1
|
Leroux J, Khayath N, Matau C, Marcot C, Migueres N, Barnig C, Molard A, Ochea D, Ohana M, Lefebvre F, de Blay F. Efficacy of bronchial thermoplasty in patients with severe asthma and frequent severe exacerbations: A randomized controlled study ✰. Respir Med Res 2024; 86:101109. [PMID: 38875851 DOI: 10.1016/j.resmer.2024.101109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 03/24/2024] [Accepted: 04/15/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Bronchial thermoplasty (BT) is a bronchoscopic procedure for patients with severe uncontrolled asthma, but randomized controlled studies of its efficacy in severe asthma with frequent exacerbations are lacking. The current aim was to assess BT efficacy in this patient population. METHODS Thirty patients with asthma (GINA 5) who had experienced at least four severe exacerbations in the preceding year were randomized to BT (n = 15) or control groups (n = 15). All patients had four follow-up visits over the following 15 months, corresponding to 3, 6, 9, and 12 months after the last procedure for the BT group. The primary outcome was number of exacerbations at 15 months after inclusion (i.e. 12 months after bronchial thermoplasty). RESULTS All but three patients had received an asthma biologic without receiving benefit. In the year preceding enrollment, patients in the BT group had an average of five exacerbations, compared with six among controls. For patients in the BT group, oral steroid intake was 9.3 mg/d, compared with 11.0 mg/d among controls. The BT group had 1.58 fewer severe exacerbations (mean, 6.09) compared with controls (mean, 8.28) in the 12-month period after the therapy (p = 0.047). Oral steroid intake during follow-up after BT was significantly lower in the BT group (ratio vs controls: 0.61; p = 0.0002). Quality-of-life measures between inclusion and the last visit were significantly improved in the BT group, but not among controls. Few mild to moderate adverse events were reported, and all were controlled within days. CONCLUSION In patients with severe asthma and frequent severe exacerbations, BT significantly decreased the rate of severe exacerbations and oral steroid intake and led to improved quality of life during the 15 months after inclusion. BT appears to offer a therapeutic option for severe asthma with frequent exacerbations.
Collapse
Affiliation(s)
- Justine Leroux
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France.
| | - Naji Khayath
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Cezar Matau
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Christophe Marcot
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Nicolas Migueres
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Cindy Barnig
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Anita Molard
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Diana Ochea
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| | - Mickael Ohana
- Radiology Department, Strasbourg University Hospital, France
| | | | - Frédéric de Blay
- Chest diseases department, Strasbourg University Hospital and University of Strasbourg, France
| |
Collapse
|
2
|
Wang H, Zhong B, Geng Y, Hao J, Jin Q, Zhang Y, Dong L, Gao D, Li J, Hou W. TIPE2 inhibits PDGF-BB-induced phenotype switching in airway smooth muscle cells through the PI3K/Akt signaling pathway. Respir Res 2021; 22:238. [PMID: 34446024 PMCID: PMC8393827 DOI: 10.1186/s12931-021-01826-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/16/2021] [Indexed: 12/28/2022] Open
Abstract
Background Childhood asthma is a common respiratory disease characterized by airway inflammation. Tumor necrosis factor-α-induced protein 8-like 2 (TIPE2) has been found to be involved in the progression of asthma. This study aimed to explore the role of TIPE2 in the regulation of airway smooth muscle cells (ASMCs), which are one of the main effector cells in the development of asthma. Materials and methods ASMCs were transfected with pcDNA3.0-TIPE2 or si-TIPE2 for 48 h and then treated with platelet-derived growth factor (PDGF)-BB. Cell proliferation of ASMCs was measured using the MTT assay. Cell migration of ASMCs was determined by a transwell assay. The mRNA expression levels of calponin and smooth muscle protein 22α (SM22α) were measured using qRT-PCR. The levels of TIPE2, calponin, SM22α, PI3K, p-PI3K, Akt, and p-Akt were detected by Western blotting. Results Our results showed that PDGF-BB treatment significantly reduced TIPE2 expression at both the mRNA and protein levels in ASMCs. Overexpression of TIPE2 inhibited PDGF-BB-induced ASMC proliferation and migration. In addition, overexpression of TIPE2 increased the expression of calponin and SM22α in PDGF-BB-stimulated ASMCs. However, an opposite effect was observed with TIPE2 knockdown. Furthermore, TIPE2 overexpression blocked PDGF-BB-induced phosphorylation of PI3K and Akt, whereas the expression of p-PI3K and p-Akt were aggravated by TIPE2 knockdown. Additionally, the effects of TIPE2 overexpression and TIPE2 knockdown were altered by IGF-1 and LY294002 treatments, respectively. Conclusions Our findings demonstrate that TIPE2 inhibits PDGF-BB-induced ASMC proliferation, migration, and phenotype switching via the PI3K/Akt signaling pathway. Thus, TIPE2 may be a potential therapeutic target for the treatment of asthma.
Collapse
Affiliation(s)
- Huiyuan Wang
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Bo Zhong
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Yan Geng
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Juanjuan Hao
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Qiaoyan Jin
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Yang Zhang
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Lijuan Dong
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Dan Gao
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Jing Li
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Wei Hou
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, NO.157, Xiwu Road, Xi'an, 710004, Shaanxi, China.
| |
Collapse
|
3
|
Chen H, Xia Q, Feng X, Cao F, Yu H, Song Y, Ni X. Effect of P2X4R on airway inflammation and airway remodeling in allergic airway challenge in mice. Mol Med Rep 2015; 13:697-704. [PMID: 26648454 PMCID: PMC4686060 DOI: 10.3892/mmr.2015.4622] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 10/29/2015] [Indexed: 11/29/2022] Open
Abstract
P2X4 receptor (P2X4R) is the most widely expressed subtype of the P2XRs in the purinergic receptor family. Adenosine triphosphate (ATP), a ligand for this receptor, has been implicated in the pathogenesis of asthma. ATP-P2X4R signaling is involved in pulmonary vascular remodeling, and in the proliferation and differentiation of airway and alveolar epithelial cell lines. However, the role of P2X4R in asthma remains to be elucidated. This aim of the present study was to investigate the effects of P2X4R in a murine experimental asthma model. The asthmatic model was established by the inhalation of ovalbumin (OVA) in BALB/c mice. The mice were treated with P2X4R-specific agonists and antagonists to investigate the role of this receptor in vivo. Pathological changes in the bronchi and lung tissues were examined using hematoxylin and eosin staining, Masson's trichrome staining and Alcian blue staining. The inflammatory cells in the bronchoalveolar lavage fluid were counted, and the expression levels of P2X4R, α-smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) were detected using western blotting. In the OVA-challenged mice, inflammation, infiltration, collagen deposition, mucus production, and the expression levels of P2X4R and PCNA were all increased; however, the expression of α-SMA was decreased, compared with the mice in the control group. Whereas treatment with the P2X4R agonist, ATP, enhanced the allergic reaction, treatment with the P2X4R antagonist, 5-BDBD, attenuated the allergic reaction. The results suggested that ATP-P2X4R signaling may not only contribute to airway inflammation, but it may also contribute to airway remodeling in allergic asthma in mice.
Collapse
Affiliation(s)
- Hongxia Chen
- Department of Pathology, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Qingqing Xia
- Department of Anatomy, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Xiaoqian Feng
- Department of Pathology, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Fangyuan Cao
- Department of Pathology, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Hang Yu
- Department of Physiology, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Yinli Song
- Department of Pathology, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| | - Xiuqin Ni
- Department of Anatomy, Harbin Medical University-Daqing, Daqing, Heilongjiang 163319, P.R. China
| |
Collapse
|
4
|
Shi Y, Xu X, Tan Y, Mao S, Fang S, Gu W. A liver-X-receptor ligand, T0901317, attenuates IgE production and airway remodeling in chronic asthma model of mice. PLoS One 2014; 9:e92668. [PMID: 24681543 PMCID: PMC3969355 DOI: 10.1371/journal.pone.0092668] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/25/2014] [Indexed: 01/09/2023] Open
Abstract
The liver-X-receptors have shown anti-inflammatory ability in several animal models of respiratory disease. Our purpose is to investigate the effect of LXR ligand in allergen-induced airway remodeling in mice. Ovalbumin-sensitized mice were chronically challenged with aerosolized ovalbumin for 8 weeks. Some mice were administered a LXR agonist, T0901317 (12.5, 25, 50 mg/kg bodyweight) before challenge. Then mice were evaluated for airway inflammation, airway hyperresponsiveness and airway remodeling. T0901317 failed to attenuate the inflammatory cells and Th2 cytokines in bronchoalveolar lavage fluid. But the application of T0901317 reduced the thickness of airway smooth muscle and the collagen deposition. Meanwhile, T0901317 treatment evidently abolished the high level of OVA-specific IgE, TGF-β1 and MMP-9 in lung. So LXRs may attenuate the progressing of airway remodeling, providing a potential treatment of asthma.
Collapse
Affiliation(s)
- Ying Shi
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiantao Xu
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yan Tan
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shan Mao
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Surong Fang
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Gu
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- * E-mail:
| |
Collapse
|
5
|
Shi Y, Tan Y, Mao S, Gu W. Naringenin inhibits allergen‑induced airway remodeling in a murine model of asthma. Mol Med Rep 2014; 9:1204-8. [PMID: 24534822 DOI: 10.3892/mmr.2014.1940] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 01/23/2014] [Indexed: 11/05/2022] Open
Abstract
The flavonoid naringenin has been shown to attenuate airway inflammation and airway hyper‑reactivity in acute murine models of asthma. The purpose of this study was to investigate the effects of naringenin in allergen‑induced airway remodeling in mice. Ovalbumin (OVA)‑sensitized mice were challenged with OVA for 8 weeks to produce a model of chronic asthma. Airway hyper-responsiveness (AHR), inflammation and remodeling were evaluated in mice receiving naringenin prior to OVA challenge. Compared to OVA-sensitized and -challenged mice, those treated with naringenin showed markedly attenuated chronic inflammation, persistent AHR and airway remodeling. In addition, naringenin treatment caused a significant reduction in the levels of total serum IgE and of T helper 2 (Th2) cytokines in the bronchoalveolar lavage fluid (BALF). Naringenin may thus delay the progression of airway remodeling, providing a potential treatment for asthma.
Collapse
Affiliation(s)
- Ying Shi
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Yan Tan
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Shan Mao
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Wei Gu
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| |
Collapse
|
6
|
Royce SG, Lee M, Tang MLK. The contribution of L-selectin to airway hyperresponsiveness in chronic allergic airways disease. J Asthma Allergy 2010; 3:9-17. [PMID: 21437035 PMCID: PMC3047908 DOI: 10.2147/jaa.s9775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Indexed: 11/23/2022] Open
Abstract
L-selectin is a cell adhesion molecule, which mediates leukocyte rolling on bronchopulmonary endothelium. Previous studies in a murine model of allergic airways disease have shown that L-selectin plays a role in the regulation of airway hyperresponsiveness in asthma via mechanisms independent of inflammation. Airway remodeling has been shown to modulate airway hyperresponsiveness independently of inflammation.
Collapse
Affiliation(s)
- Simon G Royce
- Department of Allergy and Immunology, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | | | | |
Collapse
|
7
|
Pretolani M. [From mollusk to man: YKL-40, a novel mediator of severe asthma]. Med Sci (Paris) 2008; 24:235-7. [PMID: 18334164 DOI: 10.1051/medsci/2008243235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
8
|
Makinde T, Murphy RF, Agrawal DK. The regulatory role of TGF-beta in airway remodeling in asthma. Immunol Cell Biol 2007; 85:348-56. [PMID: 17325694 DOI: 10.1038/sj.icb.7100044] [Citation(s) in RCA: 209] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Both structural and inflammatory cells are capable of secreting transforming growth factor (TGF)-beta and expressing TGF-beta receptors. TGF-beta can induce multiple cellular responses including differentiation, apoptosis, survival and proliferation, and has been implicated in the development of several pathogenic conditions including cancer and asthma. Elevated levels of TGF-beta have been reported in the asthmatic airway. TGF-beta binds to its receptor complex and activates multiple pathways involving proteins such as Sma and Mad homologues, phosphatidylinositol-3 kinase and the mitogen-activated protein kinases, leading to the transcription of several genes. Cell type, cellular condition, and microenvironment, all play a role in determining which pathway is activated, which, in turn, is an indication of which gene is to be transcribed. TGF-beta has been shown to induce apoptosis in airway epithelial cells. A possible role for TGF-beta in the regulation of epithelial cell adhesion properties has also been reported. Enhancement of goblet cell proliferation by TGF-beta suggests a role in mucus hyper-secretion. Elevated levels of TGF-beta correlate with subepithelial fibrosis. TGF-beta induces proliferation of fibroblast cells and their differentiation into myofibroblasts and extracellular matrix (ECM) protein synthesis during the development of subepithelial fibrosis. TGF-beta also induces proliferation and survival of and ECM secretion in airway smooth muscle cells (ASMCs), suggesting a possible cause of increased thickness of airway tissues. TGF-beta also induces the production and release of vascular endothelial cell growth factor and plasminogen activator inhibitor, contributing to the vascular remodeling in the asthmatic airway. Blocking TGF-beta activity inhibits epithelial shedding, mucus hyper-secretion, angiogenesis, ASMC hypertrophy and hyperplasia in an asthmatic mouse model. Reduction of TGF-beta production and control of TGF-beta effects would be beneficial in the development of therapeutic intervention for airway remodeling in chronic asthma.
Collapse
Affiliation(s)
- Toluwalope Makinde
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE 68178, USA
| | | | | |
Collapse
|