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Chang EH, Pouladi N, Guerra S, Jandova J, Kim A, Li H, Li J, Morgan W, Stern DA, Willis AL, Lussier YA, Martinez FD. Epithelial cell responses to rhinovirus identify an early-life-onset asthma phenotype in adults. J Allergy Clin Immunol 2022; 150:604-611. [PMID: 35367470 PMCID: PMC9463086 DOI: 10.1016/j.jaci.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study of pathogenic mechanisms in adult asthma is often marred by a lack of precise information about the natural history of the disease. Children who have persistent wheezing (PW) during the first 6 years of life and whose symptoms start before age 3 years (PW+) are much more likely to have wheezing illnesses due to rhinovirus (RV) in infancy and to have asthma into adult life than are those who do not have PW (PW-). OBJECTIVE Our aim was to determine whether nasal epithelial cells from PW+ asthmatic adults as compared with cells from PW- asthmatic adults show distinct biomechanistic processes activated by RV exposure. METHODS Air-liquid interface cultures derived from nasal epithelial cells of 36-year old participants with active asthma with and without a history of PW in childhood (10 PW+ participants and 20 PW- participants) from the Tucson Children's Respiratory Study were challenged with a human RV-A strain (RV-A16) or control, and their RNA was sequenced. RESULTS A total of 35 differentially expressed genes involved in extracellular remodeling and angiogenesis distinguished the PW+ group from the PW- group at baseline and after RV-A stimulation. Notably, 22 transcriptomic pathways showed PW-by-RV interactions; the pathways were invariably overactivated in PW+ patients, and were involved in Toll-like receptor- and cytokine-mediated responses, remodeling, and angiogenic processes. CONCLUSIONS Asthmatic adults with a history of persistent wheeze in the first 6 years of life have specific biomolecular alterations in response to RV-A that are not present in patients without such a history. Targeting these mechanisms may slow the progression of asthma in these patients.
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Affiliation(s)
- Eugene H Chang
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Nima Pouladi
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Stefano Guerra
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Jana Jandova
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Alexander Kim
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Haiquan Li
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Jianrong Li
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Wayne Morgan
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Debra A Stern
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Amanda L Willis
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Yves A. Lussier
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Fernando D Martinez
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
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2
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Kimura G, Takahashi R, Nagamoto A, Yoshino K, Ueda K, Nishimoto Y, Kizawa Y. [Inhibitory Effects of Dabigatran on Airway Inflammation Induced by Lipopolysaccharide in Mice]. YAKUGAKU ZASSHI 2020; 140:1477-1483. [PMID: 32921648 DOI: 10.1248/yakushi.20-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are characterised by chronic inflammation in the lung that is associated with airway obstruction. Inhaled therapy with a combination of corticosteroid and a long-acting β2-agonist is an effective anti-inflammatory medicine for asthma, but in patients with severe asthma and COPD fails to completely control these symptoms with current therapies. The inflammatory process in these diseases, which involves activation of the coagulation and fibrinolytic system in the lung, offers the opportunity for alternative anti-inflammatory therapies. In this study, we investigated the effects of anti-coagulants on lipopolysaccharide (LPS)-induced airway inflammation in mice. A/J mice were exposed to LPS, a bacterial endotoxin, intranasally and accumulation of inflammatory cells, TNF-α, C-X-C motif chemokine (CXCL) 1, and osteopontin in bronchoalveolar lavage fluid (BALF) was monitored by flow cytometry and an enzyme-linked immunosorbent assay. LPS exposure induced airway neutrophilia and accumulation of TNF-α, CXCL1, and osteopontin in BALF. This LPS-induced airway inflammation was not relieved using a corticosteroid, fluticasone propionate (FP), or a direct inhibitor of Factor Xa, rivaroxaban. In contrast, a direct thrombin inhibitor, dabigatran, inhibited LPS-induced airway neutrophilia and decreased inflammatory cytokine production in a dose dependent manner. Furthermore, combination of dabigatran and FP elicited stronger inhibition of LPS-induced airway inflammation. Therefore, these results suggest that dabigatran could be an effective new therapy for severe respiratory diseases.
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Affiliation(s)
- Genki Kimura
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Risa Takahashi
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Ayaka Nagamoto
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Kotomi Yoshino
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Keitaro Ueda
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Yuki Nishimoto
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
| | - Yasuo Kizawa
- Laboratory of Physiology and Anatomy, School of Pharmacy, Nihon University
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3
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Cho SH, Jo A, Casale T, Jeong SJ, Hong SJ, Cho JK, Holbrook JT, Kumar R, Smith LJ. Soy isoflavones reduce asthma exacerbation in asthmatic patients with high PAI-1-producing genotypes. J Allergy Clin Immunol 2019; 144:109-117.e4. [PMID: 30707970 PMCID: PMC6612283 DOI: 10.1016/j.jaci.2019.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 12/20/2018] [Accepted: 01/11/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND The 4G4G genotype of plasminogen activator inhibitor 1 (PAI-1) is associated with increased plasma PAI-1 levels and poor asthma control. Previous studies suggest that soy isoflavones can reduce PAI-1 levels. OBJECTIVE We sought to investigate PAI-1 genotype-specific differences of the soy isoflavone response in asthma outcomes. METHODS A PAI-1 functional polymorphism (rs1799768, 4G5G) was characterized in subjects with poorly controlled asthma enrolled in a randomized clinical trial of soy isoflavones (n = 265). Genotype-specific treatment responses on asthma outcomes were compared between soy isoflavones and placebo. Normal human bronchial epithelial cells were cultured with or without TGF-β1, genistein, or both, and PAI-1 levels were measured. RESULTS The 4G4G/4G5G genotype was associated with a greater risk for allergy-related worsened asthma symptoms and eczema at baseline compared with the 5G5G genotype. There was a significant interaction between the genotype and soy isoflavone intervention on oral corticosteroid use for asthma exacerbation (P = .005). In a subgroup analysis soy isoflavones significantly reduced the use of oral corticosteroids (number of events/person-year) by 4-fold compared with placebo in the 4G4G/4G5G genotype (0.2 vs 0.8; relative risk, 0.28; P < .001) but not in the 5G5G genotype. Soy isoflavones reduced plasma PAI-1 levels compared with placebo. Genistein treatment reduced TGF-β1-induced PAI-1 production in normal human bronchial epithelial cells. CONCLUSIONS This study demonstrates that soy isoflavone treatment provides a significant benefit in reducing the number of severe asthma exacerbations in asthmatic patients with the high PAI-1-producing genotype. PAI-1 polymorphisms can be used as a genetic biomarker for soy isoflavone-responsive patients with asthma.
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Affiliation(s)
- Seong H Cho
- Division of Allergy-Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Fla; Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
| | - Ara Jo
- Division of Allergy-Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Thomas Casale
- Division of Allergy-Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Su J Jeong
- Department of Statistics Support, Medical Science Research Institute, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Joong K Cho
- Division of Allergy-Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Janet T Holbrook
- Center for Clinical Trials and Evidence Synthesis Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md
| | - Rajesh Kumar
- Division of Allergy-Immunology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Lewis J Smith
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill
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4
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Sherenian MG, Cho SH, Levin A, Min JY, Oh SS, Hu D, Galanter J, Sen S, Huntsman S, Eng C, Rodriguez-Santana JR, Serebrisky D, Avila PC, Kalhan R, Smith LJ, Borrell LN, Seibold MA, Keoki Williams L, Burchard EG, Kumar R. PAI-1 gain-of-function genotype, factors increasing PAI-1 levels, and airway obstruction: The GALA II Cohort. Clin Exp Allergy 2017; 47:1150-1158. [PMID: 28543872 DOI: 10.1111/cea.12958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/27/2017] [Accepted: 04/27/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND PAI-1 gain-of-function variants promote airway fibrosis and are associated with asthma and with worse lung function in subjects with asthma. OBJECTIVE We sought to determine whether the association of a gain-of-function polymorphism in plasminogen activator inhibitor-1 (PAI-1) with airway obstruction is modified by asthma status, and whether any genotype effect persists after accounting for common exposures that increase PAI-1 level. METHODS We studied 2070 Latino children (8-21y) with genotypic and pulmonary function data from the GALA II cohort. We estimated the relationship of the PAI-1 risk allele with FEV1/FVC by multivariate linear regression, stratified by asthma status. We examined the association of the polymorphism with asthma and airway obstruction within asthmatics via multivariate logistic regression. We replicated associations in the SAPPHIRE cohort of African Americans (n=1056). Secondary analysis included the effect of the at-risk polymorphism on postbronchodilator lung function. RESULTS There was an interaction between asthma status and the PAI-1 polymorphism on FEV1 /FVC (P=.03). The gain-of-function variants, genotypes (AA/AG), were associated with lower FEV1 /FVC in subjects with asthma (β=-1.25, CI: -2.14,-0.35, P=.006), but not in controls. Subjects with asthma and the AA/AG genotypes had a 5% decrease in FEV1 /FVC (P<.001). In asthmatics, the risk genotype (AA/AG) was associated with a 39% increase in risk of clinically relevant airway obstruction (OR=1.39, CI: 1.01, 1.92, P=.04). These associations persisted after exclusion of factors that increase PAI-1 including tobacco exposure and obesity. CONCLUSIONS AND CLINICAL RELEVANCE The decrease in the FEV1 /FVC ratio associated with the risk genotype was modified by asthma status. The genotype increased the odds of airway obstruction by 75% within asthmatics only. As exposures known to increase PAI-1 levels did not mitigate this association, PAI-1 may contribute to airway obstruction in the context of chronic asthmatic airway inflammation.
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Affiliation(s)
- M G Sherenian
- Division of Allergy-Immunology, Department of Pediatrics, Northwestern University, Chicago, IL, USA.,The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - S H Cho
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, IL, USA.,Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - A Levin
- Department of Public Health Science, Henry Ford Health System, Detroit, MI, USA
| | - J-Y Min
- Department of Otolaryngology, Northwestern University, Chicago, IL, USA
| | - S S Oh
- Department of Medicine, University of California, San Francisco, CA, USA
| | - D Hu
- Department of Medicine, University of California, San Francisco, CA, USA
| | - J Galanter
- Department of Medicine, University of California, San Francisco, CA, USA
| | - S Sen
- Division of Biostatistics, Department of Preventive Medicine, UTHSC, Memphis, TN, USA
| | - S Huntsman
- Department of Medicine, University of California, San Francisco, CA, USA
| | - C Eng
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - D Serebrisky
- Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY, USA
| | - P C Avila
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - R Kalhan
- Division of Pulmonary Medicine, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - L J Smith
- Division of Pulmonary Medicine, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - L N Borrell
- Department of Health Sciences, Lehman College, CUNY, New York, NY, USA
| | - M A Seibold
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - L Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - E G Burchard
- Department of Medicine, University of California, San Francisco, CA, USA
| | - R Kumar
- Division of Allergy-Immunology, Department of Pediatrics, Northwestern University, Chicago, IL, USA.,The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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5
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Sneeboer MMS, Fens N, van de Pol MA, Majoor CJ, Meijers JCM, Kamphuisen PW, Lutter R, Sterk PJ, Bel EHD. Loss of asthma control and activation of coagulation and fibrinolysis. Clin Exp Allergy 2016; 46:422-7. [PMID: 26509255 DOI: 10.1111/cea.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/19/2015] [Accepted: 10/24/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Epidemiologic studies have shown that patients with severe asthma have increased risk of pulmonary embolism, in particular patients with frequent asthma exacerbations. Therefore, we hypothesized that asthma exacerbations are associated with increased haemostatic activity. OBJECTIVE To investigate whether induced loss of asthma control is associated with changes in coagulation and fibrinolytic parameters in peripheral blood. METHODS We performed a prospective, inhaled steroid withdrawal study in 23 patients with moderate to moderately severe asthma, consisting of a baseline visit and a visit after loss of asthma control. During the visits, we measured asthma control questionnaire (ACQ), atopy, lung function, inflammatory markers (eosinophils and neutrophils), and haemostatic parameters in plasma. RESULTS Complete cessation of inhaled corticosteroids led to a loss of asthma control in 22 of 23 patients. We found increased asthma symptoms (ACQ 0.9 vs. 2.9, P < 0.01), significantly reduced lung function (forced expiratory volume in 1 s (FEV1) 3.51L vs. 3.13L, P < 0.01) and increased levels of eosinophils in plasma (0.26 × 10(E9)/L vs. 0.16 × 10(E9)/L, P = 0.03) in patients after loss of asthma control. However, we observed no significant changes in the coagulation and fibrinolysis parameters. CONCLUSION Loss of asthma control after cessation of inhaled corticosteroids does not lead to increased haemostatic activation in patients with moderate to moderately severe asthma. This suggests that more severe inflammation or additional risk factors are required for activation of coagulation or reduction of fibrinolysis in asthma.
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Affiliation(s)
- M M S Sneeboer
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - N Fens
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - M A van de Pol
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - C J Majoor
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - J C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - P W Kamphuisen
- Department of Vascular Medicine, University Medical Center Groningen, The Netherlands
| | - R Lutter
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - P J Sterk
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - E H D Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
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6
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Rawson R, Yang T, Newbury RO, Aquino M, Doshi A, Bell B, Broide DH, Dohil R, Kurten R, Aceves SS. TGF-β1-induced PAI-1 contributes to a profibrotic network in patients with eosinophilic esophagitis. J Allergy Clin Immunol 2016; 138:791-800.e4. [PMID: 27212082 PMCID: PMC5014565 DOI: 10.1016/j.jaci.2016.02.028] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 12/29/2015] [Accepted: 02/11/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Eosinophilic esophagitis (EoE) is an allergic disease of increasing worldwide incidence. Complications are due to tissue remodeling and involve TGF-β1-mediated fibrosis. Plasminogen activator inhibitor 1 (PAI-1/serpinE1) can be induced by TGF-β1, but its role in EoE is not known. OBJECTIVE We sought to understand the expression and role of PAI-1 in patients with EoE. METHODS We used esophageal biopsy specimens and plasma samples from control subjects and patients with EoE, primary human esophageal epithelial cells, and fibroblasts from patients with EoE in immunohistochemistry, quantitative PCR, and immunoassay experiments to understand the induction of PAI-1 by TGF-β1, the relationship between PAI-1 and esophageal fibrosis, and the role of PAI-1 in fibrotic gene expression. RESULTS PAI-1 expression was significantly increased in epithelial cells of biopsy specimens from patients with active EoE compared with that seen in biopsy specimens from patients with inactive EoE or control subjects (P < .001). Treatment of primary esophageal epithelial cells with recombinant TGF-β1 increased PAI-1 transcription, intracellular protein expression, and secretion. Esophageal PAI-1 expression correlated with basal zone hyperplasia, fibrosis, and markers of esophageal remodeling, including vimentin, TGF-β1, collagen I, fibronectin, and matrix metalloproteases, and plasma PAI-1 levels correlated with plasma TGF-β1 levels. PAI-1 inhibition significantly decreased baseline and TGF-β1-induced fibrotic gene expression. CONCLUSIONS PAI-1 expression is significantly increased in the epithelium in patients with EoE and reflects fibrosis, and its inhibition decreases TGF-β1-induced gene expression. Epithelial PAI-1 might serve as a marker of EoE severity and form part of a TGF-β1-induced profibrotic network.
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Affiliation(s)
- Renee Rawson
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif; Center for Infection, Immunity, and Inflammation, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Tom Yang
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif; Center for Infection, Immunity, and Inflammation, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Robert O Newbury
- Department of Pediatric Pathology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Melissa Aquino
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Ashmi Doshi
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif; Center for Infection, Immunity, and Inflammation, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Braxton Bell
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif; Center for Infection, Immunity, and Inflammation, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - David H Broide
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Ranjan Dohil
- Division of Pediatric Gastroenterology and Nutrition, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif
| | - Richard Kurten
- Department of Physiology and Biophysics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital Research Institute, Little Rock, Ark
| | - Seema S Aceves
- Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif; Center for Infection, Immunity, and Inflammation, Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, and Rady Children's Hospital, San Diego, Calif.
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7
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Cho SH, Min JY, Kim DY, Oh SS, Torgerson DR, Pino-Yanes M, Hu D, Sen S, Huntsman S, Eng C, Farber HJ, Rodriguez-Cintron W, Rodriguez-Santana JR, Serebrisky D, Thyne SM, Borrell LN, Williams LK, DuPont W, Seibold MA, Burchard EG, Avila PC, Kumar R. Association of a PAI-1 Gene Polymorphism and Early Life Infections with Asthma Risk, Exacerbations, and Reduced Lung Function. PLoS One 2016; 11:e0157848. [PMID: 27556405 PMCID: PMC4996454 DOI: 10.1371/journal.pone.0157848] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/06/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Plasminogen activator inhibitor-1 (PAI-1) is induced in airways by virus and may mediate asthmatic airway remodeling. We sought to evaluate if genetic variants and early life lower respiratory infections jointly affect asthma risk. METHODS We included Latino children, adolescents, and young adults aged 8-21 years (1736 subjects with physician-diagnosed asthma and 1747 healthy controls) from five U.S. centers and Puerto Rico after excluding subjects with incomplete clinical or genetic data. We evaluated the independent and joint effects of a PAI-1 gain of function polymorphism and bronchiolitis / Respiratory Syncytial Virus (RSV) or other lower respiratory infections (LRI) within the first 2 years of life on asthma risk, asthma exacerbations and lung function. RESULTS RSV infection (OR 9.9, 95%CI 4.9-20.2) and other LRI (OR 9.1, 95%CI 7.2-11.5) were independently associated with asthma, but PAI-1 genotype was not. There were joint effects on asthma risk for both genotype-RSV (OR 17.7, 95% CI 6.3-50.2) and genotype-LRI (OR 11.7, 95% CI 8.8-16.4). A joint effect of genotype-RSV resulted in a 3.1-fold increased risk for recurrent asthma hospitalizations. In genotype-respiratory infection joint effect analysis, FEV1% predicted and FEV1/FVC % predicted were further reduced in the genotype-LRI group (β -2.1, 95% CI -4.0 to -0.2; β -2.0, 95% CI -3.1 to -0.8 respectively). Similarly, lower FEV1% predicted was noted in genotype-RSV group (β -3.1, 95% CI -6.1 to -0.2) with a trend for lower FEV1/FVC % predicted. CONCLUSIONS A genetic variant of PAI-1 together with early life LRI such as RSV bronchiolitis is associated with an increased risk of asthma, morbidity, and reduced lung function in this Latino population.
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Affiliation(s)
- Seong H. Cho
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Jin-Young Min
- Department of Otolaryngology, Northwestern University, Chicago, Illinois, United States of America
| | - Dong Young Kim
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Sam S. Oh
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Dara R. Torgerson
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Maria Pino-Yanes
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Saunak Sen
- Division of Biostatistics, Department of Preventive Medicine, UTHSC, Memphis, Tennessee, United States of America
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Harold J. Farber
- Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, United States of America
| | | | | | - Denise Serebrisky
- Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, New York, United States of America
| | - Shannon M. Thyne
- Department of Pediatrics, University of California, San Francisco, California, United States of America
| | - Luisa N. Borrell
- Department of Health Sciences, Lehman College, CUNY, New York, New York, United States of America
| | - L. Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, United States of America
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, United States of America
| | - William DuPont
- Department of Biostatistics, Vanderbilt University Medical School, Nashville, Tennessee, United States of America
| | - Max A. Seibold
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado, United States of America
| | - Esteban G. Burchard
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Pedro C. Avila
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Rajesh Kumar
- Division of Allergy-Immunology, Department of Pediatrics, Northwestern University, Chicago, Illinois, United States of America
- The Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- * E-mail:
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8
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Peden DB, Bush RK. Advances in environmental and occupational disorders in 2014. J Allergy Clin Immunol 2016; 136:866-71. [PMID: 26449799 DOI: 10.1016/j.jaci.2015.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 08/14/2015] [Accepted: 08/19/2015] [Indexed: 01/26/2023]
Abstract
In 2014, the Journal published a number of studies that have advanced our understanding of the effects of various environmental factors and immune responses in patients with allergic diseases. In this review we emphasize reports that have appeared in the Journal over the past year that deal with environmental and occupational respiratory disorders and novel approaches to their treatment. The review will focus on the effects of environmental factors and immune responses in allergic airway diseases, identification of new allergens, and risk factors in stinging insect allergy, development of asthma in different age groups, effects of viral infections, and benefits of new therapies.
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Affiliation(s)
- David B Peden
- Department of Pediatrics, Division of Allergy, Immunology, and Rheumatology, University of North Carolina School of Medicine, Chapel Hill, NC.
| | - Robert K Bush
- Department of Medicine, Division of Allergy, Immunology, Pulmonary, Critical Care, and Sleep Medicine, University of Wisconsin, School of Medicine and Public Health, Madison, Wis
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Liu RM, Eldridge S, Watanabe N, Deshane J, Kuo HC, Jiang C, Wang Y, Liu G, Schwiebert L, Miyata T, Thannickal VJ. Therapeutic potential of an orally effective small molecule inhibitor of plasminogen activator inhibitor for asthma. Am J Physiol Lung Cell Mol Physiol 2015; 310:L328-36. [PMID: 26702150 DOI: 10.1152/ajplung.00217.2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 12/19/2015] [Indexed: 11/22/2022] Open
Abstract
Asthma is one of the most common respiratory diseases. Although progress has been made in our understanding of airway pathology and many drugs are available to relieve asthma symptoms, there is no cure for chronic asthma. Plasminogen activator inhibitor 1 (PAI-1), a primary inhibitor of tissue-type and urokinase-type plasminogen activators, has pleiotropic functions besides suppression of fibrinolysis. In this study, we show that administration of TM5275, an orally effective small-molecule PAI-1 inhibitor, 25 days after ovalbumin (OVA) sensitization-challenge, significantly ameliorated airway hyperresponsiveness in an OVA-induced chronic asthma model. Furthermore, we show that TM5275 administration significantly attenuated OVA-induced infiltration of inflammatory cells (neutrophils, eosinophils, and monocytes), the increase in the levels of OVA-specific IgE and Th2 cytokines (IL-4 and IL-5), the production of mucin in the airways, and airway subepithelial fibrosis. Together, the results suggest that the PAI-1 inhibitor TM5275 may have therapeutic potential for asthma through suppressing eosinophilic allergic response and ameliorating airway remodeling.
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Affiliation(s)
- Rui-Ming Liu
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama;
| | - Stephanie Eldridge
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nobuo Watanabe
- United Centers for Advanced Research and Translational Medicine, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Jessy Deshane
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Hui-Chien Kuo
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Chunsun Jiang
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yong Wang
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gang Liu
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lisa Schwiebert
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Toshio Miyata
- United Centers for Advanced Research and Translational Medicine, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Victor J Thannickal
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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10
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Sneeboer MMS, Majoor CJ, de Kievit A, Meijers JCM, van der Poll T, Kamphuisen PW, Bel EH. Prothrombotic state in patients with severe and prednisolone-dependent asthma. J Allergy Clin Immunol 2015; 137:1727-1732. [PMID: 26714414 DOI: 10.1016/j.jaci.2015.10.038] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/18/2015] [Accepted: 10/30/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidemiologic studies have shown that asthmatic patients, in particular those with severe disease, have increased risk of pulmonary embolism. It is unknown whether these patients have a prothrombotic state under stable conditions. OBJECTIVE We sought to compare coagulation and fibrinolysis parameters between healthy subjects and patients with mild, severe, and prednisolone-dependent asthma under stable conditions and to investigate whether hemostatic markers correlate with airway inflammation. METHODS In 126 adults (33 healthy control subjects, 31 patients with mild asthma, 32 patients with severe asthma, and 30 patients with prednisolone-dependent asthma) parameters of inflammation (peripheral blood eosinophils and neutrophils) and markers of hemostasis (endogenous thrombin potential [ETP], thrombin-antithrombin complex, plasmin-α2-antiplasmin complex, plasminogen activator inhibitor type 1 [PAI-1], D-dimer, and von Willebrand factor [vWF]) were measured in plasma. One-way ANOVA with the post hoc Bonferroni test was used for group comparison, and linear regression analysis was used for correlations. RESULTS We observed increased ETP (121% vs 99%, overall P < .01), plasmin-α2-antiplasmin complex (520 vs 409 μg/L, overall P = .04), PAI-1 (10 vs 7 ng/mL, overall P = .02), and vWF (142% vs 87%, overall P < .01) levels in asthmatic patients compared with healthy control subjects. ETP, PAI-1, and vWF levels increased with increasing asthma severity. In addition, we found a correlation between ETP and vWF with neutrophil but not eosinophil counts. CONCLUSION Asthmatic patients have a prothrombotic state that increases with asthma severity. This might explain why patients with asthma, in particular those with severe disease, have an increased risk of venous thromboembolism.
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Affiliation(s)
- Marlous M S Sneeboer
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Christof J Majoor
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne de Kievit
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joost C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - Tom van der Poll
- Center of Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter W Kamphuisen
- Department of Vascular Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth H Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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