur G, Nagarkar DR, Jia G, Wright AKA, Ohri CM, Doran E, Butler CA, Hargadon B, Abbas AR, Jackman J, Wu LC, Heaney LG, Arron JR, Bradding P. A CEACAM6-High Airway Neutrophil Phenotype and CEACAM6-High Epithelial Cells Are Features of Severe Asthma. THE JOURNAL OF IMMUNOLOGY 2017; 198:3307-3317. [PMID: 28275137 DOI: 10.4049/jimmunol.1600606] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 02/06/2017] [Indexed: 12/27/2022]
Abstract
Severe asthma represents a major unmet clinical need; understanding the pathophysiology is essential for the development of new therapies. Using microarray analysis, we previously found three immunological clusters in asthma: Th2-high, Th17-high, and Th2/17-low. Although new therapies are emerging for Th2-high disease, identifying molecular pathways in Th2-low disease remains an important goal. Further interrogation of our previously described microarray dataset revealed upregulation of gene expression for carcinoembryonic Ag cell adhesion molecule (CEACAM) family members in the bronchi of patients with severe asthma. Our aim was therefore to explore the distribution and cellular localization of CEACAM6 using immunohistochemistry on bronchial biopsy tissue obtained from patients with mild-to-severe asthma and healthy control subjects. Human bronchial epithelial cells were used to investigate cytokine and corticosteroid in vitro regulation of CEACAM6 gene expression. CEACAM6 protein expression in bronchial biopsies was increased in airway epithelial cells and lamina propria inflammatory cells in severe asthma compared with healthy control subjects. CEACAM6 in the lamina propria was localized to neutrophils predominantly. Neutrophil density in the bronchial mucosa was similar across health and the spectrum of asthma severity, but the percentage of neutrophils expressing CEACAM6 was significantly increased in severe asthma, suggesting the presence of an altered neutrophil phenotype. CEACAM6 gene expression in cultured epithelial cells was upregulated by wounding and neutrophil elastase. In summary, CEACAM6 expression is increased in severe asthma and primarily associated with airway epithelial cells and tissue neutrophils. CEACAM6 may contribute to the pathology of treatment-resistant asthma via neutrophil and airway epithelial cell-dependent pathways.
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Affiliation(s)
- Aarti Shikotra
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester LE3 9QP, United Kingdom
| | | | - Salman Siddiqui
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester LE3 9QP, United Kingdom
| | - Greer Arthur
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester LE3 9QP, United Kingdom
| | | | - Guiquan Jia
- Genentech, Inc., South San Francisco, CA 94080
| | - Adam K A Wright
- University Hospitals of Leicester National Health Service Trust, Glenfield Hospital, Leicester LE3 9QP, United Kingdom; and
| | - Chandra M Ohri
- University Hospitals of Leicester National Health Service Trust, Glenfield Hospital, Leicester LE3 9QP, United Kingdom; and
| | - Emma Doran
- Centre for Infection and Immunity, Queen's University Belfast, Belfast BT9 7AE, United Kingdom
| | - Claire A Butler
- Centre for Infection and Immunity, Queen's University Belfast, Belfast BT9 7AE, United Kingdom
| | - Beverley Hargadon
- University Hospitals of Leicester National Health Service Trust, Glenfield Hospital, Leicester LE3 9QP, United Kingdom; and
| | | | | | - Lawren C Wu
- Genentech, Inc., South San Francisco, CA 94080
| | - Liam G Heaney
- Centre for Infection and Immunity, Queen's University Belfast, Belfast BT9 7AE, United Kingdom
| | | | - Peter Bradding
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester LE3 9QP, United Kingdom;
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79
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Asthma Yardstick. Ann Allergy Asthma Immunol 2017; 118:133-142.e3. [DOI: 10.1016/j.anai.2016.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 01/13/2023]
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80
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Tian BP, Xia LX, Bao ZQ, Zhang H, Xu ZW, Mao YY, Cao C, Che LQ, Liu JK, Li W, Chen ZH, Ying S, Shen HH. Bcl-2 inhibitors reduce steroid-insensitive airway inflammation. J Allergy Clin Immunol 2016; 140:418-430. [PMID: 28043871 DOI: 10.1016/j.jaci.2016.11.027] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 09/12/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Asthmatic inflammation is dominated by accumulation of either eosinophils, neutrophils, or both in the airways. Disposal of these inflammatory cells is the key to disease control. Eosinophilic airway inflammation is responsive to corticosteroid treatment, whereas neutrophilic inflammation is resistant and increases the burden of global health care. Corticosteroid-resistant neutrophilic asthma remains mechanistically poorly understood and requires novel effective therapeutic strategies. OBJECTIVE We sought to explore the underlying mechanisms of airway inflammation persistence, as well as corticosteroid resistance, and to investigate a new strategy of effective treatment against corticosteroid-insensitive neutrophilic asthma. METHODS Mouse models of either eosinophil-dominated or neutrophil-dominated airway inflammation were used in this study to test corticosteroid sensitivity in vivo and in vitro. We also used vav-Bcl-2 transgenic mice to confirm the importance of granulocytes apoptosis in the clearance of airway inflammation. Finally, the Bcl-2 inhibitors ABT-737 or ABT-199 were tested for their therapeutic effects against eosinophilic or neutrophilic airway inflammation and airway hyperresponsiveness. RESULTS Overexpression of Bcl-2 protein was found to be responsible for persistence of granulocytes in bronchoalveolar lavage fluid after allergic challenge. This was important because allergen-induced airway inflammation aggravated and persisted in vav-Bcl-2 transgenic mice, in which nucleated hematopoietic cells were overexpressed with Bcl-2 and resistant to apoptosis. The Bcl-2 inhibitors ABT-737 or ABT-199 play efficient roles in alleviation of either eosinophilic or corticosteroid-resistant neutrophilic airway inflammation by inducing apoptosis of immune cells, such as eosinophils, neutrophils, TH2 cells, TH17 cells, and dendritic cells. Moreover, these inhibitors were found to be more efficient than steroids to induce granulocyte apoptosis ex vivo from patients with severe asthma. CONCLUSION Apoptosis of inflammatory cells is essential for clearance of allergen-induced airway inflammation. The Bcl-2 inhibitors ABT-737 or ABT-199 might be promising drugs for the treatment of airway inflammation, especially for corticosteroid-insensitive neutrophilic airway inflammation.
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Affiliation(s)
- Bao-Ping Tian
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Li-Xia Xia
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Zheng-Qiang Bao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China; Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China
| | - Hao Zhang
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Zhi-Wei Xu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China; Department of Critical Care Medicine, Ningbo Medical Center, Lihuili Hospital, Ningbo University, Ningbo, China
| | - Yuan-Yuan Mao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Chao Cao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Luan-Qing Che
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Jin-Kai Liu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Wen Li
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Zhi-Hua Chen
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China
| | - Songmin Ying
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China; Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China.
| | - Hua-Hao Shen
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Site of National Clinical Research Center for Respiratory Disease, Hangzhou, China; State Key Laboratory of Respiratory Diseases, Guangzhou, China.
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81
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Liu Y, Pu Y, Li D, Zhou L, Wan L. Azithromycin ameliorates airway remodeling via inhibiting airway epithelium apoptosis. Life Sci 2016; 170:1-8. [PMID: 27916734 DOI: 10.1016/j.lfs.2016.11.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/17/2016] [Accepted: 11/25/2016] [Indexed: 02/05/2023]
Abstract
AIMS Azithromycin can benefit treating allergic airway inflammation and remodeling. In the present study, we hypothesized that azithromycin alleviated airway epithelium injury through inhibiting airway epithelium apoptosis via down regulation of caspase-3 and Bax/Bcl2 ratio in vivo and in vitro. MAIN METHODS Ovalbumin induced rat asthma model and TGF-β1-induced BEAS-2B cell apoptosis model were established, respectively. In vivo experiments, airway epithelium was stained with hematoxylin and eosin (HE) and periodic acid-Schiff (PAS) to histologically evaluate the airway inflammation and remodeling. Airway epithelium apoptotic index (AI) was further analyzed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), while expression of apoptosis related gene (Bax, Bcl2, Caspase-3) in lungs were measured by qRT-PCR and western blotting, respectively. In vitro experiments, apoptosis were evaluated by Flow cytometry (FCM) and TUNEL. Above apoptosis related gene were also measured by qRT-PCR and western blotting. KEY FINDINGS Compared with the OVA group, azithromycin significantly reduced the inflammation score, peribronchial smooth muscle layer thickness, epithelial thickening and goblet cell metaplasia (P<0.05), and effectively suppressed AI of airway epithelium (P<0.05). Moreover, the increasing mRNA and protein expressions of Caspase-3 and Bax/Bcl-2 ratio in lung tissue were all significantly decreased in azithromycin-treated rats (P<0.05). In vitro, azithromycin significantly suppressed TGF-β1-induced BEAS-2B cells apoptosis (P<0.05) and reversed TGF-β1 elevated Caspase-3 mRNA level and Bax/Bcl-2 ratio (P<0.05). SIGNIFICANCE Azithromycin is an attractive treatment option for reducing airway epithelial cell apoptosis by improving the imbalance of Bax/Bcl-2 ratio and inhibiting Caspase-3 level in airway epithelium.
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Affiliation(s)
- Yuanqi Liu
- Department of Pharmacology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China; Sichuan University "985 project -- Science and Technology Innovation Platform for Novel Drug Development", Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yue Pu
- Department of Pharmacology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China; Sichuan University "985 project -- Science and Technology Innovation Platform for Novel Drug Development", Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Diandian Li
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Liming Zhou
- Department of Pharmacology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China; Sichuan University "985 project -- Science and Technology Innovation Platform for Novel Drug Development", Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Lihong Wan
- Department of Pharmacology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China; Sichuan University "985 project -- Science and Technology Innovation Platform for Novel Drug Development", Sichuan University, Chengdu, Sichuan 610041, PR China.
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82
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Fitzpatrick AM. Severe Asthma in Children: Lessons Learned and Future Directions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 4:11-9; quiz 20-1. [PMID: 26772923 DOI: 10.1016/j.jaip.2015.10.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/14/2015] [Accepted: 10/16/2015] [Indexed: 01/02/2023]
Abstract
Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.
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Affiliation(s)
- Anne M Fitzpatrick
- Department of Pediatrics, Emory University, Atlanta, Ga; Children's Healthcare of Atlanta Center for Cystic Fibrosis and Airways Disease Research, Atlanta, Ga.
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83
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Kim HJ, Lee J, Kim JH, Park SY, Kwon HS, Kim TB, Moon HB, Cho YS. Factors Affecting Recovery Time of Pulmonary Function in Hospitalized Patients With Acute Asthma Exacerbations. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:499-504. [PMID: 27582400 PMCID: PMC5011049 DOI: 10.4168/aair.2016.8.6.499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/15/2016] [Accepted: 03/25/2016] [Indexed: 12/26/2022]
Abstract
Purpose Prolonged recovery time of pulmonary function after an asthma exacerbation is a significant burden on asthmatics, and management of these patients needs to be improved. The aim of this study was to evaluate factors associated with a longer recovery time of pulmonary function among asthmatic patients hospitalized due to a severe asthma exacerbation. Methods We retrospectively reviewed the medical records of 89 patients who were admitted for the management of acute asthma exacerbations. The recovery time of pulmonary function was defined as the time from the date each patient initially received treatment for asthma exacerbations to the date the patient reached his or her previous best FEV1% value. We investigated the influence of various clinical and laboratory factors on the recovery time. Results The median recovery time of the patients was 1.7 weeks. Multiple linear regression analysis revealed that using regular inhaled corticosteroids (ICS) before an acute exacerbation of asthma and concurrent with viral infection at admission were associated with the prolonged recovery time of pulmonary function. Conclusions The prolonged recovery time of pulmonary function after a severe asthma exacerbation was not shown to be directly associated with poor adherence to ICS. Therefore the results indicate that an unknown subtype of asthma may be associated with the prolonged recovery of pulmonary function time after an acute exacerbation of asthma despite regular ICS use. Further prospective studies to investigate factors affecting the recovery time of pulmonary function after an asthma exacerbation are warranted.
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Affiliation(s)
- Hyo Jung Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaemoon Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hyun Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Young Park
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Bom Moon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You Sook Cho
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Urbanek K, De Angelis A, Spaziano G, Piegari E, Matteis M, Cappetta D, Esposito G, Russo R, Tartaglione G, De Palma R, Rossi F, D’Agostino B. Intratracheal Administration of Mesenchymal Stem Cells Modulates Tachykinin System, Suppresses Airway Remodeling and Reduces Airway Hyperresponsiveness in an Animal Model. PLoS One 2016; 11:e0158746. [PMID: 27434719 PMCID: PMC4951036 DOI: 10.1371/journal.pone.0158746] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/21/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The need for new options for chronic lung diseases promotes the research on stem cells for lung repair. Bone marrow-derived mesenchymal stem cells (MSCs) can modulate lung inflammation, but the data on cellular processes involved in early airway remodeling and the potential involvement of neuropeptides are scarce. OBJECTIVES To elucidate the mechanisms by which local administration of MSCs interferes with pathophysiological features of airway hyperresponsiveness in an animal model. METHODS GFP-tagged mouse MSCs were intratracheally delivered in the ovalbumin mouse model with subsequent functional tests, the analysis of cytokine levels, neuropeptide expression and histological evaluation of MSCs fate and airway pathology. Additionally, MSCs were exposed to pro-inflammatory factors in vitro. RESULTS Functional improvement was observed after MSC administration. Although MSCs did not adopt lung cell phenotypes, cell therapy positively affected airway remodeling reducing the hyperplastic phase of the gain in bronchial smooth muscle mass, decreasing the proliferation of epithelium in which mucus metaplasia was also lowered. Decrease of interleukin-4, interleukin-5, interleukin-13 and increase of interleukin-10 in bronchoalveolar lavage was also observed. Exposed to pro-inflammatory cytokines, MSCs upregulated indoleamine 2,3-dioxygenase. Moreover, asthma-related in vivo upregulation of pro-inflammatory neurokinin 1 and neurokinin 2 receptors was counteracted by MSCs that also determined a partial restoration of VIP, a neuropeptide with anti-inflammatory properties. CONCLUSION Intratracheally administered MSCs positively modulate airway remodeling, reduce inflammation and improve function, demonstrating their ability to promote tissue homeostasis in the course of experimental allergic asthma. Because of a limited tissue retention, the functional impact of MSCs may be attributed to their immunomodulatory response combined with the interference of neuropeptide system activation and tissue remodeling.
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MESH Headings
- Animals
- Bronchoalveolar Lavage Fluid/chemistry
- Bronchoalveolar Lavage Fluid/immunology
- Gene Expression
- Genes, Reporter
- Green Fluorescent Proteins/genetics
- Green Fluorescent Proteins/metabolism
- Indoleamine-Pyrrole 2,3,-Dioxygenase/genetics
- Indoleamine-Pyrrole 2,3,-Dioxygenase/immunology
- Interleukin-10/genetics
- Interleukin-10/immunology
- Interleukin-13/genetics
- Interleukin-13/immunology
- Interleukin-4/genetics
- Interleukin-4/immunology
- Interleukin-5/genetics
- Interleukin-5/immunology
- Intubation, Intratracheal
- Lung/immunology
- Lung/pathology
- Mesenchymal Stem Cell Transplantation
- Mesenchymal Stem Cells/cytology
- Mesenchymal Stem Cells/immunology
- Mice
- Mice, Inbred BALB C
- Ovalbumin
- Receptors, Neurokinin-1/genetics
- Receptors, Neurokinin-1/immunology
- Receptors, Neurokinin-2/genetics
- Receptors, Neurokinin-2/immunology
- Respiratory Hypersensitivity/chemically induced
- Respiratory Hypersensitivity/immunology
- Respiratory Hypersensitivity/pathology
- Respiratory Hypersensitivity/therapy
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Affiliation(s)
- Konrad Urbanek
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Antonella De Angelis
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
- * E-mail: (AA); (BA)
| | - Giuseppe Spaziano
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Elena Piegari
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Maria Matteis
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Donato Cappetta
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Grazia Esposito
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Rosa Russo
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Gioia Tartaglione
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Raffaele De Palma
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Bruno D’Agostino
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
- * E-mail: (AA); (BA)
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Bronchial thermoplasty and biological therapy as targeted treatments for severe uncontrolled asthma. THE LANCET RESPIRATORY MEDICINE 2016; 4:585-592. [PMID: 27230825 DOI: 10.1016/s2213-2600(16)30018-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/08/2016] [Accepted: 03/15/2016] [Indexed: 01/08/2023]
Abstract
Although a small proportion of patients with asthma have severe disease, it accounts for the majority of morbidity related to the illness. Severe asthma comprises a heterogeneous group of phenotypes. Targeted treatments for these phenotypes represent a major advancement in the management of severe asthma. Omalizumab, a monoclonal antibody to IgE, improves asthma control in patients with a predominant allergic phenotype. Monoclonal antibodies targeted to interleukin 4α and interleukin 5 have shown substantial benefit in patients with the eosinophilic asthma phenotype; so too have monoclonal antibodies targeted to interleukin 13 in patients with a type 2 allergic phenotype. Bronchial thermoplasty, a new technique to reduce airway smooth muscle mass, improves symptoms and reduces exacerbations in patients with severe uncontrolled asthma and the chronic airflow obstruction phenotype. While awaiting comparative trials, we can now use a targeted approach with these phenotypes, guiding our treatment selection with the best evidence. This Review will focus on the latest developments in these new treatments and inform the clinician on how to select the appropriate patient for these treatments.
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86
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Chung KF. Asthma phenotyping: a necessity for improved therapeutic precision and new targeted therapies. J Intern Med 2016; 279:192-204. [PMID: 26076339 DOI: 10.1111/joim.12382] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Asthma is a common heterogeneous disease with a complex pathophysiology that carries a significant mortality rate and high morbidity. Current therapies based on inhaled corticosteroids and long-acting β-agonists remain effective in a large proportion of patients with asthma, but ~10% (considered to have 'severe asthma') do not respond to these treatments even at high doses or with the use of oral corticosteroids. Analytical clustering methods have revealed phenotypes that include dependence on high-dose corticosteroid treatment, severe airflow obstruction and recurrent exacerbations associated with an allergic background and late onset of disease. One severe phenotype is eosinophilic inflammation-predominant asthma, with late-onset disease, rhinosinusitis, aspirin sensitivity and exacerbations. Blood and sputum eosinophilia have been used to distinguish patients with high Th2 inflammation and to predict therapeutic response to treatments targeted towards Th2-associated cytokines. New therapies in the form of humanized antibodies against Th2 targets, such as anti-IgE, anti-IL4Rα, anti-IL-5 and anti-IL-13 antibodies, have shown encouraging results in terms of reduction in exacerbations and improvement in airflow in patients with a 'Th2-high' expression profile and blood eosinophilia. Research efforts are now focusing on elucidating the phenotypes underlying the non-Th2-high (or Th2-low) group, which constitutes ~50% of severe asthma cases. There is an increasing need to use biomarkers to indicate the group of patients who will respond to a specifically targeted treatment. The use of improved tools to measure activity of disease, a better definition of severe asthma and the delineation of inflammatory pathways with omics analyses using computational tools, will lead to better-defined phenotypes for specific therapies.
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Affiliation(s)
- Kian Fan Chung
- Airway Disease Section, National Heart and Lung Institute, Imperial College London, London, UK.,National Institute for Health Research (NIHR), Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College London, London, UK
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87
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High mobility group box 1-induced epithelial mesenchymal transition in human airway epithelial cells. Sci Rep 2016; 6:18815. [PMID: 26739898 PMCID: PMC4703978 DOI: 10.1038/srep18815] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/13/2015] [Indexed: 12/31/2022] Open
Abstract
Epithelial–mesenchymal transition (EMT) is implicated in bronchial remodeling and loss of lung function in chronic inflammatory airway diseases. Previous studies showed the involvement of the high mobility group box 1 (HMGB1) protein in the pathology of chronic pulmonary inflammatory diseases. However, the role of HMGB1 in EMT of human airway epithelial cells is still unclear. In this study, we used RNA sequencing to show that HMGB1 treatment regulated EMT-related gene expression in human primary-airway epithelial cells. The top five upregulated genes were SNAI2, FGFBP1, VIM, SPARC (osteonectin), and SERPINE1, while the downregulated genes included OCLN, TJP1 (ZO-1), FZD7, CDH1 (E-cadherin), and LAMA5. We found that HMGB1 induced downregulation of E-cadherin and ZO-1, and upregulation of vimentin mRNA transcription and protein translation in a dose-dependent manner. Additionally, we observed that HMGB1 induced AKT phosphorylation, resulting in GSK3β inactivation, cytoplasmic accumulation, and nuclear translocation of β-catenin to induce EMT in human airway epithelial cells. Treatment with PI3K inhibitor (LY294006) and β-catenin shRNA reversed HMGB1-induced EMT. Moreover, HMGB1 induced expression of receptor for advanced glycation products (RAGE), but not that of Toll-like receptor (TLR) 2 or TLR4, and RAGE shRNA inhibited HMGB1-induced EMT in human airway epithelial cells. In conclusion, we found that HMGB1 induced EMT through RAGE and the PI3K/AKT/GSK3β/β-catenin signaling pathway.
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88
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Protein-protein interaction network analysis and identifying regulation microRNAs in asthmatic children. Allergol Immunopathol (Madr) 2015; 43:584-92. [PMID: 25979194 DOI: 10.1016/j.aller.2015.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/25/2014] [Accepted: 01/14/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Asthma is a chronic inflammatory airway disease, the incidence of which has increased recently. In order to identify the potential biomarkers for allergic asthma therapy, microarray data were analysed to find meaningful information. METHODS Microarray data GSE18965 were downloaded from Gene Expression Ominibus (GEO), including seven asthmatic epithelium samples from children with allergic asthma and nine healthy controls. Limma package was used to detect differentially expressed genes (DEGs) and the criteria were |log fold change|>0.5 and p value<0.05. We used Database for Annotation, Visualization and Integrated Discovery (DAVID) tool to perform GO function and KEGG pathway analysis. STRING database was used to construct protein-protein interaction (PPI) network. MicroRNA (miRNA) regulation network was constructed according to miRecords database. RESULTS We identified 274 DEGs in asthma epithelium samples comparing with healthy controls. There were 123 up-regulated DEGs and 151 down-regulated DEGs. PPI network analysis showed that TSPO, G6PD and TXN had higher degree. miRNA regulation network demonstrated that miR-16 and miR-15a had higher degree. The target genes of miRNAs were significantly enriched in the apoptosis function. CONCLUSIONS TSPO, G6PD and TXN, miR-16, miR-15a and apoptosis may be used as the targets for children's allergic asthma therapy.
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89
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Effect of Reducing Field of View on Multidetector Quantitative Computed Tomography Parameters of Airway Wall Thickness in Asthma. J Comput Assist Tomogr 2015; 39:584-90. [PMID: 25938213 DOI: 10.1097/rct.0000000000000238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We reduced the computed tomography (CT)-reconstructed field of view (FOV), increasing pixel density across airway structures and reducing partial volume effects, to determine whether this would improve accuracy of airway wall thickness quantification. METHODS We performed CT imaging on a lung phantom and 29 participants. Images were reconstructed at 30-, 15-, and 10-cm FOV using a medium-smooth kernel. Cross-sectional airway dimensions were compared at each FOV with repeated-measures analysis of variance. RESULTS Phantom measurements were more accurate when FOV decreased from 30 to 15 cm (P < 0.05). Decreasing FOV further to 10 cm did not significantly improve accuracy. Human airway measurements similarly decreased by decreasing FOV (P < 0.001). Percent changes in all measurements when reducing FOV from 30 to 15 cm were less than 3%. CONCLUSIONS Airway measurements at 30-cm FOV are near the limits of CT resolution using a medium-smooth kernel. Reducing reconstructed FOV would minimally increase sensitivity to detect differences in airway dimensions.
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90
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Behndig AF, Shanmuganathan K, Whitmarsh L, Stenfors N, Brown JL, Frew AJ, Kelly FJ, Mudway IS, Sandström T, Wilson SJ. Effects of controlled diesel exhaust exposure on apoptosis and proliferation markers in bronchial epithelium - an in vivo bronchoscopy study on asthmatics, rhinitics and healthy subjects. BMC Pulm Med 2015; 15:99. [PMID: 26303256 PMCID: PMC4547420 DOI: 10.1186/s12890-015-0096-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 08/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological evidence demonstrates that exposure to traffic-derived pollution worsens respiratory symptoms in asthmatics, but controlled human exposure studies have failed to provide a mechanism for this effect. Here we investigated whether diesel exhaust (DE) would induce apoptosis or proliferation in the bronchial epithelium in vivo and thus contribute to respiratory symptoms. METHODS Moderate (n = 16) and mild (n = 16) asthmatics, atopic non-asthmatic controls (rhinitics) (n = 13) and healthy controls (n = 21) were exposed to filtered air or DE (100 μg/m(3)) for 2 h, on two separate occasions. Bronchial biopsies were taken 18 h post-exposure and immunohistochemically analysed for pro-apoptotic and anti-apoptotic proteins (Bad, Bak, p85 PARP, Fas, Bcl-2) and a marker of proliferation (Ki67). Positive staining was assessed within the epithelium using computerized image analysis. RESULTS No evidence of epithelial apoptosis or proliferation was observed in healthy, allergic or asthmatic airways following DE challenge. CONCLUSION In the present study, we investigated whether DE exposure would affect markers of proliferation and apoptosis in the bronchial epithelium of asthmatics, rhinitics and healthy controls, providing a mechanistic basis for the reported increased airway sensitivity in asthmatics to air pollutants. In this first in vivo exposure investigation, we found no evidence of diesel exhaust-induced effects on these processes in the subject groups investigated.
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Affiliation(s)
- Annelie F Behndig
- Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden.
| | - Karthika Shanmuganathan
- Histochemistry Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Laura Whitmarsh
- Histochemistry Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Nikolai Stenfors
- Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden.
| | - Joanna L Brown
- Histochemistry Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Anthony J Frew
- Histochemistry Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Frank J Kelly
- MRC - PHE Centre for Environment and Health, Franklin-Wilkins Building, King's College London, London, UK.
| | - Ian S Mudway
- MRC - PHE Centre for Environment and Health, Franklin-Wilkins Building, King's College London, London, UK.
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden.
| | - Susan J Wilson
- Histochemistry Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. .,Histochemistry Research Unit, Sir Henry Wellcome Laboratories, Mailpoint 894, Level B, South Block, Southampton General Hospital, Tremona Road, Southampton, UK.
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Sumino K, Sheshadri A, Castro M. Calcium channel blocker reduces airway remodeling-or does it? Am J Respir Crit Care Med 2015; 191:863-4. [PMID: 25876196 DOI: 10.1164/rccm.201502-0322ed] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kaharu Sumino
- 1 Division of Pulmonary and Critical Care Medicine Washington University School of Medicine Saint Louis, Missouri and
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Haj-Salem I, Fakhfakh R, Bérubé JC, Jacques E, Plante S, Simard MJ, Bossé Y, Chakir J. MicroRNA-19a enhances proliferation of bronchial epithelial cells by targeting TGFβR2 gene in severe asthma. Allergy 2015; 70:212-9. [PMID: 25443138 DOI: 10.1111/all.12551] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Allergic asthma is characterized by inflammation and airway remodeling. Bronchial epithelium is considered a key player in coordinating airway wall remodeling. In mild asthma, the epithelium is damaged and fails to proliferate and to repair, whereas in severe asthma, the epithelium is highly proliferative and thicker. This may be due to different regulatory mechanisms. The purpose of our study was to determine the role of miRNAs in regulating proliferation of bronchial epithelial cells obtained from severe asthmatic subjects in comparison with cells obtained from mild asthmatics and healthy controls. METHODS Human bronchial epithelial cells (BEC) were isolated by bronchoscopy from bronchial biopsies of healthy donors and patients with mild and severe asthma. MiRNA expression was evaluated using the TaqMan low-density arrays and qRT-PCR. Transfection studies of bronchial epithelial cells were performed to determine the target genes. Cell proliferation was evaluated by BrdU incorporation test. RESULTS MiR-19a was upregulated in epithelia of severe asthmatic subjects compared with cells from mild asthmatics and healthy controls. Functional studies based on luciferase reporter and Western blot assays suggest that miR-19a enhances cell proliferation of BEC in severe asthma through targeting TGF-β receptor 2 mRNA. Moreover, repressed expression of miR-19a increased SMAD3 phosphorylation through TGF-β receptor 2 signaling and abrogated BEC proliferation. CONCLUSION Our study uncovers a new regulatory pathway involving miR-19a that is critical to the severe phenotype of asthma and indicates that downregulating miR-19a expression could be explored as a potential new therapy to modulate epithelium repair in asthma.
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Affiliation(s)
- I. Haj-Salem
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - R. Fakhfakh
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - J.-C. Bérubé
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - E. Jacques
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - S. Plante
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - M. J. Simard
- St-Patrick Research Group in Basic Oncology; Hôtel-Dieu de Québec (Centre Hospitalier Universitaire de Québec); Laval University; Cancer Research Center; Quebec City Québec Canada
| | - Y. Bossé
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
| | - J. Chakir
- Centre de recherche; Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Québec Canada
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Tay HL, Plank M, Collison A, Mattes J, Kumar RK, Foster PS. MicroRNA: potential biomarkers and therapeutic targets for allergic asthma? Ann Med 2014; 46:633-9. [PMID: 25307360 DOI: 10.3109/07853890.2014.958196] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
MicroRNAs are small non-coding RNAs that bind to multiple target mRNAs to control gene expression post-transcriptionally by inhibiting translation. In mammalian cells, microRNAs play important roles in a diverse array of cellular processes (e.g. cell proliferation and differentiation). However, alterations in their levels may compromise cellular function, predisposing to disease. In this review, we discuss microRNAs that have been linked with pathogenesis of asthma and propose functional roles in the regulation of disease. MicroRNAs have the potential to be biomarkers for asthma and provide the platform for the development of new classes of therapeutic compounds.
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Affiliation(s)
- Hock L Tay
- Priority Research Centre for Asthma and Respiratory Disease, Department of Microbiology and Immunology, School of Pharmacy and Biomedical Sciences, Faculty of Health and Hunter Medical Research Institute, University of Newcastle , Newcastle 2308 , Australia
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95
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Trejo Bittar HE, Yousem SA, Wenzel SE. Pathobiology of severe asthma. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2014; 10:511-45. [PMID: 25423350 DOI: 10.1146/annurev-pathol-012414-040343] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Severe asthma (SA) afflicts a heterogeneous group of asthma patients who exhibit poor responses to traditional asthma medications. SA patients likely represent 5-10% of all asthma patients; however, they have a higher economic burden when compared with milder asthmatics. Considerable research has been performed on pathological pathways and structural changes associated with SA. Although limitations of the pathological approaches, ranging from sampling, to quantitative assessments, to heterogeneity of disease, have prevented a more definitive understanding of the underlying pathobiology, studies linking pathology to molecular markers to targeted therapies are beginning to solidify the identification of select molecular phenotypes. This review addresses the pathobiology of SA and discusses the current limitations of studies, the inflammatory cells and pathways linked to emerging phenotypes, and the structural and remodeling changes associated with severe disease. In all cases, an effort is made to link pathological findings to specific clinical/molecular phenotypes.
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96
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Alcala SE, Benton AS, Watson AM, Kureshi S, Reeves EMK, Damsker J, Wang Z, Nagaraju K, Anderson J, Williams AM, Lee AJY, Hayes K, Rose MC, Hoffman EP, Freishtat RJ. Mitotic asynchrony induces transforming growth factor-β1 secretion from airway epithelium. Am J Respir Cell Mol Biol 2014; 51:363-9. [PMID: 24669775 DOI: 10.1165/rcmb.2013-0396oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We recently proposed that mitotic asynchrony in repairing tissue may underlie chronic inflammation and fibrosis, where immune cell infiltration is secondary to proinflammatory cross-talk among asynchronously repairing adjacent tissues. Building on our previous finding that mitotic asynchrony is associated with proinflammatory/fibrotic cytokine secretion (e.g., transforming growth factor [TGF]-β1), here we provide evidence supporting cause-and-effect. Under normal conditions, primary airway epithelial basal cell populations undergo mitosis synchronously and do not secrete proinflammatory or profibrotic cytokines. However, when pairs of nonasthmatic cultures were mitotically synchronized at 12 hours off-set and then combined, the mixed cell populations secreted elevated levels of TGF-β1. This shows that mitotic asynchrony is not only associated with but is also causative of TGF-β1 secretion. The secreted cytokines and other mediators from asthmatic cells were not the cause of asynchronous regeneration; synchronously mitotic nonasthmatic epithelia exposed to conditioned media from asthmatic cells did not show changes in mitotic synchrony. We also tested if resynchronization of regenerating asthmatic airway epithelia reduces TGF-β1 secretion and found that pulse-dosed dexamethasone, simvastatin, and aphidicolin were all effective. We therefore propose a new model for chronic inflammatory and fibrotic conditions where an underlying factor is mitotic asynchrony.
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97
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Critical review of bronchial thermoplasty: where should it fit into asthma therapy? Curr Allergy Asthma Rep 2014; 14:470. [PMID: 25189294 DOI: 10.1007/s11882-014-0470-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Bronchial thermoplasty is a device-based therapy for treatment of severe refractory asthma that uses radiofrequency energy to reduce airway smooth muscle and decrease bronchoconstriction. BT improves quality of life and decreases the rate of severe exacerbations with no known major long-term complications. The effectiveness of bronchial thermoplasty persists at least 5 years after the treatment is completed. Further investigation is needed to better define the specific subpopulation of patients with severe asthma who would best benefit from this treatment.
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98
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Witt CA, Sheshadri A, Carlstrom L, Tarsi J, Kozlowski J, Wilson B, Gierada DS, Hoffman E, Fain SB, Cook-Granroth J, Sajol G, Sierra O, Giri T, O'Neill M, Zheng J, Schechtman KB, Bacharier LB, Jarjour N, Busse W, Castro M. Longitudinal changes in airway remodeling and air trapping in severe asthma. Acad Radiol 2014; 21:986-93. [PMID: 25018070 PMCID: PMC4100072 DOI: 10.1016/j.acra.2014.05.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 04/27/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
Abstract
RATIONALE AND OBJECTIVES Previous cross-sectional studies have demonstrated that airway wall thickness and air trapping are greater in subjects with severe asthma than in those with mild-to-moderate asthma. However, a better understanding of how airway remodeling and lung density change over time is needed. This study aimed to evaluate predictors of airway wall remodeling and change in lung function and lung density over time in severe asthma. MATERIALS AND METHODS Phenotypic characterization and quantitative multidetector-row computed tomography (MDCT) of the chest were performed at baseline and ∼2.6 years later in 38 participants with asthma (severe n = 24 and mild-to-moderate n = 14) and nine normal controls from the Severe Asthma Research Program. RESULTS Subjects with severe asthma had a significant decline in postbronchodilator forced expiratory volume in 1 second percent (FEV1%) predicted over time (P < .001). Airway wall thickness measured by MDCT was increased at multiple airway generations in severe asthma compared to mild-to-moderate asthma (wall area percent [WA%]: P < .05) and normals (P < .05) at baseline and year 2. Over time, there was an increase in WA% and wall thickness percent (WT%) in all subjects (P = .030 and .009, respectively) with no change in emphysema-like lung or air trapping. Baseline prebronchodilator FEV1% inversely correlated with WA% and WT% (both P < .05). In a multivariable regression model, baseline WA%, race, and health care utilization were predictors of subsequent airway remodeling. CONCLUSIONS Severe asthma subjects have a greater decline in lung function over time than normal subjects or those with mild-to-moderate asthma. MDCT provides a noninvasive measure of airway wall thickness that may predict subsequent airway remodeling.
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Affiliation(s)
- Chad A Witt
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Ajay Sheshadri
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Luke Carlstrom
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Jaime Tarsi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - James Kozlowski
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Brad Wilson
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - David S Gierada
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Eric Hoffman
- Department of Radiology, University of Iowa College of Medicine, Iowa City, Iowa
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Janice Cook-Granroth
- Department of Radiology, University of Iowa College of Medicine, Iowa City, Iowa
| | - Geneline Sajol
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Oscar Sierra
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Tusar Giri
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Michael O'Neill
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093
| | - Jie Zheng
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Leonard B Bacharier
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Nizar Jarjour
- Division of Pulmonary and Critical Care, University of Wisconsin, Madison, Wisconsin
| | - William Busse
- Division of Allergy and Immunology, University of Wisconsin, Madison, Wisconsin
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave, St. Louis, MO 63110-1093.
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Ge XN, Ha SG, Rao A, Greenberg YG, Rushdi MN, Esko JD, Rao SP, Sriramarao P. Endothelial and leukocyte heparan sulfates regulate the development of allergen-induced airway remodeling in a mouse model. Glycobiology 2014; 24:715-27. [PMID: 24794009 DOI: 10.1093/glycob/cwu035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Heparan sulfate (HS) proteoglycans (HSPGs) participate in several aspects of inflammation because of their ability to bind to growth factors, chemokines, interleukins and extracellular matrix proteins as well as promote inflammatory cell trafficking and migration. We investigated whether HSPGs play a role in the development of airway remodeling during chronic allergic asthma using mice deficient in endothelial- and leukocyte-expressed N-deacetylase/N-sulfotransferase-1 (Ndst1), an enzyme involved in modification reactions during HS biosynthesis. Ndst1-deficient and wild-type (WT) mice exposed to repetitive allergen (ovalbumin [OVA]) challenge were evaluated for the development of airway remodeling. Chronic OVA-challenged WT mice exhibited increased HS expression in the lungs along with airway eosinophilia, mucus hypersecretion, peribronchial fibrosis, increased airway epithelial thickness and smooth muscle mass. In OVA-challenged Ndst1-deficient mice, lung eosinophil and macrophage infiltration as well as airway mucus accumulation, peribronchial fibrosis and airway epithelial thickness were significantly lower than in allergen-challenged WT mice along with a trend toward decreased airway smooth muscle mass. Leukocyte and endothelial Ndst 1 deficiency also resulted in significantly decreased expression of IL-13 as well as remodeling-associated mediators such as VEGF, FGF-2 and TGF-β1 in the lung tissue. At a cellular level, exposure to eotaxin-1 failed to induce TGF-β1 expression by Ndst1-deficient eosinophils relative to WT eosinophils. These studies suggest that leukocyte and endothelial Ndst1-modified HS contribute to the development of allergen-induced airway remodeling by promoting recruitment of inflammatory cells as well as regulating expression of pro-remodeling factors such as IL-13, VEGF, TGF-β1 and FGF-2 in the lung.
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Affiliation(s)
- Xiao Na Ge
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - Sung Gil Ha
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - Amrita Rao
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - Yana G Greenberg
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - Muaz Nik Rushdi
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - Jeffrey D Esko
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Savita P Rao
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
| | - P Sriramarao
- Department of Veterinary & Biomedical Sciences, University of Minnesota, St. Paul, MN 55108, USA
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Al-Ramli W, Al Samri M, Hamid Q. Th-17 cell-related cytokines' potential role in the pathogenesis of severe asthma. J Asthma 2013; 45 Suppl 1:41-4. [PMID: 19093286 DOI: 10.1080/02770900802594759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Severe asthma represents a distinct, poorly-understood phenotype of asthma that has higher morbidity, mortality and a disproportionate need for health care support. Studies have indicated the presence of a specific inflammatory response in severe asthmatics, including the paucity of expression of classical Th-2 type cytokines. Following antigenic stimulation, naive CD4+ T cells proliferate and differentiate into various effector subsets such as Th-1 and Th-2 cells. A third subset of CD4+ T cells has recently been identified and designated as Th-17 cells, which produce IL-17A and F, IL-6, and TNF-alpha. In severe asthma, there may be a predominant Th-17 phenotype. These cells may promote the release of neutrophil chemotactic factors and induce the expression of GR-beta, which is responsible for corticosteroid hyporesponsiveness in immune and structural cells. If the role of Th-17 cytokines is confirmed, it might provide a new option in controlling this refractory subtype of asthma.
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Affiliation(s)
- Wisam Al-Ramli
- Meakins-Christie Laboratories, Montreal Chest Institute, McGill University Hospital Centre, Montreal, QC, Canada
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