Nitric oxide in allergic airway inflammation

Combining nitric oxide and calcium sensing for the detection of endothelial dysfunction

Cardiovascular diseases are the leading cause of death worldwide and are not typically diagnosed until the disease has manifested. Endothelial dysfunction is an early, reversible precursor in the irreversible development of cardiovascular diseases and is characterized by a decrease in nitric oxide production. We believe that more reliable and reproducible methods are necessary for the detection of endothelial dysfunction. Both nitric oxide and calcium play important roles in the endothelial function. Here we review different types of molecular sensors used in biological settings. Next, we review the current nitric oxide and calcium sensors available. Finally, we review methods for using both sensors for the detection of endothelial dysfunction.

Supramolecular Control of Photonic Response and Sensing of Nitricoxide using Iron(III) Corrole Monolayers and Their Stacks

In this work, we assemble amphiphilic iron(III) corroles at air-water interfaces into well-defined quasi-two-dimensional molecular monolayers and theirs stacks for sensing of nitric oxide (NO). For this purpose, we use the Langmuir-Blodgett (LB) technique, which allows varying the packing density of iron(III) corroles anchored to the aqueous subphase via one molecular side. The stacks of ten down to three molecular monolayers on the front and back sides of the substrates are sufficiently optically dense to detect NO binding to the layers photometrically. This sensing with few layers demonstrates the potential for electronic detection, where very thin surface functionalizations enable efficient electronic communication between the layer and the (semi)conductor. Despite increasing optical densities, the spectral responses to NO exposure become smaller with increasing packing density until the collapse point of the monolayers is reached. This demonstrates that the highest molecular efficiency for binding and detection of NO is achieved at the smallest packing densities. This finding is relevant to all molecular sensor films with axial binding of analytes to the sensor molecules and demonstrates the advantage of sensor molecule assembly into monolayers on water-air interfaces using the LB technique.

Effect of experimental exposures to 3-D printer emissions on nasal allergen responses and lung diffusing capacity for inhaled carbon monoxide/nitric oxide in subjects with seasonal allergic rhinitis

3-D printers are widely used. Based on previous findings, we hypothesized that their emissions could enhance allergen responsiveness and reduce lung diffusing capacity. Using a cross-over design, 28 young subjects with seasonal allergic rhinitis were exposed to 3-D printer emissions, either from polylactic acid (PLA) or from acrylonitrile butadiene styrene copolymer (ABS), for 2 h each. Ninety minutes later, nasal allergen challenges were performed, with secretions sampled after 1.5 h. Besides nasal functional and inflammatory responses, assessments included diffusing capacity. There was also an inclusion day without exposure. The exposures elicited slight reductions in lung diffusing capacity for inhaled nitric oxide (DL_NO ) that were similar for PLA and ABS. Rhinomanometry showed the same allergen responses after both exposures. In nasal secretions, concentrations of interleukin 6 and tumor necrosis factor were slightly reduced after ABS exposure versus inclusion day, while that of interleukin 5 was slightly increased after PLA exposure versus inclusion.

Nepetoidin B from Salvia plebeia R. Br. Inhibits Inflammation by Modulating the NF-κB and Nrf2/HO-1 Signaling Pathways in Macrophage Cells

Salvia plebeia has been used to treat a variety of inflammatory diseases, as well as colds and bronchitis. Macrophages have antioxidant defense mechanisms to cope with the intracellular reactive oxygen species (ROS) produced as part of the immune response. The nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase (HO)-1 pathway in inflamed macrophages is an appealing target due to its protective effect against ROS-induced cell damage. In this study, nepetoidin B (NeB) was first isolated from S. plebeia and identified by nuclear magnetic resonance spectroscopy. NeB reduced pro-inflammatory mediators (nitric oxide and prostaglandin E₂) and cytokines (tumor necrosis factor-α, interleukin (IL)-6, and IL-1β) in LPS-activated RAW 264.7 cells by inhibiting the NF-κB signaling pathway. In the NeB-treated group, catalase and superoxide dismutase levels were significantly higher, and ROS expression decreased. By activating Nrf2 signaling, NeB enhanced HO-1 expression. Furthermore, when the cells were pretreated with tin protoporphyrin (an HO-1 inhibitor), the anti-inflammatory effects of NeB were reduced. Therefore, NeB may activate the Nrf2/ HO-1 pathway. These results reveal the NeB isolated from S. plebeia exerts anti-inflammatory effects by modulating NF-κB signaling and activating the Nrf2/HO-1 pathway in LPS-stimulated RAW 264.7 cells.

Beneficial Effect of Herbal Formulation KM1608 on Inflammatory Bowl Diseases: A Preliminary Experimental Study

Aucklandia lappa DC., Terminalia chebula Retz and Zingiber officinale Roscoe have been traditionally used in east Asia to treat chronic diarrhea and abdominal pain. This study aimed to evaluated the anti-inflammatory activity of KM1608, which is composed of three natural herbs in a mouse model of dextran sodium sulfate (DSS)-induced ulcerative colitis. The anti-inflammatory activity and underlying mechanism were assessed in vitro using LPS-treated RAW264.7 cells. The in vivo effect of KM1608 on DSS-induced colitis was examined after oral administration in mice. KM1608 significantly inhibited the inflammatory mediators such as nitric oxide, interleukin (IL)-6, monocyte chemotactic protein 1 (MCP-1) and tumor necrosis factor (TNF)-α in LPS-treated RAW264.7 cells. The inhibitory effect of KM1608 was attributed to the reduction of Akt phosphorylation in the LPS-treated cells. In the mouse model, oral administration of KM1608 significantly improved DSS-induced colitis symptoms, such as disease activity index (DAI), colon length, and colon weight, as well as suppressed the expression of IL-6, TNF-α, and myeloperoxidase (MPO) in the DSS-induced colitis tissues. Taken together, KM1608 improved colitis through the regulation of inflammatory responses, suggesting that KM1608 has potential therapeutic use in the treatment of inflammatory diseases.

Diagnostic significance of nitric oxide concentrations in exhaled air from the airways in allergic rhinitis patients

INTRODUCTION

The effect of nitric oxide (NO) on the human body is very important due its physiological regulation of the following functions of airways: modulation of ciliary movement and maintenance of sterility in sinuses.

AIM

To evaluate the diagnostic significance of NO concentrations in exhaled air from the upper and lower airways in patients diagnosed with allergic rhinitis (AR).

MATERIAL AND METHODS

The subjects included in the study were a group of 30 people diagnosed with sensitivity to environmental allergens and a control group consisting of 30 healthy subjects. The measurement of NO in the air exhaled from the lower and upper airways was performed using an on-line method by means of Restricted Exhaled Breath (REB), as well as using the measurement procedure (chemiluminescence) set out in the guidelines prepared in 2005 by the American Thoracic Society and the European Respiratory Society.

RESULTS

In the late phase of the allergic reaction, higher values of the level of exhaled NO concentration from the lower airways were observed in the groups of subjects up to the threshold values of 25.17 ppb in the group of subjects with year-round allergic rhinitis and 21.78 ppb in the group with diagnosed seasonal allergic rhinitis. The difference in the concentration of NO exhaled from the lungs between the test group and the control group in the 4(th) h of the test was statistically significant (p = 0.045).

CONCLUSIONS

Exhaled NO should be considered as a marker of airway inflammation. It plays an important role in the differential diagnosis of allergy.

In silico analysis and experimental validation of molecular mechanisms of salvianolic acid A-inhibited LPS-stimulated inflammation, in RAW264.7 macrophages

OBJECTIVES

The aim of this study was to explore mechanisms by which salvianolic acid A (SAA) revealed its anti-inflammatory activity, in lipopolysaccharide (LPS)-stimulated RAW264.7 cells.

MATERIALS AND METHODS

Nitric oxide (NO) concentration was determined by the Griess reaction and cell viability was assessed by MTT assay. Interleukin-6, TNFα and interleukin-1β were determined by ELISA. The RAW264.7 cells were transfected with siRNA against p38 or HO-1. Expressions of COX-2, inducible NO synthase (iNOS), NF-κB, HO-1, p-p38 and phosphorylation of IκB kinase α/β were detected by western blotting. Potential targets of SAA were analysed by homology modelling, target prediction, protein-protein interaction prediction and docking studies.

RESULTS

Salvianolic acid A suppressed LPS-triggered production of NO, TNFα and Interleukin-6. It also reduced protein expression of inducible NO synthase and COX-2, and reduced translocation of NF-κB to nuclei. Moreover, SAA promoted expression of phosphorylated p38, and downstream HO-1. Zn (II) protoporphyrin IX, a specific inhibitor of HO-1, or siRNA against HO-1 could effectively increase transfer of NF-κB. SAA was predicted to target amyloid-beta protein-like protein and arachidonate 5-lipoxygenase, that could regulate p38 and HO-1.

CONCLUSIONS

In silico analysis and experimental validation together demonstrated that SAA exhibited its anti-inflammatory effect via the p38-HO-1 pathway in LPS-stimulated RAW264.7 cells, reduced transfer of NF-κB to the nuclei and thus reduced production of inflammatory mediators.

Pharmacological, antioxidant, genotoxic studies and modulation of rat splenocyte functions by Cyperus rotundus extracts

BACKGROUND

Cyperus rotundus Linn. (Cyperaceae) is a Tunisian medicinal plant used in folkloric (traditional) medicine to treat stomach disorders and inflammatory diseases. The present study explored the analgesic, anti-inflammatory and genotoxic activities of extracts from the aerial parts of C. rotundus. The antioxidant capacity and the modulation of splenocyte functions by these extracts were also investigated in mice. The phytochemical analysis was carried out using standard methods.

METHODS

Aqueous, ethyl acetate, methanol and TOF-enriched extracts (300, 150, and 50 μg/ml) were evaluated for their analgesic and anti-inflammatory activities. 4, 2, and 1 mg/ml of each extract were tested to investigate their effect on lipid peroxidation. The genotoxic study was monitored by measuring the structural chromosome aberrations of mice treated with 300 mg/kg of extract. The proliferation of lymphocytes in the absence and presence of mitogens was assessed at a concentration range 1-1000 μg/ml.

RESULTS

The tested extracts were able to decrease the mouse ear oedema induced by xylene. Furthermore, it was shown that the same extracts reduced the number of abdominal contractions caused by acetic acid in mice, revealing the peripheral analgesic activity of these extracts. It is worth noting that mice treated with doses up to 300 mg/kg b.w. of Cyperus rotundus extracts did not exhibit any toxicity. The tested extracts significantly enhance lymphocyte proliferation at 1 mg/ml.

CONCLUSIONS

It appears that C. rotundus extracts contain potent components such as flavonoids that may potentially be useful for modulating the immune cell functions, provoking analgesic, anti-inflammatory and antioxidant effects.

The influence of neighborhood traffic density on the respiratory health of elementary schoolchildren

BACKGROUND

Several studies have found that living near major roadways is associated with an increase in respiratory illness but few studies have measured the volume and type of traffic.

OBJECTIVE

We investigated the relation between traffic volume and respiratory health of 2328 children 9 to 11 years old in the city of Windsor, Canada.

METHODS

We identified the roadways within a 200 meter radius of the child's neighborhood using the latitude and longitude of the residential postal code. Traffic exposure was defined as the sum of the annual volume of vehicles on all of these roadways. Volume was calculated using sensors to detect passing vehicles (simple traffic counts), and by counts and direction of traffic at intersections (turning movement counts). Ventilatory lung function was measured by spirometry and airway inflammation by exhaled nitric oxide (eNO).

RESULTS

The odds ratio between an interquartile increase in truck turning movement counts and chest congestion was 1.20 (1.06-1.35). The percentage of predicted FVC declined 0.68%, (95% CI 1.32, 0.03) for an interquartile increase in simple traffic counts (33,787 vehicles daily). Among those with self-reported asthma, effect sizes were larger. Percentage predicted FEV(1) declined 1.84% (95% CI 0.07, 3.61) associated with an interquartile range increase in turning movement counts. No statistically significant change was detected between traffic measures and exhaled nitric oxide.

CONCLUSIONS

Our findings provide further support for the hypothesis that neighborhood exposure to traffic-related air pollution increases respiratory symptoms and reduces ventilatory function in children, especially those with self-reported asthma.

ent-kaur-16-en-19-oic Acid, isolated from the roots of Aralia continentalis, induces activation of Nrf2

ETHNOPHARMACOLOGICAL RELEVANCE

Excessive inflammation can lead to tissue damage and dysfunction of vital organs. Hence, regulating inflammatory response is a viable therapeutic approach. In Asian countries, various inflammatory diseases have often effectively been treated with herbal remedies including the root extract of Aralia continentalis Kitagawa (Araliaceae). Here, we investigated the effect of kaurenoic acid (ent-kaur-16-en-19-oic acid: KA), a diterpenoid that is extracted from Aralia continentalis Kitagawa root, on inflammation.

MATERIALS, METHODS, AND RESULTS

Western blot and RT-PCR analyses show that KA induced the nuclear localization of Nrf2 as low as 1 nM in concentration and that KA treatment induced the expression of Nrf2 dependent genes such as GCLC and HO-1. On the other hand, KA did not affect the degradation of cytoplasmic IκB-α, the nuclear localization of RelA (p65), and NF-κB transcriptional activity in RAW264.7 cells treated with endotoxin. Consistent with these data, KA treatment failed to suppress gene expression of representative pro-inflammatory mediators including COX-2, nitric oxide, IL-1β, TNF-α, and IL-12, indicating that KA did not have an important impact on NF-κB activation.

CONCLUSION

Together, these results show that KA was an effective activator of Nrf2, and suggest that the beneficial effects of Aralia continentalis Kitagawa root extract are, at least in part, mediated by activating Nrf2.

Effects of atopy and rhinitis on exhaled nitric oxide values - a systematic review

Background

Atopy and rhinitis are among the factors affecting exhaled nitric oxide (FeNO) values and may contribute to difficulties in the clinical interpretation of FeNO measurements. However, data assessing their effects on FeNO values had never been summarized. This review aims to evaluate the effect of atopy and rhinitis in FeNO values in otherwise healthy individuals.

Methods

A systematic review was performed in Pubmed, Scopus and ISI Web of Knowledge. A two-step selection process was completed, and from 2357 references 19 were included. The inclusion criteria were: participants without known diseases other than rhinitis; atopy assessement by SPT or Specific IgE; and FeNO measurements according to ATS/ERS recommendations.

Results

The 8 articles measuring FeNO in children showed higher values in both allergic rhinitis and atopic children when compared with healthy children. The 11 articles performed in adults observed higher FeNO in AR patients comparatively with either healthy or atopic individuals. However, adult healthy and atopic individuals had similar FeNO values.

Conclusions

FeNO values are higher in individuals with rhinitis and/or atopy without other health problems. These effects are small, seem to be independent and should be further studied using multivariate models. The effect of atopy was observed only in children. The combined effect of atopy and rhinitis produced higher FeNO values in adults. These results support that both atopy and rhinitis should be considered when interpreting or when defining FeNO reference values.

Inhibitory effect of a glycoprotein isolated from golden oyster mushroom ( Pleurotus citrinopileatus ) on the lipopolysaccharide-induced inflammatory reaction in RAW 264.7 macrophage

Mushrooms have become an important source of natural antitumor, antiviral, antibacterial, immunomodulatory, and anti-inflammatory agents. Golden oyster mushroom, Pleurotus citrinopileatus , is a common mushroom in oriental countries for human consumption. The present study investigated the anti-inflammatory reaction of the bioactive nonlectin glycoprotein (PCP-3A) isolated from the fresh fruiting body of this mushroom. Western blot analysis on LPS-induced iNOS, COX-2, and NF-κB expressions in RAW 264.7 cells as affected by PCP3-A was performed to elucidate the mechanism of NO and PGE2 reduction. The results showed that PCP-3A failed to affect RAW 264.7 viability at a concentration up to 6.25 μg/mL, but inhibited LPS (1 μg/mL)-induced expression, and that PCP-3A inhibited the production of NO and PGE2 in LPS-activated macrophages via the down-regulation of certain pro-inflammatory mediators, including iNOS and NF-κB.

Immune markers in breast milk and fetal and maternal body fluids: a systematic review of perinatal concentrations

Breastfeeding represents the continued exposure of the infant to the maternal immune environment.Uterine, perinatal, and postnatal exposure to immune factors may contribute to an infant’s risk of developing immune-mediated disorders, including allergies. A PubMed search was conducted to review studies in humans and analyze concentrations of immune markers (TGF-beta, IFN-gamma, eotaxin, CCL5, CXCL10, TNF-alpha, MCP-1, IL-1beta, IL-4, IL-5, IL-6,IL-8, IL-10, IL-12, IL-13, sCD14, sIgA, IgG4, IgM) found in maternal serum, amniotic fluid, cord serum, colostrum, transition and mature milk. Concentrations of immune markers showed large variations across samples and studies. Reports documented conflicting results. Small sample sizes, differences in population characteristics, inconsistent sample collection times, and various sample collection and measurement methods may have led to wide variations in the concentrations of immune markers. Studies analyzing the associations between immune markers in maternal fluids and infant allergies remain inconclusive because of gaps in knowledge and a lack of standardized methods.

Subjects in a Population Study with High Levels of FENO Have Associated Eosinophil Airway Inflammation

Background. Measurement of fraction of exhaled nitric oxide (FENO) is a promising tool to increase validity in epidemiological studies of asthma. The association between airway inflammation and FENO has, however, only been examined in clinical settings and may be biased by selection of patients with asthma. Methods. In a population study with FENO registrations on 370 individuals, we identified nine subjects out of thirty subjects with high levels of FENO (>85th percentile, 30.3 ppb), irrespective of presence of respiratory symptoms, and 21 control subjects with FENO at median levels (11.1–16.4 ppb) willing to undergo bronchoscopy and bronchoalveolar lavage (BAL), all nonsmokers. FENO was measured in accordance with ATS criteria, and the examination also included spirometry, methacholine challenge test, and sampling of exhaled breath condensate (EBC). Results. Subjects with high FENO levels had significantly higher median the percentage of eosinophils in BAL than controls (2.1 versus 0.6, P < .006), and there was a significant association between FENO and the percentage of eosinophils in BAL (ρ=0.6, P < .002) and ECP in BAL (ρ=0.65, P < .05) examining the whole group, but no association with gender, FEV1, or degree of metacholine sensitivity or any of the biomarkers in EBC. All subjects with high FENO had respiratory symptoms, but only three had diagnosed asthma. There were a significant association between hydrogen peroxide in EBC and the percentage of neutrophils in bronchial wash. Conclusion. High FENO levels signal asthmatic or allergic respiratory disease in a population-based study. FENO levels are associated with degree of eosinophil airway inflammation as measured by the percentage of eosinophils and ECP in BAL.

Vitamin D serum levels and markers of asthma control in Italian children

OBJECTIVE

To establish the relationship between vitamin D serum levels, pulmonary function, and asthma control in children.

STUDY DESIGN

We studied the relationship between 25-hydroxy cholecalciferol [25(OH)D] concentrations and baseline spirometry and levels of asthma control, assessed according to Global Initiative for Asthma guidelines and the Childhood Asthma Control Test, in 75 children with asthma (age range 5-11 years; 43 males) in a cross-sectional study carried out during the winter and early spring.

RESULTS

Only 9.4% of our children had a sufficient serum 25(OH)D (at least 30 to 40 ng/mL). A significant positive correlation was found between forced vital capacity percent predicted and serum 25(OH)D (r = 0.25, P = .040). This was true also for forced expiratory volume in 1 second, even though it was not statistically significant (r = 0.16, P = .157). Subjects with well-controlled asthma had higher serum levels of 25(OH)D than children with partially controlled or non-controlled asthma, with values of (median [Q1; Q3]) 22.2 (16.3; 25.4), 17.8 (11.8; 22.1) and 18.1 (15.0; 18.5), respectively (P = .023). Furthermore, a positive correlation was found between 25(OH)D and the Childhood Asthma Control Test (r = 0.28; P = .011).

CONCLUSIONS

Our results indicate that hypovitaminosis D is frequent in children with asthma living in a Mediterranean country. In those children, lower levels of vitamin D are associated with reduced asthma control.

Decreased fraction of exhaled nitric oxide in obese subjects with asthma symptoms: data from the population study INTERGENE/ADONIX

BACKGROUND

Several studies have demonstrated an association between obesity and asthma. However, it is uncertain if fraction of exhaled nitric oxide (Feno), which is used as a marker of airway inflammation, and atopy are associated with BMI. The aim of this study was to examine if obese subjects with asthma symptoms have a different phenotype of asthma than nonobese subjects as indicated by Feno.

METHODS

The subjects (N = 2,187) consisted of women and men, aged 25 to 74, living in Gothenburg, Sweden, who participated in the randomly selected INTERGENE study cohort. Measurements included anthropometric measures, bioelectric impedance, Feno, pulmonary function, and blood samples for IgE; questionnaires included items on respiratory symptoms. Obesity was defined as BMI ≥ 30 kg/m(2). In this cross-sectional analysis, general linear models were used to analyze how Feno was associated with anthropometry, body composition, wheezing, and atopy.

RESULTS

In nonobese subjects, wheezing was associated with raised Feno and atopy, whereas in contrast, obese subjects who reported wheezing had lower Feno than obese subjects without wheezing (16.1 vs 19.1 parts per billion, P < .01). The prevalence of atopy was similar in both of those subgroups (25.0% vs 20.7%, P = .4). Similarly, in 395 subjects (19%) who reported wheezing, Feno was negatively associated with BMI, waist-to-hip ratio, and percentage of body fat, whereas no significant relationships were observed in those without respiratory symptoms.

CONCLUSIONS

Wheezing was significantly associated with reduced Feno in obese subjects, whereas there was a positive association between wheezing and Feno among the nonobese subjects, indicating a possible difference in asthma phenotype, based on body weight.

Evaluation of biomarkers in bronchoalveolar lavage fluid for discrimination between asthma and chronic bronchitis in cats

OBJECTIVE

To compare concentrations of interleukin (IL)-4, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha and total nitric oxide (NO) metabolites in bronchoalveolar lavage fluid (BALF) for discrimination between asthma and chronic bronchitis in cats.

ANIMALS

97 cats.

PROCEDURES

Cats screened with cytologic examination of BALF included 13 client-owned cats with naturally developing asthma, 8 client-owned cats with chronic bronchitis, 23 research cats with experimentally induced asthma, 33 research cats with experimentally induced nonseptic suppurative inflammation of the airways, and 20 healthy control cats. Banked unconcentrated BALF supernatant samples were assayed for concentrations of IL-4, IFN-gamma, TNF-alpha, and total NO metabolites.

RESULTS

Concentrations of IL-4 and IFN-gamma in BALF were less than the limits of detection for most cats, precluding statistical analysis. No significant differences were detected among groups for TNF-alpha concentrations. Concentrations of total NO metabolites were significantly higher in cats with clinical chronic bronchitis, compared with research cats with nonseptic suppurative inflammation or research cats with asthma.

CONCLUSIONS AND CLINICAL RELEVANCE

There were no significant differences in tested biomarkers between cats with asthma and healthy control cats. None of the measured cytokines or NO metabolites were useful for discriminating between cats with naturally developing asthma and those with chronic bronchitis.

Low levels of exhaled nitric oxide are associated with impaired lung function in cystic fibrosis

Fraction of exhaled nitric oxide (FENO) is often reduced in cystic fibrosis (CF). FENO at different expiratory flows can provide an indication of the site of nitric oxide production. The aim of this study was to examine whether NO parameters are related to overall (FEV(1)) or peripheral (lung clearance index, LCI, measured by multiple breath SF(6) washout) airway function and systemic inflammation in CF. Secondary aim was to compare alveolar NO and bronchial NO flux calculated by two different mathematical models, a linear and a nonlinear method. Thirty-five healthy and 45 CF children were recruited. FENO at 50 ml/sec (FENO(50)) and bronchial NO flux were lower in CF than controls, 9.5 (2.7-38.8) (median (range)) versus 12.4 (5.2-40.1) ppb, P = 0.029, and 391 (97-1772) versus 578 (123-1993) (pl/sec), P = 0.036, respectively. No difference in alveolar NO was shown. The nonlinear method resulted in lower alveolar NO and higher bronchial flux, than the linear method, but the result was closely correlated in both groups. LCI was higher in CF than controls, 8.4 (6.5-12.9) versus 5.9 (5.1-7.8), P < 0.001. FENO(50) was negatively correlated with LCI (r = -0.43; P = 0.003) and positively correlated with FEV(1) (r = 0.42, P = 0.004) in CF. Alveolar NO correlated negatively with inflammatory markers: orosomucoid (r = -0.42, P = 0.005), platelets (r = -0.50, P < 0.001) and white blood cell count (r = -0.48, P = 0.001). In conclusion, FENO(50) and bronchial NO flux are reduced in young CF subjects and low FENO(50) is associated with overall and small airway obstruction. NO parameters derived from the different models were closely related but the values differed slightly.

Two variants of occupational asthma separable by exhaled breath nitric oxide level

Exhaled nitric oxide (FE(NO)) has been used as a marker of asthmatic inflammation in non-occupational asthma, but some asthmatics have a normal FE(NO). In this study we investigated whether, normal FE(NO) variants have less reactivity in methacholine challenge and smaller peak expiratory flow (PEF) responses than high FE(NO) variants in a group of occupational asthmatics.

METHODS

We measured FE(NO) and PD(20) in methacholine challenge in 60 workers currently exposed to occupational agents, who were referred consecutively to a specialist occupational lung disease clinic and whose serial PEF records confirmed occupational asthma. Bronchial responsiveness (PD(20) in methacholine challenge) and the degree of PEF change to occupational exposures, (measured by calculating diurnal variation and the area between curves score of the serial PEF record in Oasys), were compared between those with normal and raised FE(NO). Potential confounding factors such as smoking, atopy and inhaled corticosteroid use were adjusted for.

RESULTS

There was a significant correlation between FE(NO) and bronchial hyper-responsiveness in methacholine challenge (p = 0.011), after controlling for confounders. Reactivity to methacholine was significantly lower in the normal FE(NO) group compared to the raised FE(NO) group (p = 0.035). The two FE(NO) variants did not differ significantly according to the causal agent, the magnitude of the response in PEF to the asthmagen at work, or diurnal variation.

CONCLUSIONS

Occupational asthma patients present as two different variants based on FE(NO). The group with normal FE(NO) have less reactivity in methacholine challenge, while the PEF changes in relation to work are similar.

Progesterone inhibits Toll-like receptor 4-mediated innate immune response in macrophages by suppressing NF-kappaB activation and enhancing SOCS1 expression

Although progesterone has been recognized as essential for the establishment and maintenance of pregnancy, this steroid hormone has been implicated to have a functional role in immune response, mainly at concentrations commensurate with pregnancy. However, the underlying mechanisms remain to be fully understood. Here we present the evidences that progesterone inhibited immune response to lipopolysaccharide (LPS) and CpG oligodeoxynucleotides (CpG ODNs) through modulating Toll-like receptor (TLR) signaling. Pretreatment with progesterone can significantly inhibit TLR4 and TLR9-triggered IL-6 and nitric oxide (NO) production in macrophages. Furthermore, we found that progesterone can significantly inhibit LPS-induced nitric oxide synthesis (iNOS), TLR4 expression and nuclear factor-kappaB (NF-kappaB) activation. Consistently, as a negative feedback inhibitor, the expression of suppressor of cytokine signaling (SOCS1) protein was up-regulated by progesterone in LPS-stimulated macrophages. These results support the concept that progesterone might inhibit innate immune response by suppressing NF-kappaB activation and enhancement of SOCS1 expression, providing a possible mechanistic explanation for the function of progesterone in regulating innate immune responses.

Clinical effects of purified air administered to the breathing zone in allergic asthma: A double-blind randomized cross-over trial

BACKGROUND

Exposure to inhaled allergens is a pathogenetic factor in allergic asthma. However, most studies that previously looked at air cleaning devices have shown little or no effect on patients with perennial allergic asthma.

AIMS AND OBJECTIVES

We examined a novel treatment using temperature regulated laminar airflow with a very low particle concentration directed to the breathing zone of teenagers and young adults with mild to moderate allergic asthma during night sleep. We hypothesised that the decreased allergen exposure during the night would have an effect on bronchial inflammation and quality of life.

METHOD

Twenty-two patients (mean 18.8 years) were randomized to start with active or placebo treatment for 10 weeks. All patients received both active and placebo treatment with unfiltered air, with a 2-week wash-out period in between treatments. Maintenance treatment with inhaled corticosteroids was unaltered during the trial period. Health related quality of life (miniAQLQ) was the primary effectiveness measure. Exhaled nitric oxide (FeNO) and spirometry were also investigated.

RESULTS

Active treatment resulted in an improved miniAQLQ compared to placebo (mean score 0.54, p<0.05, n=20). An effect on bronchial inflammation was also detected with significantly lower FeNO values during the active treatment period (mean -6.95 ppb, p<0.05, n=22). Both effects were evident after 5 weeks. The change in lung function was not statistically significant.

CONCLUSION

Clean air, administered directly to the breathing zone during sleep, can have a positive effect on bronchial inflammation and quality of life in patients with perennial allergic asthma.

Anti-inflammatory effects of ethyl acetate fraction from Melilotus suaveolens Ledeb on LPS-stimulated RAW 264.7 cells

AIM OF THE STUDY

This paper aimed to elucidate the anti-inflammatory effects of EtOAc fraction prepared from Melilotus suaveolens Ledeb ethanol extract with a cellular model of LPS-stimulated RAW 264.7 cell.

MATERIALS AND METHODS

Some key pro-inflammatory cytokines and mediators including IL-1 beta, IL-6, NO, iNOS, COX-2 and TNF-alpha, two important anti-inflammatory cytokines and mediators IL-10 and HO-1, I-kappaB and NF-kappaB were studied by sandwich ELISA, real-time PCR, western blot analysis and immunocytochemistry. At last a HPLC fingerprint was taken to evaluate the fraction.

RESULTS

The EtOAc fraction could significantly inhibit the production of IL-1 beta, IL-6, NO, TNF-alpha, COX-2 in LPS-stimulated cell than that of single LPS-stimulated cell (p<0.01 or p<0.05), and the extract could increase the production of IL-10 and HO-1 than that of single LPS intervention cell (p<0.01 or p<0.05). Meanwhile, the extract also could inhibit the production of NF-kappaB compared to single LPS-stimulated cell. All the results showed that the extract had a good anti-inflammatory effect on LPS-stimulated RAW264.7 cell.

CONCLUSIONS

Taken together, the anti-inflammatory actions of M. suaveolens Ledeb EtOAc fraction might be due to the down-regulation of IL-1 beta, IL-6, NO, TNF-alpha and COX-2 via the suppression of NF-kappaB activation, and another pathway was up regulating the production of IL-10 and HO-1. Meanwhile, the EtOAc fraction might be further studied to isolate the active anti-inflammatory ingredients besides coumarin.

Reduced allergic lung inflammation in rats following formaldehyde exposure: long-term effects on multiple effector systems

Clinical and experimental evidences show that formaldehyde (FA) exposure has an irritant effect on the upper airways. As being an indoor and outdoor pollutant, FA is known to be a causal factor of occupational asthma. This study aimed to investigate the repercussion of FA exposure on the course of a lung allergic process triggered by an antigen unrelated to FA. For this purpose, male Wistar rats were subjected to FA inhalation for 3 consecutive days (1%, 90-min daily), subsequently sensitized with ovalbumin (OVA)-alum via the intraperitoneal route, and 2 weeks later challenged with aerosolized OVA. The OVA challenge in rats after FA inhalation (FA/OVA group) evoked a low-intensity lung inflammation as indicated by the reduced enumerated number of inflammatory cells in bronchoalveolar lavage as compared to FA-untreated allergic rats (OVA/OVA group). Treatment with FA also reduced the number of bone marrow cells and blood leukocytes in sensitized animals challenged with OVA, which suggests that the effects of FA had not been only localized to the airways. As indicated by passive cutaneous anaphylactic reaction, FA treatment did not impair the anti-OVA IgE synthesis, but reduced the magnitude of OVA challenge-induced mast cell degranulation. Moreover, FA treatment was associated to a diminished lung expression of PECAM-1 (platelet-endothelial cell adhesion molecule 1) in lung endothelial cells after OVA challenge and an exacerbated release of nitrites by BAL-cultured cells. Keeping in mind that rats subjected solely to either FA or OVA challenge were able to significantly increase the cell influx into lung, our study shows that FA inhalation triggers long-lasting effects that affect multiple mediator systems associated to OVA-induced allergic lung such as the reduction of mast cells activation, PECAM-1 expression and exacerbation of NO generation, thereby contributing to the decrease of cell recruitment after the OVA challenge. In conclusion, repeated expositions to air-borne FA may impair the lung cell recruitment after an allergic stimulus, thereby leading to a non-responsive condition against inflammatory stimuli likely those where mast cells are involved.

Inhibition of MAP kinases and down regulation of TNF-alpha, IL-beta and COX-2 genes by the crude extracts from marine bacteria

Crude ethyl acetate extracts from marine bacterial isolates Staphylococcus arlettae KP2 (GenBank accession No. EU594442) and Planococcus maritimus KP8 (GenBank accession No. EU594443) isolated from Andaman seas were studied for their anti-inflammatory effect by lymphocyte proliferation assay (LPA) employing peripheral blood mononuclear cells (PBMCs). The crude extracts from both the bacteria down regulated the synthesis of inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and cyclooxygenase-2 (COX-2), besides markedly inhibiting p38 mitogen activated protein (MAP) kinase. These results suggest that the crude ethyl acetate extracts from both the isolates do contain compounds capable of inhibiting inflammation in mitogen induced PBMC and efforts to score potential bioactive molecules from these extracts may prove to be a promising preposition.

The influence of living near roadways on spirometry and exhaled nitric oxide in elementary schoolchildren

BACKGROUND

Living near major roadways has been associated with an increase in respiratory symptoms, but little is known about how this relates to airway inflammation.

OBJECTIVE

We assessed the effects of living near local residential roadways based on objective indicators of ventilatory function and airway inflammation.

METHODS

We estimated ambient air pollution, resolved to the level of the child's neighborhood, using a land-use regression model for children 9-11 years of age. We also summed the length of roadways found within a 200-m radius of each child's neighborhood. We had measurements of both air pollution exposure and spirometry for 2,328 children, and also had measurements of exhaled nitric oxide (eNO) for 1,613 of these children.

RESULTS

Each kilometer of local roadway within a 200-m radius of the home was associated with a 6.8% increase in eNO (p = 0.045). Each kilometer of any type of roadway (local, major, highway) was also associated with an increase in eNO of 10.1% (p = 0.002). Each microgram per cubic meter increase in PM2.5 was associated with a 3.9% increase in eNO (p = 0.058) and 0.70% decrease in forced vital capacity (FVC) expressed as a percentage of predicted (p = 0.39). Associations between roadway density and both forced expired volume in 1 sec and FVC were negative but not statistically significant at p < 0.05.

CONCLUSION

Traffic from local neighborhood roadways may cause airway inflammation as indicated by eNO. This may be a more sensitive indicator of adverse air pollution effects than traditional measures of ventilatory function.

Exhaled nitric oxide in the diagnosis and management of asthma

PURPOSE OF REVIEW

Gaseous nitric oxide is present in our exhaled breath and may be a biomarker for asthma. The purpose of the present paper is to review recent studies that have explored the potential of exhaled nitric oxide as a biomarker for asthma diagnosis and treatment.

RECENT FINDINGS

The upper limit of exhaled nitric oxide has been described in several populations, using a standard methodology. Measurements of exhaled nitric oxide have good specificity but relatively poor sensitivity for diagnosing asthma. The inter- and intra-subject variability of exhaled nitric oxide values in asthmatics remains uncertain. Clinical trials have used exhaled nitric oxide to guide steroid treatment in asthmatics with varied success. The greatest success is in studies where inhaled corticosteroids are reduced and/or withdrawn in stable asthmatics. These pioneering clinical trials have given insight into how exhaled nitric oxide might be a useful index of control of eosinophilic airway inflammation.

SUMMARY

Measurements of exhaled nitric oxide have the potential to be useful in the management of allergic asthma and the answers to a number of important questions are awaited.

Alveolar, but not bronchial nitric oxide production is elevated in cystic fibrosis

Exhaled nitric oxide (NO) remains a promising non-invasive marker for measuring inflammation in lung diseases. In cystic fibrosis (CF), exhaled NO measured at a single expiratory flow has been found to be normal or low. However, this measure cannot localize the anatomical site of NO production. The aims of this study were to apply a multiple-flow NO analysis to compare alveolar NO concentration and bronchial NO flux in CF children with healthy controls. Twenty-two children with CF and 17 healthy controls had exhaled NO measured at four different expiratory flows to calculate bronchial NO flux and alveolar NO concentration. Median (range) alveolar NO concentration was 2.2 (0.6-5.6) ppb for children with CF and 1.5 (0.4-2.6) ppb for healthy controls. Median (range) bronchial NO flux was 445 (64-1,256) pL/sec for children with CF and 509 (197-1,913) pL/sec for healthy controls. Children with CF had a significantly higher alveolar NO concentration, but no significant difference in bronchial NO flux compared to healthy children. In conclusion, children with CF have increased alveolar NO production, but not bronchial NO flux compared to healthy controls. The distal airway is a major site of inflammation in CF, and measuring alveolar NO may be a marker of distal inflammation in this disease.

A proof-of-concept study to assess the putative dose response to topical corticosteroid in persistent allergic rhinitis using adenosine monophosphate challenge

INTRODUCTION

The aim of this proof-of-concept study was to assess whether nasal adenosine monophosphate (AMP) challenge may be used to quantify dose response to topical fluticasone propionate (FP) in persistent allergic rhinitis (PER).

METHODS

Eligible subjects with PER entered a randomized double-blind crossover study of 2 weeks of intranasal FP at 100 microg or 400 microg daily, with a 2-week placebo washout period before each randomized treatment. Measurements after each washout or treatment comprised: peak nasal inspiratory flow (PNIF) response to nasal AMP (the primary outcome), domiciliary PNIF, the mini rhinoconjunctivitis quality of life questionnaire (miniRQLQ), symptom scores, nasal nitric oxide levels and overnight urinary cortisol:creatinine ratios.

RESULTS

Thirteen patients completed per protocol. Maximal PNIF response to AMP was attenuated 0.9% (95% confidence interval -7.1 to 9.0, P=NS) by FP 100 microg, and 12.9% (4.8-20.9, P=0.009) by FP 400 microg. The 400-100 microg difference was 12.0% U (2.6-21.3, P=0.049). None of the other outcomes were responsive enough to detect any significant treatment effects. The standardized response means to FP 400 microg were 81% for AMP challenge, 54% for domiciliary PNIF, 53% for miniRQLQ, 24% for symptom scores and 18% for nasal nitric oxide. No adrenal suppression was detected at either dose.

CONCLUSION

FP exhibited dose-related suppression of nasal airway hyperresponsiveness to AMP challenge, but without associated detectable adrenal suppression at the higher dose. Moreover, the AMP response demonstrated the highest signal to noise ratio compared with other outcome measures in PER.

Immunomodulatory effects of macrolide antibiotics in respiratory disease: therapeutic implications for asthma and cystic fibrosis

The macrolide antibiotics are a family of related 14- or 15-membered lactone ring antibiotics. There has been recent interest in the beneficial effects of these drugs as immune modulators in respiratory conditions in children. Cystic fibrosis (CF) and asthma, both of which occur in childhood, have an underlying inflammatory component and are associated with significant morbidity. The pathogenesis of both conditions is poorly understood but several molecular mechanisms have been suggested. In CF, these mechanisms broadly involve altered chloride transport and alteration of the airway surface liquid with disordered neutrophilic inflammation. There is much evidence for a proinflammatory propensity in CF immune effector and epithelial cells and many studies indicate that macrolides modulate these inflammatory processes. Recent studies have confirmed a clinical improvement in CF following treatment with macrolides, but the exact mechanisms by which they work are unknown. Asthma is likely to represent several different phenotypes but in all of these, airway obstruction, bronchial hyperresponsiveness, and inflammation are central processes. Results from trials using macrolides have suggested an improvement in clinical outcome. The putative mechanisms of macrolide immunomodulatory action include improvement of the primary defense mechanisms, inhibition of the bacteria-epithelial cell interaction, modulation of the signaling pathway and chemokine release, and direct neutrophil effects. Putative mechanisms of phenotypic modulation have also been proposed involving interactions with nitric oxide, endothelin-1, and bronchoconstriction, endothelial growth factors and airway remodeling, and bioactive phospholipids in both CF and asthma. Further characterization of these effects and development of targeted designer drugs will further expand our therapeutic repertoire and lead to improved quality and quantity of life for patients with CF and asthma.

Effects of levocetirizine as add-on therapy to fluticasone in seasonal allergic rhinitis

BACKGROUND

Addition of H(1) antagonists to intranasal corticosteroid treatment of allergic rhinitis (AR) is common in clinical practice and recommended by guidelines, despite some evidence that the additive benefits are negligible.

OBJECTIVE

To assess additional benefits of 5 mg levocetirizine dihydrochloride in seasonal AR patients using 200 mcg fluticasone propionate nasal spray once daily.

METHODS

In a double-blind placebo-controlled crossover study of 27 patients, following 2 weeks without treatment, subjects used fluticasone with levocetirizine or identical placebo for 2 weeks each. Assessments were the Juniper mini Rhinoconjunctivitis Quality-of-Life Questionnaire (mini-RQLQ), domiciliary peak nasal inspiratory flow (PNIF), total nasal symptoms (TNS) scores and nasal nitric oxide concentrations. Effects were interpreted and tested against minimal clinically important differences.

RESULTS

Add-on effects for levocetirizine vs. placebo excluded any clinically significant benefits: mean effects (one sided 95% confidence intervals) were mini-RQLQ -0.11 (-0.34), PNIF +0.57 (+5.23), and TNS -0.11 (-0.60). Numbers needed to treat (95% confidence intervals) by outcome were mini-RQLQ 14 (5 to 49), PNIF 4 (3-7), and TNS 3 (2-6). No significant within or between treatment effects were seen for nasal nitric oxide.

CONCLUSION

Contrary to current practice, the present results demonstrate that for the majority of patients, antihistamine add-on to effective nasal steroid treatment is inappropriate. Further work is required to confirm that this is also true in the most severe cases, and the available evidence needs to be put into guidelines and implemented.

The effect of allergic rhinitis on adenosine concentration in exhaled breath condensate

BACKGROUND

Patients with allergic rhinitis (AR) frequently develop asthma. This initiating inflammation in the lower airways may result in increased levels of inflammatory mediators such as adenosine in the exhaled breath.

OBJECTIVE

We compared adenosine levels in exhaled breath condensate (EBC) and both exhaled and nasal nitric oxide (NO) levels of AR patients and healthy control subjects. We also tested whether inhalation through inflamed nasal cavity during EBC sampling influences adenosine concentrations in exhaled air.

METHODS

Exhaled and nasal NO levels were measured and EBC samples (at oral inhalation) were collected from 27 patients and 15 healthy controls. EBC collection was repeated after 15 min with subjects inhaling through their nose. Adenosine was measured by HPLC and NO was determined by chemiluminescence.

RESULTS

The concentration of EBC adenosine was higher in patients with AR than in healthy controls (12.4+/-1.3 nM vs. 6.5+/-0.7 nM, P=0.0019) and this was accompanied by an increase in the concentration of exhaled NO (10.2+/-1.3 ppb vs. 5.3+/-0.5 ppb; P=0.0099, respectively). No difference in nasal NO was detected. EBC adenosine concentration showed a significant positive correlation with the level of exhaled NO. In contrast to healthy control subjects, patients with rhinitis had higher levels of exhaled adenosine when inhaling via the nose instead of the mouth (17.7+/-2.8 nM, P=0.007).

CONCLUSION

When compared with healthy subjects, patients with AR exhibit an increased concentration of exhaled adenosine and a related increase in exhaled NO concentration. EBC adenosine is further increased when rhinitis patients inhale through their nose than via their mouth. Our data suggest that non-asthmatic patients with rhinitis may have subclinical inflammation in their lower airways.

Exhaled nitric oxide as a screening tool for asthma in school children

It is now widely accepted that augmented levels of fractional exhaled nitric oxide (FeNO) reflect airway inflammation and the methodology has been optimised for potential clinical use. We were interested in investigating whether this measurement can be used as a tool to screen and identify school children with asthma. To do this, FeNO was measured using an on-line single exhalation analyser in 368 children aged 8-10 years in six Oxfordshire primary schools, by two investigators blinded to the disease status of the children. The children were then categorised into 'normal', 'atopic asthma', 'non-atopic asthma' and 'atopy only' groups, according to their responses to the ISAAC questionnaire and perusal of the children's medical records kept by their family practitioners. Increased levels of FeNO were found in 'atopic asthmatic', 'non-atopic asthmatics' and 'atopic only' groups (median values of 24.4, 7.8 and 15.3 ppb, respectively, compared to normal controls' of 6.9 ppb). Levels were increased in atopic children regardless of whether they had asthma and were significantly higher than non-atopic asthmatics. We conclude that FeNO measurement is not a useful tool for identifying children with asthma in the community, as increased levels did not discriminate between those with asthmatic and atopic symptoms.

Asthma therapy for children under 5 years of age

PURPOSE OF REVIEW

The evidence for effectiveness of currently used asthma medication for wheeze in young children is reviewed.

RECENT FINDINGS

The management of the infant and preschool child with wheezing is complicated by the uncertainty with respect to the aetiology. Difficulties in defining phenotypes and objective outcome parameters combined with the transient nature of symptoms which often resolve spontaneously have confounded many therapeutic studies. Recent studies on the effect of pharmacotherapy in wheezing infants have tried to define a more homogeneous phenotype as well as make a selection of patients that are likely to respond to the studied drug. In addition, these studies have used lung function parameters and nitric oxide as one of the outcome measurements. Studies on the nature of inflammation and the development of airway remodelling in infants and young children are done to further define phenotypes.

SUMMARY

Currently, there are no evidence-based guidelines and not even consensus statements on the right approach in pharmacological treatment of wheezing in infants and preschool children. The main issue still is the difficulty in coming to a correct diagnosis. Further studies are needed on the nature and the diagnostics of phenotypes and on the effect of early intervention.

Measurement of bronchial and alveolar nitric oxide production in normal children and children with asthma

RATIONALE

Airway inflammation is characteristic of asthma. Distal inflammation may be particularly important.

OBJECTIVE

To calculate alveolar nitric oxide (NO) concentration (C(alv)) and bronchial flux NO (J(NO)) in children.

METHODS

We measured C(alv) and J(NO) from the fractional exhaled NO (FeNO(50)) measured at multiple exhalation flow rates in 132 children (aged 4-18 yr) with known atopic status, medication, and asthma control.

MEASUREMENTS AND MAIN RESULTS

Of participants, 85% (112/132) completed all measurements. In 20 of 112, the result did not fit the linear model. Thus, J(NO) and C(alv) were assessed in 92 (70%) subjects. The median (range) values of asthmatic (n = 52), normal (n = 20), and nonasthmatic atopic (n = 20) children were as follows: FeNO(50): 28.1 (4.3-190), 10.35 (3.3-29), 21.8 (8.7-69) ppb, respectively; J(NO): 1,230 (204-9,236), 480 (196-1,913), 1,225 (486-4,119) pl/s, respectively; C(alv): 2.22 (0.44-6.63), 1.63 (0.44-3), 1.21 (0.03-2.85) ppb, respectively. A reproducibility study in 18 other children gave intraclass correlation coefficients (single measures) of 0.99 (J(NO)) and 0.81 (C(alv)). J(NO) and C(alv) were higher in children with asthma than normal children (p = 0.0004 and p = 0.0002, respectively). Children with poorly controlled asthma (n = 27) had higher FeNO(50) measurements than children with good symptom control (n = 25): C(alv): mean (+/- SD), 3.17 +/- 1.62 versus 2.26 +/- 1.30 ppb, p = 0.03; J(NO): mean (+/- SD), 2,634 +/- 2,255 versus 1,193 +/- 1,294 pl/s, p = 0.007, respectively.

CONCLUSIONS

Measurement of J(NO) and C(alv) is feasible in 70% of school-age children. FeNO(50) and J(NO) give the same information (r = 0.97, p < 0.0001), C(alv) is higher in asthmatic children than in normal children and is affected by asthma control, but not by atopy. C(alv) may possibly reflect alveolar inflammation in asthma.

In vitro anti-inflammatory and anti-oxidative effects of Cinnamomum camphora extracts

Cinnamomum camphora Sieb (Lauraceae) has long been prescribed in traditional medicine for the treatment of inflammation-related diseases such as rheumatism, sprains, bronchitis and muscle pains. In this study, therefore, we aimed to investigate the inhibitory effects of Cinnamomum camphora on various inflammatory phenomena to explore its potential anti-inflammatory mechanisms under non-cytotoxic (less than 100 microg/ml) conditions. The total crude extract (100 microg/ml) prepared with 80% methanol (MeOH extract) and its fractions (100 microg/ml) obtained by solvent partition with hexane and ethyl acetate (EtOAc) significantly blocked the production of interleukin (IL)-1 beta, IL-6 and the tumor necrosis factor (TNF)-alpha from RAW264.7 cells stimulated by lipopolysaccharide (LPS) up to 20-70%. The hexane and EtOAc extracts (100 microg/ml) also inhibited nitric oxide (NO) production in LPS/interferon (IFN)-gamma-activated macrophages by 65%. The MeOH extract (100 microg/ml) as well as two fractions (100 microg/ml) prepared by solvent partition with n-butanol (BuOH) and EtOAc strongly suppressed the prostaglandin E(2) (PGE(2)) production in LPS/IFN-gamma-activated macrophages up to 70%. It is interesting to note that hexane, BuOH and EtOAc extracts (100 microg/ml) also inhibited the functional activation of beta1-integrins (CD29) assessed by U937 homotypic aggregation up to 70-80%. Furthermore, EtOAc and BuOH extracts displayed strong anti-oxidative activity with IC(50) values of 14 and 15 microM, respectively, when tested by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and xanthine oxide (XO) assays. Taken together, these data suggest that the anti-inflammatory actions of Cinnamomum camphora may be due to the modulation of cytokine, NO and PGE(2) production and oxidative stress, and of the subfractions tested, the EtOAc extract may be further studied to isolate the active anti-inflammatory principles.

Exhaled nitric oxide: sources of error in offline measurement

Delayed offline measurement of exhaled nitric oxide (eNO), although useful in environmental and clinical research, is limited by the instability of stored breath samples. The authors characterized sources of instability with the goal of minimizing them. Breath and other air samples were stored under various conditions, and NO levels were measured repeatedly over 1-7 d. Concentration change rates varied positively with temperature and negatively with initial NO level, thus "stable" levels reflected a balance of NO-adding and NO-removing processes. Storage under refrigeration for a standardized period of time can optimize offline eNO measurement, although samples at room temperature are effectively stable for several hours.

Exhaled breath measures of inflammation: are they useful in neonatal chronic lung disease?

Neonatal chronic lung disease is a common problem for surviving infants of extreme prematurity. Although the precise pathophysiology is still not known, it is clear that inflammation provides a common link that amplifies the injury to the premature lung. Current invasive measures of pulmonary inflammation include markers in blood and airway effluent, with the cellular composition of tracheal fluid being the "gold standard". In this article available exhaled breath measures, particularly nitric oxide, carbon monoxide, volatile hydrocarbons, and exhaled breath condensate, are reviewed with particular reference to sample collection, analysis, and common pitfalls as they apply to the ventilated premature newborn at risk of chronic lung disease. Although they have great potential, all measures require thorough validation before being used clinically.

Tools to assess (and achieve?) long-term asthma control

Assessment tools are needed to monitor asthma control and to detect exacerbations before the alteration of functional parameters and the occurrence of symptoms. The ability to effectively monitor asthma control would enable clinicians to increase corticosteroid dose or to stop corticosteroid tapering before symptoms occur. As a few severe exacerbations are expected per year in treated patients, these tools must be suitable for long-term use. They must also be reproducible, acceptable to patients and be non-invasive. Tools currently available to assess asthma control include assessment of: clinical parameters (e.g. nocturnal awakenings; bronchodilator intake; symptom scores); lung function (e.g. peak expiratory flow and forced expiratory volume in 1 s); subjective parameters of asthma control (e.g. asthma control questionnaire (ACQ)); bronchial hyper-responsiveness; eosinophilia in induced sputum; and exhaled nitric oxide (NO) concentration. Clinical symptoms, lung function and the ACQ have proved to be inadequate markers of asthma control, as changes in these parameters occur at the same time as symptom manifestation. By contrast, sputum eosinophilia and exhaled NO concentrations are truly predictive of asthma exacerbations; monitoring these parameters are useful in preventing exacerbations from occurring in the first instance. They also assess, and help to achieve asthma control in the long term.

Decreased arginine bioavailability and increased serum arginase activity in asthma

Recent studies suggest that a nitric oxide (NO) deficiency and elevated arginase activity may play a role in the pathogenesis of asthma. Although much attention has been directed toward measurements of exhaled NO in asthma, no studies to date have evaluated levels of plasma arginase or arginine, the substrate for NO production, in patients with asthma. This study, therefore, measured amino acid levels, arginase activity, and nitric oxide metabolites in the blood of patients with asthma, as well as NO in exhaled breath. Although levels of virtually all amino acids were reduced, patients with asthma exhibited a striking reduction in plasma arginine levels compared with normal control subjects without asthma (45 +/- 22 vs. 94 +/- 29 microM, p < 0.0001), and serum arginase activity was elevated (1.6 +/- 0.8 vs. 0.5 +/- 0.3 micromol/ml/hour, asthma vs. control, p < 0.0001). High arginase activity in patients with asthma may contribute to low circulating arginine levels, thereby limiting arginine bioavailability and creating a NO deficiency that induces hyperreactive airways. Addressing the alterations in arginine metabolism may result in new strategies for treatment of asthma.

In vitro anti-inflammatory and pro-aggregative effects of a lipid compound, petrocortyne A, from marine sponges

(3 S,14 S)-Petrocortyne A, a lipid compound (a C(46) polyacetylenic alcohol), from marine sponges ( Petrosia sp.) is potently cytotoxic against several solid tumour cells. In this study, we investigated in vitro anti-inflammatory and pro-aggregative effects of petrocortyne A at non-cytotoxic concentrations on various cellular inflammatory phenomena using the macrophage and monocytic cell lines RAW264.7 and U937. Petrocortyne A blocked tumour necrosis factor-alpha (TNF-alpha) production strongly and concentration-dependently in lipopolysaccharide (LPS)-activated RAW264.7 cells and phorbol 12-myristate 13-acetate (PMA)/LPS-treated U937 cells. It also blocked NO production concentration-dependently in LPS- or interferon (IFN)-gamma-treated RAW264.7 cells. Among the migration factors tested, the compound selectively blocked the expression of hepatocyte growth factor/scatter factor (HGF/SF). On the other hand, as assessed by a cell-cell adhesion assay, petrocortyne A did not block the activation of adhesion molecules induced by aggregative antibodies to adhesion molecules, but suppressed PMA-induced cell-cell adhesion significantly. Intriguingly, petrocortyne A induced U937 homotypic aggregation following long exposure (2 and 3 days), accompanied by weak induction of pro-aggregative signals such as tyrosine phosphorylation of p132 and phosphorylation of extracellular signal-related kinase 1 and 2 (ERK 1/2). Petrocortyne A may thus inhibit cellular inflammatory processes and immune cell migration to inflamed tissue.