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Abstract
Cystic fibrosis is a common life-limiting autosomal recessive genetic disorder, with highest prevalence in Europe, North America, and Australia. The disease is caused by mutation of a gene that encodes a chloride-conducting transmembrane channel called the cystic fibrosis transmembrane conductance regulator (CFTR), which regulates anion transport and mucociliary clearance in the airways. Functional failure of CFTR results in mucus retention and chronic infection and subsequently in local airway inflammation that is harmful to the lungs. CFTR dysfunction mainly affects epithelial cells, although there is evidence of a role in immune cells. Cystic fibrosis affects several body systems, and morbidity and mortality is mostly caused by bronchiectasis, small airways obstruction, and progressive respiratory impairment. Important comorbidities caused by epithelial cell dysfunction occur in the pancreas (malabsorption), liver (biliary cirrhosis), sweat glands (heat shock), and vas deferens (infertility). The development and delivery of drugs that improve the clearance of mucus from the lungs and treat the consequent infection, in combination with correction of pancreatic insufficiency and undernutrition by multidisciplinary teams, have resulted in remarkable improvements in quality of life and clinical outcomes in patients with cystic fibrosis, with median life expectancy now older than 40 years. Innovative and transformational therapies that target the basic defect in cystic fibrosis have recently been developed and are effective in improving lung function and reducing pulmonary exacerbations. Further small molecule and gene-based therapies are being developed to restore CFTR function; these therapies promise to be disease modifying and to improve the lives of people with cystic fibrosis.
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Affiliation(s)
- J Stuart Elborn
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, and Belfast City Hospital, Belfast, UK.
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102
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The impact of impaired macrophage functions in cystic fibrosis disease progression. J Cyst Fibros 2016; 16:443-453. [PMID: 27856165 DOI: 10.1016/j.jcf.2016.10.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/21/2016] [Accepted: 10/23/2016] [Indexed: 01/29/2023]
Abstract
The underlying cause of morbidity in cystic fibrosis (CF) is the decline in lung function, which results in part from chronic inflammation. Inflammation and infection occur early in infancy in CF and the role of innate immune defense in CF has been highlighted in the last years. Once thought simply to be consumers of bacteria, macrophages have emerged as highly sensitive immune cells that are located at the balance point between inflammation and resolution of this inflammation in CF pathophysiology. In order to assess the potential role of macrophage in CF, we review the evidence that: (1) CF macrophage has a dysregulated inflammatory phenotype; (2) CF macrophage presents altered phagocytosis capacity and bacterial killing; and (3) lipid disorders in CF macrophage affect its function. These alterations of macrophage weaken innate defense of CF patients and may be involved in CF disease progression and lung damage.
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103
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Hauptmann M, Schaible UE. Linking microbiota and respiratory disease. FEBS Lett 2016; 590:3721-3738. [PMID: 27637588 DOI: 10.1002/1873-3468.12421] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 08/30/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022]
Abstract
An increasing body of evidence indicates the relevance of microbiota for pulmonary health and disease. Independent investigations recently demonstrated that the lung harbors a resident microbiota. Therefore, it is intriguing that a lung microbiota can shape pulmonary immunity and epithelial barrier functions. Here, we discuss the ways how the composition of the microbial community in the lung may influence pulmonary health and vice versa, factors that determine community composition. Prominent microbiota at other body sites such as the intestinal one may also contribute to pulmonary health and disease. However, it is difficult to discriminate between influences of lung vs. gut microbiota due to systemic mutuality between both communities. With focuses on asthma and respiratory infections, we discuss how microbiota of lung and gut can determine pulmonary immunity and barrier functions.
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Affiliation(s)
- Matthias Hauptmann
- Priority Program Infections, Cellular Microbiology, Research Center Borstel, Germany
| | - Ulrich E Schaible
- Priority Program Infections, Cellular Microbiology, Research Center Borstel, Germany.,German Centre for Infection Research, TTU-TB, Borstel, Germany
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104
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Abstract
INTRODUCTION Mutations in the cystic fibrosis transmembrane conductance regulator protein (CFTR) cause cystic fibrosis (CF), a disease with life threatening pulmonary and gastrointestinal manifestations. Recent breakthrough therapies restore function to select disease-causing CFTR mutations. Ivacaftor is a small molecule that increases the open channel probability of certain CFTR mutations, producing clear evidence of bioactivity and efficacy in pediatric CF patients. CFTR modulators represent a significant advancement in CF treatment. Extending these therapies to young CF patients is proposed to have the greatest long term impact, potentially preventing later disease. AREAS COVERED Here we summarize the research experience of CFTR modulators in pediatrics, focusing on ivacaftor and highlighting challenges in pediatric studies. As a result of these studies, ivacaftor has been approved in CF patients age 2 years and older who have one of ten CFTR mutations. EXPERT OPINION Conducting studies in young CF patients presents unique challenges, including small numbers of patients and difficulty selecting sensitive biomarkers and meaningful outcome measures. Adverse events may be more pronounced in children and deserve special attention. Ongoing efforts must focus on expanding and validating new biomarkers, innovative study design, and thorough monitoring of adverse events in children treated with CFTR modulators.
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Affiliation(s)
- Elizabeth L Kramer
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229
| | - John P Clancy
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229
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105
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c- Src and its role in cystic fibrosis. Eur J Cell Biol 2016; 95:401-413. [DOI: 10.1016/j.ejcb.2016.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 12/15/2022] Open
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106
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Wolf L, Sapich S, Honecker A, Jungnickel C, Seiler F, Bischoff M, Wonnenberg B, Herr C, Schneider-Daum N, Lehr CM, Bals R, Beisswenger C. IL-17A-mediated expression of epithelial IL-17C promotes inflammation during acute Pseudomonas aeruginosa pneumonia. Am J Physiol Lung Cell Mol Physiol 2016; 311:L1015-L1022. [PMID: 27694471 DOI: 10.1152/ajplung.00158.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/26/2016] [Indexed: 12/31/2022] Open
Abstract
Lung epithelial cells are suggested to promote pathogen-induced pulmonary inflammation by the release of chemokines, resulting in enhanced recruitment of circulating leukocytes. Recent studies have shown that the interleukin-17C (IL-17C) regulates innate immune functions of epithelial cells in an autocrine manner. The aim of this study was to investigate the contribution of IL-17C to pulmonary inflammation in a mouse model of acute Pseudomonas aeruginosa pneumonia. Infection with P. aeruginosa resulted in an increased expression of IL-17C in lung tissue of wild-type mice. Numbers of neutrophils and the expression of the neutrophil-recruiting chemokines keratinocyte-derived chemokine and macrophage inflammatory protein 2 were significantly decreased in lungs of IL-17C-deficient (IL-17C-/-) mice infected with P. aeruginosa at 24 h. Systemic concentrations of interleukin-6 (IL-6) were significantly decreased in infected IL-17C-/- mice at 24 h and the survival of IL-17C-/- mice was significantly increased at 48 h. The expression of IL-17C was reduced in infected mice deficient for interleukin-17A (IL-17A), whereas pulmonary concentrations of IL-17A were not affected by the deficiency for IL-17C. Stimulation of primary alveolar epithelial cells with IL-17A resulted in a significantly increased expression of IL-17C in vitro. Our data suggest that IL-17A-mediated expression of epithelial IL-17C amplifies the release of chemokines by epithelial cells and thereby contributes to the recruitment of neutrophils and systemic inflammation during acute P. aeruginosa pneumonia.
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Affiliation(s)
- Lisa Wolf
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Sandra Sapich
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany; and
| | - Anja Honecker
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Christopher Jungnickel
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Frederik Seiler
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Markus Bischoff
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Bodo Wonnenberg
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Christian Herr
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Nicole Schneider-Daum
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany; and
| | - Claus-Michael Lehr
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany; and.,Biopharmaceutics and Pharmaceutical Technology, Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Robert Bals
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Christoph Beisswenger
- Department of Internal Medicine V-Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany;
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107
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Li L, Krause L, Somerset S. Associations between micronutrient intakes and gut microbiota in a group of adults with cystic fibrosis. Clin Nutr 2016; 36:1097-1104. [PMID: 27595636 DOI: 10.1016/j.clnu.2016.06.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 06/23/2016] [Accepted: 06/30/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) involves chronic inflammation and oxidative stress affecting mainly the respiratory and digestive systems. Survival rates for CF have improved with advances in treatment including nutritional interventions such as micronutrient supplementation. Diet can modulate gut microbiota in the general population with consequences on local and systemic immunity, and inflammation. The gut microbiota appears disrupted and may associate with pulmonary status in CF. This study investigated associations between micronutrient intakes and gut microbiota variations in a group of adults with CF. METHODS Faecal microbiota of sixteen free-living adults with CF was profiled by 16ss rDNA sequencing on the GS-FLX platform. Associations were tested between UniFrac distances of faecal microbiota and time-corresponding micronutrient intakes. Associations between relative abundances of bacterial taxa and micronutrient intakes (those showing significant associations with UniFrac distances) were examined by Spearman correlation. RESULTS Unweighted UniFrac distances were associated with intakes of potassium and antioxidant vitamins C, E and beta-carotene equivalents, whereas weighted UniFrac distances were associated with antioxidant vitamins riboflavin, niacin equivalents, beta-carotene equivalents and vitamin A equivalents. Intakes of beta-carotene equivalents, vitamin C, vitamin E, niacin equivalents and riboflavin correlated negatively with Bacteroides and/or its corresponding higher level taxa. Intakes of beta-carotene equivalents and vitamin E also positively correlated with Firmicutes and specific taxa belonging to Firmicutes. CONCLUSION Some micronutrients, particularly antioxidant vitamins, correlated with gut microbiota variations in the studied cohort. Further research is required to clarify whether antioxidant vitamin intakes can influence CF gut microbiota and potential clinical/therapeutic implications in CF.
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Affiliation(s)
- Li Li
- School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Lutz Krause
- The University of Queensland, Diamantina Institute, Translational Research Institute, Woolloongabba 4102, Brisbane, Queensland, Australia
| | - Shawn Somerset
- School of Medicine, Griffith University, Brisbane, Queensland, Australia; School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia.
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108
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De Boeck K, Amaral MD. Progress in therapies for cystic fibrosis. THE LANCET RESPIRATORY MEDICINE 2016; 4:662-674. [DOI: 10.1016/s2213-2600(16)00023-0] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 12/19/2022]
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109
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Stellari F, Bergamini G, Ruscitti F, Sandri A, Ravanetti F, Donofrio G, Boschi F, Villetti G, Sorio C, Assael BM, Melotti P, Lleo MM. In vivo monitoring of lung inflammation in CFTR-deficient mice. J Transl Med 2016; 14:226. [PMID: 27468800 PMCID: PMC4964274 DOI: 10.1186/s12967-016-0976-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/13/2016] [Indexed: 12/14/2022] Open
Abstract
Background Experimentally, lung inflammation in laboratory animals is usually detected by the presence of inflammatory markers, such as immune cells and cytokines, in the bronchoalveolar lavage fluid (BALF) of sacrificed animals. This method, although extensively used, is time, money and animal life consuming, especially when applied to genetically modified animals. Thus a new and more convenient approach, based on in vivo imaging analysis, has been set up to evaluate the inflammatory response in the lung of CFTR-deficient (CF) mice, a murine model of cystic fibrosis. Methods Wild type (WT) and CF mice were stimulated with P. aeruginosa LPS, TNF-alpha and culture supernatant derived from P. aeruginosa (strain VR1). Lung inflammation was detected by measuring bioluminescence in vivo in mice transiently transgenized with a luciferase reporter gene under the control of a bovine IL-8 gene promoter. Results Differences in bioluminescence (BLI) signal were revealed by comparing the two types of mice after intratracheal challenge with pro-inflammatory stimuli. BLI increased at 4 h after stimulation with TNF-alpha and at 24 h after administration of LPS and VR1 supernatant in CF mice with respect to untreated animals. The BLI signal was significantly more intense and lasted for longer times in CF animals when compared to WT mice. Analysis of BALF markers: leukocytes, cytokines and histology revealed no significant differences between CF and WT mice. Conclusions In vivo gene delivery technology and non-invasive bioluminescent imaging has been successfully adapted to CFTR-deficient mice. Activation of bIL-8 transgene promoter can be monitored by non-invasive BLI imaging in the lung of the same animal and compared longitudinally in both CF or WT mice, after challenge with pro-inflammatory stimuli. The combination of these technologies and the use of CF mice offer the unique opportunity of evaluating the impact of therapies aimed to control inflammation in a CF background. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0976-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabio Stellari
- Pharmacology & Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici, Largo Belloli, 11/A, 43122, Parma, Italy.
| | | | - Francesca Ruscitti
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università di Parma, Parma, Italy
| | - Angela Sandri
- Dipartimento di Diagnostica e Salute Pubblica, Università di Verona, Verona, Italy
| | - Francesca Ravanetti
- Dipartimento di Scienze Medico Veterinarie, Università di Parma, Parma, Italy
| | - Gaetano Donofrio
- Dipartimento di Scienze Medico Veterinarie, Università di Parma, Parma, Italy
| | - Federico Boschi
- Dipartimento di Informatica, Università di Verona, Verona, Italy
| | - Gino Villetti
- Pharmacology & Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici, Largo Belloli, 11/A, 43122, Parma, Italy
| | - Claudio Sorio
- Dipartimento di Medicina, Università di Verona, Verona, Italy
| | - Barouk M Assael
- Centro Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Paola Melotti
- Centro Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Maria M Lleo
- Dipartimento di Diagnostica e Salute Pubblica, Università di Verona, Verona, Italy
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110
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Colonization of CF patients’ upper airways with S. aureus contributes more decisively to upper airway inflammation than P. aeruginosa. Med Microbiol Immunol 2016; 205:485-500. [DOI: 10.1007/s00430-016-0463-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/20/2016] [Indexed: 01/29/2023]
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111
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Hodge S, Upham JW, Pizzutto S, Petsky HL, Yerkovich S, Baines KJ, Gibson P, Simpson JL, Buntain H, Chen ACH, Hodge G, Chang AB. Is Alveolar Macrophage Phagocytic Dysfunction in Children With Protracted Bacterial Bronchitis a Forerunner to Bronchiectasis? Chest 2016; 149:508-515. [PMID: 26867834 DOI: 10.1016/j.chest.2015.10.066] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/11/2015] [Accepted: 10/15/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children with recurrent protracted bacterial bronchitis (PBB) and bronchiectasis share common features, and PBB is likely a forerunner to bronchiectasis. Both diseases are associated with neutrophilic inflammation and frequent isolation of potentially pathogenic microorganisms, including nontypeable Haemophilus influenzae (NTHi), from the lower airway. Defective alveolar macrophage phagocytosis of apoptotic bronchial epithelial cells (efferocytosis), as found in other chronic lung diseases, may also contribute to tissue damage and neutrophil persistence. Thus, in children with bronchiectasis or PBB and in control subjects, we quantified the phagocytosis of airway apoptotic cells and NTHi by alveolar macrophages and related the phagocytic capacity to clinical and airway inflammation. METHODS Children with bronchiectasis (n = 55) or PBB (n = 13) and control subjects (n = 13) were recruited. Alveolar macrophage phagocytosis, efferocytosis, and expression of phagocytic scavenger receptors were assessed by flow cytometry. Bronchoalveolar lavage fluid interleukin (IL) 1β was measured by enzyme-linked immunosorbent assay. RESULTS For children with PBB or bronchiectasis, macrophage phagocytic capacity was significantly lower than for control subjects (P = .003 and P < .001 for efferocytosis and P = .041 and P = .004 for phagocytosis of NTHi; PBB and bronchiectasis, respectively); median phagocytosis of NTHi for the groups was as follows: bronchiectasis, 13.7% (interquartile range [IQR], 11%-16%); PBB, 16% (IQR, 11%-16%); control subjects, 19.0% (IQR, 13%-21%); and median efferocytosis for the groups was as follows: bronchiectasis, 14.1% (IQR, 10%-16%); PBB, 16.2% (IQR, 14%-17%); control subjects, 18.1% (IQR, 16%-21%). Mannose receptor expression was significantly reduced in the bronchiectasis group (P = .019), and IL-1β increased in both bronchiectasis and PBB groups vs control subjects. CONCLUSIONS A reduced alveolar macrophage phagocytic host response to apoptotic cells or NTHi may contribute to neutrophilic inflammation and NTHi colonization in both PBB and bronchiectasis. Whether this mechanism also contributes to the progression of PBB to bronchiectasis remains unknown.
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Affiliation(s)
- Sandra Hodge
- Chronic Inflammatory Lung Disease Research Laboratory, Lung Research Unit, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, and The School of Medicine, The University of Adelaide, Adelaide, SA, Australia.
| | - John W Upham
- Princess Alexandra Hospital, Brisbane, QLD, Australia; The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Susan Pizzutto
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Helen L Petsky
- Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stephanie Yerkovich
- The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Katherine J Baines
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Peter Gibson
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Jodie L Simpson
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Helen Buntain
- Queensland Children's Health Service, Brisbane, QLD, and Queensland Children's Medical Research Institute, Brisbane, QLD, Australia
| | - Alice C H Chen
- The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Greg Hodge
- Chronic Inflammatory Lung Disease Research Laboratory, Lung Research Unit, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, and The School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia; Queensland Children's Health Service, Brisbane, QLD, and Queensland Children's Medical Research Institute, Brisbane, QLD, Australia
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112
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Lucca F, Da Dalt L, Ros M, Gucciardi A, Pirillo P, Naturale M, Perilongo G, Giordano G, Baraldi E. Asymmetric dimethylarginine and related metabolites in exhaled breath condensate of children with cystic fibrosis. CLINICAL RESPIRATORY JOURNAL 2016; 12:140-148. [PMID: 27216780 DOI: 10.1111/crj.12502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/18/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Asymmetric dimethylarginine (ADMA) competitively inhibits nitric oxide synthase (NOS). Its levels in specimens from murine models and asthmatic patients are related to inflammation and oxidative stress. Patients with cystic fibrosis(CF) reportedly have higher arginase activity, lower NO production and NOS expression than healthy controls. OBJECTIVE The objective was to assess the role of ADMA and related metabolites as disease biomarkers in exhaled breath condensate (EBC) of pediatric CF patients, compared with age-matched healthy controls (HC). METHODS A longitudinal design was conceived and 34 CF patients (21 stable, 13 at the onset of exacerbation) and 16 HC were enrolled. All CF patients underwent clinical examination, spirometry and EBC collection at enrolment; the same tests were performed also after an antibiotic course in those patients with exacerbation. Metabolites levels in EBC were measured with an ultra-performance liquid chromatography and tandem mass spectrometry technique. RESULTS All CF patients had ADMA levels (expressed as ratio to tyrosine) similar to those in HC (median 0.0112, IQR 0.0103-0.0120 and median 0.0114, IQR 0.0090-0.0128, respectively; P = 0.983), while a significant increase in the citrulline/tyrosine ratio was found in CF patients (median 0.6419, IQR 0.5738-0.6899 in CF vs median 0.4176, IQR 0.2986-0.5082 in HC; P = 0.00003). No differences in ADMA levels emerged between stable patients and those with exacerbation. CONCLUSION ADMA and related aminoacids were measured simultaneously for the first time in EBC from CF patients. Higher citrulline/tyrosine ratios were found in CF children with normal ADMA levels, suggesting a dysregulated ADMA metabolism in these patients.
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Affiliation(s)
- Francesca Lucca
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Liviana Da Dalt
- Women's and Children's Health Department, University of Padova, Padova, Italy.,Cystic Fibrosis Unit, Pediatric Department, Treviso Hospital, Treviso, Italy
| | - Mirco Ros
- Cystic Fibrosis Unit, Pediatric Department, Treviso Hospital, Treviso, Italy
| | - Antonina Gucciardi
- Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
| | - Paola Pirillo
- Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
| | - Mauro Naturale
- Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
| | - Giorgio Perilongo
- Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
| | - Giuseppe Giordano
- Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
| | - Eugenio Baraldi
- Women's and Children's Health Department, University of Padova, Padova, Italy.,Institute for Pediatric Research (IRP) "Città della Speranza", University of Padova, Padova, Italy
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113
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Epithelial Anion Transport as Modulator of Chemokine Signaling. Mediators Inflamm 2016; 2016:7596531. [PMID: 27382190 PMCID: PMC4921137 DOI: 10.1155/2016/7596531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/03/2016] [Accepted: 05/12/2016] [Indexed: 12/16/2022] Open
Abstract
The pivotal role of epithelial cells is to secrete and absorb ions and water in order to allow the formation of a luminal fluid compartment that is fundamental for the epithelial function as a barrier against environmental factors. Importantly, epithelial cells also take part in the innate immune system. As a first line of defense they detect pathogens and react by secreting and responding to chemokines and cytokines, thus aggravating immune responses or resolving inflammatory states. Loss of epithelial anion transport is well documented in a variety of diseases including cystic fibrosis, chronic obstructive pulmonary disease, asthma, pancreatitis, and cholestatic liver disease. Here we review the effect of aberrant anion secretion with focus on the release of inflammatory mediators by epithelial cells and discuss putative mechanisms linking these transport defects to the augmented epithelial release of chemokines and cytokines. These mechanisms may contribute to the excessive and persistent inflammation in many respiratory and gastrointestinal diseases.
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114
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Poghosyan A, Patel JK, Clifford RL, Knox AJ. Epigenetic dysregulation of interleukin 8 (CXCL8) hypersecretion in cystic fibrosis airway epithelial cells. Biochem Biophys Res Commun 2016; 476:431-437. [PMID: 27240956 DOI: 10.1016/j.bbrc.2016.05.140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 05/26/2016] [Indexed: 12/13/2022]
Abstract
Airway epithelial cells in cystic fibrosis (CF) overexpress Interleukin 8 (CXCL8) through poorly defined mechanisms. CXCL8 transcription is dependent on coordinated binding of CCAAT/enhancer binding protein (C/EBP)β, nuclear factor (NF)-κB, and activator protein (AP)-1 to the promoter. Here we show abnormal epigenetic regulation is responsible for CXCL8 overexpression in CF cells. Under basal conditions CF cells had increased bromodomain (Brd)3 and Brd4 recruitment and enhanced NF-κB and C/EBPβ binding to the CXCL8 promoter compared to non-CF cells due to trimethylation of histone H3 at lysine 4 (H3K4me3) and DNA hypomethylation at CpG6. IL-1β increased NF-κB, C/EBPβ and Brd4 binding. Furthermore, inhibitors of bromodomain and extra-terminal domain family (BET) proteins reduced CXCL8 production in CF cells suggesting a therapeutic target for the BET pathway.
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Affiliation(s)
- Anna Poghosyan
- Division of Respiratory Medicine, Nottingham Respiratory Research Unit, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, United Kingdom.
| | - Jamie K Patel
- Division of Respiratory Medicine, Nottingham Respiratory Research Unit, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - Rachel L Clifford
- Division of Respiratory Medicine, Nottingham Respiratory Research Unit, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - Alan J Knox
- Division of Respiratory Medicine, Nottingham Respiratory Research Unit, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, United Kingdom.
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115
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Lund-Palau H, Turnbull AR, Bush A, Bardin E, Cameron L, Soren O, Wierre-Gore N, Alton EWFW, Bundy JG, Connett G, Faust SN, Filloux A, Freemont P, Jones A, Khoo V, Morales S, Murphy R, Pabary R, Simbo A, Schelenz S, Takats Z, Webb J, Williams HD, Davies JC. Pseudomonas aeruginosa infection in cystic fibrosis: pathophysiological mechanisms and therapeutic approaches. Expert Rev Respir Med 2016; 10:685-97. [PMID: 27175979 DOI: 10.1080/17476348.2016.1177460] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pseudomonas aeruginosa is a remarkably versatile environmental bacterium with an extraordinary capacity to infect the cystic fibrosis (CF) lung. Infection with P. aeruginosa occurs early, and although eradication can be achieved following early detection, chronic infection occurs in over 60% of adults with CF. Chronic infection is associated with accelerated disease progression and increased mortality. Extensive research has revealed complex mechanisms by which P. aeruginosa adapts to and persists within the CF airway. Yet knowledge gaps remain, and prevention and treatment strategies are limited by the lack of sensitive detection methods and by a narrow armoury of antibiotics. Further developments in this field are urgently needed in order to improve morbidity and mortality in people with CF. Here, we summarize current knowledge of pathophysiological mechanisms underlying P. aeruginosa infection in CF. Established treatments are discussed, and an overview is offered of novel detection methods and therapeutic strategies in development.
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Affiliation(s)
- Helena Lund-Palau
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK
| | - Andrew R Turnbull
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK.,b Department of Respiratory Paediatrics , Royal Brompton and Harefield NHS Foundation Trust , London , UK
| | - Andrew Bush
- b Department of Respiratory Paediatrics , Royal Brompton and Harefield NHS Foundation Trust , London , UK.,c National Heart and Lung Institute, Imperial College , London , UK
| | - Emmanuelle Bardin
- d Biomolecular Medicine, Department of Surgery and Cancer, Faculty of Medicine , Imperial College , London , UK
| | - Loren Cameron
- e Department of Medicine , Imperial College , London , UK
| | - Odel Soren
- f Biological Sciences, Institute for Life Sciences , University of Southampton , Southampton , UK
| | | | - Eric W F W Alton
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK
| | - Jacob G Bundy
- c National Heart and Lung Institute, Imperial College , London , UK
| | - Gary Connett
- g NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust , University of Southampton , Southampton , UK
| | - Saul N Faust
- g NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust , University of Southampton , Southampton , UK
| | - Alain Filloux
- h Department of Life Sciences , Imperial College , London , UK
| | - Paul Freemont
- e Department of Medicine , Imperial College , London , UK
| | - Andy Jones
- i Department of Respiratory Medicine , Royal Brompton Hospital , London , UK
| | - Valerie Khoo
- c National Heart and Lung Institute, Imperial College , London , UK
| | | | - Ronan Murphy
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK
| | - Rishi Pabary
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK
| | - Ameze Simbo
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK
| | - Silke Schelenz
- k Department of Microbiology , Royal Brompton Hospital , London UK
| | - Zoltan Takats
- d Biomolecular Medicine, Department of Surgery and Cancer, Faculty of Medicine , Imperial College , London , UK
| | - Jeremy Webb
- k Department of Microbiology , Royal Brompton Hospital , London UK
| | - Huw D Williams
- g NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust , University of Southampton , Southampton , UK
| | - Jane C Davies
- a Department of Gene Therapy, National Heart and Lung Institute , Imperial College , London , UK.,b Department of Respiratory Paediatrics , Royal Brompton and Harefield NHS Foundation Trust , London , UK
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Nagy B, Nagy B, Fila L, Clarke LA, Gönczy F, Bede O, Nagy D, Újhelyi R, Szabó Á, Anghelyi A, Major M, Bene Z, Fejes Z, Antal-Szalmás P, Bhattoa HP, Balla G, Kappelmayer J, Amaral MD, Macek M, Balogh I. Human Epididymis Protein 4: A Novel Serum Inflammatory Biomarker in Cystic Fibrosis. Chest 2016; 150:661-72. [PMID: 27105680 DOI: 10.1016/j.chest.2016.04.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/04/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increased expression of the human epididymis protein 4 (HE4) was previously described in lung biopsy samples from patients with cystic fibrosis (CF). It remains unknown, however, whether serum HE4 concentrations are elevated in CF. METHODS Seventy-seven children with CF from six Hungarian CF centers and 57 adult patients with CF from a Czech center were enrolled. In addition, 94 individuals with non-CF lung diseases and 117 normal control subjects with no pulmonary disorders were analyzed. Serum HE4 levels were measured by using an immunoassay, and their expression was further investigated via the quantification of HE4 messenger RNA by using quantitative reverse transcription polymerase chain reaction in CF vs non-CF respiratory epithelium biopsy specimens. The expression of the potential regulator miR-140-5p was analyzed by using an UPL-based quantitative reverse transcription polymerase chain reaction assay. HE4 was measured in the supernatants from unpolarized and polarized cystic fibrosis bronchial epithelial cells expressing wild-type or F508del-CFTR. RESULTS Median serum HE4 levels were significantly elevated in children with CF (99.5 [73.1-128.9] pmol/L) compared with control subjects (36.3 [31.1-43.4] pmol/L; P < .0001). This observation was replicated in adults with CF (115.7 [77.8-148.7] pmol/L; P < .0001). In contrast, abnormal but lower HE4 concentrations were found in cases of severe bronchitis, asthma, pneumonia, and bronchiectasis. In patients with CF, the concentrations of HE4 were positively correlated with overall disease severity and C-reactive protein concentrations, whereas a significant inverse relationship was found between HE4 and the spirometric FEV1 value. Relative HE4 mRNA levels were significantly upregulated (P = .011) with a decreased miR-140-5p expression (P = .020) in the CF vs non-CF airway biopsy specimens. Twofold higher HE4 concentrations were recorded in the supernatant of polarized F508del-CF transmembrane conductance regulator/bronchial epithelial cells compared with wild-type cells. CONCLUSIONS HE4 serum levels positively correlate with the overall severity of CF and the degree of pulmonary dysfunction. HE4 may thus be used as a novel inflammatory biomarker and possibly also as a measure of treatment efficacy in CF lung disease.
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Affiliation(s)
- Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Béla Nagy
- Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Libor Fila
- Department of Pulmonology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Luka A Clarke
- University of Lisboa, Faculty of Sciences, BioISI-Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | | | - Olga Bede
- Department of Pediatrics, Szent-Györgyi Albert Medical University, Szeged, Hungary
| | - Dóra Nagy
- Department of Pediatrics, Szent-Györgyi Albert Medical University, Szeged, Hungary
| | | | - Ágnes Szabó
- Department of Pediatrics, Szent-Györgyi Albert Medical University, Szeged, Hungary
| | | | - Miklós Major
- Markusovszky Lajos County Hospital, Szombathely, Hungary
| | - Zsolt Bene
- Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsolt Fejes
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Antal-Szalmás
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - György Balla
- Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - János Kappelmayer
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Margarida D Amaral
- University of Lisboa, Faculty of Sciences, BioISI-Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Milan Macek
- Department of Biology and Medical Genetics, Motol University Hospital, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - István Balogh
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Division of Clinical Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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117
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Lubamba BA, Jones LC, O'Neal WK, Boucher RC, Ribeiro CMP. X-Box-Binding Protein 1 and Innate Immune Responses of Human Cystic Fibrosis Alveolar Macrophages. Am J Respir Crit Care Med 2016; 192:1449-61. [PMID: 26331676 DOI: 10.1164/rccm.201504-0657oc] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Alveolar macrophages (AMs) play a key role in host defense to inhaled bacterial pathogens, in part by secreting inflammatory mediators. Cystic fibrosis (CF) airways exhibit a persistent, robust inflammatory response that may contribute to the pathophysiology of CF. Recent findings have linked endoplasmic reticulum stress responses mediated by inositol-requiring enzyme 1α-dependent messenger RNA splicing (activation) of X-box-binding protein-1 (XBP-1s) to inflammation in peripheral macrophages. However, the role of XBP-1s in CF AM function is not known. OBJECTIVES To evaluate inflammatory responses of AMs from chronically infected/inflamed human CF lungs and test whether XBP-1s is required for AM-mediated inflammation. METHODS Basal and LPS-induced inflammatory responses were evaluated in primary cultures of non-CF versus CF AMs. XBP-1s was measured and its function was evaluated in AMs using 8-formyl-7-hydroxy-4-methylcoumarin (4μ8C), an inhibitor of inositol-requiring enzyme 1α-dependent XBP-1s, and in THP-1 cells stably expressing XBP-1 shRNA, XBP-1s, or a dominant-negative XBP-1. MEASUREMENTS AND MAIN RESULTS CF AMs exhibited exaggerated basal and LPS-induced production of tumor necrosis factor-α and IL-6, and these responses were coupled to increased levels of XBP-1s. In non-CF and CF AMs, LPS-induced cytokine production was blunted by 4µ8C. A role for XBP-1s in AM inflammatory responses was further established by data from dTHP-1 cells indicating that expression of XBP-1 shRNA reduced XBP-1s levels and LPS-induced inflammatory responses; and LPS-induced inflammation was up-regulated by expression of XBP-1s and inhibited by dominant-negative XBP-1. CONCLUSIONS These findings suggest that AMs contribute to the robust inflammation of CF airways via an up-regulation of XBP-1s-mediated cytokine production.
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Affiliation(s)
- Bob A Lubamba
- 1 Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Lisa C Jones
- 1 Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Wanda K O'Neal
- 1 Marsico Lung Institute/Cystic Fibrosis Research Center.,2 Department of Medicine, and
| | - Richard C Boucher
- 1 Marsico Lung Institute/Cystic Fibrosis Research Center.,2 Department of Medicine, and
| | - Carla M P Ribeiro
- 1 Marsico Lung Institute/Cystic Fibrosis Research Center.,2 Department of Medicine, and.,3 Department of Cell Biology and Physiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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118
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Grabiec AM, Hussell T. The role of airway macrophages in apoptotic cell clearance following acute and chronic lung inflammation. Semin Immunopathol 2016; 38:409-23. [PMID: 26957481 PMCID: PMC4896990 DOI: 10.1007/s00281-016-0555-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 01/29/2016] [Indexed: 12/19/2022]
Abstract
Acute and chronic inflammatory responses in the lung are associated with the accumulation of large quantities of immune and structural cells undergoing apoptosis, which need to be engulfed by phagocytes in a process called ‘efferocytosis’. Apoptotic cell recognition and removal from the lung is mediated predominantly by airway macrophages, though immature dendritic cells and non-professional phagocytes, such as epithelial cells and mesenchymal cells, can also display this function. Efficient clearance of apoptotic cells from the airways is essential for successful resolution of inflammation and the return to lung homeostasis. Disruption of this process leads to secondary necrosis of accumulating apoptotic cells, release of necrotic cell debris and subsequent uncontrolled inflammatory activation of the innate immune system by the released ‘damage associated molecular patterns’ (DAMPS). To control the duration of the immune response and prevent autoimmune reactions, anti-inflammatory signalling cascades are initiated in the phagocyte upon apoptotic cell uptake, mediated by a range of receptors that recognise specific phospholipids or proteins externalised on, or secreted by, the apoptotic cell. However, prolonged activation of apoptotic cell recognition receptors, such as the family of receptor tyrosine kinases Tyro3, Axl and MerTK (TAM), may delay or prevent inflammatory responses to subsequent infections. In this review, we will discuss recent advances in our understanding of the mechanism controlling apoptotic cell recognition and removal from the lung in homeostasis and during inflammation, the contribution of defective efferocytosis to chronic inflammatory lung diseases, such as chronic obstructive pulmonary disease, asthma and cystic fibrosis, and implications of the signals triggered by apoptotic cells in the susceptibility to pulmonary microbial infections.
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Affiliation(s)
- Aleksander M Grabiec
- Manchester Collaborative Centre for Inflammation Research, Core Technology Facility, The University of Manchester, 46 Grafton Street, M13 9NT, Manchester, UK
| | - Tracy Hussell
- Manchester Collaborative Centre for Inflammation Research, Core Technology Facility, The University of Manchester, 46 Grafton Street, M13 9NT, Manchester, UK.
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119
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Boon M, Verleden SE, Bosch B, Lammertyn EJ, McDonough JE, Mai C, Verschakelen J, Kemner-van de Corput M, Tiddens HAW, Proesmans M, Vermeulen FL, Verbeken EK, Cooper J, Van Raemdonck DE, Decramer M, Verleden GM, Hogg JC, Dupont LJ, Vanaudenaerde BM, De Boeck K. Morphometric Analysis of Explant Lungs in Cystic Fibrosis. Am J Respir Crit Care Med 2016; 193:516-26. [DOI: 10.1164/rccm.201507-1281oc] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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120
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Huus KE, Joseph J, Zhang L, Wong A, Aaron SD, Mah TF, Sad S. Clinical Isolates of Pseudomonas aeruginosa from Chronically Infected Cystic Fibrosis Patients Fail To Activate the Inflammasome during Both Stable Infection and Pulmonary Exacerbation. THE JOURNAL OF IMMUNOLOGY 2016; 196:3097-108. [PMID: 26895832 DOI: 10.4049/jimmunol.1501642] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 01/20/2016] [Indexed: 12/13/2022]
Abstract
Immune recognition of pathogen-associated ligands leads to assembly and activation of inflammasomes, resulting in the secretion of inflammatory cytokines IL-1β and IL-18 and an inflammatory cell death called pyroptosis. Inflammasomes are important for protection against many pathogens, but their role during chronic infectious disease is poorly understood. Pseudomonas aeruginosa is an opportunistic pathogen that persists in the lungs of cystic fibrosis (CF) patients and may be responsible for the repeated episodes of pulmonary exacerbation characteristic of CF. P. aeruginosa is capable of inducing potent inflammasome activation during acute infection. We hypothesized that to persist within the host during chronic infection, P. aeruginosa must evade inflammasome activation, and pulmonary exacerbations may be the result of restoration of inflammasome activation. We therefore isolated P. aeruginosa from chronically infected CF patients during stable infection and exacerbation and evaluated the impact of these isolates on inflammasome activation in macrophages and neutrophils. P. aeruginosa isolates from CF patients failed to induce inflammasome activation, as measured by the secretion of IL-1β and IL-18 and by pyroptotic cell death, during both stable infection and exacerbation. Inflammasome evasion likely was due to reduced expression of inflammasome ligands and reduced motility and was not observed in environmental isolates or isolates from acute, non-CF infection. These results reveal a novel mechanism of pathogen adaptation by P. aeruginosa to avoid detection by inflammasomes in CF patients and indicate that P. aeruginosa-activated inflammasomes are not involved in CF pulmonary exacerbations.
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Affiliation(s)
- Kelsey E Huus
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada; Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Julie Joseph
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Li Zhang
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Alex Wong
- Department of Biology, Faculty of Science, Carleton University, Ottawa, Ontario K1N 6N5, Canada; and
| | - Shawn D Aaron
- Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Thien-Fah Mah
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Subash Sad
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada;
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Durupt S, Mazur S, Reix P. [Therapeutic advances in cystic fibrosis in 2014]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:77-86. [PMID: 25727661 DOI: 10.1016/j.pneumo.2014.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 11/03/2014] [Accepted: 11/08/2014] [Indexed: 06/04/2023]
Abstract
Twenty-five years after the cystic fibrosis (CF) gene identification, this discovery actually begins to benefit to patients. Increasing our knowledge on CFTR biology, as well as technical progress made in order to screen for new drugs have made therapeutic strategies move an important step forward. It is likely that in the forthcoming years, the panel of molecules available for CF patients will be larger, with new activators and potentiators. The disease by itself may consequently change in its natural history. CF is an example of the so-called personalized medicine, aiming to fit treatment according to patient's genetic background. Ongoing clinical trials may enlarge the actually limited eligible number of CF patients for new drugs such as ivacaftor. Beyond this exciting and promising new therapeutic approach, one may not push symptomatic treatments on the side. Improvements have been made for inhaled antibiotics administration, aiming to simplify patient's life; clinical trials using new molecules able to liquefy mucus or with anti-inflammatory properties are actually underway. One important next step in the care for CF will be to design and conduct early intervention trials in CF infants. Newborn screening program have been widely implanted around the word, and cohorts studies have shown that both functional and structural abnormalities occurred very early, making the therapeutic window of opportunity tight.
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Affiliation(s)
- S Durupt
- Service de médecine interne, centre de référence de la mucoviscidose, centre adulte de ressource et de compétences de la mucoviscidose, centre hospitalier Lyon-Sud, 69495 Pierre-Bénite cedex, France
| | - S Mazur
- Équipe EMET, UMR 5558, service de pédiatrie, d'allergologie et de pneumologie, centre de référence de la mucoviscidose, centre pédiatrique de ressources et de compétences de la mucoviscidose, hôpital femme-mère-enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - P Reix
- Équipe EMET, UMR 5558, service de pédiatrie, d'allergologie et de pneumologie, centre de référence de la mucoviscidose, centre pédiatrique de ressources et de compétences de la mucoviscidose, hôpital femme-mère-enfant, 59, boulevard Pinel, 69677 Bron cedex, France.
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122
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Ween M, Ahern J, Carroll A, Hodge G, Pizzutto S, Jersmann H, Reynolds P, Hodge S. A small volume technique to examine and compare alveolar macrophage phagocytosis of apoptotic cells and non typeable Haemophilus influenzae (NTHi). J Immunol Methods 2016; 429:7-14. [DOI: 10.1016/j.jim.2015.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/07/2015] [Accepted: 12/07/2015] [Indexed: 12/11/2022]
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Affiliation(s)
- Laura M. Filkins
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - George A. O’Toole
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
- * E-mail:
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Abstract
Cystic Fibrosis (CF) is a rare, multisystem disease leading to significant morbidity and mortality. CF is caused by defects in the cystic fibrosis transmembrane conductance regulator protein (CFTR), a chloride and bicarbonate transporter. Early diagnosis and access to therapies provides benefits in nutrition, pulmonary health, and cognitive ability. Several screening and diagnostic tests are available to support a diagnosis. We discuss the characteristics of screening and diagnostic tests for CF and guideline-based algorithms using these tools to establish a diagnosis. We discuss classification and management of common "diagnostic dilemmas," including the CFTR-related metabolic syndrome and other CFTR-associated diseases.
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Affiliation(s)
- John Brewington
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - J P Clancy
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
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Brewington JJ, McPhail GL, Clancy JP. Lumacaftor alone and combined with ivacaftor: preclinical and clinical trial experience of F508del CFTR correction. Expert Rev Respir Med 2015; 10:5-17. [PMID: 26581802 DOI: 10.1586/17476348.2016.1122527] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator protein (CFTR), leading to significant morbidity and mortality. CFTR is a chloride and bicarbonate channel at the epithelial cell membrane. The most common CFTR mutation is F508del, resulting in minimal CFTR at the plasma membrane. Current disease management is supportive, whereas an ultimate goal is to develop therapies to restore CFTR activity. We summarize experience with lumacaftor, a small molecule that increases F508del-CFTR levels at the plasma membrane. Lumacaftor in combination with ivacaftor, a modulator of CFTR gating defects, improves clinical outcome measures in patients homozygous for the F508del mutation. Lumacaftor represents a significant advancement in the treatment of biochemical abnormalities in CF. Further development of CFTR modulators will improve upon current therapies, although it remains unclear whether this approach will provide therapies for all CFTR mutations.
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Affiliation(s)
- John J Brewington
- a Division of Pulmonary Medicine, Department of Pediatrics , Cincinnati Children's Hospital Medical Center and the University of Cincinnati , Cincinnati , OH , USA
| | - Gary L McPhail
- a Division of Pulmonary Medicine, Department of Pediatrics , Cincinnati Children's Hospital Medical Center and the University of Cincinnati , Cincinnati , OH , USA
| | - John P Clancy
- a Division of Pulmonary Medicine, Department of Pediatrics , Cincinnati Children's Hospital Medical Center and the University of Cincinnati , Cincinnati , OH , USA
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Mirković B, Murray MA, Lavelle GM, Molloy K, Azim AA, Gunaratnam C, Healy F, Slattery D, McNally P, Hatch J, Wolfgang M, Tunney MM, Muhlebach MS, Devery R, Greene CM, McElvaney NG. The Role of Short-Chain Fatty Acids, Produced by Anaerobic Bacteria, in the Cystic Fibrosis Airway. Am J Respir Crit Care Med 2015; 192:1314-24. [PMID: 26266556 PMCID: PMC4731701 DOI: 10.1164/rccm.201505-0943oc] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/12/2015] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Anaerobic bacteria are present in large numbers in the airways of people with cystic fibrosis (PWCF). In the gut, anaerobes produce short-chain fatty acids (SCFAs) that modulate immune and inflammatory processes. OBJECTIVES To investigate the capacity of anaerobes to contribute to cystic fibrosis (CF) airway pathogenesis via SCFAs. METHODS Samples of 109 PWCF were processed using anaerobic microbiological culture with bacteria present identified by 16S RNA sequencing. SCFA levels in anaerobic supernatants and bronchoalveolar lavage (BAL) were determined by gas chromatography. The mRNA and/or protein expression of two SCFA receptors, GPR41 and GPR43, in CF and non-CF bronchial brushings and 16HBE14o(-) and CFBE41o(-) cells were evaluated using reverse transcription polymerase chain reaction, Western blot analysis, laser scanning cytometry, and confocal microscopy. SCFA-induced IL-8 secretion was monitored by ELISA. MEASUREMENTS AND MAIN RESULTS Fifty-seven (52.3%) of 109 PWCF were anaerobe positive. Prevalence increased with age, from 33.3% to 57.7% in PWCF younger (n = 24) and older (n = 85) than 6 years of age. All evaluated anaerobes produced millimolar concentrations of SCFAs, including acetic, propionic, and butyric acids. SCFA levels were higher in BAL samples of adults than in those of children. GPR41 levels were elevated in CFBE41o(-) versus 16HBE14o(-) cells; CF versus non-CF bronchial brushings; and 16HBE14o(-) cells after treatment with cystic fibrosis transmembrane conductance regulator inhibitor CFTR(inh)-172, CF BAL, or inducers of endoplasmic reticulum stress. SCFAs induced a dose-dependent and pertussis toxin-sensitive IL-8 response in bronchial epithelial cells, with a higher production of IL-8 in CFBE41o(-) than in 16HBE14o(-) cells. CONCLUSIONS This study illustrates that SCFAs contribute to excessive production of IL-8 in CF airways colonized with anaerobes via up-regulated GPR41.
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Affiliation(s)
- Bojana Mirković
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Michelle A. Murray
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Gillian M. Lavelle
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Kevin Molloy
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Ahmed Abdul Azim
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Cedric Gunaratnam
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Fiona Healy
- Temple Street Children’s University Hospital, Dublin, Ireland
| | | | - Paul McNally
- Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
| | - Joe Hatch
- Cystic Fibrosis/Pulmonary Research and Treatment Center
- Department of Microbiology and Immunology, and
| | - Matthew Wolfgang
- Cystic Fibrosis/Pulmonary Research and Treatment Center
- Department of Microbiology and Immunology, and
| | - Michael M. Tunney
- CF & Airways Microbiology Group and
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom; and
| | - Marianne S. Muhlebach
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rosaleen Devery
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Catherine M. Greene
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Noel G. McElvaney
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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Gileles-Hillel A, Shoseyov D, Polacheck I, Korem M, Kerem E, Cohen-Cymberknoh M. Association of chronic Candida albicans respiratory infection with a more severe lung disease in patients with cystic fibrosis. Pediatr Pulmonol 2015; 50:1082-9. [PMID: 26383963 DOI: 10.1002/ppul.23302] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 07/27/2015] [Accepted: 08/22/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite the increase in fungal isolates, the significance of chronic Candida albicans airway colonization in CF is unclear. AIM To investigate the impact of C. albicans airway colonization on CF disease severity. METHODS Longitudinal analysis of clinical data from CF patients followed during 2003-2009 at our CF center. Patients were stratified based on their C. albicans colonization status--chronic, intermittent, and none. RESULTS A total of 4,244 cultures were obtained from 91 patients (mean age 19.7 years, range 5-68). The three colonization groups were similar in age, gender,and body mass index (BMI). Compared to the non-colonized group (n = 27, 30%), the chronic C. albicans colonization group (n = 34, 37%), had a significantly lower FEV1 percent predicted (74.3 ± 23.1% vs. 93.9% ± 22.2) with a higher annual rate of FEV1 decline (-1.9 ± 4.2% vs. 0.7 ± 4.5%). The patients who were intermittently colonized with C. albicans had intermediate values. CONCLUSIONS Chronic respiratory colonization of C. albicans is associated with worsening of FEV1 in CF. Prospective studies are needed to confirm this finding and to corroborate whether indeed C. albicans drives a deleterious lung phenotype.
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Affiliation(s)
- Alex Gileles-Hillel
- Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - David Shoseyov
- Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Itzhack Polacheck
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Maya Korem
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Eitan Kerem
- Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Malena Cohen-Cymberknoh
- Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
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Abstract
Cystic fibrosis (CF) is the most common life-limiting inherited illness of whites. Most of the morbidity and mortality in CF stems from impaired mucociliary clearance leading to chronic, progressive airways obstruction and damage. Significant progress has been made in the care of patients with CF, with advances focused on improving mucociliary clearance, minimizing inflammatory damage, and managing infections; these advances include new antimicrobial therapies, mucolytic and osmotic agents, and antiinflammatory treatments. More recently, researchers have targeted disease-causing mutations using therapies to promote gene transcription and improve channel function, which has led to impressive physiologic changes in some patients. As we develop more advanced, allele-directed therapies for the management of CF, it will become increasingly important to understand the specific genetic and environmental interactions that cause the significant heterogeneity of lung disease seen in the CF population. This understanding of CF endotypes will allow for more targeted, personalized therapies for future patients. This article reviews the genetic and molecular basis of CF lung disease, the treatments currently available, and novel therapies that are in development.
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Affiliation(s)
| | - Thomas W Ferkol
- Department of Pediatrics; Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO
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129
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Xie N, Liu G. ncRNA-regulated immune response and its role in inflammatory lung diseases. Am J Physiol Lung Cell Mol Physiol 2015; 309:L1076-87. [PMID: 26432871 DOI: 10.1152/ajplung.00286.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 09/29/2015] [Indexed: 02/08/2023] Open
Abstract
Despite the greatly expanded knowledge on the regulation of immune response by protein molecules, there is increasing understanding that noncoding RNAs (ncRNAs) are also an integral component of this regulatory network. Abnormal immune response serves a central role in the initiation, progression, and exacerbation of inflammatory lung diseases, such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, and acute respiratory distress syndrome/acute lung injury. Dysregulation of ncRNAs has been linked to various immunopathologies. In this review, we highlighted the role of ncRNAs in the regulation of innate and adaptive immunity and summarized recent findings that ncRNAs participate in the pathogenesis of inflammatory lung diseases via their regulation of pulmonary immunity. We also discussed therapeutic potentials for targeting ncRNAs to treat these lung disorders.
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Affiliation(s)
- Na Xie
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gang Liu
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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130
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Abstract
Cystic fibrosis is the most common genetically determined, life-limiting disorder in populations of European ancestry. The genetic basis of cystic fibrosis is well established to be mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene that codes for an apical membrane chloride channel principally expressed by epithelial cells. Conventional approaches to cystic fibrosis care involve a heavy daily burden of supportive treatments to combat lung infection, help clear airway secretions and maintain nutritional status. In 2012, a new era of precision medicine in cystic fibrosis therapeutics began with the licensing of a small molecule, ivacaftor, which successfully targets the underlying defect and improves CFTR function in a subgroup of patients in a genotype-specific manner. Here, we review the three main targeted approaches that have been adopted to improve CFTR function: potentiators, which recover the function of CFTR at the apical surface of epithelial cells that is disrupted in class III and IV genetic mutations; correctors, which improve intracellular processing of CFTR, increasing surface expression, in class II mutations; and production correctors or read-through agents, which promote transcription of CFTR in class I mutations. The further development of such approaches offers great promise for future therapeutic strategies in cystic fibrosis.
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131
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Dauletbaev N, Cammisano M, Herscovitch K, Lands LC. Stimulation of the RIG-I/MAVS Pathway by Polyinosinic:Polycytidylic Acid Upregulates IFN-β in Airway Epithelial Cells with Minimal Costimulation of IL-8. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2015; 195:2829-41. [PMID: 26283481 DOI: 10.4049/jimmunol.1400840] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/22/2015] [Indexed: 12/24/2022]
Abstract
Pharmacological stimulation of the antiviral cytokine IFN-β in the airways may help to counter deleterious virus-induced exacerbations in chronic inflammatory lung diseases (asthma, chronic obstructive pulmonary disease, or cystic fibrosis). Polyinosinic-polycytidylic acid [poly(I:C)] is a known inducer of IFN-β but also costimulates an inflammatory response. The latter response is undesirable given the pre-existing airway inflammation in these diseases. The objective of our study was to identify conditions for poly(I:C) to selectively upregulate IFN-β in airway epithelial cells without a concomitant inflammatory response. The inflammatory response was gauged by production of the chemokine IL-8. Using cell lines and primary airway epithelial cells (both submerged and well-differentiated), we observed that pure poly(I:C) stimulated IFN-β mainly through the TLR3/TRIF pathway and IL-8 through an unidentified pathway. The magnitude of the IL-8 response stimulated by pure poly(I:C) matched or even exceeded that of IFN-β. Furthermore, this IL-8 response could not be pharmacologically downregulated without affecting IFN-β. In contrast, we show that stimulation of the RIG-I/MAVS pathway, such as when poly(I:C) is delivered intracellularly in a complex with liposomes or via nucleofection, selectively stimulates IFN-β with low IL-8 costimulation. The magnitude of IFN-β stimulation by liposome-encapsulated poly(I:C) is markedly diminished in well-differentiated cells. In conclusion, it is feasible to augment IFN-β production in airway epithelial cells without excessive costimulation of IL-8 if the RIG-I/MAVS pathway is stimulated, such as via liposomal delivery of poly(I:C). Better cytoplasmic delivery vehicles are needed to efficiently stimulate this pathway in well-differentiated cells.
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Affiliation(s)
- Nurlan Dauletbaev
- The Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada; and
| | - Maria Cammisano
- The Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada; and
| | - Kassey Herscovitch
- The Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada; and
| | - Larry C Lands
- Respiratory Medicine, Montreal Children's Hospital, Montreal, Quebec H4A 3J1, Canada
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Dzinic SH, Chen K, Thakur A, Kaplun A, Bonfil RD, Li X, Liu J, Bernardo MM, Saliganan A, Back JB, Yano H, Schalk DL, Tomaszewski EN, Beydoun AS, Dyson G, Mujagic A, Krass D, Dean I, Mi QS, Heath E, Sakr W, Lum LG, Sheng S. Maspin expression in prostate tumor elicits host anti-tumor immunity. Oncotarget 2015; 5:11225-36. [PMID: 25373490 PMCID: PMC4294340 DOI: 10.18632/oncotarget.2615] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 10/21/2014] [Indexed: 12/13/2022] Open
Abstract
The goal of the current study is to examine the biological effects of epithelial-specific tumor suppressor maspin on tumor host immune response. Accumulated evidence demonstrates an anti-tumor effect of maspin on tumor growth, invasion and metastasis. The molecular mechanism underlying these biological functions of maspin is thought to be through histone deacetylase inhibition, key to the maintenance of differentiated epithelial phenotype. Since tumor-driven stromal reactivities co-evolve in tumor progression and metastasis, it is not surprising that maspin expression in tumor cells inhibits extracellular matrix degradation, increases fibrosis and blocks hypoxia-induced angiogenesis. Using the athymic nude mouse model capable of supporting the growth and progression of xenogeneic human prostate cancer cells, we further demonstrate that maspin expression in tumor cells elicits neutrophil- and B cells-dependent host tumor immunogenicity. Specifically, mice bearing maspin-expressing tumors exhibited increased systemic and intratumoral neutrophil maturation, activation and antibody-dependent cytotoxicity, and decreased peritumoral lymphangiogenesis. These results reveal a novel biological function of maspin in directing host immunity towards tumor elimination that helps explain the significant reduction of xenograft tumor incidence in vivo and the clinical correlation of maspin with better prognosis of several types of cancer. Taken together, our data raised the possibility for novel maspin-based cancer immunotherapies.
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Affiliation(s)
- Sijana H Dzinic
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Kang Chen
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan. Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan. Department of Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), Detroit, Michigan. Mucosal Immunology Studies Team, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland
| | - Archana Thakur
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Alexander Kaplun
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Current address: BIOBASE Corporation, Beverly, Massachusetts
| | - R Daniel Bonfil
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Urology, Wayne State University School of Medicine, Detroit, Michigan
| | - Xiaohua Li
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Jason Liu
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - M Margarida Bernardo
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Allen Saliganan
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Urology, Wayne State University School of Medicine, Detroit, Michigan
| | - Jessica B Back
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Hiroshi Yano
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Dana L Schalk
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Elyse N Tomaszewski
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Ahmed S Beydoun
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Gregory Dyson
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Adelina Mujagic
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - David Krass
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Ivory Dean
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Qing-Sheng Mi
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, Michigan. Henry Ford Health Systems, Detroit, Michigan
| | - Elisabeth Heath
- Department of Urology, Wayne State University School of Medicine, Detroit, Michigan. Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Wael Sakr
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Lawrence G Lum
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan. Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan
| | - Shijie Sheng
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan. Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
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133
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Stellari F, Bergamini G, Sandri A, Donofrio G, Sorio C, Ruscitti F, Villetti G, Assael BM, Melotti P, Lleo MM. In vivo imaging of the lung inflammatory response to Pseudomonas aeruginosa and its modulation by azithromycin. J Transl Med 2015; 13:251. [PMID: 26239109 PMCID: PMC4522964 DOI: 10.1186/s12967-015-0615-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/21/2015] [Indexed: 01/08/2023] Open
Abstract
Background Chronic inflammation of the airways is a central component in lung diseases and is frequently associated with bacterial infections. Monitoring the pro-inflammatory capability of bacterial virulence factors in vivo is challenging and usually requires invasive methods. Methods Lung inflammation was induced using the culture supernatants from two Pseudomonas aeruginosa clinical strains, VR1 and VR2, isolated from patients affected by cystic fibrosis and showing different phenotypes in terms of motility, colony characteristics and biofilm production as well as pyoverdine and pyocyanine release. More interesting, the strains differ also for the presence in supernatants of metalloproteases, a family of virulence factors with known pro-inflammatory activity. We have evaluated the benefit of using a mouse model, transiently expressing the luciferase reporter gene under the control of an heterologous IL-8 bovine promoter, to detect and monitoring lung inflammation. Results In vivo imaging indicated that VR1 strain, releasing in its culture supernatant metalloproteases and other virulence factors, induced lung inflammation while the VR2 strain presented with a severely reduced pro-inflammatory activity. The bioluminescence signal was detectable from 4 to 48 h after supernatant instillation. The animal model was also used to test the anti-inflammatory activity of azithromycin (AZM), an antibiotic with demonstrated inhibitory effect on the synthesis of bacterial exoproducts. The inflammation signal in mice was in fact significantly reduced when bacteria grew in the presence of a sub-lethal dose of AZM causing inhibition of the synthesis of metalloproteases and other bacterial elements. The in vivo data were further supported by quantification of immune cells and cytokine expression in mouse broncho-alveolar lavage samples. Conclusions This experimental animal model is based on the transient transduction of the bovine IL-8 promoter, a gene representing a major player during inflammation, essential for leukocytes recruitment to the inflamed tissue. It appears to be an appropriate molecular read-out for monitoring the activation of inflammatory pathways caused by bacterial virulence factors. The data presented indicate that the model is suitable to functionally monitor in real time the lung inflammatory response facilitating the identification of bacterial factors with pro-inflammatory activity and the evaluation of the anti-inflammatory activity of old and new molecules for therapeutic use.
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Affiliation(s)
- Fabio Stellari
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A. Parma, Largo Belloli, 11/A, 43122, Parma, Italy.
| | - Gabriella Bergamini
- Dipartimento di Patologia e Diagnostica, Università di Verona, Verona, Italy.
| | - Angela Sandri
- Dipartimento di Patologia e Diagnostica, Università di Verona, Verona, Italy.
| | - Gaetano Donofrio
- Dipartimento di Scienze Medico Veterinarie, Università di Parma, Parma, Italy.
| | - Claudio Sorio
- Dipartimento di Patologia e Diagnostica, Università di Verona, Verona, Italy.
| | - Francesca Ruscitti
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università di Parma, Parma, Italy.
| | - Gino Villetti
- Pharmacology and Toxicology Department Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A. Parma, Largo Belloli, 11/A, 43122, Parma, Italy.
| | - Barouk M Assael
- Centro Regionale Fibrosi Cistica, AOUI Verona, Verona, Italy.
| | - Paola Melotti
- Centro Regionale Fibrosi Cistica, AOUI Verona, Verona, Italy.
| | - Maria M Lleo
- Dipartimento di Patologia e Diagnostica, Università di Verona, Verona, Italy.
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Mazzi P, Caveggion E, Lapinet-Vera JA, Lowell CA, Berton G. The Src-Family Kinases Hck and Fgr Regulate Early Lipopolysaccharide-Induced Myeloid Cell Recruitment into the Lung and Their Ability To Secrete Chemokines. THE JOURNAL OF IMMUNOLOGY 2015; 195:2383-95. [PMID: 26232427 DOI: 10.4049/jimmunol.1402011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 07/04/2015] [Indexed: 12/20/2022]
Abstract
Myeloid leukocyte recruitment into the lung in response to environmental cues represents a key factor for the induction of lung damage. We report that Hck- and Fgr-deficient mice show a profound impairment in early recruitment of neutrophils and monocytes in response to bacterial LPS. The reduction in interstitial and airway neutrophil recruitment was not due to a cell-intrinsic migratory defect, because Hck- and Fgr-deficient neutrophils were attracted to the airways by the chemokine CXCL2 as wild type cells. However, early accumulation of chemokines and TNF-α in the airways was reduced in hck(-/-)fgr(-/-) mice. Considering that chemokine and TNF-α release into the airways was neutrophil independent, as suggested by a comparison between control and neutrophil-depleted mice, we examined LPS-induced chemokine secretion by neutrophils and macrophages in wild type and mutant cells. Notably, mutant neutrophils displayed a marked deficit in their capability to release the chemokines CXCL1, CXCL2, CCL3, and CCL4 and TNF-α in response to LPS. However, intracellular accumulation of these chemokines and TNF-α, as well as secretion of a wide array of cytokines, including IL-1α, IL-1β, IL-6, and IL-10, by hck(-/-)fgr(-/-) neutrophils was normal. Intriguingly, secretion of CXCL1, CXCL2, CCL2, CCL3, CCL4, RANTES, and TNF-α, but not IL-1α, IL-1β, IL-6, IL-10, and GM-CSF, was also markedly reduced in bone marrow-derived macrophages. Consistently, the Src kinase inhibitors PP2 and dasatinib reduced chemokine secretion by neutrophils and bone marrow-derived macrophages. These findings identify Src kinases as a critical regulator of chemokine secretion in myeloid leukocytes during lung inflammation.
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Affiliation(s)
- Paola Mazzi
- Section of General Pathology, Department of Pathology and Diagnostics, University of Verona, Verona, 37134, Italy; and
| | - Elena Caveggion
- Section of General Pathology, Department of Pathology and Diagnostics, University of Verona, Verona, 37134, Italy; and
| | - Josè A Lapinet-Vera
- Section of General Pathology, Department of Pathology and Diagnostics, University of Verona, Verona, 37134, Italy; and
| | - Clifford A Lowell
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143
| | - Giorgio Berton
- Section of General Pathology, Department of Pathology and Diagnostics, University of Verona, Verona, 37134, Italy; and
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135
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Earl CS, An SQ, Ryan RP. The changing face of asthma and its relation with microbes. Trends Microbiol 2015; 23:408-18. [PMID: 25840766 PMCID: PMC4710578 DOI: 10.1016/j.tim.2015.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/27/2015] [Accepted: 03/09/2015] [Indexed: 12/21/2022]
Abstract
During the past 50 years, the prevalence of asthma has increased and this has coincided with our changing relation with microorganisms. Asthma is a complex disease associated with local tissue inflammation of the airway that is determined by environmental, immunological, and host genetic factors. In a subgroup of sufferers, respiratory infections are associated with the development of chronic disease and more frequent inflammatory exacerbations. Recent studies suggest that these infections are polymicrobial in nature. Furthermore, there is increasing evidence that the recently discovered asthma airway microbiota may play a critical role in pathophysiological processes associated with the disease. Here, we discuss the current data regarding a possible role for infection in chronic asthma with a particular focus on the role bacteria may play. We discuss recent advances that are beginning to elucidate the complex relations between the microbiota and the immune response in asthma patients. We also highlight the clinical implications of these recent findings in regards to the development of novel therapeutic strategies.
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Affiliation(s)
- Chris S Earl
- Division of Molecular Microbiology, College of Life Sciences, University of Dundee, Dundee, UK
| | - Shi-qi An
- Division of Molecular Microbiology, College of Life Sciences, University of Dundee, Dundee, UK
| | - Robert P Ryan
- Division of Molecular Microbiology, College of Life Sciences, University of Dundee, Dundee, UK.
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Ermund A, Meiss LN, Gustafsson JK, Hansson GC. Hyper-osmolarity and calcium chelation: Effects on cystic fibrosis mucus. Eur J Pharmacol 2015; 764:109-117. [PMID: 26134505 DOI: 10.1016/j.ejphar.2015.06.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/22/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022]
Abstract
A non-functional Cystic Fibrosis Transmembrane conductance Regulator (CFTR) leads to the disease cystic fibrosis (CF). Although the CFTR is expressed in multiple organs, pulmonary disease is the major cause of illness and death in patients with CF. Stagnant mucus, causing airway obstruction, bacterial overgrowth, persistent inflammation and tissue destruction characterizes the disease, but how the defect in CFTR function is coupled to the mucus phenotype is still controversial. We have recently shown that bicarbonate ions passing through CFTR are necessary for proper unfolding of the MUC2 mucin, thus highlighting the importance of bicarbonate ion transport via the CFTR and the ability of these ions to raise the pH and chelate calcium bound to the mucin as the important steps in forming normal mucus. In order to find potential CF treatments and expand our knowledge about the usefulness of bicarbonate as an active ingredient in formulations to alleviate mucus plugging, we used an Ussing-type chamber and explants from the F508del-CFTR mutant mouse ileum to test the effect of calcium chelators on mucus attachment, either in isolation or in combination with osmolytes such as mannitol or hypertonic saline. We found that increasing the concentration of bicarbonate, both alone or in combination with increased osmolarity of the solution, detached the otherwise attached CF mucus.
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Affiliation(s)
- Anna Ermund
- Department of Medical Biochemistry, University of Gothenburg, Medicinaregatan 9A, SE-413 90 Gothenburg, Sweden.
| | - Lauren N Meiss
- Department of Medical Biochemistry, University of Gothenburg, Medicinaregatan 9A, SE-413 90 Gothenburg, Sweden
| | - Jenny K Gustafsson
- Department of Medical Biochemistry, University of Gothenburg, Medicinaregatan 9A, SE-413 90 Gothenburg, Sweden.
| | - Gunnar C Hansson
- Department of Medical Biochemistry, University of Gothenburg, Medicinaregatan 9A, SE-413 90 Gothenburg, Sweden.
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Tatke G, Kumari H, Silva-Herzog E, Ramirez L, Mathee K. Pseudomonas aeruginosa MifS-MifR Two-Component System Is Specific for α-Ketoglutarate Utilization. PLoS One 2015; 10:e0129629. [PMID: 26114434 PMCID: PMC4482717 DOI: 10.1371/journal.pone.0129629] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/10/2015] [Indexed: 12/31/2022] Open
Abstract
Pseudomonas aeruginosa is a Gram-negative, metabolically versatile opportunistic pathogen that elaborates a multitude of virulence factors, and is extraordinarily resistant to a gamut of clinically significant antibiotics. This ability, in part, is mediated by two-component regulatory systems (TCS) that play a crucial role in modulating virulence mechanisms and metabolism. MifS (PA5512) and MifR (PA5511) form one such TCS implicated in biofilm formation. MifS is a sensor kinase whereas MifR belongs to the NtrC superfamily of transcriptional regulators that interact with RpoN (σ54). In this study we demonstrate that the mifS and mifR genes form a two-gene operon. The close proximity of mifSR operon to poxB (PA5514) encoding a ß-lactamase hinted at the role of MifSR TCS in regulating antibiotic resistance. To better understand this TCS, clean in-frame deletions were made in P. aeruginosa PAO1 creating PAO∆mifS, PAO∆mifR and PAO∆mifSR. The loss of mifSR had no effect on the antibiotic resistance profile. Phenotypic microarray (BioLOG) analyses of PAO∆mifS and PAO∆mifR revealed that these mutants were unable to utilize C5-dicarboxylate α-ketoglutarate (α-KG), a key tricarboxylic acid cycle intermediate. This finding was confirmed using growth analyses, and the defect can be rescued by mifR or mifSR expressed in trans. These mifSR mutants were able to utilize all the other TCA cycle intermediates (citrate, succinate, fumarate, oxaloacetate or malate) and sugars (glucose or sucrose) except α-KG as the sole carbon source. We confirmed that the mifSR mutants have functional dehydrogenase complex suggesting a possible defect in α-KG transport. The inability of the mutants to utilize α-KG was rescued by expressing PA5530, encoding C5-dicarboxylate transporter, under a regulatable promoter. In addition, we demonstrate that besides MifSR and PA5530, α-KG utilization requires functional RpoN. These data clearly suggests that P. aeruginosa MifSR TCS is involved in sensing α-KG and regulating its transport and subsequent metabolism.
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Affiliation(s)
- Gorakh Tatke
- Department of Biological Sciences, College of Arts & Sciences, Florida International University, Miami, Florida, United States of America
- Department of Molecular Microbiology and Infectious Diseases, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Hansi Kumari
- Department of Molecular Microbiology and Infectious Diseases, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Eugenia Silva-Herzog
- Department of Molecular Microbiology and Infectious Diseases, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Lourdes Ramirez
- Department of Biological Sciences, College of Arts & Sciences, Florida International University, Miami, Florida, United States of America
| | - Kalai Mathee
- Department of Molecular Microbiology and Infectious Diseases, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
- * E-mail:
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Müller U, Hentschel J, Janhsen WK, Hünniger K, Hipler UC, Sonnemann J, Pfister W, Böer K, Lehmann T, Mainz JG. Changes of Proteases, Antiproteases, and Pathogens in Cystic Fibrosis Patients' Upper and Lower Airways after IV-Antibiotic Therapy. Mediators Inflamm 2015; 2015:626530. [PMID: 26185365 PMCID: PMC4491395 DOI: 10.1155/2015/626530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/18/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In cystic fibrosis (CF) the upper (UAW) and lower airways (LAW) are reservoirs for pathogens like Pseudomonas aeruginosa. The consecutive hosts' release of proteolytic enzymes contributes to inflammation and progressive pulmonary destruction. Objectives were to assess dynamics of protease : antiprotease ratios and pathogens in CF-UAW and LAW sampled by nasal lavage (NL) and sputum before and after intravenous- (IV-) antibiotic therapy. METHODS From 19 IV-antibiotic courses of 17 CF patients NL (10 mL/nostril) and sputum were collected before and after treatment. Microbiological colonization and concentrations of NE/SLPI/CTSS (ELISA) and MMP-9/TIMP-1 (multiplex bead array) were determined. Additionally, changes of sinonasal symptoms were assessed (SNOT-20). RESULTS IV-antibiotic treatment had more pronounced effects on inflammatory markers in LAW, whereas trends to decrease were also found in UAW. Ratios of MMP-9/TIMP-1 were higher in sputum, and ratios of NE/SLPI were higher in NL. Remarkably, NE/SLPI ratio was 10-fold higher in NL compared to healthy controls. SNOT-20 scores decreased significantly during therapy (P = 0.001). CONCLUSION For the first time, changes in microbiological patterns in UAW and LAW after IV-antibiotic treatments were assessed, together with changes of protease/antiprotease imbalances. Delayed responses of proteases and antiproteases to IV-antibiotic therapy were found in UAW compared to LAW.
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Affiliation(s)
- Ulrike Müller
- Department of Pediatrics, Cystic Fibrosis Center, Jena University Hospital, 07740 Jena, Germany
| | - Julia Hentschel
- Department of Pediatrics, Cystic Fibrosis Center, Jena University Hospital, 07740 Jena, Germany
| | - Wibke K. Janhsen
- Department of Pediatrics, Cystic Fibrosis Center, Jena University Hospital, 07740 Jena, Germany
| | - Kerstin Hünniger
- Septomics Research Center, Friedrich Schiller University, 07745 Jena, Germany
- Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany
| | | | - Jürgen Sonnemann
- Department of Pediatric Hematology and Oncology, Jena University Hospital, 07740 Jena, Germany
| | - Wolfgang Pfister
- Institute of Medical Microbiology, University of Jena, 07740 Jena, Germany
| | - Klas Böer
- Institute for Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, 07740 Jena, Germany
| | - Thomas Lehmann
- Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, 07740 Jena, Germany
| | - Jochen G. Mainz
- Department of Pediatrics, Cystic Fibrosis Center, Jena University Hospital, 07740 Jena, Germany
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139
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Genetic Deletion and Pharmacological Inhibition of PI3K γ Reduces Neutrophilic Airway Inflammation and Lung Damage in Mice with Cystic Fibrosis-Like Lung Disease. Mediators Inflamm 2015; 2015:545417. [PMID: 26185363 PMCID: PMC4491401 DOI: 10.1155/2015/545417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/20/2015] [Indexed: 01/09/2023] Open
Abstract
Purpose. Neutrophil-dominated airway inflammation is a key feature of progressive lung damage in cystic fibrosis (CF). Thus, reducing airway inflammation is a major goal to prevent lung damage in CF. However, current anti-inflammatory drugs have shown several limits. PI3Kγ plays a pivotal role in leukocyte recruitment and activation; in the present study we determined the effects of genetic deletion and pharmacologic inhibition of PI3Kγ on airway inflammation and structural lung damage in a mouse model of CF lung disease. Methods. βENaC overexpressing mice (βENaC-Tg) were backcrossed with PI3Kγ-deficient (PI3KγKO) mice. Tissue damage was assessed by histology and morphometry and inflammatory cell number was evaluated in bronchoalveolar lavage fluid (BALF). Furthermore, we assessed the effect of a specific PI3Kγ inhibitor (AS-605240) on inflammatory cell number in BALF. Results. Genetic deletion of PI3Kγ decreased neutrophil numbers in BALF of PI3KγKO/βENaC-Tg mice, and this was associated with reduced emphysematous changes. Treatment with the PI3Kγ inhibitor AS-605240 decreased the number of neutrophils in BALF of βENaC-Tg mice, reproducing the effect observed with genetic deletion of the enzyme. Conclusions. These results demonstrate the biological efficacy of both genetic deletion and pharmacological inhibition of PI3Kγ in reducing chronic neutrophilic inflammation in CF-like lung disease in vivo.
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140
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Choi HC, Kim CSK, Tarran R. Automated acquisition and analysis of airway surface liquid height by confocal microscopy. Am J Physiol Lung Cell Mol Physiol 2015; 309:L109-18. [PMID: 26001773 DOI: 10.1152/ajplung.00027.2015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 05/14/2015] [Indexed: 11/22/2022] Open
Abstract
The airway surface liquid (ASL) is a thin-liquid layer that lines the luminal side of airway epithelia. ASL contains many molecules that are involved in primary innate defense in the lung. Measurement of ASL height on primary airway cultures by confocal microscopy is a powerful tool that has enabled researchers to study ASL physiology and pharmacology. Previously, ASL image acquisition and analysis were performed manually. However, this process is time and labor intensive. To increase the throughput, we have developed an automatic ASL measurement technique that combines a fully automated confocal microscope with novel automatic image analysis software that was written with image processing techniques derived from the computer science field. We were able to acquire XZ ASL images at the rate of ∼ 1 image/s in a reproducible fashion. Our automatic analysis software was able to analyze images at the rate of ∼ 32 ms/image. As proofs of concept, we generated a time course for ASL absorption and a dose response in the presence of SPLUNC1, a known epithelial sodium channel inhibitor, on human bronchial epithelial cultures. Using this approach, we determined the IC50 for SPLUNC1 to be 6.53 μM. Furthermore, our technique successfully detected a difference in ASL height between normal and cystic fibrosis (CF) human bronchial epithelial cultures and detected changes in ATP-stimulated Cl(-)/ASL secretion. We conclude that our automatic ASL measurement technique can be applied for repeated ASL height measurements with high accuracy and consistency and increased throughput.
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Affiliation(s)
- Hyun-Chul Choi
- Department of Electronic Engineering, Yeungnam University, Kyungsan, Kyungbuk, South Korea; and
| | - Christine Seul Ki Kim
- Cystic Fibrosis Center/Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina
| | - Robert Tarran
- Cystic Fibrosis Center/Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina
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141
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Trinh NTN, Bilodeau C, Maillé É, Ruffin M, Quintal MC, Desrosiers MY, Rousseau S, Brochiero E. Deleterious impact of Pseudomonas aeruginosa on cystic fibrosis transmembrane conductance regulator function and rescue in airway epithelial cells. Eur Respir J 2015; 45:1590-602. [PMID: 25792634 DOI: 10.1183/09031936.00076214] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 12/28/2014] [Indexed: 11/05/2022]
Abstract
The epithelial response to bacterial airway infection, a common feature of lung diseases such as chronic obstructive pulmonary disease and cystic fibrosis, has been extensively studied. However, its impact on cystic fibrosis transmembrane conductance regulator (CFTR) channel function is not clearly defined. Our aims were, therefore, to evaluate the effect of Pseudomonas aeruginosa on CFTR function and expression in non-cystic fibrosis airway epithelial cells, and to investigate its impact on ΔF508-CFTR rescue by the VRT-325 corrector in cystic fibrosis cells. CFTR expression/maturation was evaluated by immunoblotting and its function by short-circuit current measurements. A 24-h exposure to P. aeruginosa diffusible material (PsaDM) reduced CFTR currents as well as total and membrane protein expression of the wildtype (wt) CFTR protein in CFBE-wt cells. In CFBE-ΔF508 cells, PsaDM severely reduced CFTR maturation and current rescue induced by VRT-325. We also confirmed a deleterious impact of PsaDM on wt-CFTR currents in non-cystic fibrosis primary airway cells as well as on the rescue of ΔF508-CFTR function induced by VRT-325 in primary cystic fibrosis cells. These findings show that CFTR function could be impaired in non-cystic fibrosis patients infected by P. aeruginosa. Our data also suggest that CFTR corrector efficiency may be affected by infectious components, which should be taken into account in screening assays of correctors.
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Affiliation(s)
- Nguyen Thu Ngan Trinh
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada Dept de médecine, Université de Montréal, Montréal, QC, Canada Both authors contributed equally
| | - Claudia Bilodeau
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada Dept de médecine, Université de Montréal, Montréal, QC, Canada Both authors contributed equally
| | - Émilie Maillé
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Manon Ruffin
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada Dept de médecine, Université de Montréal, Montréal, QC, Canada
| | - Marie-Claude Quintal
- Paediatric Otolaryngology Service, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Martin-Yvon Desrosiers
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Simon Rousseau
- Meakins-Christie Laboratories, Dept of Medicine, McGill University, Montréal, QC, Canada
| | - Emmanuelle Brochiero
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada Dept de médecine, Université de Montréal, Montréal, QC, Canada
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142
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Glasgow AMA, Small DM, Scott A, McLean DT, Camper N, Hamid U, Hegarty S, Parekh D, O'Kane C, Lundy FT, McNally P, Elborn JS, McAuley DF, Weldon S, Taggart CC. A role for whey acidic protein four-disulfide-core 12 (WFDC12) in the regulation of the inflammatory response in the lung. Thorax 2015; 70:426-32. [PMID: 25770093 DOI: 10.1136/thoraxjnl-2014-206488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/10/2015] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Secretory leucocyte protease inhibitor and elafin are members of the whey acidic protein (WAP), or WAP four disulfide-core (WFDC), family of proteins and have multiple contributions to innate defence including inhibition of neutrophil serine proteases and inhibition of the inflammatory response to lipopolysaccharide (LPS). This study aimed to explore potential activities of WFDC12, a previously uncharacterised WFDC protein expressed in the lung. METHODS Recombinant expression and purification of WFDC12 were optimised in Escherichia coli. Antiprotease, antibacterial and immunomodulatory activities of recombinant WFDC12 were evaluated and levels of endogenous WFDC12 protein were characterised by immunostaining and ELISA. RESULTS Recombinant WFDC12 inhibited cathepsin G, but not elastase or proteinase-3 activity. Monocytic cells pretreated with recombinant WFDC12 before LPS stimulation produced significantly lower levels of the pro-inflammatory cytokines interleukin-8 and monocyte chemotactic protein-1 compared with cells stimulated with LPS alone. Recombinant WFDC12 became conjugated to fibronectin in a transglutaminase-mediated reaction and retained antiprotease activity. In vivo WFDC12 expression was confirmed by immunostaining of human lung tissue sections. WFDC12 levels in human bronchoalveolar lavage fluid from healthy and lung-injured patients were quantitatively compared, showing WFDC12 to be elevated in both patients with acute respiratory distress syndrome and healthy subjects treated with LPS, relative to healthy controls. CONCLUSIONS Together, these results suggest a role for this lesser known WFDC protein in the regulation of lung inflammation.
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Affiliation(s)
- Arlene M A Glasgow
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Donna M Small
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Aaron Scott
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Denise T McLean
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Nicolas Camper
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Umar Hamid
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Shauna Hegarty
- Department of Pathology, Royal Victoria Hospital, Belfast, UK
| | - Dhruv Parekh
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Cecilia O'Kane
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Fionnuala T Lundy
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Paul McNally
- Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - J Stuart Elborn
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Danny F McAuley
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Sinéad Weldon
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
| | - Clifford C Taggart
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK
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143
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Azithromycin use in patients with cystic fibrosis. Eur J Clin Microbiol Infect Dis 2015; 34:1071-9. [DOI: 10.1007/s10096-015-2347-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 02/01/2015] [Indexed: 12/14/2022]
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144
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Kamath KS, Kumar SS, Kaur J, Venkatakrishnan V, Paulsen IT, Nevalainen H, Molloy MP. Proteomics of hosts and pathogens in cystic fibrosis. Proteomics Clin Appl 2015; 9:134-46. [DOI: 10.1002/prca.201400122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/27/2014] [Accepted: 11/18/2014] [Indexed: 12/13/2022]
Affiliation(s)
| | - Sheemal Shanista Kumar
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Jashanpreet Kaur
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | | | - Ian T. Paulsen
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Helena Nevalainen
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Mark P. Molloy
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
- Australian Proteome Analysis Facility; Macquarie University; Sydney Australia
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145
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Cao K, Chen M, Jie X, Wang Y, Li Q, Xu J. H5N1 Virus Hemagglutinin Inhibition of cAMP-Dependent CFTR via TLR4-Mediated Janus Tyrosine Kinase 3 Activation Exacerbates Lung Inflammation. Mol Med 2015; 21:134-42. [PMID: 25587856 PMCID: PMC4461576 DOI: 10.2119/molmed.2014.00189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/12/2015] [Indexed: 01/19/2023] Open
Abstract
The host tolerance mechanisms to avian influenza virus (H5N1) infection that limit tissue injury remain unknown. Emerging evidence indicates that cystic fibrosis transmembrane conductance regulator (CFTR), a cAMP-dependent Cl− channel, modulates airway inflammation. Janus tyrosine kinase (JAK) 3, a JAK family member that plays a central role in inflammatory responses, prominently contributes to the dysregulated innate immune response upon H5N1 attachment; therefore, this study aims to elucidate whether JAK3 activation induced by H5N1 hemagglutinin (HA) inhibits cAMP-dependent CFTR channels. We performed short-circuit current, immunohistochemistry and molecular analyses of the airway epithelium in Jak3+/+ and Jak3+/− mice. We demonstrate that H5N1 HA attachment inhibits cAMP-dependent CFTR Cl− channels via JAK3-mediated adenylyl cyclase (AC) suppression, which reduces cAMP production. This inhibition leads to increased nuclear factor-kappa B (NF-κB) signaling and inflammatory responses. H5N1 HA is detected by TLR4 expressed on respiratory epithelial cells, facilitating JAK3 activation. This activation induces the interaction between TLR4 and Gαi protein, which blocks ACs. Our findings provide novel insight into the pathogenesis of acute lung injury via the inhibition of cAMP-dependent CFTR channels, indicating that the administration of cAMP-elevating agents and targeting JAK3 may activate host tolerance to infection for the management of influenza virus–induced fatal pneumonia.
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Affiliation(s)
- Ke Cao
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Minhui Chen
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Xiang Jie
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yansheng Wang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Qiasheng Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Jun Xu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
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146
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Reverri EJ, Morrissey BM, Cross CE, Steinberg FM. Inflammation, oxidative stress, and cardiovascular disease risk factors in adults with cystic fibrosis. Free Radic Biol Med 2014; 76:261-77. [PMID: 25172163 DOI: 10.1016/j.freeradbiomed.2014.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/31/2014] [Accepted: 08/05/2014] [Indexed: 12/21/2022]
Abstract
Cystic fibrosis (CF) represents one of a number of localized lung and non-lung diseases with an intense chronic inflammatory component associated with evidence of systemic oxidative stress. Many of these chronic inflammatory diseases are accompanied by an array of atherosclerotic processes and cardiovascular disease (CVD), another condition strongly related to inflammation and oxidative stress. As a consequence of a dramatic increase in long-lived patients with CF in recent decades, the specter of CVD must be considered in these patients who are now reaching middle age and beyond. Buttressed by recent data documenting that CF patients exhibit evidence of endothelial dysfunction, a recognized precursor of atherosclerosis and CVD, the spectrum of risk factors for CVD in CF is reviewed here. Epidemiological data further characterizing the presence and extent of atherogenic processes in CF patients would seem important to obtain. Such studies should further inform and offer mechanistic insights into how other chronic inflammatory diseases potentiate the processes leading to CVDs.
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Affiliation(s)
- Elizabeth J Reverri
- Department of Nutrition, University of California Davis, One Shields Avenue, 3135 Meyer Hall, Davis, CA 95616, USA
| | - Brian M Morrissey
- Adult Cystic Fibrosis Clinic and Division of Pulmonary-Critical Care Medicine, University of California Davis Medical Center, 4150 V Street, Sacramento, CA 95817, USA
| | - Carroll E Cross
- Adult Cystic Fibrosis Clinic and Division of Pulmonary-Critical Care Medicine, University of California Davis Medical Center, 4150 V Street, Sacramento, CA 95817, USA.
| | - Francene M Steinberg
- Department of Nutrition, University of California Davis, One Shields Avenue, 3135 Meyer Hall, Davis, CA 95616, USA
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147
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Pfister S, Weber T, Härtig W, Schwerdel C, Elsaesser R, Knuesel I, Fritschy JM. Novel role of cystic fibrosis transmembrane conductance regulator in maintaining adult mouse olfactory neuronal homeostasis. J Comp Neurol 2014; 523:406-30. [PMID: 25271146 DOI: 10.1002/cne.23686] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 02/03/2023]
Abstract
The olfactory epithelium (OE) of mice deficient in cystic fibrosis transmembrane conductance regulator (CFTR) exhibits ion transport deficiencies reported in human CF airways, as well as progressive neuronal loss, suggesting defects in olfactory neuron homeostasis. Microvillar cells, a specialized OE cell-subtype, have been implicated in maintaining tissue homeostasis. These cells are endowed with a PLCβ2/IP3 R3/TRPC6 signal transduction pathway modulating release of neuropeptide Y (NPY), which stimulates OE stem cell activity. It is unknown, however, whether microvillar cells also mediate the deficits observed in CFTR-null mice. Here we show that Cftr mRNA in mouse OE is exclusively localized in microvillar cells and CFTR immunofluorescence is coassociated with the scaffolding protein NHERF-1 and PLCβ2 in microvilli. In CFTR-null mice, PLCβ2 was undetectable, NHERF-1 mislocalized, and IP3 R3 more intensely stained, along with increased levels of NPY, suggesting profound alteration of the PLCβ2/IP3 R3 signaling pathway. In addition, basal olfactory neuron homeostasis was altered, shown by increased progenitor cell proliferation, differentiation, and apoptosis and by reduced regenerative capacity following methimazole-induced neurodegeneration. The importance of CFTR in microvillar cells was further underscored by decreased thickness of the OE mucus layer and increased numbers of immune cells within this tissue in CFTR-KO mice. Finally, we observed enhanced immune responses to an acute viral-like infection, as well as hyper-responsiveness to chemical and physical stimuli applied intranasally. Taken together, these data strengthen the notion that microvillar cells in the OE play a key role in maintaining tissue homeostasis and identify several mechanisms underlying this regulation through the multiple functions of CFTR.
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Affiliation(s)
- Sandra Pfister
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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d'Angelo I, Conte C, La Rotonda MI, Miro A, Quaglia F, Ungaro F. Improving the efficacy of inhaled drugs in cystic fibrosis: challenges and emerging drug delivery strategies. Adv Drug Deliv Rev 2014; 75:92-111. [PMID: 24842473 DOI: 10.1016/j.addr.2014.05.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/23/2014] [Accepted: 05/09/2014] [Indexed: 02/06/2023]
Abstract
Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians associated with early death. Although the faulty gene is expressed in epithelia throughout the body, lung disease is still responsible for most of the morbidity and mortality of CF patients. As a local delivery route, pulmonary administration represents an ideal way to treat respiratory infections, excessive inflammation and other manifestations typical of CF lung disease. Nonetheless, important determinants of the clinical outcomes of inhaled drugs are the concentration/permanence at the lungs as well as the ability of the drug to overcome local extracellular and cellular barriers. This review focuses on emerging delivery strategies used for local treatment of CF pulmonary disease. After a brief description of the disease and formulation rules dictated by CF lung barriers, it describes current and future trends in inhaled drugs for CF. The most promising advanced formulations are discussed, highlighting the advantages along with the major challenges for researchers working in this field.
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Affiliation(s)
- Ivana d'Angelo
- Di.S.T.A.B.i.F., Second University of Napoli, Via Vivaldi 43, 81100 Caserta, Italy
| | - Claudia Conte
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Maria Immacolata La Rotonda
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Agnese Miro
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Fabiana Quaglia
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Francesca Ungaro
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
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Hussain S, Varelogianni G, Särndahl E, Roomans GM. N-acetylcysteine and azithromycin affect the innate immune response in cystic fibrosis bronchial epithelial cells in vitro. Exp Lung Res 2014; 41:251-60. [DOI: 10.3109/01902148.2014.934411] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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150
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Pereira LCR, Moreira EAM, Bennemann GD, Moreno YMF, Buss ZDS, Barbosa E, Ludwig-Neto N, Wilhelm Filho D, Fröde TS. Influence of inflammatory response, infection, and pulmonary function in cystic fibrosis. Life Sci 2014; 109:30-6. [DOI: 10.1016/j.lfs.2014.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/26/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
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