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Hránková V, Balner T, Gubová P, Staníková L, Zeleník K, Komínek P. Narrative review of relationship between chronic cough and laryngopharyngeal reflux. Front Med (Lausanne) 2024; 11:1348985. [PMID: 38707186 PMCID: PMC11066273 DOI: 10.3389/fmed.2024.1348985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/08/2024] [Indexed: 05/07/2024] Open
Abstract
Gastroesophageal reflux disease (GERD) as a possible cause of chronic cough is known for decades. However, more than 75% of patients with extraoesophageal symptoms do not suffer from typical symptoms of GERD like pyrosis and regurgitations and have negative upper gastrointestinal endoscopy. For such a condition term laryngopharyngeal reflux (LPR) was introduced and is used for more than two decades. Since the comprehensive information on relationship between chronic cough and LPR is missing the aim of this paper is to summarize current knowledge based on review of published information during last 13 years. Laryngopharyngeal reflux is found in 20% of patients with chronic cough. The main and recognized diagnostic method for LPR is 24-h multichannel intraluminal impedance-pH (MII-pH) monitoring, revealing reflux episodes irritating the upper and lower respiratory tract mucosa. The treatment of LPR should be initiated with dietary and lifestyle measures, followed by proton pump inhibitor (PPI) therapy and other measures. Despite progress, more research is needed for accurate diagnosis and targeted therapies. Key areas for exploration include biomarkers for diagnosis, the impact of non-acid reflux on symptom development, and the efficacy of new drugs. Further studies with a focused population, excluding other causes like asthma, and using new diagnostic criteria for LPR are essential. It's crucial to consider LPR as a potential cause of unexplained chronic cough and to approach diagnosis and treatment with a multidisciplinary perspective.
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Affiliation(s)
- Viktória Hránková
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Tomáš Balner
- Department of Allergology and Clinical Immunology, University Hospital of Ostrava, Ostrava, Czechia
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Patrícia Gubová
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czechia
| | - Lucia Staníková
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Karol Zeleník
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Pavel Komínek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
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2
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Leonti M, Baker J, Staub P, Casu L, Hawkins J. Taste shaped the use of botanical drugs. eLife 2024; 12:RP90070. [PMID: 38265283 PMCID: PMC10945733 DOI: 10.7554/elife.90070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
The perception of taste and flavour (a combination of taste, smell, and chemesthesis), here also referred to as chemosensation, enables animals to find high-value foods and avoid toxins. Humans have learned to use unpalatable and toxic substances as medicines, yet the importance of chemosensation in this process is poorly understood. Here, we generate tasting-panel data for botanical drugs and apply phylogenetic generalised linear mixed models to test whether intensity and complexity of chemosensory qualities as well as particular tastes and flavours can predict ancient Graeco-Roman drug use. We found chemosensation to be strongly predictive of therapeutic use: botanical drugs with high therapeutic versatility have simple yet intense tastes and flavours, and 21 of 22 chemosensory qualities predicted at least one therapeutic use. In addition to the common notion of bitter tasting medicines, we also found starchy, musky, sweet, and soapy drugs associated with versatility. In ancient Greece and Rome, illness was thought to arise from imbalance in bodily fluids or humours, yet our study suggests that uses of drugs were based on observed physiological effects that are often consistent with modern understanding of chemesthesis and taste receptor pharmacology.
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Affiliation(s)
- Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - Joanna Baker
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Peter Staub
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - Laura Casu
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - Julie Hawkins
- School of Biological Sciences, University of Reading, Reading, United Kingdom
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3
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Xu J, Ghadiri M, Svolos M, McParland B, Traini D, Ong HX, Young PM. Investigating Potential TRPV1 Positive Feedback to Explain TRPV1 Upregulation in Airway Disease States. Drug Dev Ind Pharm 2022; 47:1924-1934. [PMID: 35473456 DOI: 10.1080/03639045.2022.2070759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The airway epithelium is a potential source of pathophysiology through activation of transient potential receptor vallinoid type 1 (TRPV1) channel. A positive feedback cycle caused by TRPV1 activity is hypothesised to induce upregulation and production of inflammatory cytokines, leading to exacerbations of chronic airway diseases. These cytokine and protein regulation effects were investigated in this study. METHODS Healthy (BEAS-2B) and cancer-derived (Calu-3) airway epithelial cell lines were assessed for changes to TRPV1 protein expression and mRNA expression following exposure to capsaicin (5 µM to 50 µM), and TRPV1 modulators including heat (43 °C), and hydrochloric acid (pH 3.4 to pH 6.4). Cytotoxicity was measured to determine the working concentration ranges of treatment. Subsequent bronchoconstriction by TRPV1 activation with capsaicin was measured on guinea pig airway tissue to confirm locally mediated activity without the action of known neuronal inputs. RESULTS TRPV1 protein expression was not different for all capsaicin, acidity, and heat exposures (P > 0.05), and was replicated in mRNA protein expression (P > 0.05). IL-6 and IL-8 expression were lower in BEAS-2B and Calu-3 cell lines exposed with acidity and heat (P < 0.05), but not consistently with capsaicin exposure, with potential cytotoxic effects possible. CONCLUSIONS TRPV1 expression was present in airway epithelial cells but its expression was not changed after activation by TRPV1 activators. Thus, it was not apparent the reason for reported TRPV1 upregulation in patients with airway disease states. More complex mechanisms are likely involved and will require further investigation.
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Affiliation(s)
- Jesse Xu
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia.,School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2006, Australia
| | - Maliheh Ghadiri
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia
| | - Maree Svolos
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia
| | - Brent McParland
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2006, Australia
| | - Daniela Traini
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia.,Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Hui Xin Ong
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia.,Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Paul M Young
- Respiratory Technology Group, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037, Australia.,Department of Marketing, Macquarie Business School, Macquarie University, NSW 2109, Australia
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4
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Hiroki CH, Sarden N, Hassanabad MF, Yipp BG. Innate Receptors Expression by Lung Nociceptors: Impact on COVID-19 and Aging. Front Immunol 2021; 12:785355. [PMID: 34975876 PMCID: PMC8716370 DOI: 10.3389/fimmu.2021.785355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
The lungs are constantly exposed to non-sterile air which carries harmful threats, such as particles and pathogens. Nonetheless, this organ is equipped with fast and efficient mechanisms to eliminate these threats from the airways as well as prevent pathogen invasion. The respiratory tract is densely innervated by sensory neurons, also known as nociceptors, which are responsible for the detection of external stimuli and initiation of physiological and immunological responses. Furthermore, expression of functional innate receptors by nociceptors have been reported; however, the influence of these receptors to the lung function and local immune response is poorly described. The COVID-19 pandemic has shown the importance of coordinated and competent pulmonary immunity for the prevention of pathogen spread as well as prevention of excessive tissue injury. New findings suggest that lung nociceptors can be a target of SARS-CoV-2 infection; what remains unclear is whether innate receptor trigger sensory neuron activation during SARS-CoV-2 infection and what is the relevance for the outcomes. Moreover, elderly individuals often present with respiratory, neurological and immunological dysfunction. Whether aging in the context of sensory nerve function and innate receptors contributes to the disorders of these systems is currently unknown. Here we discuss the expression of innate receptors by nociceptors, particularly in the lungs, and the possible impact of their activation on pulmonary immunity. We then demonstrate recent evidence that suggests lung sensory neurons as reservoirs for SARS-CoV-2 and possible viral recognition via innate receptors. Lastly, we explore the mechanisms by which lung nociceptors might contribute to disturbance in respiratory and immunological responses during the aging process.
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Affiliation(s)
- Carlos H. Hiroki
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nicole Sarden
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mortaza F. Hassanabad
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bryan G. Yipp
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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5
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Advances in TRP channel drug discovery: from target validation to clinical studies. Nat Rev Drug Discov 2021; 21:41-59. [PMID: 34526696 PMCID: PMC8442523 DOI: 10.1038/s41573-021-00268-4] [Citation(s) in RCA: 212] [Impact Index Per Article: 70.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/20/2022]
Abstract
Transient receptor potential (TRP) channels are multifunctional signalling molecules with many roles in sensory perception and cellular physiology. Therefore, it is not surprising that TRP channels have been implicated in numerous diseases, including hereditary disorders caused by defects in genes encoding TRP channels (TRP channelopathies). Most TRP channels are located at the cell surface, which makes them generally accessible drug targets. Early drug discovery efforts to target TRP channels focused on pain, but as our knowledge of TRP channels and their role in health and disease has grown, these efforts have expanded into new clinical indications, ranging from respiratory disorders through neurological and psychiatric diseases to diabetes and cancer. In this Review, we discuss recent findings in TRP channel structural biology that can affect both drug development and clinical indications. We also discuss the clinical promise of novel TRP channel modulators, aimed at both established and emerging targets. Last, we address the challenges that these compounds may face in clinical practice, including the need for carefully targeted approaches to minimize potential side-effects due to the multifunctional roles of TRP channels.
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6
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Kong L, Huang H, Luan S, Liu H, Ye M, Wu F. Inhibition of ASIC1a-Mediated ERS Improves the Activation of HSCs and Copper Transport Under Copper Load. Front Pharmacol 2021; 12:653272. [PMID: 34135753 PMCID: PMC8201774 DOI: 10.3389/fphar.2021.653272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Hepatolenticular degeneration (HLD) is an autosomal recessive genetic disease caused by the toxic accumulation of copper in the liver. Excessive copper will disrupt the redox balance in cells and tissues, causing ischemia, hypoxia, and inflammation. Acid-sensitive ion channel 1a is a cationic channel activated by extracellular acid and allowing Ca2+ and Na+ to flow into cells. Its expression appears in inflammation, arthritis, fibrotic tissue, and damaged environment, but its role in hepatolenticular degeneration has not been studied. This study established a Wistar rat model of high copper accumulation and used CuSO4 to induce the activation of HSC-T6 in an in vitro experiment. In vivo, Wistar rats were examined to determine the serum copper concentration, serum ALT and AST activities, and liver copper accumulation, and liver tissue HE staining and immunohistochemical analyses were conducted. The expression of ASIC1a, α-SMA, Collagen-Ι, GRP78, XBP1, ATP7B, and CCS were detected. Besides, immunofluorescence technology can detect the expression of the phosphorylated protein in vitro. It is suggested that ASIC1a is involved in the quality control of the endoplasmic reticulum, which degrades mutant ATP7B and increases the accumulation of copper. After blocking or silencing the expression of ASIC1a, ELISA can detect the level of inflammatory factors, the expression of endoplasmic reticulum stress-related factors, and ATP7B was improved in a higher copper environment reduction of copper deposition was observed in liver Timm’s staining. Collectively, we conclude that ASIC1a is involved in the HSC activation induced by copper accumulation and promotes the occurrence of hepatolenticular fibrosis.
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Affiliation(s)
- Lingjin Kong
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Huiping Huang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Shaohua Luan
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Hui Liu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Manping Ye
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Fanrong Wu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
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7
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Aliabadi F, Ajami M, Pazoki–Toroudi H. Why does COVID‐19 pathology have several clinical forms? Bioessays 2020; 42:e2000198. [DOI: 10.1002/bies.202000198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Fatemeh Aliabadi
- Physiology Research Center, Department of Medicine Iran University of Medical Sciences Tehran Iran
| | - Marjan Ajami
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hamidreza Pazoki–Toroudi
- Physiology Research Center, Department of Medicine Iran University of Medical Sciences Tehran Iran
- Department of Physiology, Department of Medicine Iran University of Medical Sciences Tehran Iran
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8
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Abstract
Cough sensitivity can be described as the reaction intensity of the cough reflex to different stimuli which activate chemically and mechanically sensitive vagal afferent nerves innervating airways and lungs. Measurement of cough reflex sensitivity plays an important role in revealing the underlying mechanisms of cough and evaluating the effects of pharmacological interventions. Besides, different responses to cough suppression therapies indicate the existence of cough hypersensitivity. In consideration of these factors stated above, cough sensitivity should therefore be assessed with a variety of cough challenge tests. Based on the neuroanatomical characteristics of the cough reflex, chemical challenge tests have been developed to objectively assess cough sensitivity. In cough inhalation challenges, capsaicin and citric acid are commonly used as the tussive agents to induce cough, which are validated for describing a profile of cough sensitivity to chemical irritants. Recently, mechanical methodologies have also been tried to measure the mechanical sensitivity of the cough reflex. Methodological consideration and selection are necessary for the reasonable assessment of cough sensitivity while employing cough challenges in clinical trials. Thus, in this review, we will focus on describing various methodologies of cough sensitivity measurement and, detailing some factors influencing on the accuracy of outcomes in the experimentally induced cough.
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Affiliation(s)
- Yonglin Mai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Nanshan School of Medicine, Guangzhou Medical University, Guangzhou, China
| | - Liman Fang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuxin Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - S Dushinka Shaniya Helen de Silva
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,International College of Education, Guangzhou Medical University, Guangzhou, China
| | - Ruchong Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kefang Lai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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9
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Demoulin B, Coutier-Marie L, Ioan I, Schweitzer CE, Foucauld L, Demoulin-Alexikova S. In Vivo Documentation of Stimulus Velocity Tuning of Mechanically Induced Reflex Cough. Physiol Res 2020; 69:S139-S145. [PMID: 32228019 DOI: 10.33549/physiolres.934397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
In order to clear airways and lungs defensive reflexes are provoked rather by the dynamic phase of mechanical stimulus. It is speculated that provocation of defensive response depends not only on stimulus duration but also on stimulus velocity. Fourteen adult rabbits were anaesthetized and tracheotomized. Mechanical stimulus was provoked by a mechanical probe introduced through the tracheotomy and rotated by a small electrical motor using a rotational velocity of 40 rpm/s and 20 rpm/s. Threshold, incidence and intensity of cough reflex (CR) were analyzed for each animal. Statistical comparisons between two velocities were performed using Friedman nonparametric test for repeated measurements. Results are median (25-75 %). The threshold of CR was significantly increased (p=0.005) from 350 ms (300-500 ms) to 550 ms (350-1150 ms) and the incidence of cough reflex was significantly reduced (p=0.002) from 50 % (19 50 %) to 0 % (0-25 %) when the rotational velocity of the mechanical probe was reduced by half. The findings of this study are of interest as they show that protective reflex cough, an important mechanism that allows clearing airways even during sleep or anesthesia, is tuned by mechanical stimulus velocity.
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Affiliation(s)
- B Demoulin
- Research Unit EA 3450 DevAH-Development, Adaptation and Handicap, Campus Biologie Santé, University of Lorraine, Vandoeuvre-les-Nancy,
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10
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Nahama A, Ramachandran R, Cisternas AF, Ji H. The role of afferent pulmonary innervation in ARDS associated with COVID-19 and potential use of resiniferatoxin to improve prognosis: A review. MEDICINE IN DRUG DISCOVERY 2020; 5:100033. [PMID: 32292906 PMCID: PMC7147194 DOI: 10.1016/j.medidd.2020.100033] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) is one of the major causes of mortality associated with COVID-19 disease. Many patients will require intensive care with ventilatory support. Despite progress and best efforts, the mortality rates projected remain high. Historical data outlook points towards 80% expected fatality for patients progressing to advanced pulmonary disease, even when hospitalized in the intensive care unit. This is particularly true among the patient population over 65. Novel life-saving strategies are desperately needed to mitigate the high mortality that will be associated with the late stage SARS-CoV-2 viral infection associated with the fatal respiratory distress. We hypothesize that the morbidity, severity of the disease, and underlying physiological events leading to mortality are closely linked to the TRPV1 expressing neuronal system (afferent/efferent neurons) in the lungs. TRPV1 expressing cells are responsible for pain transmission, inflammation and immunomodulation throughout the entire pulmonary system and are modulating the processes associated with localized cytokine release (storm) and overall rapid disease progression. We suggest that therapeutic approaches targeting TRPV1 containing nerve fibers in the lungs will modulate the inflammatory and immune signal activity, leading to reduced mortality and better overall outcomes. We also propose to further explore the use of resiniferatoxin (RTX), an ultra-potent TRPV1 agonist currently in clinical trials for cancer and osteoarthritis pain, as a possible ablating agent of TRPV1 positive pulmonary pathways in patients with advanced COVID-19 disease.
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Affiliation(s)
- Alexis Nahama
- Sorrento Therapeutics Inc., 4955 Directors’ Place, San Diego, CA, 92121
| | | | | | - Henry Ji
- Sorrento Therapeutics Inc., 4955 Directors’ Place, San Diego, CA, 92121
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11
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Smith JA, Wortley MA, Bonvini S, Birrell M, Belvisi MG. "Truth is ever to be found in simplicity, and not in the multiplicity and confusion of things" - Sir Isaac Newton. Eur Respir J 2020; 55:55/2/1901566. [PMID: 32029640 DOI: 10.1183/13993003.01566-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/01/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Jaclyn A Smith
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK .,Manchester University NHS Foundation Trust, Manchester, UK
| | - Mike A Wortley
- Respiratory Pharmacology Group, Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara Bonvini
- Respiratory Pharmacology Group, Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark Birrell
- Respiratory Pharmacology Group, Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK.,Respiratory, Inflammation and Autoimmune (RIA), BioPharmaceuticals R&D, AstraZeneca, Sweden
| | - Maria G Belvisi
- Respiratory Pharmacology Group, Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK.,Respiratory, Inflammation and Autoimmune (RIA), BioPharmaceuticals R&D, AstraZeneca, Sweden
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12
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Patrone LGA, Duarte JB, Bícego KC, Steiner AA, Romanovsky AA, Gargaglioni LH. TRPV1 Inhibits the Ventilatory Response to Hypoxia in Adult Rats, but Not the CO₂-Drive to Breathe. Pharmaceuticals (Basel) 2019; 12:ph12010019. [PMID: 30682830 PMCID: PMC6469189 DOI: 10.3390/ph12010019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/27/2018] [Accepted: 12/07/2018] [Indexed: 12/31/2022] Open
Abstract
Receptors of the transient receptor potential (TRP) channels superfamily are expressed in many tissues and have different physiological functions. However, there are few studies investigating the role of these channels in cardiorespiratory control in mammals. We assessed the role of central and peripheral TRPV1 receptors in the cardiorespiratory responses to hypoxia (10% O2) and hypercapnia (7% CO2) by measuring pulmonary ventilation (V˙E), heart rate (HR), mean arterial pressure (MAP) and body temperature (Tb) of male Wistar rats before and after intraperitoneal (AMG9810 [2.85 µg/kg, 1 mL/kg]) or intracebroventricular (AMG9810 [2.85 µg/kg, 1 µL] or AMG7905 [28.5 μg/kg, 1 µL]) injections of TRPV1 antagonists. Central or peripheral injection of TRPV1 antagonists did not change cardiorespiratory parameters or Tb during room air and hypercapnic conditions. However, the hypoxic ventilatory response was exaggerated by both central and peripheral injection of AMG9810. In addition, the peripheral antagonist blunted the drop in Tb induced by hypoxia. Therefore, the current data provide evidence that TRPV1 channels exert an inhibitory modulation on the hypoxic drive to breathe and stimulate the Tb reduction during hypoxia.
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Affiliation(s)
- Luis Gustavo A Patrone
- Department of Animal Morphology and Physiology, Faculty of Agricultural and Veterinarian Sciences, UNESP at Jaboticabal, Rod. Prof. Paulo Donato Castellane s/n, Jaboticabal SP 14870-000, Brazil.
| | - Jaime B Duarte
- Department of Animal Morphology and Physiology, Faculty of Agricultural and Veterinarian Sciences, UNESP at Jaboticabal, Rod. Prof. Paulo Donato Castellane s/n, Jaboticabal SP 14870-000, Brazil.
| | - Kênia Cardoso Bícego
- Department of Animal Morphology and Physiology, Faculty of Agricultural and Veterinarian Sciences, UNESP at Jaboticabal, Rod. Prof. Paulo Donato Castellane s/n, Jaboticabal SP 14870-000, Brazil.
| | - Alexandre A Steiner
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo 05508-090, Brazil.
| | - Andrej A Romanovsky
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
| | - Luciane H Gargaglioni
- Department of Animal Morphology and Physiology, Faculty of Agricultural and Veterinarian Sciences, UNESP at Jaboticabal, Rod. Prof. Paulo Donato Castellane s/n, Jaboticabal SP 14870-000, Brazil.
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13
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Fang Z, Huang C, Zhang JJ, Xie J, Dai S, Ge E, Xiang J, Yao H, Huang R, Bi X, Wang B, Zhong N, Lai K. Traffic-related air pollution induces non-allergic eosinophilic airway inflammation and cough hypersensitivity in guinea-pigs. Clin Exp Allergy 2019; 49:366-377. [PMID: 30415484 DOI: 10.1111/cea.13308] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/30/2018] [Accepted: 11/04/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND The pathogenesis and pathophysiology of eosinophilia-related chronic cough such as non-asthmatic eosinophilic bronchitis and cough variant asthma are still not clear. OBJECTIVE This study is to examine the potential role of traffic-related air pollution (TRAP) in eosinophilic inflammation and cough responses. METHODS Non-sensitized guinea-pigs were exposed to TRAP in an urban traffic tunnel or kept in a filtered air environment for 7 or 14 days. Reflexive cough was measured using citric acid and allyl isothiocyanate (AITC) challenges, respectively. Spontaneous cough counting was determined using audio recording and a waveform analysis. Airway inflammation was evaluated using differential cells in bronchoalveolar lavage fluid (BALF) and lung histopathology. To further elucidate the relationship between airway inflammation and cough hypersensitivity, a subgroup of those exposed for 14 days received a dexamethasone treatment. RESULTS Compared to reflexive cough count (mean (95% confidence interval) in 10 minutes) provoked by the AITC challenge for the unexposed animals (3.1 (1.7-4.5)), those were increased significantly following both the 7-day (12.0 (6.8-17.2), P < 0.01) and the 14-day (12.0 (6.4-17.6), P < 0.01) TRAP exposure. The effect provoked by the citric acid challenge was more profound following the 14-day exposure (26.0 (19.5-32.5) vs 3.8 (1.5-6.0) for the control, P < 0.001). TRAP exposures enhanced spontaneous cough events, caused a significant increase of eosinophils and neutrophils in BALF and resulted in a dramatic eosinophilic infiltration in submucosal layer of trachea and bronchus, which can be inhibited significantly by dexamethasone treatment. CONCLUSIONS & CLINICAL RELEVANCE TRAP exposures induced cough hypersensitivity and non-allergic eosinophilic inflammation of airways in guinea-pigs. This study highlights the potential mechanisms of eosinophilia-related chronic cough that can be induced by traffic-related air pollution.
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Affiliation(s)
- Zhangfu Fang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chuqin Huang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junfeng Jim Zhang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Global Health Institute, Nicholas School of the Environment, Duke University, Durham, North Carolina
| | - Jiaxing Xie
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shouhui Dai
- Equipment Public Service Center, South China Sea Institute of Oceanology, Chinese Academy of Sciences, Guangzhou, China
| | - Erjia Ge
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Juan Xiang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongmei Yao
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rongquan Huang
- Department of Pathology, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
| | - Xinhui Bi
- State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kefang Lai
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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14
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Yamaguchi Y, Mizumaki K, Sakamoto T, Nakatani Y, Tsujino Y, Inoue H, Kinugawa K. Citrus fruits induced swallow syncope with atrioventricular block or sinus arrest. J Electrocardiol 2018; 51:613-616. [PMID: 29996999 DOI: 10.1016/j.jelectrocard.2018.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/07/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
Swallow syncope is a relatively rare syndrome and caused by various foods and drinks. A 76-year-old man was admitted with frequent syncope while eating. Holter electrocardiogram revealed frequent occurrence of atrioventricular block during meals. Both atrioventricular block and sinus arrest were induced by only eating citrus fruits, citrus jelly, and acidic foods but not by other drinks and foods. These arrhythmias were suppressed after administration of atropine. No further episodes of syncope recurred after the implantation of a DDD pacemaker. This case indicated that acidic stimulation of citrus induced a vasovagal reflex via esophageal nociceptors leading to syncope.
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Affiliation(s)
- Yoshiaki Yamaguchi
- The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan
| | | | - Tamotsu Sakamoto
- The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yosuke Nakatani
- The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yasushi Tsujino
- The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan
| | | | - Koichiro Kinugawa
- The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan
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15
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Bronchodilator therapy for chronic cough. Pulm Pharmacol Ther 2017; 47:88-92. [PMID: 28527922 DOI: 10.1016/j.pupt.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/12/2017] [Accepted: 05/16/2017] [Indexed: 02/08/2023]
Abstract
Experimental studies indicate that airway calibre increases the sensitivity of the afferents involved in the cough reflex but it has proved difficult to demonstrate that airway calibre increases the sensitivity of the afferents involved in the cough reflex. Therefore, bronchodilators might have a role, although rather minor, in the treatment of cough. However, although bronchodilators represent the standard of care in the treatment of airway obstruction associated with asthma or COPD, controversy persists regarding the mechanism(s) by which these agents alleviate cough. Furthermore, the available evidence indicates that the effects of bronchodilators on cough are rather inconsistent in humans and casts doubt on the appropriateness of the common practice of using bronchodilators in the treatment of patients with cough without any other evidence of airway obstruction. Regrettably, appropriate long-term trials specifically aimed at evaluating the clinical efficacy of bronchodilators in pathologic cough have not yet been performed. Therefore, properly executed clinical studies of bronchodilators in various types of acute and chronic pathologic cough are required.
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16
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Omar S, Clarke R, Abdullah H, Brady C, Corry J, Winter H, Touzelet O, Power UF, Lundy F, McGarvey LPA, Cosby SL. Respiratory virus infection up-regulates TRPV1, TRPA1 and ASICS3 receptors on airway cells. PLoS One 2017; 12:e0171681. [PMID: 28187208 PMCID: PMC5302416 DOI: 10.1371/journal.pone.0171681] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/24/2017] [Indexed: 12/23/2022] Open
Abstract
Receptors implicated in cough hypersensitivity are transient receptor potential vanilloid 1 (TRPV1), transient receptor potential cation channel, Subfamily A, Member 1 (TRPA1) and acid sensing ion channel receptor 3 (ASIC3). Respiratory viruses, such as respiratory syncytial virus (RSV) and measles virus (MV) may interact directly and/or indirectly with these receptors on sensory nerves and epithelial cells in the airways. We used in vitro models of sensory neurones (SHSY5Y or differentiated IMR-32 cells) and human bronchial epithelium (BEAS-2B cells) as well as primary human bronchial epithelial cells (PBEC) to study the effect of MV and RSV infection on receptor expression. Receptor mRNA and protein levels were examined by qPCR and flow cytometry, respectively, following infection or treatment with UV inactivated virus, virus-induced soluble factors or pelleted virus. Concentrations of a range of cytokines in resultant BEAS-2B and PBEC supernatants were determined by ELISA. Up-regulation of TRPV1, TRPA1 and ASICS3 expression occurred by 12 hours post-infection in each cell type. This was independent of replicating virus, within the same cell, as virus-induced soluble factors alone were sufficient to increase channel expression. IL-8 and IL-6 increased in infected cell supernatants. Antibodies against these factors inhibited TRP receptor up-regulation. Capsazepine treatment inhibited virus induced up-regulation of TRPV1 indicating that these receptors are targets for treating virus-induced cough.
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Affiliation(s)
- Shadia Omar
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Rebecca Clarke
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Haniah Abdullah
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Clare Brady
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - John Corry
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Hanagh Winter
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Olivier Touzelet
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Ultan F. Power
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Fionnuala Lundy
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - Lorcan P. A. McGarvey
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
| | - S. Louise Cosby
- Queen’s University Belfast, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Medical Biology Centre, Belfast, United Kingdom
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17
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Reznikov LR, Meyerholz DK, Adam RJ, Abou Alaiwa M, Jaffer O, Michalski AS, Powers LS, Price MP, Stoltz DA, Welsh MJ. Acid-Sensing Ion Channel 1a Contributes to Airway Hyperreactivity in Mice. PLoS One 2016; 11:e0166089. [PMID: 27820848 PMCID: PMC5098826 DOI: 10.1371/journal.pone.0166089] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/22/2016] [Indexed: 01/10/2023] Open
Abstract
Neurons innervating the airways contribute to airway hyperreactivity (AHR), a hallmark feature of asthma. Several observations suggested that acid-sensing ion channels (ASICs), neuronal cation channels activated by protons, might contribute to AHR. For example, ASICs are found in vagal sensory neurons that innervate airways, and asthmatic airways can become acidic. Moreover, airway acidification activates ASIC currents and depolarizes neurons innervating airways. We found ASIC1a protein in vagal ganglia neurons, but not airway epithelium or smooth muscle. We induced AHR by sensitizing mice to ovalbumin and found that ASIC1a-/- mice failed to exhibit AHR despite a robust inflammatory response. Loss of ASIC1a also decreased bronchoalveolar lavage fluid levels of substance P, a sensory neuropeptide secreted from vagal sensory neurons that contributes to AHR. These findings suggest that ASIC1a is an important mediator of AHR and raise the possibility that inhibiting ASIC channels might be beneficial in asthma.
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Affiliation(s)
- Leah R. Reznikov
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - David K. Meyerholz
- Department of Pathology, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Ryan J. Adam
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, Iowa, United States of America
| | - Mahmoud Abou Alaiwa
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Omar Jaffer
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Andrew S. Michalski
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Linda S. Powers
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Margaret P. Price
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - David A. Stoltz
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Department of Molecular Physiology and Biophysics, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, Iowa, United States of America
| | - Michael J. Welsh
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Department of Molecular Physiology and Biophysics, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Pappajohn Biomedical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- Howard Hughes Medical Institute, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
- * E-mail:
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18
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Mutolo D, Cinelli E, Iovino L, Pantaleo T, Bongianni F. Downregulation of the cough reflex by aclidinium and tiotropium in awake and anesthetized rabbits. Pulm Pharmacol Ther 2016; 38:1-9. [DOI: 10.1016/j.pupt.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/08/2016] [Accepted: 04/10/2016] [Indexed: 01/23/2023]
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19
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Troy AE, Simmonds SS, Stocker SD, Browning KN. High fat diet attenuates glucose-dependent facilitation of 5-HT3 -mediated responses in rat gastric vagal afferents. J Physiol 2015; 594:99-114. [PMID: 26456775 DOI: 10.1113/jp271558] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/04/2015] [Indexed: 01/13/2023] Open
Abstract
KEY POINTS Glucose regulates the density and function of 5-HT3 receptors on gastric vagal afferent neurones. Diet-induced obesity compromises the excitability and responsiveness of vagal afferents. In this study, we assessed whether exposure to a high fat diet (HFD) compromises the glucose-dependent modulation of 5-HT responses in gastric vagal afferents prior to the development of obesity. We show that HFD does not alter the response of gastric vagal afferent nerves and neurones to 5-HT but attenuates the ability of glucose to amplify 5-HT3-induced responses. These results suggest that glucose-dependent vagal afferent signalling is compromised by relatively short periods of exposure to HFD well in advance of the development of obesity or glycaemic dysregulation. Glucose regulates the density and function of 5-HT3 receptors on gastric vagal afferent neurones. Since diet-induced obesity attenuates the responsiveness of gastric vagal afferents to several neurohormones, the aim of the present study was to determine whether high fat diet (HFD) compromises the glucose-dependent modulation of 5-HT responses in gastric vagal afferents prior to the development of obesity. Rats were fed control or HFD (14% or 60% kilocalories from fat, respectively) for up to 8 weeks. Neurophysiological recordings assessed the ability of 5-HT to increase anterior gastric vagal afferent nerve (VAN) activity in vivo before and after acute hyperglycaemia, while electrophysiological recordings from gastric-projecting nodose neurones assessed the ability of glucose to modulate the 5-HT response in vitro. Immunocytochemical studies determined alterations in the neuronal distribution of 5-HT3 receptors. 5-HT and cholecystokinin (CCK) induced dose-dependent increases in VAN activity in all rats; HFD attenuated the response to CCK, but not 5-HT. The 5-HT-induced response was amplified by acute hyperglycaemia in control, but not HFD, rats. Similarly, although 5-HT induced an inward current in both control and HFD gastric nodose neurones in vitro, the 5-HT response and receptor distribution was amplified by acute hyperglycaemia only in control rats. These data suggest that, while HFD does not affect the response of gastric-projecting vagal afferents to 5-HT, it attenuates the ability of glucose to amplify 5-HT effects. This suggests that glucose-dependent vagal afferent signalling is compromised by short periods of exposure to HFD well in advance of obesity or glycaemic dysregulation.
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Affiliation(s)
- Amanda E Troy
- Department of Neural and Behavioural Sciences, Penn State University College of Medicine, Hershey, PA, 17033, USA
| | - Sarah S Simmonds
- Department of Cellular and Integrative Physiology, Penn State University College of Medicine, Hershey, PA, 17033, USA
| | - Sean D Stocker
- Department of Neural and Behavioural Sciences, Penn State University College of Medicine, Hershey, PA, 17033, USA.,Department of Cellular and Integrative Physiology, Penn State University College of Medicine, Hershey, PA, 17033, USA
| | - Kirsteen N Browning
- Department of Neural and Behavioural Sciences, Penn State University College of Medicine, Hershey, PA, 17033, USA
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20
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Laryngopharyngeal symptoms in patients with chronic obstructive pulmonary disease. Eur Arch Otorhinolaryngol 2015; 273:953-8. [DOI: 10.1007/s00405-015-3830-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022]
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21
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Balbani APS. Cough: neurophysiology, methods of research, pharmacological therapy and phonoaudiology. Int Arch Otorhinolaryngol 2015; 16:259-68. [PMID: 25991944 PMCID: PMC4435438 DOI: 10.7162/s1809-97772012000200016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Accepted: 06/25/2011] [Indexed: 12/13/2022] Open
Abstract
Introduction: The cough is the more common respiratory symptom in children and adults. Objective: To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords “cough” or “anti-cough”. Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system. Experimental techniques allow studying the consequence of the cough to the cellular and molecular level to develop new anti-cough agents. It does not have evidences of that anti-cough exempt of medical lapsing they have superior effectiveness to the one of placebo for the relief of the cough. The phonoaudiology therapy can benefit patients with refractory chronic cough to the pharmacological treatment, over all when paradoxical movement of the vocal folds coexists. Final Comments: The boarding to multidiscipline has basic paper in the etiological diagnosis and treatment of the cough. The otolaryngologist must inform the patients on the risks of the anti-cough of free sales in order to prevent adverse poisonings and effect, especially in children.
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22
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Makwana R, Venkatasamy R, Spina D, Page C. The Effect of Phytocannabinoids on Airway Hyper-Responsiveness, Airway Inflammation, and Cough. J Pharmacol Exp Ther 2015; 353:169-80. [DOI: 10.1124/jpet.114.221283] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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23
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Abstract
Sensory nerves innervating the lung and airways play an important role in regulating various cardiopulmonary functions and maintaining homeostasis under both healthy and disease conditions. Their activities conducted by both vagal and sympathetic afferents are also responsible for eliciting important defense reflexes that protect the lung and body from potential health-hazardous effects of airborne particulates and chemical irritants. This article reviews the morphology, transduction properties, reflex functions, and respiratory sensations of these receptors, focusing primarily on recent findings derived from using new technologies such as neural immunochemistry, isolated airway-nerve preparation, cultured airway neurons, patch-clamp electrophysiology, transgenic mice, and other cellular and molecular approaches. Studies of the signal transduction of mechanosensitive afferents have revealed a new concept of sensory unit and cellular mechanism of activation, and identified additional types of sensory receptors in the lung. Chemosensitive properties of these lung afferents are further characterized by the expression of specific ligand-gated ion channels on nerve terminals, ganglion origin, and responses to the action of various inflammatory cells, mediators, and cytokines during acute and chronic airway inflammation and injuries. Increasing interest and extensive investigations have been focused on uncovering the mechanisms underlying hypersensitivity of these airway afferents, and their role in the manifestation of various symptoms under pathophysiological conditions. Several important and challenging questions regarding these sensory nerves are discussed. Searching for these answers will be a critical step in developing the translational research and effective treatments of airway diseases.
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Affiliation(s)
- Lu-Yuan Lee
- Department of Physiology, University of Kentucky, Lexington, Kentucky
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24
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Dusenkova S, Ru F, Surdenikova L, Nassenstein C, Hatok J, Dusenka R, Banovcin P, Kliment J, Tatar M, Kollarik M. The expression profile of acid-sensing ion channel (ASIC) subunits ASIC1a, ASIC1b, ASIC2a, ASIC2b, and ASIC3 in the esophageal vagal afferent nerve subtypes. Am J Physiol Gastrointest Liver Physiol 2014; 307:G922-30. [PMID: 25190475 PMCID: PMC4216991 DOI: 10.1152/ajpgi.00129.2014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Acid-sensing ion channels (ASICs) have been implicated in esophageal acid sensing and mechanotransduction. However, insufficient knowledge of ASIC subunit expression profile in esophageal afferent nerves hampers the understanding of their role. This knowledge is essential because ASIC subunits form heteromultimeric channels with distinct functional properties. We hypothesized that the esophageal putative nociceptive C-fiber nerves (transient receptor potential vanilloid 1, TRPV1-positive) express multiple ASIC subunits and that the ASIC expression profile differs between the nodose TRPV1-positive subtype developmentally derived from placodes and the jugular TRPV1-positive subtype derived from neural crest. We performed single cell RT-PCR on the vagal afferent neurons retrogradely labeled from the esophagus. In the guinea pig, nearly all (90%-95%) nodose and jugular esophageal TRPV1-positive neurons expressed ASICs, most often in a combination (65-75%). ASIC1, ASIC2, and ASIC3 were expressed in 65-75%, 55-70%, and 70%, respectively, of both nodose and jugular TRPV1-positive neurons. The ASIC1 splice variants ASIC1a and ASIC1b and the ASIC2 splice variant ASIC2b were similarly expressed in both nodose and jugular TRPV1-positive neurons. However, ASIC2a was found exclusively in the nodose neurons. In contrast to guinea pig, ASIC3 was almost absent from the mouse vagal esophageal TRPV1-positive neurons. However, ASIC3 was similarly expressed in the nonnociceptive TRPV1-negative (tension mechanoreceptors) neurons in both species. We conclude that the majority of esophageal vagal nociceptive neurons express multiple ASIC subunits. The placode-derived nodose neurons selectively express ASIC2a, known to substantially reduce acid sensitivity of ASIC heteromultimers. ASIC3 is expressed in the guinea pig but not in the mouse vagal esophageal TRPV1-positive neurons, indicating species differences in ASIC expression.
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Affiliation(s)
- Svetlana Dusenkova
- 1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ,2Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Fei Ru
- 1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland;
| | - Lenka Surdenikova
- 2Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Christina Nassenstein
- 1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ,6Institute of Anatomy and Cell Biology-Cardiopulmonary Neurobiology, Justus-Liebig-University, Giessen, Germany
| | - Jozef Hatok
- 3Department of Biochemistry, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Robert Dusenka
- 3Department of Biochemistry, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia; ,4Department of Urology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Peter Banovcin
- 5Department of Gastroenterology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Jan Kliment
- 4Department of Urology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Milos Tatar
- 2Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
| | - Marian Kollarik
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia;
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25
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Halicka J, Banovcin P, Halickova M, Demeter M, Hyrdel R, Tatar M, Kollarik M. Acid infusion into the esophagus increases the number of meal-induced transient lower esophageal sphincter relaxations (TLESRs) in healthy volunteers. Neurogastroenterol Motil 2014; 26:1469-76. [PMID: 25155416 PMCID: PMC4177286 DOI: 10.1111/nmo.12409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 07/15/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Transient lower esophageal sphincter relaxation (TLESR) is the major mechanism of gastroesophageal reflux (GER) but the regulation of TLESR by stimuli in the esophagus is incompletely understood. If stimuli in the esophagus can influence TLESR, then such regulation may perpetuate or limit GER. We addressed the hypothesis that acid in the esophagus enhances TLESRs. METHODS We evaluated the effect of acid infusion into the distal esophagus on TLESRs evoked by a standard meal in a paired randomized study in healthy subjects. TLESRs were evaluated by using high resolution manometry (HRM). KEY RESULTS We found that acid in the esophagus enhanced meal-induced TLESRs. Compared to control infusion the number of TLESRs (median [interquartile range]) was increased during 2 h following the acid infusion (11 [9-14] vs 17 [12.5-20], p < 0.01). The average duration of individual TLESRs was not affected. The time-course analysis revealed that a robust increase in TLESRs occurred already in the first hour when the number of TLESRs nearly doubled (6 [5.5-7.5] vs 11 [7.5-12.5], p < 0.05). In contrast to the enhancement of TLESRs, the number of swallows was not changed. CONCLUSIONS & INFERENCES The acid infusion into the esophagus increases the number of meal-induced TLESRs in healthy subjects. Our results provide evidence for the concept that the stimuli in the esophagus can influence TLESRs. The regulation of TLESR by stimuli in the esophagus may contribute to pathogenesis of GER in some patients.
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Affiliation(s)
- J Halicka
- Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - P Banovcin
- Department of Gastroenterology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - M Halickova
- Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - M Demeter
- Department of Gastroenterology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - R Hyrdel
- Department of Gastroenterology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - M Tatar
- Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia
| | - M Kollarik
- Department of Pathophysiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, USA
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Ionotropic and metabotropic proton-sensing receptors involved in airway inflammation in allergic asthma. Mediators Inflamm 2014; 2014:712962. [PMID: 25197168 PMCID: PMC4147257 DOI: 10.1155/2014/712962] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 07/10/2014] [Accepted: 07/24/2014] [Indexed: 12/19/2022] Open
Abstract
An acidic microenvironment has been shown to evoke a variety of airway responses, including cough, bronchoconstriction, airway hyperresponsiveness (AHR), infiltration of inflammatory cells in the lung, and stimulation of mucus hyperproduction. Except for the participation of transient receptor potential vanilloid-1 (TRPV1) and acid-sensing ion channels (ASICs) in severe acidic pH (of less than 6.0)-induced cough and bronchoconstriction through sensory neurons, the molecular mechanisms underlying extracellular acidic pH-induced actions in the airways have not been fully understood. Recent studies have revealed that ovarian cancer G protein-coupled receptor 1 (OGR1)-family G protein-coupled receptors, which sense pH of more than 6.0, are expressed in structural cells, such as airway smooth muscle cells and epithelial cells, and in inflammatory and immune cells, such as eosinophils and dendritic cells. They function in a variety of airway responses related to the pathophysiology of inflammatory diseases, including allergic asthma. In the present review, we discuss the roles of ionotropic TRPV1 and ASICs and metabotropic OGR1-family G protein-coupled receptors in the airway inflammation and AHR in asthma and respiratory diseases.
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Vysotskaya ZV, Moss CR, Gu Q. Differential regulation of ASICs and TRPV1 by zinc in rat bronchopulmonary sensory neurons. Lung 2014; 192:927-34. [PMID: 25108402 DOI: 10.1007/s00408-014-9634-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 07/25/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE Zinc has been known to act as a signaling molecule that regulates a variety of neuronal functions. In this study, we aimed to study the effect of zinc on two populations of acid-sensitive ion channels, acid-sensing ion channels (ASICs), and transient receptor potential vanilloid receptor-1 (TRPV1), in vagal bronchopulmonary sensory neurons. METHODS Rat vagal sensory neurons innervating lungs and airways were retrogradely labeled with a fluorescent tracer. Whole-cell perforated patch-clamp recordings were carried out in primarily cultured bronchopulmonary sensory neurons. The acid-evoked ASIC and TRPV1 currents were measured and compared between before and after the zinc pretreatment. RESULTS ASIC currents were induced by a pH drop from 7.4 to 6.8 or 6.5 in the presence of capsazepine (10 µM), a specific TRPV1 antagonist. Pretreatment with zinc (50 or 300 µM, 2 min) displayed different effects on the two distinct phenotypes of ASIC currents: a marked potentiation on ASIC channels with fast kinetics of activation and inactivation or no significant effect on ASIC currents with slow activation and inactivation. On the other hand, pretreatment with zinc significantly inhibited the acid (pH 5.5 or 5.3)-induced TRPV1 currents. The inhibition was abolished by intracellular chelation of zinc by TPEN (25 µM), indicating that intracellular accumulation of zinc was likely required for its inhibitory effect on TRPV1 channels. CONCLUSIONS Our study showed that zinc differentially regulates the activities of ASICs and TRPV1 channels in rat vagal bronchopulmonary sensory neurons.
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Affiliation(s)
- Zhanna V Vysotskaya
- Division of Basic Medical Sciences, Mercer University School of Medicine, 1550 College Street, Macon, GA, 31207, USA
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Hamdan AL, Jaffal H, Btaiche R, Turfe ZA, Bawab I, Kanj N, Tamim H. Laryngopharyngeal symptoms in patients with asthma: a cross-sectional controlled study. CLINICAL RESPIRATORY JOURNAL 2014; 10:40-7. [PMID: 24995539 DOI: 10.1111/crj.12179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/12/2014] [Accepted: 06/22/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the frequency and severity of laryngopharyngeal symptoms in asthmatic patients. The role of laryngopharyngeal reflux disease as a co-morbid disease to asthma has not been previously reported. SUBJECTS AND METHOD Seventy-two subjects, 36 asthmatics and 36 controls were included in this study. Demographic data included age, gender, status of asthma, use of steroid inhalers, smoking and history of allergy. Pulmonary function test was reported in 13 subjects. The evaluation consisted of filling the Reflux Symptom Index (RSI) described by Belafsky et al. The total score, frequency and average score of each laryngopharyngeal symptom was computed in both groups. RESULTS The mean age of patients was 46.61 ± 17.59 years with a female to male ratio of 2.3:1. Twenty patients were using steroid inhalers. Close to one third were smokers (30.6%) and 55.6% had allergic rhinitis. Thirty-six percent had controlled asthma vs 64% were uncontrolled. The mean of the total RSI was significantly higher in patients compared with controls (12.03 ± 8.3 vs 6.64 ± 6.08, P value < 0.05). In the asthmatic group, 15 subjects had a positive RSI compared with only 4 in the control group (P value of 0.003). There was a significant difference in the prevalence and means of four laryngopharyngeal symptoms in patients vs controls. CONCLUSION Laryngopharyngeal reflux disease is more prevalent and more severe in patients with asthma vs controls.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussein Jaffal
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rachel Btaiche
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zaahir A Turfe
- Faculty of Medicine, Michigan State University College of Human Medicine, Beirut, Lebanon
| | - Ibrahim Bawab
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Kim D, Liao J, Hanrahan JW. The buffer capacity of airway epithelial secretions. Front Physiol 2014; 5:188. [PMID: 24917822 PMCID: PMC4042063 DOI: 10.3389/fphys.2014.00188] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 04/28/2014] [Indexed: 01/20/2023] Open
Abstract
The pH of airway epithelial secretions influences bacterial killing and mucus properties and is reduced by acidic pollutants, gastric reflux, and respiratory diseases such as cystic fibrosis (CF). The effect of acute acid loads depends on buffer capacity, however the buffering of airway secretions has not been well characterized. In this work we develop a method for titrating micro-scale (30 μl) volumes and use it to study fluid secreted by the human airway epithelial cell line Calu-3, a widely used model for submucosal gland serous cells. Microtitration curves revealed that HCO−3 is the major buffer. Peak buffer capacity (β) increased from 17 to 28 mM/pH during forskolin stimulation, and was reduced by >50% in fluid secreted by cystic fibrosis transmembrane conductance regulator (CFTR)-deficient Calu-3 monolayers, confirming an important role of CFTR in HCO−3 secretion. Back-titration with NaOH revealed non-volatile buffer capacity due to proteins synthesized and released by the epithelial cells. Lysozyme and mucin concentrations were too low to buffer Calu-3 fluid significantly, however model titrations of porcine gastric mucins at concentrations near the sol-gel transition suggest that mucins may contribute to the buffer capacity of ASL in vivo. We conclude that CFTR-dependent HCO−3 secretion and epithelially-derived proteins are the predominant buffers in Calu-3 secretions.
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Affiliation(s)
- Dusik Kim
- Department of Physiology, McGill University Montréal, QC, Canada
| | - Jie Liao
- Department of Physiology, McGill University Montréal, QC, Canada
| | - John W Hanrahan
- Department of Physiology, McGill University Montréal, QC, Canada ; McGill University Health Centre Research Institute Montréal, QC, Canada
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Nosáľova G, Jureček L, Turjan J, Capek P, Prisenžňáková L, Fraňová S. The cough suppressive activity of sulfated glucuronoxylan from Fagus sylvatica L. Int J Biol Macromol 2014; 67:312-7. [DOI: 10.1016/j.ijbiomac.2014.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 03/08/2014] [Accepted: 03/17/2014] [Indexed: 11/27/2022]
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Fodor GH, Peták F, Erces D, Balogh AL, Babik B. Lung mechanical changes following bronchoaspiration in a porcine model: differentiation of direct and indirect mechanisms. Respir Physiol Neurobiol 2014; 199:41-9. [PMID: 24814560 DOI: 10.1016/j.resp.2014.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/01/2014] [Accepted: 05/02/2014] [Indexed: 01/13/2023]
Abstract
Bronchoaspiration results in local deterioration of lung function through direct damage and/or indirect systemic effects related to neurohumoral pathways. We distinguished these effects by selectively intubating the two main bronchi in pigs while a PEEP of 4 or 10cm H2O was maintained. Gastric juice was instilled only into the right lung. Lung mechanical and ventilation defects were assessed by measuring unilateral pulmonary input impedance (ZL,s) and the third phase slope of the capnogram (SIII) for each lung side separately before the aspiration and for 120min thereafter. Marked transient elevations in ZL,s parameters and SIII were observed in the affected lung after aspiration. Elevating PEEP did not affect these responses in the ZL,s parameters, whereas it prevented the SIII increases. None of these indices changed in the intact left lung. These findings furnish evidence of the predominance of the local direct damage over the indirect systemic effects in the development of the deterioration of lung function, and demonstrate the benefit of an initially elevated PEEP following aspiration.
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Affiliation(s)
- Gergely H Fodor
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Ferenc Peták
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
| | - Dániel Erces
- Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Adám L Balogh
- Department of Anaesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
| | - Barna Babik
- Department of Anaesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
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Yu L, Xu XH, Chen Q, Liang SW, Lv HJ, Qiu ZM. Gastro-esophageal reflux induced cough with airway hyperresponsiveness. Int J Clin Exp Med 2014; 7:728-735. [PMID: 24753770 PMCID: PMC3992415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 02/07/2014] [Indexed: 06/03/2023]
Abstract
To investigate the characteristics of gastroesophageal reflux induced cough (GERC) with airway hyperresponsiveness (AHR). Compared to patients with GERC alone and healthy subjects, cough sensitivity, multi-channel intraluminal impedance combined with pH monitoring and airway inflammation were evaluated in patients with GERC and AHR. 23 patients were definitely diagnosed as acid reflux induced GERC, 9 patients developed AHR concomitantly. When compared with GERC patients, patients with AHR had significantly increased number of proximal extent episodes (21.5 (28.6) vs. 7.5 (1.8), Z = -2.038, P = 0.042) and increased proportion of proximal extent episodes to total refluxes episodes (24.5 (13.5)% vs. 4.2 (7.3)%, Z = -2.138, P = 0.032), and the level of IL-8 in the airway of these patients was significantly higher than that in healthy subjects (71.1 (64.0) vs. 24.3 (35.2) pg/ml, Z = -2.013, P = 0.044). Gastroesophageal reflux may cause neutrophilic airway inflammation due to the acid reflux into the airway, which results in AHR. However, AHR is not definitely able to cause chronic cough. Thus differential diagnosis is required in clinical practice.
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Affiliation(s)
- Li Yu
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Xiang-Huai Xu
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Qiang Chen
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Si-Wei Liang
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Han-Jing Lv
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
| | - Zhong-Min Qiu
- Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China
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Harrington AM, Brierley SM, Isaacs NJ, Young RL, Blackshaw LA. Identifying spinal sensory pathways activated by noxious esophageal acid. Neurogastroenterol Motil 2013; 25:e660-8. [PMID: 23848546 DOI: 10.1111/nmo.12180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/17/2013] [Accepted: 06/11/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND The transient receptor potential vanilloid 1 (TRPV1) channel is critical for spinal afferent signaling of burning pain throughout the body. Such pain frequently originates from the esophagus, following acid reflux. The contribution of TRPV1 to spinal nociceptor signaling from the esophagus remains unclear. We aimed to identify the spinal afferent pathways that convey nociceptive signaling from the esophagus, specifically those sensitive to acid, and the extent to which TRPV1 contributes. METHODS Acid/pepsin (150 mM HCl/1 mg mL(-1) pepsin) or saline/pepsin was perfused into the esophageal lumen of anesthetized wild-type and TRPV1 null mice over 20 min, followed by atraumatic perfuse fixation and removal of the cervical and thoracic spinal cord and dorsal root ganglia (DRG). To identify neurons responsive to esophageal perfusate, immunolabeling for neuronal activation marker phosphorylated extracellular receptor-regulated kinase (pERK) was used. Labeling for calcitonin gene-related peptide (CGRP) and isolectin B4 (IB4) was then used to characterize responsive neurons. KEY RESULTS Esophageal acid/pepsin perfusion significantly increased the number of pERK-immunoreactive (IR) neurons in the DRG and the cervical and thoracic spinal cord dorsal horn (DH) relative to saline/pepsin (DRG P < 0.01; cervical DH P < 0.05 and thoracic DH P < 0.005). The number of pERK-IR neurons following acid perfusion was significantly attenuated in TRPV1 -/- mice (DH P < 0.05 and DRG P < 0.05). CONCLUSIONS & INFERENCES This study has identified populations of spinal afferent DRG neurons and DH neurons involved in signaling of noxious acid from the esophagus. There is a major contribution of TRPV1 to signaling within these pathways.
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Affiliation(s)
- A M Harrington
- Nerve-Gut Research Laboratory, Discipline of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia; Department of Gastroenterology and Hepatology, Hanson Institute, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Hawkshaw MJ, Pebdani P, Sataloff RT. Reflux Laryngitis: An Update, 2009–2012. J Voice 2013; 27:486-94. [DOI: 10.1016/j.jvoice.2013.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/07/2013] [Indexed: 02/07/2023]
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Abstract
Inhalation of acid aerosol or aspiration of acid solution evokes a stimulatory effect on airway C-fiber and Aδ afferents, which in turn causes airway irritation and triggers an array of defense reflex responses (e.g., cough, reflex bronchoconstriction, etc.). Tissue acidosis can also occur locally in the respiratory tract as a result of ischemia or inflammation, such as in the airways of asthmatic patients during exacerbation. The action of proton on the airway sensory neurons is generated by activation of two different current species: a transient (rapidly activating and inactivating) current mediated through the acid-sensing ion channels, and a slowly activating and sustained current mediated through the transient receptor potential vanilloid type 1 (TRPV1) receptor. In view of the recent findings that the expression and/or sensitivity of TRPV1 are up-regulated in the airway sensory nerves during chronic inflammatory reaction, the proton-evoked irritant effects on these nerves may play an important part in the manifestation of various symptoms associated with airway inflammatory diseases.
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36
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Grace MS, Dubuis E, Birrell MA, Belvisi MG. Pre-clinical studies in cough research: role of Transient Receptor Potential (TRP) channels. Pulm Pharmacol Ther 2013; 26:498-507. [PMID: 23474212 PMCID: PMC3763377 DOI: 10.1016/j.pupt.2013.02.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/19/2013] [Accepted: 02/24/2013] [Indexed: 02/08/2023]
Abstract
Cough is a protective reflex and defence mechanism in healthy individuals, which helps clear excessive secretions and foreign material from the lungs. Cough often presents as the first and most persistent symptom of many respiratory diseases and some non-respiratory disorders, but can also be idiopathic, and is a common respiratory complaint for which medical attention is sought. Chronic cough of various aetiologies is a regular presentation to specialist respiratory clinics, and is reported as a troublesome symptom by a significant proportion of the population. Despite this, the treatment options for cough are limited. The lack of effective anti-tussives likely stems from our incomplete understanding of how the tussive reflex is mediated. However, research over the last decade has begun to shed some light on the mechanisms which provoke cough, and may ultimately provide us with better anti-tussive therapies. This review will focus on the in vitro and in vivo models that are currently used to further our understanding of the sensory innervation of the respiratory tract, and how these nerves are involved in controlling the cough response. Central to this are the Transient Receptor Potential (TRP) ion channels, a family of polymodal receptors that can be activated by such diverse stimuli as chemicals, temperature, osmotic stress, and mechanical perturbation. These ion channels are thought to be molecular pain integrators and targets for novel analgesic agents for the treatment of various pain disorders but some are also being developed as anti-tussives.
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Affiliation(s)
- Megan S Grace
- Respiratory Pharmacology, Pharmacology & Toxicology Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK
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Browning KN, Fortna SR, Hajnal A. Roux-en-Y gastric bypass reverses the effects of diet-induced obesity to inhibit the responsiveness of central vagal motoneurones. J Physiol 2013; 591:2357-72. [PMID: 23459752 DOI: 10.1113/jphysiol.2012.249268] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Diet-induced obesity (DIO) has been shown to alter the biophysical properties and pharmacological responsiveness of vagal afferent neurones and fibres, although the effects of DIO on central vagal neurones or vagal efferent functions have never been investigated. The aims of this study were to investigate whether high-fat diet-induced DIO also affects the properties of vagal efferent motoneurones, and to investigate whether these effects were reversed following weight loss induced by Roux-en-Y gastric bypass (RYGB) surgery. Whole-cell patch-clamp recordings were made from rat dorsal motor nucleus of the vagus (DMV) neurones in thin brainstem slices. The DMV neurones from rats exposed to high-fat diet for 12-14 weeks were less excitable, with a decreased membrane input resistance and decreased ability to fire action potentials in response to direct current pulse injection. The DMV neurones were also less responsive to superfusion with the satiety neuropeptides cholecystokinin and glucagon-like peptide 1. Roux-en-Y gastric bypass reversed all of these DIO-induced effects. Diet-induced obesity also affected the morphological properties of DMV neurones, increasing their size and dendritic arborization; RYGB did not reverse these morphological alterations. Remarkably, independent of diet, RYGB also reversed age-related changes of membrane properties and occurrence of charybdotoxin-sensitive (BK) calcium-dependent potassium current. These results demonstrate that DIO also affects the properties of central autonomic neurones by decreasing the membrane excitability and pharmacological responsiveness of central vagal motoneurones and that these changes were reversed following RYGB. In contrast, DIO-induced changes in morphological properties of DMV neurones were not reversed following gastric bypass surgery, suggesting that they may be due to diet, rather than obesity. These findings represent the first direct evidence for the plausible effect of RYGB to improve vagal neuronal health in the brain by reversing some effects of chronic high-fat diet as well as ageing. Vagovagal neurocircuits appear to remain open to modulation and adaptation throughout life, and understanding of these mechanisms may help in development of novel interventions to alleviate environmental (e.g. dietary) ailments and also alter neuronal ageing.
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Affiliation(s)
- Kirsteen N Browning
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, PA 17033, USA.
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Tsoukali E, Sifrim D. Investigation of extraesophageal gastroesophageal reflux disease. Ann Gastroenterol 2013; 26:290-295. [PMID: 24714277 PMCID: PMC3959476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 02/17/2013] [Indexed: 10/25/2022] Open
Abstract
The most common extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, asthma and laryngitis. There are two mechanisms proposed to explain extraesophageal syndromes caused by GERD. The first one is a direct way via irritation and/or microaspiration and the second one is an indirect, vagally mediated way. The investigation of extraesophageal manifestations of GERD is difficult and the empirical therapy with proton pump inhibitors usually double dose for at least three months is still the most common approach.
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Affiliation(s)
- Emmanouela Tsoukali
- Department of Internal Medicine, Athens General Hospital Elpis, Greece (Emmanouela Tsoukali)
| | - Daniel Sifrim
- Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, UK (Daniel Sifrim)
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Amarasiri DL, Pathmeswaran A, Dassanayake AS, de Silva AP, Ranasinha CD, de Silva HJ. Esophageal motility, vagal function and gastroesophageal reflux in a cohort of adult asthmatics. BMC Gastroenterol 2012; 12:140. [PMID: 23057471 PMCID: PMC3527260 DOI: 10.1186/1471-230x-12-140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 10/04/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Asthmatics are known to have esophageal hypomotility. Vagal hypofunction and prolonged intra-esophageal acidification cause esophageal hypomotility. The contribution of gastroesophageal reflux (GER) and vagal function to esophageal motility in asthmatics is unclear. We studied the relationship between esophageal motility, GER and vagal function in a cohort of adult asthmatics. METHODS Thirty mild, stable asthmatics (ATS criteria) and 30 healthy volunteers underwent 24-hour ambulatory esophageal monitoring, manometry, autonomic function testing and GER symptom assessment. 27 asthmatics underwent gastroscopy. A vagal function score calculated from 3 tests (valsalva maneuver, heart rate response to deep breathing and to standing from supine position) was correlated with esophageal function parameters. RESULTS Asthmatics (mean age 34.8 (SD 8.4), 60% female) had more frequent GERD symptoms than controls (mean age 30.9 (SD 7.7), 50% female). 10/27 asthmatics had esophageal mucosal damage, 22 showed hypervagal response, none had a hyperadrenergic response. 14 asthmatics had ineffective esophageal motility. Higher GERD-score asthmatics had significantly fewer peristaltic and more simultaneous contractions than controls, and higher esophageal acid contact times than those with lower scores. All reflux parameters were significantly higher and acid clearance time prolonged in asthmatics than controls (p < 0.001, Mann-Whitney U test). There was no correlation between vagal function score and esophageal function parameters. CONCLUSIONS A cohort of adult asthmatics was found to have peristaltic dysfunction and pathological GER, but otherwise normal esophageal motility. The peristaltic dysfunction seems to be associated with vagal hyperreactivity rather than vagal hypofunction.
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Affiliation(s)
- D Lakmali Amarasiri
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
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Surdenikova L, Ru F, Nassenstein C, Tatar M, Kollarik M. The neural crest- and placodes-derived afferent innervation of the mouse esophagus. Neurogastroenterol Motil 2012; 24:e517-25. [PMID: 22937918 DOI: 10.1111/nmo.12002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND The mouse is an invaluable model for mechanistic studies of esophageal nerves, but the afferent innervation of the mouse esophagus is incompletely understood. Vagal afferent neurons are derived from two embryonic sources: neural crest and epibranchial placodes. We hypothesized that both neural crest and placodes contribute to the TRPV1-positive (potentially nociceptive) vagal innervation of the mouse esophagus. METHODS Vagal jugular/nodose ganglion (JNG) and spinal dorsal root ganglia (DRG) neurons were retrogradely labeled from the cervical esophagus. Single cell RT-PCR was performed on the labeled neurons. KEY RESULTS In the Wnt1Cre/R26R mice expressing a reporter in the neural crest-derived cells we found that both the neural crest- and the placodes-derived vagal JNG neurons innervate the mouse esophagus. In the wild-type mouse the esophageal vagal JNG TRPV1-positive neurons segregated into two subsets: putative neural crest-derived purinergic receptor P2X(2) -negative/preprotachykinin-A (PPT-A)-positive subset and putative placodes-derived P2X(2) -positive/PPTA-negative subset. These subsets also segregated by the expression of TrkA and GFRα(3) in the putative neural crest-derived subset, and TrkB in the putative placodes-derived subset. The TRPV1-positive esophageal DRG neurons had the phenotype similar to the vagal putative neural crest-derived subset. CONCLUSIONS & INFERENCES The TRPV1-positive (potentially nociceptive) vagal afferent neurons innervating the mouse esophagus originate from both neural crest and placodes. The expression profile of the receptors for neurotrophic factors is similar between the neural crest-derived vagal and spinal nociceptors, but distinct from the vagal placodes-derived nociceptors.
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Affiliation(s)
- L Surdenikova
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Yu H, Li Q, Zhou X, Kolosov VP, Perelman JM. Transient receptor potential vanilloid 1 receptors mediate acid-induced mucin secretion via Ca2+ influx in human airway epithelial cells. J Biochem Mol Toxicol 2012; 26:179-86. [PMID: 22566028 DOI: 10.1002/jbt.20413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/09/2011] [Accepted: 08/20/2011] [Indexed: 12/20/2022]
Abstract
Mucin hypersecretion is a key pathological feature of inflammatory respiratory diseases. Previous studies have reported that acids (gastroesophageal reflux or environmental exposure) induce many respiratory symptoms and are implicated in the pathophysiology of obstructive airway diseases. To understand these mechanisms, we measured acid-induced mucin secretion in human bronchial epithelial cells. In the present study, acid induced inward currents of transient receptor potential vanilloid (TRPV)1 and mucin 5AC (MUC5AC) secretion dose dependently, which were inhibited by TRPV1 antagonist capsazepine in a concentration-dependent manner. TRPV1 agonist capsaicin mediated a concentration-dependent increase in TRPV1 inward currents and MUC5AC secretion. Furthermore, capsaicin enhanced acid-induced TRPV1 inward currents and MUC5AC secretion. Acid-induced Ca(2+) influx was prevented by capsazepine dose dependently and enhanced by capsaicin. Pretreatment only with capsaicin also increased the Ca(2+) concentration in a concentration-dependent manner. These data suggest that pharmacological inhibition of calcium-permeable TRPV1 receptors could be used to prevent acid-induced mucin secretion, thereby providing a potential mechanism to reduce their toxicity.
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Affiliation(s)
- Hongmei Yu
- Division of Respiratory Medicine, Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, People's Republic of China
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Wise PM, Breslin PAS, Dalton P. Sweet taste and menthol increase cough reflex thresholds. Pulm Pharmacol Ther 2012; 25:236-41. [PMID: 22465565 DOI: 10.1016/j.pupt.2012.03.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 03/14/2012] [Indexed: 02/01/2023]
Abstract
Cough is a vital protective reflex that is triggered by both mechanical and chemical stimuli. The current experiments explored how chemosensory stimuli modulate this important reflex. Cough thresholds were measured using a single-inhalation capsaicin challenge. Experiment 1 examined the impact of sweet taste: Cough thresholds were measured after rinsing the mouth with a sucrose solution (sweet) or with water (control). Experiment 2 examined the impact of menthol: Cough thresholds were measured after inhaling headspace above a menthol solution (menthol vapor) or headspace above the mineral oil solvent (control). Experiment 3 examined the impact of rinsing the mouth with a (bitter) sucrose octaacetate solution. Rinsing with sucrose and inhaling menthol vapor significantly increased measured cough thresholds. Rinsing with sucrose octaacete caused a non-significant decrease in cough thresholds, an important demonstration of specificity. Decreases in cough reflex sensitivity from sucrose or menthol could help explain why cough syrups without pharmacologically active ingredients are often almost as effective as formulations with an added drug. Further, the results support the idea that adding menthol to cigarettes might make tobacco smoke more tolerable for beginning smokers, at least in part, by reducing the sensitivity of an important airway defense mechanism.
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Affiliation(s)
- Paul M Wise
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA 19104-3308, USA.
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Abstract
This review dissects the complex human cough reflex and suggests hypotheses about the evolutionary basis for the reflex. A mechanosensory-induced cough reflex conveys through branches of myelinated Aδ nerve fibers is not chemically reactive (i.e., capsaicin, bradykinin); possibly, its evolution is to prevent the harmful effects of aspiration of gastric or particulate contents into the lungs. This became necessary as the larynx moves closer to the opening of the esophagus as human ancestors adapt phonation over olfaction beginning less than 10 million years ago. The second type of cough reflex, a chemosensory type, is carried by unmyelinated C fibers. Supposedly, its origin dates back when prehistoric humans began living in close proximity to each other and were at risk for infectious respiratory diseases or irritant-induced lung injury. The mechanism for the latter type of cough is analogous to induced pain after tissue injury; and, it is controlled by the identical transient receptor potential vanilloid cation channel (TRPV1). The airways do not normally manifest nociceptive pain from a stimulus but the only consistent response that capsaicin and lung inflammation provoke in healthy human airways is cough. TRPA1, another excitatory ion channel, has been referred to as the "irritant receptor" and its activation also induces cough. For both types of cough, the motor responses are identical and via coordinated, precisely-timed and sequential respiratory events orchestrated by complex neuromuscular networking of the diaphragm, chest and abdominal respiratory muscles, the glottis and parts of the brain.
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Affiliation(s)
- Stuart M Brooks
- Colleges of Public Health and Medicine, University of South Florida, Tampa, Florida.
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Brozmanova M, Ru F, Surdenikova L, Mazurova L, Taylor-Clark T, Kollarik M. Preferential activation of the vagal nodose nociceptive subtype by TRPA1 agonists in the guinea pig esophagus. Neurogastroenterol Motil 2011; 23:e437-45. [PMID: 21883700 PMCID: PMC3175634 DOI: 10.1111/j.1365-2982.2011.01768.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The TRPA1 receptor is directly activated by a wide range of chemicals including many endogenous molecules relevant for esophageal pathophysiology. We addressed the hypothesis that the TRPA1 agonists differentially activate esophageal nociceptive subtypes depending on their embryological source (neural crest or epibranchial placodes). METHODS Single cell RT-PCR and whole cell patch clamp recordings were performed on the vagal neurons retrogradely labeled from the guinea pig esophagus. Extracellular recordings were made in the isolated innervated esophagus preparation ex vivo. KEY RESULTS Single cell RT-PCR revealed that the majority of the nodose (placodes-derived) and jugular (neural crest-derived) TRPV1-positive esophageal nociceptors express TRPA1. Single fiber recording showed that the TRPA1 agonists allyl-isothiocyanate (AITC) and cinnamaldehyde were effective in inducing robust action potential discharge in the nerve terminals of nodose nociceptors, but had far less effect in jugular nociceptors (approximately fivefold less). Higher efficacy of the TRPA1 agonists to activate nodose nociceptors was confirmed in the isolated esophagus-labeled vagal neurons in the whole cell patch clamp studies. Similarly to neural crest-derived vagal jugular nociceptors, the spinal DRG nociceptors that are also neural crest-derived were only modestly activated by allyl-isothiocyanate. CONCLUSIONS & INFERENCES We conclude that the TRPA1 agonists are substantially more effective activators of the placodes-derived than the neural crest-derived esophageal nociceptors. Our data predict that in esophageal diseases the presence of endogenous TRPA1 activators will be preferentially signaled by the vagal nodose nociceptors.
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Affiliation(s)
- M Brozmanova
- Pathophysiology, Jessenius Medical School, Comenius University, Martin, Slovakia
| | - F Ru
- Medicine, The Johns Hopkins School of Medicine, Baltimore, MD
| | - L Surdenikova
- Pathophysiology, Jessenius Medical School, Comenius University, Martin, Slovakia,Medicine, The Johns Hopkins School of Medicine, Baltimore, MD
| | - L Mazurova
- Pathophysiology, Jessenius Medical School, Comenius University, Martin, Slovakia
| | - T Taylor-Clark
- Medicine, The Johns Hopkins School of Medicine, Baltimore, MD
| | - M. Kollarik
- Medicine, The Johns Hopkins School of Medicine, Baltimore, MD
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Gu Q, Lee LY. Airway irritation and cough evoked by acid: from human to ion channel. Curr Opin Pharmacol 2011; 11:238-47. [PMID: 21543258 PMCID: PMC3133870 DOI: 10.1016/j.coph.2011.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 03/16/2011] [Accepted: 04/07/2011] [Indexed: 01/28/2023]
Abstract
Inhalation or aspiration of acid solution evokes airway defense responses such as cough and reflex bronchoconstriction, resulting from activation of vagal bronchopulmonary C-fibers and Aδ afferents. The stimulatory effect of hydrogen ion on these sensory nerves is generated by activation of two major types of ion channels expressed in these neurons: a rapidly activating and inactivating current mediated through ASICs, and a slow sustaining current via activation of TRPV1. Recent studies have shown that these acid-evoked responses are elevated during airway inflammatory reaction, revealing the potential convergence of a wide array of inflammatory signaling on these ion channels. Since pH in the airway fluid drops substantially in patients with inflammatory airway diseases, these heightened stimulatory effects of acid on airway sensory nerves may play a part in the manifestation of airway irritation and excessive cough under those pathophysiological conditions.
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Affiliation(s)
- Qihai Gu
- Division of Basic Medical Sciences, Mercer University School of Medicine, Macon, Georgia 31207, USA
| | - Lu-Yuan Lee
- Department of Physiology, University of Kentucky, Lexington, Kentucky 40536, USA
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Gibson PG, Ryan NM. Cough pharmacotherapy: current and future status. Expert Opin Pharmacother 2011; 12:1745-55. [PMID: 21524236 DOI: 10.1517/14656566.2011.576249] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Chronic cough is responsible for a significant illness burden in the community. Refractory cough causes substantial quality-of-life impairment in people with this problem. Neuromodulators for sensory neuropathic cough and new compounds to block transient receptor potential (TRP) receptors hold promise for chronic cough and upper airway hypersensitivity. AREAS COVERED The authors examine current evidence on the new concepts of chronic cough that relate to the study of idiopathic/refractory cough, the role of central nervous system control of cough and the role of laryngeal irritability and sensory neuropathy in cough. Compounds in development to block TRP receptors, treatment for a neuropathic disorder with neuromodulators and cough suppression with opioids, especially codeine and morphine, are investigated. Relevant randomized control trials and case reports were identified through a PubMed search of English-language literature referring to these concepts. EXPERT OPINION The concept that sensory neuropathic disorder may underlie some cases of chronic cough is useful in characterizing cough, understanding its mechanisms and guiding drug development.
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Affiliation(s)
- Peter G Gibson
- University of Newcastle, School of Medicine and Public Health, Centre for Asthma and Respiratory Diseases, Newcastle, NSW 2308, Australia.
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Labenz J. Facts and fantasies in extra-oesophageal symptoms in GORD. Best Pract Res Clin Gastroenterol 2010; 24:893-904. [PMID: 21126702 DOI: 10.1016/j.bpg.2010.08.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Revised: 08/27/2010] [Accepted: 08/31/2010] [Indexed: 01/31/2023]
Abstract
Extra-oesophageal symptoms are common in patients with GORD, but a causal relationship is the exception rather than the rule. In the absence of specific diagnostic procedures capable of identifying patients who might respond to antireflux therapy, clinical suspicion should prompt empirical high-dose PPI treatment. pH-/impedance monitoring on PPI may help to exclude a pathogenic role of gastro-oesophageal reflux in patients refractory to PPIs. While there is some evidence that subgroups of patients with chronic cough of unknown origin or difficult-to-control asthma, who also suffer from typical reflux symptoms, may benefit from PPI therapy, the existence of the disease entity reflux laryngitis must be viewed with a certain scepticism. Clinically silent acid reflux is not a reliable predictor of the success of antireflux treatment in asthmatics. The role of antireflux surgery in the management of extra-oesophageal symptoms remains unclear. Overall, based on current evidence fantasy clearly dominates the facts.
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Affiliation(s)
- J Labenz
- Department of Internal Medicine & Gastroenterology, Diakonie Klinikum Jung-Stilling, Siegen, Germany.
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Gu Q, Lee LY. Acid-Sensing Ion Channels and Pain. Pharmaceuticals (Basel) 2010; 3:1411-1425. [PMID: 27713310 PMCID: PMC4033989 DOI: 10.3390/ph3051411] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 04/14/2010] [Accepted: 05/07/2010] [Indexed: 12/19/2022] Open
Abstract
Pathophysiological conditions such as inflammation, ischemia, infection and tissue injury can all evoke pain, and each is accompanied by local acidosis. Acid sensing ion channels (ASICs) are proton-gated cation channels expressed in both central and peripheral nervous systems. Increasing evidence suggests that ASICs represent essential sensors for tissue acidosis-related pain. This review provides an update on the role of ASICs in pain sensation and discusses their therapeutic potential for pain management.
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Affiliation(s)
- Qihai Gu
- Department of Physiology, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA.
| | - Lu-Yuan Lee
- Department of Physiology, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA.
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Long-term therapeutic outcome of patients undergoing ambulatory pH monitoring for chronic unexplained cough. J Clin Gastroenterol 2010; 44:254-60. [PMID: 19826278 PMCID: PMC4091620 DOI: 10.1097/mcg.0b013e3181b8e97b] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM Ambulatory pH monitoring is frequently performed to determine temporal associations between reflux events and chronic unexplained cough. We further explored the clinical value of ambulatory pH monitoring in predicting long-term symptomatic outcome of therapy in chronic cough. METHODS Symptom scores and reflux indicators from ambulatory pH study [acid exposure time, symptom association probability (SAP), and symptom index] were extracted from records of subjects undergoing esophageal evaluation for chronic cough. Intensity of antireflux therapy administered and symptomatic outcome were determined by telephone interview. Univariate and logistic regression analysis were performed to identify predictors of a high degree response (HDR), defined as sustained, durable symptom improvement lasting >3 months. RESULTS Fifty-three subjects (mean age 63+/-2 y, 42 females) fulfilled the inclusion criteria. Reflux parameters were abnormal on ambulatory pH monitoring in 54.7%. After a mean interval of 3+/-0.3 years, cough intensity improved significantly, 19 subjects (35.8%) achieving HDR. Only female sex and positive SAP predicted HDR on univariate analysis; SAP and intensity of antireflux therapy were retained as independent predictors (P<or=0.03) on logistic regression analysis. Sequential use of acid exposure time, SAP, and symptom index had the best value, with the highest likelihood of HDR when all three were positive (85.7%, P<0.01). CONCLUSIONS Reflux disease is a frequent cause of chronic unexplained cough and aggressive antireflux therapy forms a vital component of management. Positive SAP is an independent predictor of outcome, but hierarchical or sequential use of abnormal gastroesophageal reflux disease parameters on ambulatory pH testing has value in predicting long-term symptomatic response.
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Gu Q, Lee LY. Regulation of acid signaling in rat pulmonary sensory neurons by protease-activated receptor-2. Am J Physiol Lung Cell Mol Physiol 2009; 298:L454-61. [PMID: 20044436 DOI: 10.1152/ajplung.00381.2009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Airway acidification has been consistently observed in airway inflammatory conditions and is known to cause cardiorespiratory symptoms that are, at least in part, mediated through the activation of bronchopulmonary C fibers and the subsequent reflexes. Protease-activated receptor-2 (PAR(2)) is expressed in a variety of cells in the lung and airways and is believed to play a role in airway inflammation and hyperresponsiveness. This study was carried out to investigate the effect of PAR(2) activation on the acid signaling in rat bronchopulmonary C-fiber sensory neurons. Our RT-PCR results revealed the expression of mRNAs for transient receptor potential vanilloid receptor 1 (TRPV1) and four functional acid-sensing ion channel (ASIC) subunits 1a, 1b, 2a, and 3 in these sensory neurons. Preincubation of SLIGRL-NH(2), a specific PAR(2)-activating peptide, markedly enhanced the Ca(2+) transient evoked by extracellular acidification. Pretreatment with PAR(2) agonists significantly potentiated both acid-evoked ASIC- and TRPV1-like whole cell inward currents. Activation of PAR(2) also potentiated the excitability of these neurons to acid, but not electrical stimulation. In addition, the potentiation of acid-evoked responses was not prevented by inhibiting either PLC or PKC nor was mimicked by activation of PKC. In conclusion, activation of PAR(2) modulates the acid signaling in pulmonary sensory neurons, and the interaction may play a role in the pathogenesis of airway inflammatory conditions, where airway acidification and PAR(2) activation can occur simultaneously.
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Affiliation(s)
- Qihai Gu
- Department of Physiology, University of Kentucky Medical Center, 800 Rose St., Lexington, KY 40536-0298, USA.
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