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Azaldegi G, Korta J, Sardón O, Corcuera P, Pérez-Yarza EG. Small Airway Dysfunction in Children With Controlled Asthma. Arch Bronconeumol 2019; 55:208-213. [PMID: 30770124 DOI: 10.1016/j.arbres.2018.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/02/2018] [Accepted: 08/29/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Asthma is characterized by chronic inflammation of the central and distal airways. The aim of this study was to assess the small airway (SA) of children with moderate-severe asthma with normal FEV1. METHODS This was an open-label, prospective, observational, cross-sectional study with consecutive inclusion of patients with moderate-severe asthma, receiving standard clinical treatment, with normal baseline FEV1. We determined multiflow FEno (CAno), oscillatory resistance and reactance (R5-R20, X5), forced spirometry (FEV1, FEF25-75), total body plethysmography (RV/TLC) and bronchodilation test. SA involvement was defined as: CAno>4.5 ppb, R5-R20>0.147kPa/L/s, X5<-0.18kPa/L, FEF25-75<-1.65 z-score, RV/TLC>33%. Poor asthma control was defined as ≤ 19 points on the ACT questionnaire or ≤ 20 on the c-ACT. RESULTS In a cohort of 100 cases, 76 had moderate asthma and 24 had severe asthma; 71 children were classified as poorly controlled and 29 were well-controlled. In total, 77.78% of the group with all the correct determinations (n=72) showed ≥ 1 altered SA parameter and 48.61% ≥ 2 parameters. There were no differences between well-controlled or poorly controlled cases. CONCLUSIONS Children with moderate-severe asthma, with normal FEV1, show a phenotype of dysfunctional SA. In our series, the evaluation of SA using the techniques described above did not provide information on disease control.
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Affiliation(s)
- Garazi Azaldegi
- Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, España
| | - Javier Korta
- Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, España; Departamento de Pediatría, Universidad del País Vasco (UPV/EHU), San Sebastián, España
| | - Olaia Sardón
- Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, España; Departamento de Pediatría, Universidad del País Vasco (UPV/EHU), San Sebastián, España
| | - Paula Corcuera
- Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, España
| | - Eduardo G Pérez-Yarza
- Sección de Neumología Infantil, Hospital Universitario Donostia, San Sebastián, España; Departamento de Pediatría, Universidad del País Vasco (UPV/EHU), San Sebastián, España; Centro de Investigación Biomédica en Red, Enfermedades Respiratorias (CIBERES), San Sebastián, España.
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Pigati PA, Righetti RF, Possa SS, Romanholo BS, Rodrigues APD, dos Santos ASA, Xisto DG, Antunes MA, Prado CM, Leick EA, Martins MDA, Rocco PRM, Tibério IDFLC. Y-27632 is associated with corticosteroid-potentiated control of pulmonary remodeling and inflammation in guinea pigs with chronic allergic inflammation. BMC Pulm Med 2015; 15:85. [PMID: 26264367 PMCID: PMC4531528 DOI: 10.1186/s12890-015-0073-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 07/06/2015] [Indexed: 02/07/2023] Open
Abstract
Background Previously, we showed that treatment with the Rho-kinase inhibitor Y-27632 was able to control airway responsiveness, inflammation, remodeling, and oxidative stress in an animal model of asthma, suggesting that this drug is beneficial in asthma. However, studies evaluating the effects of these inhibitors in conjunction with corticosteroids on chronic pulmonary inflammation have not been conducted. Therefore, we evaluated the effects of treatment with the Rho-kinase inhibitor Y-27632, with or without concurrent dexamethasone treatment, on airway and lung tissue mechanical responses, inflammation, extracellular matrix remodeling, and oxidative stress in guinea pigs with chronic allergic inflammation. Methods The guinea pigs were subjected to seven ovalbumin or saline inhalation exposures. Treatment with Y-27632 (1 mM) and dexamethasone (2 mg/kg) started at the fifth inhalation. Seventy-two hours after the seventh inhalation, the pulmonary mechanics were evaluated and exhaled nitric oxide (ENO) levels were determined. The lungs were removed and histological analysis was performed using morphometry. Results The treatment of guinea pigs with the Rho-kinase inhibitor and dexamethasone (ORC group) decreased ENO, the maximal mechanical responses after antigen challenge, inflammation, extracellular matrix remodeling and oxidative stress in the lungs. This therapeutic strategy reduced the levels of collagen and IFN-γ in the airway walls, as well as IL-2, IFN-γ, 8-iso-PGF2α and NF-κB in the distal parenchyma, when compared to isolated treatment with corticosteroid or Rho-kinase inhibitor (P < 0.05) and reduced the number of TIMP-1-positive cells and eosinophils in the alveolar septa compared to corticosteroid-treated animals (P < 0.05). The combined treatment with the Rho-kinase inhibitor and the corticosteroid provided maximal control over the remodeling response and inflammation in the airways and parenchyma. Conclusions Rho-kinase inhibition, alone or in combination with corticosteroids, can be considered a future pharmacological tool for the control of asthma.
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Affiliation(s)
| | - Renato Fraga Righetti
- Department of Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Samantha Souza Possa
- Department of Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Beatriz Saraiva Romanholo
- Department of Medicine, Laboratory of Experimental Therapeutics, LIM-20, School of Medicine, University of São Paulo, São Paulo, Brazil. .,University City of São Paulo (UNICID), São Paulo, Brazil. .,Institute of Medical Assistance to the State Public Servant of São Paulo (IAMSPE), São Paulo, Brazil.
| | | | | | - Débora Gonçalves Xisto
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Ilha do Fundão, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Mariana Alves Antunes
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Ilha do Fundão, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Carla Máximo Prado
- Department of Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Edna Aparecida Leick
- Department of Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | | | - Patrícia Rieken Macedo Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Ilha do Fundão, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Gong W, Wang X, Zhang Y, Hao J, Xing C, Chu Q, Wang G, Zhao J, Wang J, Dong Q, Liu T, Zhang Y, Dong L. Interleukin-20 promotes airway remodeling in asthma. Inflammation 2015; 37:2099-105. [PMID: 25028099 DOI: 10.1007/s10753-014-9944-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Previous studies have demonstrated that interleukin-20 (IL-20) is a pro-inflammatory cytokine, and it has been implicated in psoriasis, lupus nephritis, rheumatoid arthritis, atherosclerosis, and ulcerative colitis. Little is known about the effects of IL-20 in airway remodeling in asthma. The aim of our study was to demonstrate the function of IL-20 in airway remodeling in asthma. To identify the expression of IL-20 and its receptor, IL-20R1/IL-20R2, in the airway epithelium in bronchial tissues, bronchial biopsy specimens were collected from patients and mice with asthma and healthy subjects and stained with specific antibodies. To characterize the effects of IL-20 in asthmatic airway remodeling, we silenced and stimulated IL-20 in cell lines isolated from mice by shRNA and recombinant protein approaches, respectively, and detected the expression of α-SMA and FN-1 by Western blot analysis. First, overexpression of IL-20 and its receptor, IL-20R1/IL-20R2, was detected in the airway epithelium collected from patients and mice with asthma. Second, IL-20 increased the expression of fibronectin-1 and α-SMA, and silencing of IL-20 in mouse lung epithelial (MLE)-12 cells decreased the expression of fibronectin-1 and α-SMA. IL-20 may be a critical cytokine in airway remodeling in asthma. This study indicates that targeting IL-20 and/or its receptors may be a new therapeutic strategy for asthma.
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Affiliation(s)
- Wenbin Gong
- Department of Respiratory Medicine, Qilu Hospital of Shandong University, #107, Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China
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Eusebio M, Kuna P, Kraszula L, Kupczyk M, Pietruczuk M. The relative values of CD8+CD25+Foxp3brigh Treg cells correlate with selected lung function parameters in asthma. Int J Immunopathol Pharmacol 2015; 28:218-26. [PMID: 25921629 DOI: 10.1177/0394632015584508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/02/2015] [Indexed: 11/15/2022] Open
Abstract
The study aimed to detect CD8(+)CD25(+)FoxP3(brigh) Tregs and investigate their possible association with selected lung function values. CD8(+)CD25(+)FoxP3(brigh) Tregs were detected by flow cytometry in the peripheral blood of 25 patients with severe asthma (SA), 25 patients with mild-to-moderate asthma (MA), and 25 age-matched healthy donors (NC). The percentages of CD8(+)CD25(+)FoxP3(brigh) Tregs of the patients with severe (3.4 ± 4.55), and mild-to-moderate asthma (7.5 ± 8.15), were markedly lower than those of controls (12.1 ± 13.2). The mean forced expiratory volume in 1 s (FEV1) % predicted value in severe asthma subpopulation was significantly lower (67.05 ± 15.98%) when compared with that of mild-to-moderate asthma subgroup (87.71 ± 16.12%). Interestingly, the percentages of CD8(+)CD25(+)FoxP3(brigh) Tregs correlate with mean peak expiratory flow (PEF)% predicted values in severe (r = 0.7, P <0.01) and mild-to-moderate (r = 0.73, P <0.01) asthma. In contrast, this parameter was positively correlated with FEV1% predicted values in the severe asthmatics only (r = 0.71, P <0.01). In summary, this study establishes a link between the percentage of CD8(+)CD25(+)FoxP3(brigh) Tregs and selected lung function parameters, suggesting that this parameter has potential as a marker for inflammation and airflow obstruction.
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Affiliation(s)
- M Eusebio
- Department of Laboratory Diagnostics, II Chair of Internal Medicine, Medical University of Lodz, Poland
| | - P Kuna
- Department of Internal Medicine, II Chair of Internal Medicine, Medical University of Lodz, Poland
| | - L Kraszula
- Department of Laboratory Diagnostics, II Chair of Internal Medicine, Medical University of Lodz, Poland
| | - M Kupczyk
- Department of Internal Medicine, II Chair of Internal Medicine, Medical University of Lodz, Poland
| | - M Pietruczuk
- Department of Laboratory Diagnostics, II Chair of Internal Medicine, Medical University of Lodz, Poland
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Wu J, Dong F, Wang RA, Wang J, Zhao J, Yang M, Gong W, Cui R, Dong L. Central role of cellular senescence in TSLP-induced airway remodeling in asthma. PLoS One 2013; 8:e77795. [PMID: 24167583 PMCID: PMC3805661 DOI: 10.1371/journal.pone.0077795] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022] Open
Abstract
Background Airway remodeling is a repair process that occurs after injury resulting in increased airway hyper-responsiveness in asthma. Thymic stromal lymphopoietin (TSLP), a vital cytokine, plays a critical role in orchestrating, perpetuating and amplifying the inflammatory response in asthma. TSLP is also a critical factor in airway remodeling in asthma. Objectives To examine the role of TSLP-induced cellular senescence in airway remodeling of asthma invitro and invivo. Methods Cellular senescence and airway remodeling were examined in lung specimens from patients with asthma using immunohischemical analysis. Both small molecule and shRNA approaches that target the senescent signaling pathways were used to explore the role of cellular senescence in TSLP-induced airway remodeling invitro. Senescence-Associated β-galactosidase (SA-β-Gal) staining, and BrdU assays were used to detect cellular senescence. In addition, the Stat3-targeted inhibitor, WP1066, was evaluated in an asthma mouse model to determine if inhibiting cellular senescence influences airway remodeling in asthma. Results Activation of cellular senescence as evidenced by checkpoint activation and cell cycle arrest was detected in airway epithelia samples from patients with asthma. Furthermore, TSLP-induced cellular senescence was required for airway remodeling invitro. In addition, a mouse asthma model indicates that inhibiting cellular senescence blocks airway remodeling and relieves airway resistance. Conclusion TSLP stimulation can induce cellular senescence during airway remodeling in asthma. Inhibiting the signaling pathways of cellular senescence overcomes TSLP-induced airway remodeling.
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Affiliation(s)
- Jinxiang Wu
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Fangzheng Dong
- University of Iowa College of Liberal Arts and Sciences, Iowa City, Iowa, United States of America
- Department of Dermatology & Biochemistry, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Rui-An Wang
- Department of Pathology, Fourth Military Medical University, Xian, Shanxi, China
| | - Junfei Wang
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jiping Zhao
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Mengmeng Yang
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Wenbin Gong
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Rutao Cui
- Longhua Hospital, Shanghai University of TCM, Shanghai, China
- Department of Dermatology & Biochemistry, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail: (RC); (LD)
| | - Liang Dong
- Department of Respiratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
- * E-mail: (RC); (LD)
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Souza FCR, Gobbato NB, Maciel RG, Prado CM, Martins MA, Leick EA, Tibério IFLC. Effects of corticosteroid, montelukast and iNOS inhibition on distal lung with chronic inflammation. Respir Physiol Neurobiol 2012; 185:435-45. [PMID: 23009745 DOI: 10.1016/j.resp.2012.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 08/17/2012] [Accepted: 08/20/2012] [Indexed: 12/18/2022]
Abstract
UNLABELLED We evaluated the effects of anti-iNOS (1400W - W) associated with leukotriene antagonist (montelukast - M) or corticosteroid (dexamethasone - D) on distal lung of guinea pigs (GP) with chronic pulmonary inflammation. METHODS GP were inhaled with ovalbumin (OVA-2×/week/4 weeks), treated with M (OVAM), D (OVAD) and/or W (OVAW, OVADW, OVAMW) and distal lungs were evaluated by morphometry. RESULTS Isolated treatments were not sufficient to reduce all parameters. In OVADW, all parameters were reduced with greater reduction in elastic fibers, TIMP-1, IL-4, IL-5, IFN-gamma and PGF2-alpha compared with OVAD (p<0.05). OVAMW potentiated the reduction of actin, elastic fibers, TIMP-1, IL-4, IL-5, TGF-beta, IFN-gamma, iNOS, and PGF2-alpha to a greater extent than OVAM (p<0.05). A reduction of TIMP-1, IL-4, IL-5, TGF-beta, IFN-gamma and iNOS was observed in OVADW compared with OVAMW (p<0.05). CONCLUSIONS Although anti-iNOS paired with montelukast or dexamethasone yields better results than isolated treatments, the most effective pairing for controlling inflammation, oxidative stress and remodeling in this asthma model was found to be corticosteroids and anti-iNOS.
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