1
|
Caramori G, Nucera F, Mumby S, Lo Bello F, Adcock IM. Corticosteroid resistance in asthma: Cellular and molecular mechanisms. Mol Aspects Med 2022; 85:100969. [PMID: 34090658 DOI: 10.1016/j.mam.2021.100969] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/17/2022]
Abstract
Inhaled glucocorticoids (GCs) are drugs widely used as treatment for asthma patients. They prevent the recruitment and activation of lung immune and inflammatory cells and, moreover, have profound effects on airway structural cells to reverse the effects of disease on airway inflammation. GCs bind to a specific receptor, the glucocorticoid receptor (GR), which is a member of the nuclear receptor superfamily and modulates pro- and anti-inflammatory gene transcription through a number of distinct and complementary mechanisms. Targets genes include many pro-inflammatory mediators such as chemokines, cytokines, growth factors and their receptors. Inhaled GCs are very effective for most asthma patients with little, if any, systemic side effects depending upon the dose. However, some patients show poor asthma control even after the administration of high doses of topical or even systemic GCs. Several mechanisms relating to inflammation have been considered to be responsible for the onset of the relative GC resistance observed in these patients. In these patients, the side-effect profile of GCs prevent continued use of high doses and new drugs are needed. Targeting the defective pathways associated with GC function in these patients may also reactivate GC responsiveness.
Collapse
Affiliation(s)
- Gaetano Caramori
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy.
| | - Francesco Nucera
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Sharon Mumby
- National Heart and Lung Institute, Imperial College London and the NIHR Imperial Biomedical Research Centre, London, UK
| | - Federica Lo Bello
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Ian M Adcock
- National Heart and Lung Institute, Imperial College London and the NIHR Imperial Biomedical Research Centre, London, UK.
| |
Collapse
|
2
|
Tian X, Xue Y, Xie G, Zhou Y, Xiao H, Ding F, Zhang M. (-)-Epicatechin ameliorates cigarette smoke-induced lung inflammation via inhibiting ROS/NLRP3 inflammasome pathway in rats with COPD. Toxicol Appl Pharmacol 2021; 429:115674. [PMID: 34403689 DOI: 10.1016/j.taap.2021.115674] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) with increased morbidity and mortality is a worldwide healthcare challenge closely associated with cigarette smoking (CS). Currently, there is no effective therapeutic strategy to control inflammation in COPD patients. The present study tested the protective effects of (-)-Epicatechin (EC), a type of flavonoid, on CS-induced COPD and the underlying mechanism. Also, EC repressed the production of reactive oxygen species (ROS) and improved human bronchial epithelial cell viability after cigarette smoke extract (CSE) treatment. Further studies demonstrated that EC promotes ubiquitin-mediated Keap1 degradation by upregulating tripartite motif-containing protein 25 (TRIM25) expression and enhances the nuclear localization of Nrf2 protein. Also, EC dramatically inhibits the activation of NLRP3 inflammasome and reduces the CSE-induced pyroptosis, as indicated by decreasing lactate dehydrogenase release and the number of caspase-1-positive cells. Importantly, Nrf2 knockdown reversed the protective effect of EC on human bronchial epithelial cells, at least partially. Consistent with the results in vitro, EC inhibits the activation of NLRP3 inflammasome and relieves the CS-induced lung inflammation, as evident from decreased interleukin (IL)-1β and IL-18 secretion in a COPD rat model. In conclusion, this study revealed the protective effect of EC on experimental COPD rats and elucidated the mechanism of EC promoting Nrf2 activity, which might provide a novel therapeutic strategy for COPD.
Collapse
Affiliation(s)
- Xue Tian
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Yishu Xue
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Guogang Xie
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Yan Zhou
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Hui Xiao
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Fengming Ding
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China
| | - Min Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine,100 Haining Road, Shanghai 200080, PR China..
| |
Collapse
|
3
|
Nucera F, Lo Bello F, Shen SS, Ruggeri P, Coppolino I, Di Stefano A, Stellato C, Casolaro V, Hansbro PM, Adcock IM, Caramori G. Role of Atypical Chemokines and Chemokine Receptors Pathways in the Pathogenesis of COPD. Curr Med Chem 2021; 28:2577-2653. [PMID: 32819230 DOI: 10.2174/0929867327999200819145327] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) represents a heightened inflammatory response in the lung generally resulting from tobacco smoking-induced recruitment and activation of inflammatory cells and/or activation of lower airway structural cells. Several mediators can modulate activation and recruitment of these cells, particularly those belonging to the chemokines (conventional and atypical) family. There is emerging evidence for complex roles of atypical chemokines and their receptors (such as high mobility group box 1 (HMGB1), antimicrobial peptides, receptor for advanced glycosylation end products (RAGE) or toll-like receptors (TLRs)) in the pathogenesis of COPD, both in the stable disease and during exacerbations. Modulators of these pathways represent potential novel therapies for COPD and many are now in preclinical development. Inhibition of only a single atypical chemokine or receptor may not block inflammatory processes because there is redundancy in this network. However, there are many animal studies that encourage studies for modulating the atypical chemokine network in COPD. Thus, few pharmaceutical companies maintain a significant interest in developing agents that target these molecules as potential antiinflammatory drugs. Antibody-based (biological) and small molecule drug (SMD)-based therapies targeting atypical chemokines and/or their receptors are mostly at the preclinical stage and their progression to clinical trials is eagerly awaited. These agents will most likely enhance our knowledge about the role of atypical chemokines in COPD pathophysiology and thereby improve COPD management.
Collapse
Affiliation(s)
- Francesco Nucera
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Pugliatti Square 1, 98122 Messina, Italy
| | - Federica Lo Bello
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Pugliatti Square 1, 98122 Messina, Italy
| | - Sj S Shen
- Faculty of Science, Centre for Inflammation, Centenary Institute, University of Technology, Ultimo, Sydney, Australia
| | - Paolo Ruggeri
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Pugliatti Square 1, 98122 Messina, Italy
| | - Irene Coppolino
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Pugliatti Square 1, 98122 Messina, Italy
| | - Antonino Di Stefano
- Division of Pneumology, Cyto- Immunopathology Laboratory of the Cardio-Respiratory System, Clinical Scientific Institutes Maugeri IRCCS, Veruno, Italy
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | - Phil M Hansbro
- Faculty of Science, Centre for Inflammation, Centenary Institute, University of Technology, Ultimo, Sydney, Australia
| | - Ian M Adcock
- Airway Disease Section, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Gaetano Caramori
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Pugliatti Square 1, 98122 Messina, Italy
| |
Collapse
|
4
|
Glantschnig C, Koenen M, Gil‐Lozano M, Karbiener M, Pickrahn I, Williams‐Dautovich J, Patel R, Cummins CL, Giroud M, Hartleben G, Vogl E, Blüher M, Tuckermann J, Uhlenhaut H, Herzig S, Scheideler M. A miR‐29a‐driven negative feedback loop regulates peripheral glucocorticoid receptor signaling. FASEB J 2019; 33:5924-5941. [DOI: 10.1096/fj.201801385rr] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Christina Glantschnig
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Mascha Koenen
- Institute of Comparative Molecular EndocrinologyUlm University Ulm Germany
| | - Manuel Gil‐Lozano
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Michael Karbiener
- Division of Phoniatrics, Speech, and SwallowingDepartment of OtorhinolaryngologyUniversity HospitalMedical University of Graz Graz Austria
| | - Ines Pickrahn
- Department of Legal MedicineUniversity of Salzburg Salzburg Austria
| | | | - Rucha Patel
- Department of Pharmaceutical SciencesUniversity of Toronto Toronto Ontario Canada
| | - Carolyn L. Cummins
- Department of Pharmaceutical SciencesUniversity of Toronto Toronto Ontario Canada
| | - Maude Giroud
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Götz Hartleben
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Elena Vogl
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Matthias Blüher
- Clinic for Endocrinology and NephrologyMedical Research Center Leipzig Germany
| | - Jan Tuckermann
- Institute of Comparative Molecular EndocrinologyUlm University Ulm Germany
| | - Henriette Uhlenhaut
- Research Group Molecular EndocrinologyHelmholtz Center Munich Neuherberg Germany
| | - Stephan Herzig
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- School of MedicineTechnical University Munich Munich Germany
| | - Marcel Scheideler
- Institute for Diabetes and Cancer (IDC)Helmholtz Center Munich Neuherberg Germany
- Joint Heidelberg‐IDC, Inner Medicine 1Heidelberg University Hospital Heidelberg Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| |
Collapse
|
5
|
Rider CF, Altonsy MO, Mostafa MM, Shah SV, Sasse S, Manson ML, Yan D, Kärrman-Mårdh C, Miller-Larsson A, Gerber AN, Giembycz MA, Newton R. Long-Acting β2-Adrenoceptor Agonists Enhance Glucocorticoid Receptor (GR)-Mediated Transcription by Gene-Specific Mechanisms Rather Than Generic Effects via GR. Mol Pharmacol 2018; 94:1031-1046. [PMID: 29959223 DOI: 10.1124/mol.118.112755] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/25/2018] [Indexed: 12/16/2022] Open
Abstract
In asthma, the clinical efficacy of inhaled corticosteroids (ICSs) is enhanced by long-acting β2-adrenoceptor agonists (LABAs). ICSs, or more accurately, glucocorticoids, promote therapeutically relevant changes in gene expression, and, in primary human bronchial epithelial cells (pHBECs) and airway smooth muscle cells, this genomic effect can be enhanced by a LABA. Modeling this interaction in human bronchial airway epithelial BEAS-2B cells transfected with a 2× glucocorticoid response element (2×GRE)-driven luciferase reporter showed glucocorticoid-induced transcription to be enhanced 2- to 3-fold by LABA. This glucocorticoid receptor (GR; NR3C1)-dependent effect occurred rapidly, was insensitive to protein synthesis inhibition, and was maximal when glucocorticoid and LABA were added concurrently. The ability of LABA to enhance GR-mediated transcription was not associated with changes in GR expression, serine (Ser203, Ser211, Ser226) phosphorylation, ligand affinity, or nuclear translocation. Chromatin immunoprecipitation demonstrated that glucocorticoid-induced recruitment of GR to the integrated 2×GRE reporter and multiple gene loci, whose mRNAs were unaffected or enhanced by LABA, was also unchanged by LABA. Transcriptomic analysis revealed glucocorticoid-induced mRNAs were variably enhanced, unaffected, or repressed by LABA. Thus, events leading to GR binding at target genes are not the primary explanation for how LABAs modulate GR-mediated transcription. As many glucocorticoid-induced genes are independently induced by LABA, gene-specific control by GR- and LABA-activated transcription factors may explain these observations. Because LABAs promote similar effects in pHBECs, therapeutic relevance is likely. These data illustrate the need to understand gene function(s), and the mechanisms leading to gene-specific induction, if existing ICS/LABA combination therapies are to be improved.
Collapse
Affiliation(s)
- Christopher F Rider
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Mohammed O Altonsy
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Mahmoud M Mostafa
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Suharsh V Shah
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Sarah Sasse
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Martijn L Manson
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Dong Yan
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Carina Kärrman-Mårdh
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Anna Miller-Larsson
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Anthony N Gerber
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Mark A Giembycz
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| | - Robert Newton
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada (C.F.R., M.O.A., M.M.M., S.V.S., D.Y., M.A.G., R.N.); Department of Zoology, Sohag University, Sohag, Egypt (M.O.A.); Department of Medicine, National Jewish Health, Denver, Colorado (S.S., A.N.G.); and Bioscience, Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit (M.L.M., C.K.-M.), and Respiratory GMed (A.M.-L.), AstraZeneca, Gothenburg, Molndal, Sweden
| |
Collapse
|
6
|
Dos Santos AG, Bayiha JC, Dufour G, Cataldo D, Evrard B, Silva LC, Deleu M, Mingeot-Leclercq MP. Changes in membrane biophysical properties induced by the Budesonide/Hydroxypropyl-β-cyclodextrin complex. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017. [PMID: 28642042 DOI: 10.1016/j.bbamem.2017.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Budesonide (BUD), a poorly soluble anti-inflammatory drug, is used to treat patients suffering from asthma and COPD (Chronic Obstructive Pulmonary Disease). Hydroxypropyl-β-cyclodextrin (HPβCD), a biocompatible cyclodextrin known to interact with cholesterol, is used as a drug-solubilizing agent in pharmaceutical formulations. Budesonide administered as an inclusion complex within HPβCD (BUD:HPβCD) required a quarter of the nominal dose of the suspension formulation and significantly reduced neutrophil-induced inflammation in a COPD mouse model exceeding the effect of each molecule administered individually. This suggests the role of lipid domains enriched in cholesterol for inflammatory signaling activation. In this context, we investigated the effect of BUD:HPβCD on the biophysical properties of membrane lipids. On cellular models (A549, lung epithelial cells), BUD:HPβCD extracted cholesterol similarly to HPβCD. On large unilamellar vesicles (LUVs), by using the fluorescent probes diphenylhexatriene (DPH) and calcein, we demonstrated an increase in membrane fluidity and permeability induced by BUD:HPβCD in vesicles containing cholesterol. On giant unilamellar vesicles (GUVs) and lipid monolayers, BUD:HPβCD induced the disruption of cholesterol-enriched raft-like liquid ordered domains as well as changes in lipid packing and lipid desorption from the cholesterol monolayers, respectively. Except for membrane fluidity, all these effects were enhanced when HPβCD was complexed with budesonide as compared with HPβCD. Since cholesterol-enriched domains have been linked to membrane signaling including pathways involved in inflammation processes, we hypothesized the effects of BUD:HPβCD could be partly mediated by changes in the biophysical properties of cholesterol-enriched domains.
Collapse
Affiliation(s)
- Andreia G Dos Santos
- Université catholique de Louvain, Louvain Drug Research Institute, Cellular and Molecular Pharmacology Unit, Avenue E. Mounier 73, B1.73.05, B-1200 Bruxelles, Belgium; Universidade de Lisboa, Faculdade de Farmácia, iMed.ULisboa - Research Institute for Medicines, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal; Centro de Química-Física Molecular and Institute of Nanoscience and Nanotechnology, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
| | - Jules César Bayiha
- Université catholique de Louvain, Louvain Drug Research Institute, Cellular and Molecular Pharmacology Unit, Avenue E. Mounier 73, B1.73.05, B-1200 Bruxelles, Belgium
| | - Gilles Dufour
- Université de Liège, CIRM, Laboratoire de Technologie Pharmaceutique et Biopharmacie, Avenue de l'Hôpital 3, B-4000 Liège, Belgium
| | - Didier Cataldo
- Université de Liège and CHU, Laboratory of Tumor & Development Biology (GIGA-Cancer), Avenue Hippocrate 13, B-4000 Liège, Belgium
| | - Brigitte Evrard
- Université de Liège, CIRM, Laboratoire de Technologie Pharmaceutique et Biopharmacie, Avenue de l'Hôpital 3, B-4000 Liège, Belgium
| | - Liana C Silva
- Universidade de Lisboa, Faculdade de Farmácia, iMed.ULisboa - Research Institute for Medicines, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal; Centro de Química-Física Molecular and Institute of Nanoscience and Nanotechnology, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
| | - Magali Deleu
- Université de Liège, Gembloux Agro Bio-Tech, Laboratoire de Biophysique Moléculaire aux Interfaces, Passage des Déportés, 2, B-5030 Gembloux, Belgium
| | - Marie-Paule Mingeot-Leclercq
- Université catholique de Louvain, Louvain Drug Research Institute, Cellular and Molecular Pharmacology Unit, Avenue E. Mounier 73, B1.73.05, B-1200 Bruxelles, Belgium.
| |
Collapse
|
7
|
Burnley B, P Jones H. Corticotropin-releasing hormone improves survival in pneumococcal pneumonia by reducing pulmonary inflammation. Physiol Rep 2017; 5:5/1/e13000. [PMID: 28057851 PMCID: PMC5256152 DOI: 10.14814/phy2.13000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/13/2016] [Accepted: 09/18/2016] [Indexed: 11/24/2022] Open
Abstract
The use of glucocorticoids to reduce inflammatory responses is largely based on the knowledge of the physiological action of the endogenous glucocorticoid, cortisol. Corticotropin‐releasing hormone (CRH) is a neuropeptide released from the hypothalamic–pituitary–adrenal axis of the central nervous system. This hormone serves as an important mediator of adaptive physiological responses to stress. In addition to its role in inducing downstream cortisol release that in turn regulates immune suppression, CRH has also been found to mediate inflammatory responses in peripheral tissues. Streptococcus pneumoniae is a microorganism commonly present among the commensal microflora along the upper respiratory tract. Transmission of disease stems from the resident asymptomatic pneumococcus along the nasal passages. Glucocorticoids are central mediators of immune suppression and are the primary adjuvant pharmacological treatment used to reduce inflammatory responses in patients with severe bacterial pneumonia. However, controversy exists in the effectiveness of glucocorticoid treatment in reducing mortality rates during S. pneumoniae infection. In this study, we compared the effect of the currently utilized pharmacologic glucocorticoid dexamethasone with CRH. Our results demonstrated that intranasal administration of CRH increases survival associated with a decrease in inflammatory cellular immune responses compared to dexamethasone independent of neutrophils. Thus, providing evidence of its use in the management of immune and inflammatory responses brought on by severe pneumococcal infection that could reduce mortality risks.
Collapse
Affiliation(s)
- Brittney Burnley
- Institute of Molecular Medicine, UNT Health Science Center, Fort Worth, Texas
| | - Harlan P Jones
- Institute of Molecular Medicine, UNT Health Science Center, Fort Worth, Texas
| |
Collapse
|
8
|
Kook JH, Kim HJ, Kim KW, Park SJ, Kim TH, Lim SH, Kang SH, Lee SH. The expression of 11β-hydroxysteroid dehydrogenase type 1 and 2 in nasal polyp-derived epithelial cells and its possible contribution to glucocorticoid activation in nasal polyp. Am J Rhinol Allergy 2016; 29:246-50. [PMID: 26163245 DOI: 10.2500/ajra.2015.29.4185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The actions of glucocorticoids in target tissues depend on the local metabolism of glucocorticoids catalyzed by 11β hydroxysteroid dehydrogenase (HSD) 1 and 2. Glucocorticoids are the most effective anti-inflammatory drugs in the treatment of nasal polyps. However, the mechanisms that underlie the anti-inflammatory effects are unclear. OBJECTIVE The present study analyzed the expression of 11β-HSD1, 11β-HSD2, and steroidogenic enzymes (cytochrome P450, family 11, subfamily B, polypeptide 1 [CYP11B1]; cytochrome P450, family 11, subfamily A, polypeptide 1 [CYP11A1]) in nasal polyp tissues, and endogenous cortisol levels in nasal polyp-derived epithelial cells. METHODS The expression levels and distribution pattern of 11β-HSD1, 11β-HSD2, CYP11B1, and CYP11A1 were determined in nasal polyp tissues or nasal polyp-derived epithelial cells by using real-time polymerase chain reaction, Western blot, and immunohistochemistry testing. The expression levels of cortisol by using enzyme-linked immunosorbent assay were determined in cultured polyp-derived epithelial cells treated with adrenocorticotrophic hormone (ACTH), 11β-HSD1 inhibitor, or small interfering ribonucleic acid technique. The effect of glucocorticoids on the expression levels of these enzymes was investigated in cultured cells. RESULTS Expressed in nasal polyp tissues and nasal polyp-derived epithelial cells were 11β-HSD1, 11β-HSD2, CYP11B1, and CYP11A1. Cortisol production in cultured epithelial cells was decreased in cells treated with 11β-HSD1 small interfering ribonucleic acid or inhibitor, compared with nontreated cells. Cultured cells treated with adrenocorticotropic hormone induced increased cortisol production. 11β-HSD1 expression levels were upregulated in cells treated with glucocorticoid. CONCLUSIONS Analysis of these results indicated that 11β-HSD1 expressed in polyp-derived epithelial cells may be involved in the anti-inflammatory function of glucocorticoid in the treatment of nasal polyps, which contributes to increased levels of endogenous cortisol.
Collapse
Affiliation(s)
- Jin Ho Kook
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, South Korea
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Caramori G, Kirkham P, Barczyk A, Di Stefano A, Adcock I. Molecular pathogenesis of cigarette smoking-induced stable COPD. Ann N Y Acad Sci 2015; 1340:55-64. [PMID: 25639503 DOI: 10.1111/nyas.12619] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inflammation is a central feature of stable chronic obstructive pulmonary disease (COPD) and involves both activation of structural cells of the airways and the lungs and the activation and/or recruitment of infiltrating inflammatory cells. This results in enhanced expression of many pro-inflammatory proteins and reduced expression of some anti-inflammatory mediators. An altered protein expression is generally associated with concomitant changes in gene expression profiles in a cell-specific manner. Increased understanding of the role of transcription factors and of the signaling pathways leading to their activation in stable COPD will provide new targets to enable the development of potential anti-inflammatory drugs. Several new compounds targeting these pathways and/or transcription factors are now in development for the treatment of stable COPD. Furthermore, glucocorticoids drugs already in clinical use act through their own transcription factor, the glucocorticoid receptor, to control the expression of inflammatory and anti-inflammatory genes.
Collapse
Affiliation(s)
- Gaetano Caramori
- Centro Interdipartimentale per lo Studio delle Malattie Infiammatorie delle Vie Aeree e Patologie Fumo-correlate (CEMICEF), Sezione di Medicina Interna e Cardiorespiratoria, Università di Ferrara, Ferrara, Italy
| | | | | | | | | |
Collapse
|
10
|
Reichardt SD, Weinhage T, Rotte A, Föller M, Oppermann M, Lühder F, Tuckermann JP, Lang F, van den Brandt J, Reichardt HM. Glucocorticoids induce gastroparesis in mice through depletion of l-arginine. Endocrinology 2014; 155:3899-908. [PMID: 25057793 DOI: 10.1210/en.2014-1246] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Glucocorticoids (GCs) constitute a highly pleiotropic class of drugs predominantly employed in the treatment of inflammatory diseases. In our search for new mechanisms of action, we identified a hitherto unknown effect of GCs in the gastrointestinal tract. We found that oral administration of dexamethasone (Dex) to mice caused an enlargement of the stomach due to the induction of gastroparesis and that this effect was abolished in GR(dim) mice carrying the A458T mutation in the GC receptor (GR). Gastroparesis was unrelated to the enhanced gastric acid secretion observed after Dex treatment, although both effects were mediated by the same molecular mechanism of the GR. Using conditional GR-knockout mice, we could further rule out that GC effects on enterocytes or myeloid cells were involved in the induction of gastroparesis. In contrast, we found that Dex upregulated arginase 2 (Arg2) in the stomach both at the mRNA and protein level. This suggests that GC treatment leads to a depletion of l-arginine thereby impeding the production of nitric oxide (NO), which is required for gastric motility. We tested this hypothesis by supplementing the drinking water of the mice with exogenous l-arginine to compensate for the presumed shortage of this major substrate of NO synthases. Importantly, this measure completely prevented both the enlargement of the stomach and the induction of gastroparesis after Dex treatment. Our findings raise considerations of combining orally applied GCs with l-arginine to improve tolerability of GC treatment and provide a possible explanation for the antiemetic effects of GCs widely exploited in chemotherapy.
Collapse
Affiliation(s)
- Sybille D Reichardt
- Institute for Cellular and Molecular Immunology (S.D.R., T.W., M.O., J.v.d.B., H.M.R.) and Department of Neuroimmunology (F.L.), Institute for Multiple Sclerosis Research, The Hertie Foundation and MPI for Experimental Medicine, University of Göttingen Medical School, 37073 Göttingen, Germany; Institute of Physiology (A.R., M.F., F.L.), University of Tübingen, 72076 Tübingen, Germany; and Institute of General Zoology and Endocrinology (J.P.T.), University of Ulm, 89081 Ulm, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
The clinical relevance of dry powder inhaler performance for drug delivery. Respir Med 2014; 108:1195-203. [PMID: 24929253 DOI: 10.1016/j.rmed.2014.05.009] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/08/2014] [Accepted: 05/13/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although understanding of the scientific basis of aerosol therapy with dry powder inhalers (DPIs) has increased, some misconceptions still persist. These include the beliefs that high resistance inhalers are unsuitable for some patients, that extra fine (<1.0 μm) particles improve peripheral lung deposition and that inhalers with flow rate-independent fine particle fractions (FPFs) produce a more consistent delivered dose to the lungs. OBJECTIVES This article aims to clarify the complex inter-relationships between inhaler design and resistance, inspiratory flow rate (IFR), FPF, lung deposition and clinical outcomes, as a better understanding may result in a better choice of DPI for individual patients. METHODS The various factors that determine the delivery of drug particles into the lungs are reviewed. These include aerodynamic particle size distribution, the inspiratory manoeuvre, airway geometry and the three basic principles that determine the site and extent of deposition: inertial impaction, sedimentation and diffusion. DPIs are classed as either dependent or independent of inspiratory flow rate and vary in their internal resistance to inspiration. The effects of these characteristics on drug deposition in the airways are described using data from studies directly comparing currently available inhaler devices. RESULTS Clinical experience shows that most patients can use a high resistance DPI effectively, even during exacerbations. Particles in the aerodynamic size range from 1.5-5 μm are shown to be optimal, as particles <1.0 μm are very likely to be exhaled again while those >5 μm may impact on the oropharynx. For DPIs with a constant FPF at all flow rates, less of the delivered dose reaches the central and peripheral lung when the flow rate increases, risking under-dosing of the required medication. In contrast, flow rate-dependent inhalers increase their FPF output at higher flow rates, which compensates for the greater impaction on the upper airways as flow rate increases. CONCLUSIONS The technical characteristics of different inhalers and the delivery and deposition of the fine particle dose to the lungs may be important additional considerations to help the physician to select the most appropriate device for the individual patient to optimise their treatment.
Collapse
|
12
|
Jun YJ, Park SJ, Kim TH, Lee SH, Lee KJ, Hwang SM, Lee SH. Expression of 11β-hydroxysteroid dehydrogenase 1 and 2 in patients with chronic rhinosinusitis and their possible contribution to local glucocorticoid activation in sinus mucosa. J Allergy Clin Immunol 2014; 134:926-934.e6. [PMID: 24810847 DOI: 10.1016/j.jaci.2014.03.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 02/20/2014] [Accepted: 03/31/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND It has been suggested that glucocorticoids might act in target tissues to increase their own intracellular availability in response to inflammatory stimuli. These mechanisms depend on the local metabolism of glucocorticoids catalyzed by 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) and 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2). OBJECTIVE This study is to investigate the effect of chronic rhinosinusitis (CRS) on expression of 11β-HSD1, 11β-HSD2, steroidogenic enzymes (cytochrome P450, family 11, subfamily B, polypeptide 1 [CYP11B1] and cytochrome P450, family 11, subfamily A, polypeptide 1 [CYP11A1]), and endogenous cortisol levels in human sinus mucosa. Expression levels were compared with those of healthy control subjects. METHODS The expression levels of 11β-HSD1, 11β-HSD2, CYP11B1, CYP11A1, and cortisol were measured in healthy control subjects, patients with CRS with nasal polyps, and patients with CRS without nasal polyps by using real-time PCR, Western blotting, immunohistochemistry, and ELISA. Expression levels of 11β-HSD1, 11β-HSD2, CYP11B1, CYP11A1, and cortisol were determined in cultured epithelial cells treated with CRS-relevant cytokines. The conversion ratio of cortisone to cortisol was evaluated by using the small interfering RNA technique, 11β-HSD1 inhibitor, and measurement of 11β-HSD1 activity. RESULTS 11β-HSD1, CYP11B1, and cortisol levels increased in patients with CRS with nasal polyps and those with CRS without nasal polyps, but 11β-HSD2 expression decreased. In cultured epithelial cells treated with IL-4, IL-5, IL-13, IL-1β, TNF-α, and TGF-β1, 11β-HSD1 expression and activity increased in parallel with expression levels of CYP11B1 and cortisol, but the production of 11β-HSD2 decreased. The small interfering RNA technique or the measurement of 11β-HSD1 activity showed that the sinus epithelium activates cortisone to cortisol in an 11β-HSD-dependent manner. CONCLUSION These results indicate that CRS-relevant cytokines can modulate the expression of 11β-HSD1, 11β-HSD2, and CYP11B1 in the sinus mucosa, resulting in increasing intracellular concentrations of bioactive glucocorticoids.
Collapse
Affiliation(s)
- Young Joon Jun
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Soonchunhayng University, Kumi Hospital, Kyungsangbuk-Do, Kumi, Korea
| | - Se Jin Park
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Hallym University, Chuncheon, Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Seung Hoon Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Ki Jeong Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Soo Min Hwang
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Sang Hag Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul, Korea.
| |
Collapse
|
13
|
Caramori G, Chung KF, Adcock IM. Profile of fluticasone furoate/vilanterol dry powder inhaler combination therapy as a potential treatment for COPD. Int J Chron Obstruct Pulmon Dis 2014; 9:249-56. [PMID: 24596460 PMCID: PMC3940640 DOI: 10.2147/copd.s32604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Currently, there is no cure for chronic obstructive pulmonary disease (COPD). The limited efficacy of current therapies for COPD indicates a pressing need to develop new treatments to prevent the progression of the disease, which consumes a significant amount of health care resources and is an important cause of mortality worldwide. Current national and international guidelines for the management of stable COPD patients recommend the use of inhaled long-acting bronchodilators, inhaled corticosteroids, and their combination for maintenance treatment of moderate to severe stable COPD. Once-daily fluticasone furoate/vilanterol dry powder inhaler combination therapy has recently been approved by the US Food and Drug Administration and the European Medicines Agency as a new regular treatment for patients with stable COPD. Fluticasone furoate/vilanterol dry powder inhaler combination therapy has been shown to be effective in many controlled clinical trials involving thousands of patients in the regular treatment of stable COPD. This is the first once-daily combination of ultra-long-acting inhaled β2-agonists and inhaled glucocorticoids that is available for the treatment of stable COPD and has great potential to improve compliance to long-term regular inhaled therapy and hence to improve the natural history and prognosis of COPD patients.
Collapse
Affiliation(s)
- Gaetano Caramori
- Centro Interdipartimentale per lo Studio delle Malattie Infiammatorie delle vie Aeree e Patologie Fumo-correlate (CEMICEF; formerly Centro di Ricerca su Asma e BPCO), Sezione di Medicina Interna e Cardiorespiratoria, Università di Ferrara, Ferrara, Italy
| | - Kian Fan Chung
- Airways Disease Section, National Heart and Lung Institute, Royal Brompton Hospital Biomedical Research Unit, Imperial College London, London, UK
| | - Ian M Adcock
- Airways Disease Section, National Heart and Lung Institute, Royal Brompton Hospital Biomedical Research Unit, Imperial College London, London, UK
| |
Collapse
|
14
|
Abstract
OBJECTIVES Macrophages are important cells in immunity and the main producers of pro-inflammatory cytokines. The main objective was to evaluate if specific delivery of glucocorticoid to the macrophage receptor CD163 is superior to systemic glucocorticoid therapy in dampening the cytokine response to lipopolysaccharide infusion in pigs. DESIGN Two randomized, placebo-controlled trials. SETTING University hospital laboratory. SUBJECTS Female farm-bred pigs (26-31 kg). DESIGN A humanized antibody that binds to pig and human CD163 was produced, characterized, and conjugated with dexamethasone. In the first study (total n = 12), pigs were randomly assigned to four groups: 1) saline; 2) dexamethasone (1.0 mg/kg); 3) dexamethasone (0.02 mg/kg); and 4) anti-CD163-conjugated dexamethasone (0.02 mg/kg). In the second study (total n = 36), two additional groups were included in addition to the four original groups: 5) anti-CD163-conjugated dexamethasone (0.005 mg/kg); 6) unconjugated anti-CD163. Treatments were given 20 hours prior to infusion of lipopolysaccharide (1 µg × kg × h) for 5 hours. Blood samples were analyzed for cytokines, cortisol, and adrenocorticotropic hormone. RESULTS In the saline group, lipopolysaccharide increased cytokine and plasma cortisol levels. In both studies, dexamethasone (1 mg/kg) and anti-CD163 dexamethasone (0.02 mg/kg) uniformly attenuated tumor necrosis factor-α peak levels (both p < 0.05) compared with low-dose dexamethasone (0.02 mg/kg). However, dexamethasone 1 mg/kg significantly suppressed plasma cortisol and adrenocorticotropic hormone levels compared with anti-CD163 dexamethasone (0.02 mg/kg; p < 0.05). No significant hemodynamic difference existed between groups. The anti-CD163 dexamethasone drug conjugate exhibited a fast plasma clearance, with a half-life of approximately 5-8 minutes. CONCLUSION Targeted delivery of dexamethasone to macrophages using a humanized CD163 antibody as carrier exhibits anti-inflammatory effects comparable with 50 times higher concentrations of free dexamethasone and does not inhibit endogenous cortisol production. This antibody-drug complex showing similar affinity and specificity for human CD163 is, therefore, a promising drug candidate in this novel type of anti-inflammatory therapy.
Collapse
|
15
|
Thomson NC, Spears M. Inhaled corticosteroids for asthma: on-demand or continuous use. Expert Rev Respir Med 2013; 7:687-99. [PMID: 24147563 DOI: 10.1586/17476348.2013.836062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Continuous inhaled corticosteroid treatment is highly effective in children and adults with mild persistent asthma, although some therapeutic benefits are not lost if treatment is delayed. Many patients do not adhere to continuous treatment with inhaled corticosteroids, but rather take them intermittently, usually at the time of increased symptoms. Based on these observations it has been proposed that for patients with mild persistent asthma inhaled corticosteroids should be used on-demand when symptoms are troublesome, rather than on a continuous basis. The article reviews the pharmacological properties of inhaled corticosteroids used in clinical trials of on-demand treatment, as well as the evidence for the efficacy and safety of on-demand compared with continuous inhaled corticosteroid treatment of mild persistent asthma in adults and children. The place of on-demand treatment with inhaled corticosteroids in the management of asthma is discussed, as well as future directions for different management strategies for this group.
Collapse
Affiliation(s)
- Neil C Thomson
- Institute of Infection, Immunity & Inflammation, University of Glasgow and Respiratory Medicine, Gartnavel General Hospital, Glasgow, G12 OYN, UK
| | | |
Collapse
|
16
|
Patte-Mensah C, Meyer L, Taleb O, Mensah-Nyagan AG. Potential role of allopregnanolone for a safe and effective therapy of neuropathic pain. Prog Neurobiol 2013; 113:70-8. [PMID: 23948490 DOI: 10.1016/j.pneurobio.2013.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/11/2013] [Accepted: 07/24/2013] [Indexed: 01/12/2023]
Abstract
Because the treatment and management of neuropathic pain are extremely complicated, the characterization of novel analgesics and neuroprotectors with safe toxicological profiles is a crucial need to develop efficient therapies. Several investigations revealed that the natural neurosteroid allopregnanolone (AP) exerts analgesic, neuroprotective, antidepressant and anxiolytic effects. These effects result from AP ability to modulate GABA(A), glycine, L- and T-type calcium channels. It has been shown that AP treatment induced beneficial actions in humans and animal models with no toxic side effects. In particular, a multi-parametric analysis revealed that AP efficiently counteracted chemotherapy-evoked neuropathic pain in rats. It has also been demonstrated that the modulation of AP-producing enzyme, 3α-hydroxysteroid oxido-reductase (3α-HSOR), in the spinal cord regulates thermal and mechanical pain thresholds of peripheral nerve injured neuropathic rats. The painful symptoms were exacerbated by intrathecal injections of provera (pharmacological inhibitor of 3α-HSOR) which decreased AP production in the spinal cord. By contrast, the enhancement of AP concentration in the intrathecal space induced analgesia and suppression of neuropathic symptoms. Moreover, in vivo siRNA-knockdown of 3α-HSOR expression in healthy rat dorsal root ganglia increased thermal and mechanical pain perceptions while AP evoked a potent antinociceptive action. In humans, blood levels of AP were inversely associated with low back and chest pain. Furthermore, oral administration of AP analogs induced antinociception. Altogether, these data indicate that AP, which possesses a high therapeutic potential and a good toxicological profile, may be used to develop effective and safe strategies against chronic neuropathic pain.
Collapse
Affiliation(s)
- C Patte-Mensah
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment 3 de la Faculté de Médecine, 11 rue Humann, 67 000 Strasbourg, France
| | - L Meyer
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment 3 de la Faculté de Médecine, 11 rue Humann, 67 000 Strasbourg, France
| | - O Taleb
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment 3 de la Faculté de Médecine, 11 rue Humann, 67 000 Strasbourg, France
| | - A G Mensah-Nyagan
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment 3 de la Faculté de Médecine, 11 rue Humann, 67 000 Strasbourg, France.
| |
Collapse
|
17
|
Ngkelo A, Adcock IM. New treatments for COPD. Curr Opin Pharmacol 2013; 13:362-9. [DOI: 10.1016/j.coph.2013.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/03/2013] [Accepted: 03/28/2013] [Indexed: 12/20/2022]
|
18
|
Caramori G, Casolari P, Adcock I. Role of transcription factors in the pathogenesis of asthma and COPD. ACTA ACUST UNITED AC 2013; 20:21-40. [PMID: 23472830 DOI: 10.3109/15419061.2013.775257] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Inflammation is a central feature of asthma and chronic obstructive pulmonary disease (COPD). Despite recent advances in the knowledge of the pathogenesis of asthma and COPD, much more research on the molecular mechanisms of asthma and COPD are needed to aid the logical development of new therapies for these common and important diseases, particularly in COPD where no effective treatments currently exist. In the future the role of the activation/repression of different transcription factors and the genetic regulation of their expression in asthma and COPD may be an increasingly important aspect of research, as this may be one of the critical mechanisms regulating the expression of different clinical phenotypes and their responsiveness to therapy, particularly to anti-inflammatory drugs.
Collapse
Affiliation(s)
- Gaetano Caramori
- Centro Interdipartimentale per lo Studio delle Malattie Infiammatorie delle Vie Aeree e Patologie Fumo-correlate CEMICEF; formerly named Centro di Ricerca su Asma e BPCO, Sezione di Malattie dell'Apparato Respiratorio, Università di Ferrara, Ferrara, Italy.
| | | | | |
Collapse
|