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Kim YA, Hodzic E, Amgalan B, Saslafsky A, Wojtowicz D, Przytycka TM. Mutational Signatures as Sensors of Environmental Exposures: Analysis of Smoking-Induced Lung Tissue Remodeling. Biomolecules 2022; 12:biom12101384. [PMID: 36291592 PMCID: PMC9599238 DOI: 10.3390/biom12101384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Smoking is a widely recognized risk factor in the emergence of cancers and other lung diseases. Studies of non-cancer lung diseases typically investigate the role that smoking has in chronic changes in lungs that might predispose patients to the diseases, whereas most cancer studies focus on the mutagenic properties of smoking. Large-scale cancer analysis efforts have collected expression data from both tumor and control lung tissues, and studies have used control samples to estimate the impact of smoking on gene expression. However, such analyses may be confounded by tumor-related micro-environments as well as patient-specific exposure to smoking. Thus, in this paper, we explore the utilization of mutational signatures to study environment-induced changes of gene expression in control lung tissues from lung adenocarcinoma samples. We show that a joint computational analysis of mutational signatures derived from sequenced tumor samples, and the gene expression obtained from control samples, can shed light on the combined impact that smoking and tumor-related micro-environments have on gene expression and cell-type composition in non-neoplastic (control) lung tissue. The results obtained through such analysis are both supported by experimental studies, including studies utilizing single-cell technology, and also suggest additional novel insights. We argue that the study provides a proof of principle of the utility of mutational signatures to be used as sensors of environmental exposures not only in the context of the mutational landscape of cancer, but also as a reference for changes in non-cancer lung tissues. It also provides an example of how a database collected with the purpose of understanding cancer can provide valuable information for studies not directly related to the disease.
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Ni Y, Shi G, Qu J. Indoor PM 2.5, tobacco smoking and chronic lung diseases: A narrative review. ENVIRONMENTAL RESEARCH 2020; 181:108910. [PMID: 31780052 DOI: 10.1016/j.envres.2019.108910] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
The lung is one of the most important organs exposed to environmental agents. People spend approximately 90% of their time indoors, and risks to health may thus be greater from exposure to poor air quality indoors than outdoors. Multiple indoor pollutants have been linked to chronic respiratory diseases. Environmental tobacco smoke (ETS) is known as an important source of multiple pollutants, especially in indoor environments. Indoor PM2.5 (particulate matter with aerodynamic diameter < 2.5 μm) was reported to be the most reliable marker of the presence of tobacco smoke. Recent studies have demonstrated that PM2.5 is closely correlated with chronic lung diseases. In this paper, we reviewed the relationship of tobacco smoking and indoor PM2.5 and the mechanism that underpin the link of tobacco smoke, indoor PM2.5 and chronic lung diseases.
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Affiliation(s)
- Yingmeng Ni
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guochao Shi
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieming Qu
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Strzelak A, Ratajczak A, Adamiec A, Feleszko W. Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1033. [PMID: 29883409 PMCID: PMC5982072 DOI: 10.3390/ijerph15051033] [Citation(s) in RCA: 315] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 02/06/2023]
Abstract
Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS. We demonstrate how the imbalance between oxidants and antioxidants resulting from exposure to tobacco smoke leads to oxidative stress, increased mucosal inflammation, and increased expression of inflammatory cytokines (such as interleukin (IL)-8, IL-6 and tumor necrosis factor α ([TNF]-α). Direct cellular effects of ETS on epithelial cells results in increased permeability, mucus overproduction, impaired mucociliary clearance, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of macrophages and neutrophils and disturbed lymphocyte balance towards Th2. The plethora of presented phenomena fully justifies a restrictive policy aiming at limiting the domestic and public exposure to ETS.
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Affiliation(s)
- Agnieszka Strzelak
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Aleksandra Ratajczak
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Aleksander Adamiec
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
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Anthérieu S, Garat A, Beauval N, Soyez M, Allorge D, Garçon G, Lo-Guidice JM. Comparison of cellular and transcriptomic effects between electronic cigarette vapor and cigarette smoke in human bronchial epithelial cells. Toxicol In Vitro 2017; 45:417-425. [PMID: 28065790 DOI: 10.1016/j.tiv.2016.12.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/16/2016] [Accepted: 12/30/2016] [Indexed: 01/22/2023]
Abstract
The use of electronic cigarette (e-cig) can be considered as an alternative to smoking. However, due to a lack of thorough toxicological studies, absolute safety of these products cannot be guaranteed. The aim of this in vitro work was to investigate the potential toxicity of e-vapors generated by a smoking machine in human bronchial epithelial BEAS-2B cells cultured at air-liquid interface, in comparison to cigarette smoke (CS). Although CS decreased strongly cell viability from 48min exposure, e-vapors induced no cytotoxicity up to 288min exposure. Moreover, oxidative stress was evidenced only after exposure to CS, with a decrease secretion of GRO-ɑ from 8min and of IL-8 and MCP-1 after 48min exposure. Only a low increase of IL-6 secretion was measured in cells exposed to e-vapors. Finally, transcriptomic data of exposed cells indicated that a large number of genes were deregulated in response to CS, especially genes involved in important biological functions as oxidative stress and cell death, while e-vapors elicited very discrete modulation. These results strongly suggest a lower toxicity of e-vapors compared to CS in the BEAS-2B cell line and constitute a baseline for further experimental studies with a larger spectrum of e-liquids and e-cig models.
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Affiliation(s)
- Sébastien Anthérieu
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France.
| | - Anne Garat
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France
| | - Nicolas Beauval
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France; Mines Douai, SAGE, F-59508 Douai, France
| | - Mélissa Soyez
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France
| | - Delphine Allorge
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France
| | - Guillaume Garçon
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France
| | - Jean-Marc Lo-Guidice
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483, IMPECS - IMPact of Environmental ChemicalS on human health, F-59000 Lille, France
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Wu M, Wang Z, Li M, Li K. Daily Symptom Variability in Patients With Stable COPD: A Narrative Review. West J Nurs Res 2017; 40:1543-1561. [DOI: 10.1177/0193945917705132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Daily symptom variability refers to the fluctuation of chronic obstructive pulmonary disease (COPD) symptoms over the day. Although most clinicians can describe the day-to-day variation in symptoms experienced by patients with COPD, little has been done to quantify the variability. This review aims to synthesize evidence of daily symptom variability among patients with stable COPD. Of the 325 potentially relevant articles that were retrieved, 11 observational articles were finally included in the review. Patients with stable COPD commonly experience daily symptom variability, with morning being the most troublesome time of day, followed by night. Morning symptoms had a significant effect on morning routines or daily activities, and night-time symptoms affected the sleep quality of patients. In comparison with patients without symptom variability, patients with morning/night-time symptoms or symptom variability exhibited poorer health status as well as greater disease severity and incidence of exacerbation.
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Affiliation(s)
| | | | | | - Kun Li
- Jilin University, Changchun, China
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Cheng MY, Liu H, Zhang TM, Xu JY. Different forms of adiponectin reduce the apoptotic and damaging effect of cigarette smoke extract on human bronchial epithelial cells. Exp Ther Med 2016; 12:4168-4174. [PMID: 28105143 DOI: 10.3892/etm.2016.3872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 09/22/2016] [Indexed: 12/26/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease, in which adiponectin may serve an important role. The present study investigated the role of adiponectin in the apoptotic and damaging effect of cigarette smoke extract (CSE) on human bronchial epithelial cells (16HBECs). An MTT assay showed that CSE significantly inhibited the proliferation of 16HBECs (F=1808.88, P<0.01). The 16HBECs were treated with different concentrations of high molecular weight (HMW) adiponectin and globular domain (gAd) adiponectin and it was observed that HMW and gAd dose-dependently inhibited the expression of tumor necrosis factor (TNF)-α and interleukin (IL)-8, and the generation of 4-hydroxy-nonenal and reactive oxygen species (ROS) in 16HBECs, thereby blocking the upregulating effect of CSE on these factors. However, the inhibitory effect of gAd on TNF-α and IL-8 expression was stronger compared with that of HMW, but the suppressing effect of HMW on ROS production was superior compared with that of gAd. Further testing of apoptosis indicated that CSE and HMW promoted the apoptosis of 16HBECs. However, such effects of HMW declined with an increase in concentration. In contrast, gAd showed an inhibitory effect on apoptosis and inhibited the occurrence of CSE-induced apoptosis in a dose-dependent manner. Therefore, the present study demonstrated that different forms of adiponectin may have different mechanisms of action, suggesting that further exploration of their effects may open a new avenue for the treatment of COPD.
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Affiliation(s)
- Meng-Yu Cheng
- Department of Respiratory Medicine, Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030032, P.R. China
| | - Hu Liu
- Department of Respiratory Medicine, Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030032, P.R. China
| | - Tie-Mei Zhang
- Second Department of Respiratory Medicine, Jimo City People's Hospital, Qingdao, Shandong 266200, P.R. China
| | - Jian-Ying Xu
- Department of Respiratory Medicine, Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030032, P.R. China
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Taylor GH, Williams AA, Garzino-Demo A. Highly active antiretroviral therapy reduces pulmonary IL-8 in HIV-positive women smokers. Pathog Dis 2015; 74:ftv115. [PMID: 26656889 DOI: 10.1093/femspd/ftv115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/14/2022] Open
Abstract
Increased levels of the proinflammatory cytokine IL-8 are detected in the sputum of patients with chronic obstructive pulmonary disease (COPD) and during the pathological pulmonary manifestations of HIV infection : To explore a potential interrelationship between smoking, highly active antiretroviral therapy (HAART) and HIV immune status, we collected sputum samples, along with complete pulmonary function tests from groups of HIV-infected women smokers who were either on or off HAART. Analysis of the patient's sputum for cell count along with quantitative measures of IL-8 was performed and correlated with concurrent assessment of pulmonary function test (PFT). We found that HIV-positive smokers had decreased measurements on PFT of the diffusing capacity of the lung for carbon monoxide (D(LCO)) compared to standard reference values that did not differ with HAART usage. HAART, when controlled for CD4, showed a suppressive effect on the levels of pro inflammatory cytokine IL-8 in sputum. We conclude that in the era of HAART, HIV along with concurrent tobacco smoking is associated with declines in PFT in HIV-infected women. The use of HAART in patients appears to mitigate the increases in IL-8 levels in relation to immune status based on CD4 count.
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Affiliation(s)
- Gregory H Taylor
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Adrienne A Williams
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA University of Illinois at Chicago College of Medicine, Department of Family Medicine Chicago, IL 60612, USA
| | - Alfredo Garzino-Demo
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA Department of Molecular Medicine, University of Padova, 35121 Padova, Italy
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Mahtaj LG, Feizpour A, Kianmehr M, Soukhtanloo M, Boskabady MH. The effect of carvacrol on systemic inflammation in guinea pigs model of COPD induced by cigarette smoke exposure. Pharmacol Rep 2015; 67:140-5. [DOI: 10.1016/j.pharep.2014.08.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/22/2014] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
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Mulligan JK, Nagel W, O'Connell BP, Wentzel J, Atkinson C, Schlosser RJ. Cigarette smoke exposure is associated with vitamin D3 deficiencies in patients with chronic rhinosinusitis. J Allergy Clin Immunol 2014; 134:342-9. [PMID: 24698317 DOI: 10.1016/j.jaci.2014.01.039] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 01/10/2014] [Accepted: 01/22/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cigarette smoke (CS) plays a role in the exacerbation of chronic rhinosinusitis (CRS); however, the mechanism for this is unknown. We hypothesize that CS impairs human sinonasal epithelial cell (HSNEC) conversion of 25(OH)D3 (25VD3) to 1,25-dihydroxyvitamin D3 (1,25VD3) and, furthermore, that supplementation with 1,25VD3 will reverse smoke-induced inflammatory responses by HSNECs. OBJECTIVE We sought to determine the effect of CS on vitamin D3 (VD3) levels, conversion, and regulation of CS-induced inflammation in control subjects and patients with CRS. METHODS Blood and sinus tissue explants were collected at the time of surgery from control subjects, patients with chronic rhinosinusitis without nasal polyps, and patients with chronic sinusitis with nasal polyps (CRSwNP). Expression of VD3 metabolizing enzymes were measured by using RT-PCR. Primary HSNECs were cultured from tissue explants. 25VD3 with and without cigarette smoke extract (CSE) was used to examine conversion of 25VD3 to 1,25VD3, as well as HSNEC production of proinflammatory cytokines. RESULTS CS exposure was associated with reduced circulating and sinonasal 25VD3 levels in all groups compared with those seen in CS-naive, disease-matched counterparts. CS exposure decreased expression of CYP27B1 and was especially pronounced in patients with CRSwNP. CSE impairs control HSNEC conversion of 25VD3. HSNECs from patients with CRSwNP also demonstrate an intrinsic reduction in conversion of 25VD3 to 1,25VD3. Exogenous 1,25VD3 reduces CSE-induced cytokine production by HSNECs. CONCLUSIONS Exposure to CS is associated with reduced 25VD3 levels and an impaired ability of HSNECs to convert 25VD3 to 1,25VD3. Addition of 1,25VD3 reduces the proinflammatory effects of CS on HSNECs. Impaired VD3 conversion by CS exposure represents a novel mechanism through which CS induces its proinflammatory effects.
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Affiliation(s)
- Jennifer K Mulligan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC; Department of Pediatrics, Medical University of South Carolina, Charleston, SC; Ralph H. Johnson VA Medical Center, Charleston, SC.
| | - Whitney Nagel
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Brendan P O'Connell
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Jennifer Wentzel
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Carl Atkinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
| | - Rodney J Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC; Ralph H. Johnson VA Medical Center, Charleston, SC
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Roche N, Small M, Broomfield S, Higgins V, Pollard R. Real World COPD: Association of Morning Symptoms with Clinical and Patient Reported Outcomes. COPD 2013; 10:679-86. [DOI: 10.3109/15412555.2013.844784] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nicolas Roche
- 1Hôpital Cochin–Site Val de Grâce, Université Paris-Descartes, Service de Pneumologie et Réanimation,
Paris, France
| | - Mark Small
- 2Adelphi Real World,
Macclesfield, United Kingdom
| | | | | | - Ryan Pollard
- 2Adelphi Real World,
Macclesfield, United Kingdom
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Jiménez Amador H, Casan Clarà P. Bacterial communication and human communication: what can we learn from quorum sensing? Arch Bronconeumol 2012; 48:305-7. [PMID: 22520726 DOI: 10.1016/j.arbres.2012.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 02/20/2012] [Indexed: 11/16/2022]
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Flores G, Dastmalchi K, Paulino S, Whalen K, Dabo AJ, Reynertson KA, Foronjy RF, D'Armiento JM, Kennelly EJ. Anthocyanins from Eugenia brasiliensis edible fruits as potential therapeutics for COPD treatment. Food Chem 2012; 134:1256-62. [PMID: 25005941 DOI: 10.1016/j.foodchem.2012.01.086] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/07/2011] [Accepted: 01/26/2012] [Indexed: 12/20/2022]
Abstract
Nine anthocyanins (1-9) from the edible fruits of Eugenia brasiliensis were identified by HPLC-PDA and LC-MS, and seven of these are described for the first time in this Brazilian fruit. Two of the major anthocyanins, delphinidin (8) and cyanidin (9), were studied for their inhibitory activity against chemokine interleukin-8 (IL-8) production before and after cigarette smoke extract (CSE) treatment of cells. In non-treated cells the amount of IL-8 was unchanged following treatment with cyanidin and delphinidin in concentrations 0.1-10 μM. Both delphinidin (8) and cyanidin (9) decreased the production of IL-8 in treated cells, at 1 and 10 μM, respectively. Delphinidin (8) demonstrated IL-8 inhibition in the CSE treated cells in a dose-dependent manner.
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Affiliation(s)
- Gema Flores
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States; Instituto de Fermentaciones Industriales, Consejo Superior de Investigaciones Científicas (CSIC), c/Juan de la Cierva 3, 28006 Madrid, Spain
| | - Keyvan Dastmalchi
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States
| | - Sturlainny Paulino
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States
| | - Kathleen Whalen
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States; Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, P&S 9-449, New York, NY 10032, United States
| | - Abdoulaye J Dabo
- Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, P&S 9-449, New York, NY 10032, United States
| | - Kurt A Reynertson
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States
| | - Robert F Foronjy
- Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, P&S 9-449, New York, NY 10032, United States
| | - Jeanine M D'Armiento
- Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, P&S 9-449, New York, NY 10032, United States
| | - Edward J Kennelly
- Department of Biological Sciences, Lehman College and The Graduate Center, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, United States
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