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Cui N, Zhu X, Zhao C, Meng C, Sha J, Zhu D. A Decade of Pathogenesis Advances in Non-Type 2 Inflammatory Endotypes in Chronic Rhinosinusitis: 2012-2022. Int Arch Allergy Immunol 2023; 184:1237-1253. [PMID: 37722364 DOI: 10.1159/000532067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/12/2023] [Indexed: 09/20/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by localized inflammation of the upper airways. CRS includes two main phenotypes, namely, CRS with nasal polyps and CRS without nasal polyps. The phenotype-based classification method cannot reflect the pathological mechanism. The endotype-based classification method has been paid more and more attention by researchers. It is mainly divided into type 2 and non-type 2 endotypes. The mechanism driving the pathogenesis of non-type 2 inflammation is currently unknown. In this review, the PubMed and Web of Science databases were searched to conduct a critical analysis of representative literature works on the pathogenesis of non-type 2 inflammation in CRS published in the past decade. This review summarizes the latest evidence that may lead to the pathogenesis of non-type 2 inflammation. It is the main method that analyzing the pathogenesis from the perspective of immunology. Genomics and proteomics technique provide new approaches to the study of the pathogenesis. Due to differences in race, environment, geography, and living habits, there are differences in the occurrence of non-type 2 inflammation, which increase the difficulty of understanding the pathogenesis of non-type 2 inflammation in CRS. Studies have confirmed that non-type 2 endotype is more common in Asian patients. The emergence of overlap and unclassified endotypes has promoted the study of heterogeneity in CRS. In addition, as the source of inflammatory cells and the initiation site of the inflammatory response, microvessels and microlymphatic vessels in the nasal mucosal subepithelial tissue participate in the inflammatory response and tissue remodeling. It is uncertain whether CRS patients affect the risk of infection with SARS-CoV-2. In addition, the pathophysiological mechanism of non-type 2 CRS combined with COVID-19 remains to be further studied, and it is worth considering how to select the befitting biologics for CRS patients with non-type 2 inflammation.
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Affiliation(s)
- Na Cui
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China,
| | - Xuewei Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Chen Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Cuida Meng
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jichao Sha
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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2
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Bachert C, Luong AU, Gevaert P, Mullol J, Smith SG, Silver J, Sousa AR, Howarth PH, Benson VS, Mayer B, Chan RH, Busse WW. The Unified Airway Hypothesis: Evidence From Specific Intervention With Anti-IL-5 Biologic Therapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2630-2641. [PMID: 37207831 DOI: 10.1016/j.jaip.2023.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023]
Abstract
The unified airway hypothesis proposes that upper and lower airway diseases reflect a single pathological process manifesting in different locations within the airway. Functional, epidemiological, and pathological evidence has supported this well-established hypothesis for some time. However, literature on the pathobiologic roles/therapeutic targeting of eosinophils and IL-5 in upper and lower airway diseases (including asthma, chronic rhinosinusitis with nasal polyps [CRSwNP], and nonsteroidal anti-inflammatory drug-exacerbated respiratory disease) has recently emerged. This narrative review revisits the unified airway hypothesis by searching the scientific literature for recent learnings and clinical trial/real-world data that provide a novel perspective on its relevance for clinicians. According to the available literature, eosinophils and IL-5 have important pathophysiological roles in both the upper and lower airways, although the impact of eosinophils and IL-5 may vary in asthma and CRSwNP. Some differential effects of anti-IL-5 and anti-IL-5-receptor therapies in CRSwNP have been observed, requiring further investigation. However, pharmaceutical targeting of eosinophils and IL-5 in patients with upper, lower, and comorbid upper and lower airway inflammation has led to clinical benefit, supporting the hypothesis that these are linked conditions manifesting in different locations. Consideration of this approach may improve patient care and aid clinical decision making.
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Affiliation(s)
- Claus Bachert
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Muenster, Muenster, Germany; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China; Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium.
| | - Amber U Luong
- McGovern Medical School of the University of Texas Health Science Center, Houston, Texas
| | - Philippe Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - Joaquim Mullol
- Department of Otorhinolaryngology, Hospital Clínic, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | | | - Jared Silver
- US Medical Affairs - Respiratory, GSK, Durham, NC
| | - Ana R Sousa
- Clinical Sciences - Respiratory, GSK, Brentford, United Kingdom
| | - Peter H Howarth
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, United Kingdom; Global Respiratory Franchise, GSK, Brentford, United Kingdom
| | - Victoria S Benson
- Epidemiology, Value Evidence and Outcomes, GSK, Brentford, United Kingdom
| | | | - Robert H Chan
- Clinical Sciences - Respiratory, GSK, Brentford, United Kingdom
| | - William W Busse
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin, Madison, Wis
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3
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Goulioumis AK, Kourelis K, Gkorpa M, Danielides V. Pathogenesis of Nasal Polyposis: Current Trends. Indian J Otolaryngol Head Neck Surg 2023; 75:733-741. [PMID: 37206761 PMCID: PMC10188681 DOI: 10.1007/s12070-022-03247-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 10/13/2022] [Indexed: 12/07/2022] Open
Abstract
Chronic Rhinosinusitis (CRS) is characterized by edema of the sub-epithelial layers, but, only specific types of CRS are developing polyps. Nasal polyposis may develop under different pathogenetic mechanisms rendering the typical macroscopic classification of CRS, with or without nasal polyps, rather deficient. Currently, we approach nasal polyposis, in terms of diagnosis and treatment, according to its endotype, which means that we focus on the specific cells and cytokines that are participating in its pathogenesis. It appears that the molecular procedures that contribute to polyp formation, initiating with a Th-2 response of the adaptive immune system, are local phenomena occurring in the sub-epithelial layers of the mucosa. Several hypotheses are trying to approach the etiology that drives the immune response towards Th-2 type. Extrinsic factors, like fungi, Staphylococcus superantigens, biofilms, and altered microbiome can contribute to a modified and intense local reaction of the immune system. Some hypotheses based on intrinsic factors like the elimination of Treg lymphocytes, low local vitamin-D levels, high levels of leukotrienes, epithelial to mesenchymal transition (EMT) induced by hypoxia, and altered levels of NO, add pieces to the puzzle of the pathogenesis of nasal polyposis. Currently, the most complete theory is that of epithelial immune barrier dysfunction. Intrinsic and extrinsic conditions can damage the epithelial barrier rendering sub-epithelial layers more vulnerable to invasion by pathogens that trigger a Th-2 response of the adaptive immune system. Th2 cytokines, subsequently, induce the accumulation of eosinophils and IgE together with the remodeling of the stroma in the sub-epithelial layers leading, eventually, to the formation of nasal polyps.
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Affiliation(s)
- Anastasios K. Goulioumis
- Department of Otorhinolaryngology, “Karamandanion” Pediatric Hospital of Patras, Erythrou Stavrou 40, 26331 Patras, Greece
- Anatomy Department, School of Medicine of the University of Patras, Patras, Greece
| | - Konstantinos Kourelis
- Department of Otorhinolaryngology, “Karamandanion” Pediatric Hospital of Patras, Erythrou Stavrou 40, 26331 Patras, Greece
| | | | - Vasilios Danielides
- Department of Otorhinolaryngology, University Hospital of Patras, Patras, Greece
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MacKenzie C, Goerke T, Buecking M, Heidemann M, Leichtle A, Ringbeck B, Möllenkolk F, Ploch M, Bruchhage KL, Pries R. Determination of orally administered 1,8-Cineol in nasal polyp tissues from chronic rhinosinusitis patients using gas chromatography: mass spectrometry. Sci Rep 2023; 13:3605. [PMID: 36869061 PMCID: PMC9984394 DOI: 10.1038/s41598-023-29941-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disease causing considerable disease burden. The anti-inflammatory monoterpene 1,8-Cineol is a natural plant-based therapeutic agent that is well established to treat chronic and acute airway diseases. Aim of this study was to investigate whether the herbal drug 1,8-Cineol reaches the nasal tissue via the gut and the blood stream upon its oral administration. A highly sensitive gas chromatography mass spectrometry-based method with stir bar sorptive extraction (SBSE) for sample preparation has been developed and validated for the extraction, detection and quantification of 1,8-Cineol in tissue samples of nasal polyps from 30 CRSwNP patients. Data revealed a highly sensitive detection of 1,8-Cineol in nasal tissue samples after 14 days of oral administration of 1,8-Cineol prior to surgical treatment. There was no significant correlation between the measured 1,8-Cineol concentrations and bodyweight or BMI values of the analyzed patients, respectively. Our data indicate a systemic distribution of 1,8-Cineol in the human body after its oral administration. Individual differences in terms of metabolic characteristics and have to be further investigated. The study increases our understanding of the systemic effects of 1,8-Cineol upon its therapeutic application and benefit in patients with CRSwNP.
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Affiliation(s)
- Claire MacKenzie
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Schmallenberg, Germany
| | | | - Mark Buecking
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Schmallenberg, Germany
| | - Mathias Heidemann
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Anke Leichtle
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Benedikt Ringbeck
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Schmallenberg, Germany
| | - Friederike Möllenkolk
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | | | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
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MicroRNA-21-5p promotes mucosal type 2 inflammation via regulating GLP1R/IL-33 signaling in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol 2022; 150:1460-1475. [PMID: 35835254 DOI: 10.1016/j.jaci.2022.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND It has been known that chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation-dominated disease; however, the reasons causing such type of mucosal inflammation in CRSwNP are not well elucidated. OBJECTIVE We sought to investigate the role of microRNA-21-5p (miR-21-5p) in regulating mucosal type 2 inflammation in CRSwNP. METHODS miR-21-5p expression was detected in nasal mucosa of patients with CRSwNP. Correlations between miR-21-5p and indicators of type 2 inflammation were further analyzed. miR-21 knockout mice were used to explore the role of miR-21-5p in a murine model of eosinophilic (E) CRSwNP. Target gene of miR-21-5p related to type 2 inflammation in CRSwNP was identified. RESULTS The upregulated miR-21-5p in the nasal mucosa of patients with CRSwNP, compared with control subjects, was expressed higher in patients with ECRSwNP than in patients with nonECRSwNP. miR-21-5p expression was positively correlated with mucosal eosinophil infiltrations and the expression of type 2 inflammatory cytokines. In the CRSwNP mice, miR-21 knockout significantly attenuated type 2 inflammation, as indicated by eosinophil infiltrations and expression of cytokines/chemokines in nasal mucosa and lavage fluid; moreover, genes associated with type 2 inflammation were extensively downregulated at the transcriptome level in miR-21 knockout mice. Glucagon-like peptide-1 receptor, which was negatively correlated with miR-21-5p expression in human nasal mucosa, was identified as the target of miR-21-5p. Overexpression of miR-21-5p induced IL-33 expression, whereas glucagon-like peptide-1 receptor agonist decreased IL-33 production in airway epithelial cells. CONCLUSIONS miR-21-5p aggravates type 2 inflammation in the nasal mucosa of patients with CRSwNP via targeting glucagon-like peptide-1 receptor/IL-33 signaling, which may be a potential therapeutic target for CRSwNP.
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Gevaert P, Han JK, Smith SG, Sousa AR, Howarth PH, Yancey SW, Chan R, Bachert C. The roles of eosinophils and interleukin-5 in the pathophysiology of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2022; 12:1413-1423. [PMID: 35243803 PMCID: PMC9790271 DOI: 10.1002/alr.22994] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/10/2022] [Accepted: 03/01/2022] [Indexed: 12/30/2022]
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is generally associated with eosinophilic tissue infiltration linked to type 2 inflammation and characterized by elevated levels of interleukin (IL)-5 and other type 2 inflammatory mediators. Although distinct and overlapping contributions of eosinophils and IL-5 to CRSwNP pathology are still being explored, they are both known to play an important role in NP inflammation. Eosinophils secrete numerous type 2 inflammatory mediators including granule proteins, enzymes, cytokines, chemokines, growth factors, lipids, and oxidative products. IL-5 is critical for the differentiation, migration, activation, and survival of eosinophils but is also implicated in the biological functions of mast cells, basophils, innate lymphoid cells, B cells, and epithelial cells. Results from clinical trials of therapeutics that target type 2 inflammatory mediators (including but not limited to anti-IL-5, anti-immunoglobulin-E, and anti-IL-4/13) may provide further evidence of how eosinophils and IL-5 contribute to CRSwNP. Finally, the association between eosinophilia/elevated IL-5 and greater rates of NP recurrence after endoscopic sinus surgery (ESS) suggests that these mediators may have utility as biomarkers of NP recurrence in diagnosing and assessing the severity of CRSwNP. This review provides an overview of eosinophil and IL-5 biology and explores the literature regarding the role of these mediators in CRSwNP pathogenesis and NP recurrence following ESS. Based on current published evidence, we suggest that although eosinophils play a key role in CRSwNP pathophysiology, IL-5, a cytokine that activates these cells, also represents a pertinent and effective treatment target in patients with CRSwNP.
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Affiliation(s)
- Philippe Gevaert
- Upper Airway Research LaboratoryDepartment of OtorhinolaryngologyGhent University HospitalGhentBelgium
| | | | - Steven G. Smith
- Respiratory Medical Franchise, GSKResearch Triangle ParkNorth CarolinaUSA
| | - Ana R. Sousa
- Clinical Sciences, Respiratory, GSKBrentfordMiddlesexUK
| | - Peter H. Howarth
- Clinical and Experimental SciencesFaculty of Medicine, University of Southampton and NIHR Respiratory Biomedical Research UnitSouthampton General HospitalSouthamptonUK,Global Respiratory Franchise, GSKBrentfordMiddlesexUK
| | - Steven W. Yancey
- Respiratory Medical Franchise, GSKResearch Triangle ParkNorth CarolinaUSA
| | - Robert Chan
- Clinical Sciences, Respiratory, GSKBrentfordMiddlesexUK
| | - Claus Bachert
- Upper Airway Research LaboratoryDepartment of OtorhinolaryngologyGhent University HospitalGhentBelgium,Division of ENT DiseasesCLINTECKarolinska InstituteStockholmSweden
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Trained immunity in type 2 immune responses. Mucosal Immunol 2022; 15:1158-1169. [PMID: 36065058 PMCID: PMC9705254 DOI: 10.1038/s41385-022-00557-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/27/2022] [Accepted: 08/08/2022] [Indexed: 02/04/2023]
Abstract
Immunological memory of innate immune cells, also termed "trained immunity", allows for cross-protection against distinct pathogens, but may also drive chronic inflammation. Recent studies have shown that memory responses associated with type 2 immunity do not solely rely on adaptive immune cells, such as T- and B cells, but also involve the innate immune system and epithelial cells. Memory responses have been described for monocytes, macrophages and airway epithelial cells of asthmatic patients as well as for macrophages and group 2 innate lymphoid cells (ILC2) from allergen-sensitized or helminth-infected mice. The metabolic and epigenetic mechanisms that mediate allergen- or helminth-induced reprogramming of innate immune cells are only beginning to be uncovered. Trained immunity has been implicated in helminth-driven immune regulation and allergen-specific immunotherapy, suggesting its exploitation in future therapies. Here, we discuss recent advances and key remaining questions regarding the mechanisms and functions of trained type 2 immunity in infection and inflammation.
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Polasky C, Loyal K, Idel C, Wetterauer D, Heidemann M, Bruchhage K, Pries R. Alteration of blood monocyte subsets in chronic rhinosinusitis with regard to anti-inflammatory 1,8-Cineol treatment. RHINOLOGY ONLINE 2021. [DOI: 10.4193/rhinol/21.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Chronic rhinosinusitis (CRS) affects about 10% of the european population causing considerable disease burden. The inflammatory microenvironment is mainly Th2 driven, but the impact of monocytes is still poorly understood. Aim of this study was to comprehensively investigate the composition of circulating monocytes and T cells in CRSwNP and CRSsNP patients, particularly with regard to the therapeutic herbal monoterpene 1,8-Cineol. Methodology: We analyzed the distribution of CD14 and CD16 classified monocyte subsets and the T-cell subset composition with respect to their PD-1 and PD-L1 expression in the peripheral blood of CRS patients using flow cytometry. Additionally, the M1/M2 like macrophage infiltration in nasal tissue and polyps was examined by immunofluorescence staining. Results: Data revealed a decrease of classical monocytes accompanied by a significant increase of intermediate CD16+ monocytes in CRSwNP and CRSsNP patients compared to healthy donors. PD-L1 expression on overall monocytes was also significantly increased in CRSwNP and CRSsNP patients. CRS patients with a severe drop of the proportion of classical monocytes showed a significant restoration of this subset in response to two-week 1,8-Cineol treatment. Conclusions: Our data indicate a CRS-induced shift of peripheral monocyte subsets to more inflammatory phenotypes that might be reversed by the herbal drug 1,8-Cineol.
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9
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Ahmad-Mansour N, Loubet P, Pouget C, Dunyach-Remy C, Sotto A, Lavigne JP, Molle V. Staphylococcus aureus Toxins: An Update on Their Pathogenic Properties and Potential Treatments. Toxins (Basel) 2021; 13:677. [PMID: 34678970 PMCID: PMC8540901 DOI: 10.3390/toxins13100677] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 01/12/2023] Open
Abstract
Staphylococcus aureus is a clinically important pathogen that causes a wide range of human infections, from minor skin infections to severe tissue infection and sepsis. S. aureus has a high level of antibiotic resistance and is a common cause of infections in hospitals and the community. The rising prevalence of community-acquired methicillin-resistant S. aureus (CA-MRSA), combined with the important severity of S. aureus infections in general, has resulted in the frequent use of anti-staphylococcal antibiotics, leading to increasing resistance rates. Antibiotic-resistant S. aureus continues to be a major health concern, necessitating the development of novel therapeutic strategies. S. aureus uses a wide range of virulence factors, such as toxins, to develop an infection in the host. Recently, anti-virulence treatments that directly or indirectly neutralize S. aureus toxins have showed promise. In this review, we provide an update on toxin pathogenic characteristics, as well as anti-toxin therapeutical strategies.
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Affiliation(s)
- Nour Ahmad-Mansour
- Laboratory of Pathogen Host Interactions, CNRS UMR5235, Université de Montpellier, 34000 Montpellier, France;
| | - Paul Loubet
- Virulence Bactérienne et Infections Chroniques, INSERM U1047, Department of Infectious and Tropical Diseases, Université de Montpellier, 30908 Nîmes, France; (P.L.); (A.S.)
| | - Cassandra Pouget
- Virulence Bactérienne et Infections Chroniques, INSERM U1047, Université de Montpellier, 30908 Nîmes, France;
| | - Catherine Dunyach-Remy
- Virulence Bactérienne et Infections Chroniques, INSERM U1047, Department of Microbiology and Hospital Hygiene, Université de Montpellier, 30908 Nîmes, France; (C.D.-R.); (J.-P.L.)
| | - Albert Sotto
- Virulence Bactérienne et Infections Chroniques, INSERM U1047, Department of Infectious and Tropical Diseases, Université de Montpellier, 30908 Nîmes, France; (P.L.); (A.S.)
| | - Jean-Philippe Lavigne
- Virulence Bactérienne et Infections Chroniques, INSERM U1047, Department of Microbiology and Hospital Hygiene, Université de Montpellier, 30908 Nîmes, France; (C.D.-R.); (J.-P.L.)
| | - Virginie Molle
- Laboratory of Pathogen Host Interactions, CNRS UMR5235, Université de Montpellier, 34000 Montpellier, France;
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Jordan PM, Gerstmeier J, Pace S, Bilancia R, Rao Z, Börner F, Miek L, Gutiérrez-Gutiérrez Ó, Arakandy V, Rossi A, Ialenti A, González-Estévez C, Löffler B, Tuchscherr L, Serhan CN, Werz O. Staphylococcus aureus-Derived α-Hemolysin Evokes Generation of Specialized Pro-resolving Mediators Promoting Inflammation Resolution. Cell Rep 2021; 33:108247. [PMID: 33053344 PMCID: PMC7729929 DOI: 10.1016/j.celrep.2020.108247] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/02/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
Underlying mechanisms of how infectious inflammation is resolved by the host are incompletely understood. One hallmark of inflammation resolution is the activation of specialized pro-resolving mediators (SPMs) that enhance bacterial clearance and promote tissue repair. Here, we reveal α-hemolysin (Hla) from Staphylococcus aureus as a potent elicitor of SPM biosynthesis in human M2-like macrophages and in the mouse peritoneum through selective activation of host 15-lipoxygenase-1 (15-LOX-1). S. aureus-induced SPM formation in M2 is abolished upon Hla depletion or 15-LOX-1 knockdown. Isolated Hla elicits SPM formation in M2 that is reverted by inhibition of the Hla receptor ADAM10. Lipid mediators derived from Hla-treated M2 accelerate planarian tissue regeneration. Hla but not zymosan provokes substantial SPM formation in the mouse peritoneum, devoid of leukocyte infiltration and pro-inflammatory cytokine secretion. Besides harming the host, Hla may also exert beneficial functions by stimulating SPM production to promote the resolution of infectious inflammation. Jordan et al. reveal that α-hemolysin from Staphylococcus aureus stimulates specialized pro-resolving mediator (SPM) formation through activation of 15-lipoxygenase-1 in human macrophages involving ADAM10. The host may exploit α-hemolysin as an SPM inducer to better cope with S. aureus infections and to promote inflammation resolution and tissue regeneration.
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Affiliation(s)
- Paul M Jordan
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Jana Gerstmeier
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany.
| | - Simona Pace
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Rossella Bilancia
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Via Domenico Montesano 49, 80131 Naples, Italy
| | - Zhigang Rao
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Friedemann Börner
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Laura Miek
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | | | - Vandana Arakandy
- Institute of Medical Microbiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Antonietta Rossi
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Via Domenico Montesano 49, 80131 Naples, Italy
| | - Armando Ialenti
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Via Domenico Montesano 49, 80131 Naples, Italy
| | | | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Lorena Tuchscherr
- Institute of Medical Microbiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Oliver Werz
- Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany.
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11
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Bochner BS, Stevens WW. Biology and Function of Eosinophils in Chronic Rhinosinusitis With or Without Nasal Polyps. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:8-22. [PMID: 33191674 PMCID: PMC7680832 DOI: 10.4168/aair.2021.13.1.8] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/23/2020] [Indexed: 12/24/2022]
Abstract
Chronic rhinosinusitis (CRS) with or without nasal polyposis is a complex medical condition characterized by varying patterns of chronic innate and adaptive mucosal inflammation. Treatment of CRS has been traditionally limited to corticosteroids and sinus surgery; however, novel biologics have more recently been evaluated as steroid- and surgery-sparing options. While it is clear that there are different subtypes or endotypes of CRS, perhaps the most frequent presentation involves the features of type 2 inflammation, including a prominent tissue eosinophilia component. The purpose of this review is to provide an update on eosinophil biology as well as on the potential contribution of eosinophils and their mediators to the pathophysiology of CRS, drawing mechanistic conclusions mainly from studies of human sinus mucosal tissues, nasal secretions, and benefits (or lack thereof) from the use of various pharmacotherapies. The unavoidable conclusion derived from this approach is that eosinophils themselves cannot fully explain the underlying pathophysiology of this complex disorder.
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Affiliation(s)
- Bruce S Bochner
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Whitney W Stevens
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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12
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Pezato R, Gregório LL, Pérez-Novo C, Bezerra TFP, Kosugi EM. Montelukast Has no Impact on the Systemic Production of TGFβ-1 in Patients with Nasal Polyposis Associated with Aspirin Intolerance. Int Arch Otorhinolaryngol 2021; 25:e88-e91. [PMID: 33542757 PMCID: PMC7851368 DOI: 10.1055/s-0040-1702972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/26/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Nasal polyposis is a disease characterized by a mechanical dysfunction of the nasal mucosa, closely related to the unique makeup of its extracellular matrix, which develops as the result of an anomalous tissue remodeling process. Transforming growth factor beta 1 (TGF-β1) is reduced not only in the nasal polypoid tissue, but also in the plasma of aspirin-intolerant patients. These patients exhibit an imbalance in the production of eicosanoids characterized by an increase in leukotrienes. Thus, it is important that the relationship between the production of leukotrienes and TGF-β1 be assessed. Objective To evaluate the effects of the cysteinyl leukotriene (CysLT) receptor antagonist montelukast on the systemic production of TGF-β1 in patients with nasal polyposis, with or without concomitant aspirin intolerance. Methods The sample comprised 48 individuals with diagnosis of nasal polyposis and 15 healthy controls for comparison of the baseline TGF-β1 levels in the peripheral blood and after treatment with CysLT receptor antagonist montelukast in the nasal-polyposis group. Results There was no difference in the change in TGF-β1 levels after the treatment with montelukast in the subgroup of patients with polyposis and asthma ( p = 0.82) and in the subgroup with polyposis, asthma, and aspirin intolerance ( p = 0.51). Conclusion we found no impact of the therapy with a leukotriene receptor blocker on the production of TGF-β1, making the antileukotriene therapy a highly questionable choice for the treatment of nasal polyposis, particularly from the standpoint of seeking to modify the remodeling process in this disease.
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Affiliation(s)
- Rogério Pezato
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luciano Lobato Gregório
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Claudina Pérez-Novo
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Eduardo Macoto Kosugi
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
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13
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Linking Complement C3 and B Cells in Nasal Polyposis. J Immunol Res 2020; 2020:4832189. [PMID: 32724828 PMCID: PMC7366218 DOI: 10.1155/2020/4832189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022] Open
Abstract
Nasal polyposis often is characterized by a persistent inflammation of the sinonasal mucosa, disease recurrence after medical or surgical intervention, and asthma comorbidity. Dysregulated complement activation may contribute to immunologic alterations and disease. To date, there is only scattered knowledge on the source and regulation of the central complement factors in the pathogenesis of nasal polyps. Here, we aim to study complement signatures, especially the C3-C3aR axis, and focus on cellular sources and targets in nasal polyps. Expression of complement factors, including C3, C5, and the anaphylatoxin receptors, was analyzed in nasal polyp tissue samples, the corresponding inferior turbinates, and healthy controls using transcriptomic methods and protein measurements. Distinct patterns of complement expression were found in nasal polyps compared to controls, characterized by an increased C3 activation and an increase in C3aR-bearing cells. In contrast, no difference was shown for epithelial-dependent C3 production. Besides low intracellular C3-expression levels for lymphocytes in general, we could identify an enlarged B lymphocyte population in nasal polyps displaying high amounts of intracellular C3. Our data suggest a prominent role for the C3-C3aR-axis in nasal polyps and, for the first time, describe a B cell population containing high levels of intracellular C3, suggesting a new role of B cells in the maintenance of the inflammation by complement.
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Wang M, Bu X, Luan G, Lin L, Wang Y, Jin J, Zhang L, Wang C. Distinct type 2-high inflammation associated molecular signatures of chronic rhinosinusitis with nasal polyps with comorbid asthma. Clin Transl Allergy 2020; 10:26. [PMID: 32637070 PMCID: PMC7333405 DOI: 10.1186/s13601-020-00332-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and comorbid asthma have more severe disease and are difficult to treat. However, the molecular endotypes associated with CRSwNP with comorbid asthma (CRSwNP + AS) are not clear. This study aimed to investigate the characteristics of type 2 inflammation and the molecular signatures associated with CRSwNP + AS. Methods A total of 195 subjects; including 65 CRSwNP + AS patients, 99 CRSwNP-alone patients, and 31 healthy control subjects; were enrolled in the study. Nasal tissues from patients with CRSwNP + AS, CRSwNP-alone and control subjects were assessed for infiltration of inflammatory cells and concentrations of total IgE. Whole-transcriptome sequencing was performed and differentially expressed (DE) mRNAs and long non-coding RNAs (lncRNAs) and their associated pathways were analyzed. The correlations between type 2 cytokines and local eosinophils, tissue IgE, and transcriptome signatures were evaluated. Results Significantly higher local eosinophil infiltration and higher levels of total IgE were found in nasal tissues from CRSwNP + AS patients than in nasal tissues from CRSwNP-alone patients. Furthermore, atopy and recurrence were significantly more frequent in patients with CRSwNP + AS than in patients with CRSwNP-alone (62.5% vs 28.6% and 66.7% vs 26.9%, respectively). RNA sequencing analysis identified 1988 common DE-mRNAs, and 176 common DE-lncRNAs shared by CRSwNP + AS versus control and CRSwNP-alone versus control. Weighted gene coexpression network analysis (WGCNA) identified LINC01146 as hub lncRNA dysregulated in both subtypes of CRSwNP. Overall, 968 DE-mRNAs and 312 DE-lncRNAs were identified between CRSwNP + AS and CRSwNP-alone. Both pathway enrichment analysis and WGCNA indicated that the phenotypic traits of CRSwNP + AS were mainly associated with higher activities of arachidonic acid metabolism, type 2 cytokines related pathway and fibrinolysis pathway, and lower activity of IL-17 signalling pathway. Furthermore, the expression of type 2 cytokines; IL5 and IL13, was positively correlated with local eosinophil infiltration, tissue IgE level, and the expression of DE-mRNAs that related to arachidonic acid metabolism. Moreover, WGCNA identified HK3-006 as hub lncRNA in yellow module that most positively correlated with phenotypic traits of CRSwNP + AS. Conclusions Patients with CRSwNP + AS have distinct type 2-high inflammation-associated molecular signatures in nasal tissues compared to patients with CRSwNP-alone.
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Affiliation(s)
- Ming Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China
| | - Xiangting Bu
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China
| | - Ge Luan
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China
| | - Liqing Lin
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China
| | - Yang Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China
| | - Jianmin Jin
- Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005 China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730 China
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730 China
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Braga AA, Valera FCP, Faria FM, Rossato M, Murashima AAB, Fantucci MZ, Aragon DC, Queiroz DLC, Anselmo-Lima WT, Tamashiro E. An Experimental Model of Eosinophilic Chronic Rhinosinusitis Induced by Bacterial Toxins in Rabbits. Am J Rhinol Allergy 2019; 33:737-750. [DOI: 10.1177/1945892419865642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The pathophysiology of chronic rhinosinusitis (CRS) is still not well known due to the multifactorial etiologies involved. Bacteria play a role in the pathogenesis of CRS by various means, including biofilm adhesion, intracellular persistence, or inducing inflammation secondary to toxins. Endotoxins and exotoxins, especially Staphylococcus aureus superantigens, can produce significant immune responses in the host and are implicated in patients with CRS. The majority of animal models described for CRS revalidates the pathophysiology of acute sinusitis, ostium occlusion, or foreign body associated infection. Objectives To evaluate an experimental model of eosinophilic CRS using prolonged exposure to bacterial toxins. The histological changes in rabbits exposed to S. aureus enterotoxin B (SEB), lipopolysaccharide (LPS), or lipoteichoic acid (LTA) were compared. Methods After induction with ovalbumin (OVA) sensitization with subcutaneous injection for 2 weeks, rabbits underwent surgery to insert an indwelling catheter into the maxillary sinus. The sinus was irrigated with OVA 3 times weekly for 2 weeks, followed by sinus irrigation with bacterial toxin (SEB: 1 µg/mL, LPS: 100 ng/mL, or LTA: 100 ng/mL) 3 times weekly for 4 weeks. The histological changes in the treated sinus were compared with control rabbits. Results Sinuses exposed to bacterial toxins (SEB, LPS, and LTA) produced significant mucosal thickening with infiltration of inflammatory cells, notably eosinophils. SEB was the only toxin that promoted a mixed pattern of inflammation, including eosinophilic and neutrophilic infiltration. Conclusion Our experimental model of eosinophilic CRS in rabbits produced significant mucosal thickening and inflammation in the sinuses exposed to bacterial toxins, with histological changes analogous to what is observed in patients with CRS with nasal polyps. This model may serve as a basis for future investigation of the pathogenesis of eosinophilic CRS in relation to bacterial toxins or as a model for testing new therapeutic modalities for this disease.
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Affiliation(s)
- Andréa A. Braga
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana C. P. Valera
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Francesca M. Faria
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Rossato
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Adriana A. B. Murashima
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marina Z. Fantucci
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Davi C. Aragon
- Departament of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Danielle L. C. Queiroz
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Wilma T. Anselmo-Lima
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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do Amaral JB, Bloise AC, França CN, Perez-Novo C, Machado-Santelli GM, Alencar AM, Pezato R. Alterations in cellular force parameters and cell projections in Nasal polyps-derived fibroblasts. Auris Nasus Larynx 2019; 47:98-104. [PMID: 31272842 DOI: 10.1016/j.anl.2019.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/07/2019] [Accepted: 06/20/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is a disease that features a mechanical dysfunction involving chronic inflammation and altered tissue remodeling. In this study, we aim to evaluate the fibroblast morphology and its cellular traction force in primary fibroblasts cell cultures obtained from both healthy individuals (n=7) and patients with CRSwNP (n=8). METHODS Using a Traction-force Microscopy we analyzed parameters of Force/Tension in fibroblasts cultures in both experimental groups. RESULTS The analysis of the Projected Area of Cell revealed that fibroblasts derived from nasal mucosa of healthy individuals have an area on average 39.24% larger than the fibroblasts obtained from the nasal polyp tissue. We also observed that the parameters directly related to the force of the cell, Max Cumulative Force and Net Contractile Moment, presented a high Force/Tension per unit of area in the fibroblasts derived from the healthy nasal mucosa (on average 41% and 52.54% higher than the fibroblasts of the nasal polyp respectively). CONCLUSION Our results demonstrate a cellular mechanism that may be associated with the mechanical dysfunction found in the Nasal Polyp tissue. The weak traction force of nasal polyp-derived fibroblast may, in lower dimensions, impact on the remodeling of nasal mucosa in CRSwNP.
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Affiliation(s)
- Jônatas Bussador do Amaral
- ENT Research Lab., Department of Otorhinolaryngology - Head and Neck Surgery, Federal University of Sao Paulo, Rua Coronel Lisboa, 958, Vila Clementino, São Paulo, SP, 04020-041, Brazil.
| | - Antonio Carlos Bloise
- Institute of Physics, University of Sao Paulo, Rua do Matão, Travessa R Número 187, Cidade Universitária, São Paulo, SP 05508-090, Brazil
| | - Carolina Nunes França
- Universidade Santo Amaro, Pós Graduação em Ciências da Saúde, Rua Enéas de Siqueira Neto, 340 Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
| | - Claudina Perez-Novo
- Laboratory of Proteinchemistry, Proteomics and Epigenetic Signalling Department of Biomedical Sciences, Campus Drie Eiken, building T, first floor Universiteitsplein 1 2610 Wilrijk University of Antwerp, Belgium
| | - Gláucia Maria Machado-Santelli
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Prof Lineu Prestes, 1524, dade Universitária, Sao Paulo, SP 05508-900, Brazil
| | - Adriano Mesquita Alencar
- Institute of Physics, University of Sao Paulo, Rua do Matão, Travessa R Número 187, Cidade Universitária, São Paulo, SP 05508-090, Brazil
| | - Rogério Pezato
- ENT Research Lab., Department of Otorhinolaryngology - Head and Neck Surgery, Federal University of Sao Paulo, Rua Coronel Lisboa, 958, Vila Clementino, São Paulo, SP, 04020-041, Brazil
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Pezato R, Voegels RL, Pignatari S, Gregório LC, Pinto Bezerra TF, Gregorio L, Balsalobre L, Tepedino MS, Coronel N, Pinna FDR, Mendes Neto J, Oliveira P, Macoto E, Stefanini R, Figueiredo C, Haddad F, Pilan R, Bezerra Soter A, Melo NA, Candido DA, Amaral JD, Santos RDP, Van Zele T, Fujita R, Dreyfuss JL, Chamon W, Alencar AM, Perez-Novo C, Stamm AC. Nasal Polyposis: More than a Chronic Inflammatory Disorder-A Disease of Mechanical Dysfunction-The São Paulo Position. Int Arch Otorhinolaryngol 2019; 23:241-249. [PMID: 30956711 PMCID: PMC6449132 DOI: 10.1055/s-0038-1676659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/21/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP.
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Affiliation(s)
- Rogerio Pezato
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Shirley Pignatari
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Luiz Carlos Gregório
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Luciano Gregorio
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Leonardo Balsalobre
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Nathália Coronel
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - José Mendes Neto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Pedro Oliveira
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Eduardo Macoto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renato Stefanini
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Claudia Figueiredo
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Fernanda Haddad
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renata Pilan
- Department of Otolaryngology, USP, São Paulo, SP, Brazil
| | | | | | | | - Jonatas do Amaral
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Thibaut Van Zele
- Ear, Nose and Throat Department,, University of Ghent, Ghent, Belgium
| | - Reginaldo Fujita
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Wallace Chamon
- Department of Ophthalmology and Visual Sciences, Unifesp, São Paulo, SP, Brazil
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Adriano Mesquita Alencar
- Laboratory of Microrheology and Molecular Physiology, Institute of Physics, USP, São Paulo, SP, Brazil
| | - Claudina Perez-Novo
- Proteinscience, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Aldo Cassol Stamm
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
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18
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Silva CAM, Belisle JT. Host Lipid Mediators in Leprosy: The Hypothesized Contributions to Pathogenesis. Front Immunol 2018; 9:134. [PMID: 29472920 PMCID: PMC5810268 DOI: 10.3389/fimmu.2018.00134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/16/2018] [Indexed: 12/12/2022] Open
Abstract
The spectrum of clinical forms observed in leprosy and its pathogenesis are dictated by the host's immune response against Mycobacterium leprae, the etiological agent of leprosy. Previous results, based on metabolomics studies, demonstrated a strong relationship between clinical manifestations of leprosy and alterations in the metabolism of ω3 and ω6 polyunsaturated fatty acids (PUFAs), and the diverse set of lipid mediators derived from PUFAs. PUFA-derived lipid mediators provide multiple functions during acute inflammation, and some lipid mediators are able to induce both pro- and anti-inflammatory responses as determined by the cell surface receptors being expressed, as well as the cell type expressing the receptors. However, little is known about how these compounds influence cellular immune activities during chronic granulomatous infectious diseases, such as leprosy. Current evidence suggests that specialized pro-resolving lipid mediators (SPMs) are involved in the down-modulation of the innate and adaptive immune response against M. leprae and that alteration in the homeostasis of pro-inflammatory lipid mediators versus SPMs is associated with dramatic shifts in the pathogenesis of leprosy. In this review, we discuss the possible consequences and present new hypotheses for the involvement of ω3 and ω6 PUFA metabolism in the pathogenesis of leprosy. A specific emphasis is placed on developing models of lipid mediator interactions with the innate and adaptive immune responses and the influence of these interactions on the outcome of leprosy.
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Affiliation(s)
- Carlos A. M. Silva
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, United States
| | - John T. Belisle
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, United States
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Hu DL, Ono HK, Isayama S, Okada R, Okamura M, Lei LC, Liu ZS, Zhang XC, Liu MY, Cui JC, Nakane A. Biological characteristics of staphylococcal enterotoxin Q and its potential risk for food poisoning. J Appl Microbiol 2017; 122:1672-1679. [PMID: 28375567 DOI: 10.1111/jam.13462] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/08/2017] [Accepted: 03/24/2017] [Indexed: 11/30/2022]
Abstract
AIMS To elucidate the biological characteristics and stability of a newly identified staphylococcal enterotoxin Q (SEQ) against heating and digestive enzymes and to evaluate the risk of seq-harbouring Staphylococcus aureus in food poisoning. METHODS AND RESULTS Purified SEQ was treated with heating, pepsin and trypsin which are related to food cooking, stomach and intestine conditions, respectively. Superantigenic activity of SEQ was assessed by determining the ability of IL-2 induction in mouse spleen cells. The emetic activity of SEQ was assessed using house musk shrew, a small emetic animal model. The results revealed that SEQ exhibits a remarkable resistance to heat treatment and pepsin digestion and has significant superantigenic and emetic activities. Furthermore, a sandwich ELISA for detection of SEQ production was developed, and the results showed that seq-harboring S. aureus isolates produce a large amount of SEQ. CONCLUSIONS The newly identified SEQ had remarkable stability to heat treatment and digestive enzyme degradation and exhibited significant superantigenic and emetic activities. In addition, seq-harbouring S. aureus isolated from food poisoning outbreaks produced a large amount of SEQ, suggesting that seq-harbouring S. aureus could potentially be a hazard for food safety. SIGNIFICANCE AND IMPACT OF THE STUDY This study found, for the first time, that SEQ, a nonclassical SE, had remarkable stability to heat treatment and enzyme degradation and exhibited significant emetic activity, indicating that SEQ is a high-risk toxin in food poisoning.
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Affiliation(s)
- D-L Hu
- College of Veterinary Medicine, Jilin University, Changchun, Jiling, China.,Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan.,Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - H K Ono
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan.,Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - S Isayama
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | - R Okada
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | - M Okamura
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | - L C Lei
- College of Veterinary Medicine, Jilin University, Changchun, Jiling, China
| | - Z S Liu
- College of Veterinary Medicine, Jilin University, Changchun, Jiling, China
| | - X-C Zhang
- College of Veterinary Medicine, Jilin University, Changchun, Jiling, China
| | - M Y Liu
- College of Veterinary Medicine, Jilin University, Changchun, Jiling, China
| | - J C Cui
- College of Life Science, Dalian Minzu University, Dalian, Liaoning, China
| | - A Nakane
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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20
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Role of local allergic inflammation and Staphylococcus aureus enterotoxins in Chinese patients with chronic rhinosinusitis with nasal polyps. The Journal of Laryngology & Otology 2017; 131:707-713. [DOI: 10.1017/s0022215117001335] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractObjective:To investigate the role of local allergic inflammation and Staphylococcus aureus enterotoxins in chronic rhinosinusitis with nasal polyps.Methods:This study included 36 patients with chronic rhinosinusitis with nasal polyps and 18 controls. Total immunoglobulin E, eosinophil cationic protein, staphylococcal enterotoxin types A and B specific immunoglobulin E, staphylococcal enterotoxin types A and B, and myeloperoxidase levels were determined.Results:Four patients with chronic rhinosinusitis with nasal polyps had a local allergy. All chronic rhinosinusitis with nasal polyps patients tested negative for staphylococcal enterotoxin types A and B specific immunoglobulin E. The chronic rhinosinusitis with nasal polyps group had significantly elevated staphylococcal enterotoxin types A and B levels in the supernatant. Fourteen patients belonged to the eosinophilic chronic rhinosinusitis with nasal polyps group and the others were characterised as having non-eosinophilic chronic rhinosinusitis with nasal polyps.Conclusion:Local allergy may play a role in chronic rhinosinusitis with nasal polyps, independent of staphylococcal enterotoxin superantigens. Staphylococcal enterotoxins may be important in the pathogenesis of chronic rhinosinusitis with nasal polyps; however, their roles as superantigens were not confirmed in this study. In Chinese subjects, chronic rhinosinusitis with nasal polyps usually manifests as a neutrophilic inflammation.
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Abstract
Bacterial pathogens and microbiome alterations can contribute to the initiation and propagation of mucosal inflammation in chronic rhinosinusitis (CRS). In this article, the authors review the clinical and research implications of key pathogens, discuss the role of the microbiome, and connect bacteria to mechanisms of mucosal immunity relevant in CRS.
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Affiliation(s)
- Thad W Vickery
- University of Colorado School of Medicine, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Vijay R Ramakrishnan
- Department of Otolaryngology, Head and Neck Surgery, University of Colorado, 12631 East 17th Avenue, B205, Aurora, CO 80045, USA.
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22
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Hull BP, Chandra RK. Refractory Chronic Rhinosinusitis with Nasal Polyposis. Otolaryngol Clin North Am 2017; 50:61-81. [PMID: 27888916 DOI: 10.1016/j.otc.2016.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic rhinosinusitis with nasal polyposis (CRSwNP) represents a subset of chronic sinusitis with various causes. Some forms of the disease are driven by allergy, often in association with asthma. Refractory CRSwNP can be associated with cystic fibrosis and other clinical syndromes. More recent literature is presented regarding roles of innate immunity and superantigens. Effective treatment of CRSwNP requires careful endoscopic sinus surgery followed by an individualized treatment plan that often includes oral and topical steroids. Recidivism of polyps is common, and patients require long-term follow-up.
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Affiliation(s)
- Benjamin P Hull
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University, 1215 21st Ave S, 7209 MCE-S, Nashville, TN 37232-8605, USA
| | - Rakesh K Chandra
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University, 1215 21st Ave S, 7209 MCE-S, Nashville, TN 37232-8605, USA.
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de Oliveira PWB, Pezato R, Agudelo JSH, Perez-Novo CA, Berghe WV, Câmara NO, de Almeida DC, Gregorio LC. Nasal Polyp-Derived Mesenchymal Stromal Cells Exhibit Lack of Immune-Associated Molecules and High Levels of Stem/Progenitor Cells Markers. Front Immunol 2017; 8:39. [PMID: 28194153 PMCID: PMC5276864 DOI: 10.3389/fimmu.2017.00039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022] Open
Abstract
Mesenchymal stromal cells (MSCs) are considered adult progenitor stem cells and have been studied in a multitude of tissues. In this context, the microenvironment of nasal polyp tissue has several inflammatory cells, but their stroma compartment remains little elucidated. Hence, we isolated MSCs from nasal polyps Polyp-MSCs (PO-MSCs) and compared their molecular features and gene expression pattern with bone marrow-derived MSCs (BM-MSCs). Initially, both PO-MSCs and BM-MSCs were isolated, cultivated, and submitted to morphologic, differentiation, phenotypic, immunosuppressive, and gene expression assays. Compared to BM-MSCs, PO-MSCs showed normal morphology and similar osteogenic/adipogenic differentiation potential, but their immunophenotyping showed lack of immune-associated molecules (e.g., CD117, HLA-DR, PDL-1, and PDL-2), which was linked with less immunoregulatory abilities such as (i) inhibition of lymphocytes proliferation and (ii) regulatory T cell expansion. Furthermore, we detected in the PO-MSCs a distinct gene expression profile in comparison with BM-MSCs. PO-MSC expressed higher levels of progenitor stem cells specific markers (e.g., CD133 and ABCB1), while BM-MSCs showed elevated expression of cytokines and growth factors (e.g., FGF10, KDR, and GDF6). The gene ontology analysis showed that the differentially modulated genes in PO-MSC were related with matrix remodeling process and hexose and glucose transport. For BM-MSCs, the highly expressed genes were associated with behavior, angiogenesis, blood vessel morphogenesis, cell–cell signaling, and regulation of response to external stimulus. Thus, these results suggest that PO-MSCs, while sharing similar aspects with BM-MSCs, express a different profile of molecules, which presumably can be implicated in the development of nasal polyp tissue.
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Affiliation(s)
- Pedro Wey Barbosa de Oliveira
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Rogério Pezato
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Juan Sebastian Henao Agudelo
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Claudina Angela Perez-Novo
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Wim Vanden Berghe
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Niels Olsen Câmara
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil; Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Danilo Candido de Almeida
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Luís Carlos Gregorio
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
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Staphylococcus aureus enterotoxin sensitization involvement and its association with the CysLTR1 variant in different asthma phenotypes. Ann Allergy Asthma Immunol 2016; 118:197-203. [PMID: 28034578 DOI: 10.1016/j.anai.2016.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/10/2016] [Accepted: 11/16/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sensitization to Staphylococcus aureus enterotoxin (SE) is a known risk factor for asthma susceptibility and severity. However, how SE sensitization is involved in asthma, particularly nonatopic asthma and/or late-onset asthma, remains uncertain. OBJECTIVE To clarify the involvement of SE sensitization in nonatopic and/or late-onset asthma and its association with a polymorphism of the cysteinyl leukotriene receptor 1 gene (CysLTR1), which was examined because CysLT signaling is closely associated with late-onset eosinophilic asthma. METHODS We assessed associations between sensitization to SE (A and/or B) and clinical indexes in 224 patients with asthma (mean age, 62.3 years; 171 women) from a cohort of the Kinki Hokuriku Airway Disease Conference, particularly those with nonatopic asthma (not sensitized to common aeroallergens) and/or late-onset asthma. Associations between SE sensitization and CysLTR1 polymorphism (rs2806489), a potential regulatory variant for atopic predisposition in women, were also assessed in a sex-stratified manner. RESULTS A total of 105 patients (47%) with asthma were sensitized to SE. Among patients with nonatopic asthma (n = 67) or with late-onset asthma (n = 124), those sensitized to SE had significantly higher serum total IgE and periostin levels than those not sensitized. In nonatopic patients, a rapid decrease in forced expiratory volume in 1 second was associated with SE sensitization. In women with asthma, rs2806489 was associated with sensitization to SEB and age at asthma onset. CONCLUSION SE sensitization contributes to TH2 inflammation in nonatopic and/or late-onset asthma. In women with asthma, the CysLTR1 variant might be associated with sensitization to SEB and age at asthma onset.
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DNA methylation, bacteria and airway inflammation: latest insights. Curr Opin Allergy Clin Immunol 2015; 15:27-32. [PMID: 25479316 DOI: 10.1097/aci.0000000000000130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW DNA methylation is an epigenetic mechanism that has been implicated in the pathogenesis of chronic inflammatory diseases by regulating differentiation, proliferation, apoptosis, and activation of immune cells. Changes in the methylation status of relevant genes have been linked to the origin, perpetuation, and severity of airway diseases. The DNA methylation profile can be also modified by the action of viral and bacterial colonization. Bacteria and specially Staphylococcus aureus toxins are recognized inflammatory amplifying factors in both lower and upper airway chronic diseases. This review summarizes the existent knowledge about the role of DNA methylation changes in chronic airway diseases and the contribution of bacterial infection on this event. RECENT FINDINGS It has been demonstrated that changes in DNA methylation, either intrinsic or induced by allergen or infection, may be linked to the pathogenesis of asthma and allergy. These changes in methylation may suppress the production of anti-inflammatory mediators and increase the survival and activation of pro-inflammatory cells, as well as modify the immune response in response to bacterial infection, increasing their survival and pathogenicity within the infected organism. SUMMARY Understanding the intrinsic epigenetic mechanisms, as well as the effect of environment -for example, bacterial infection in the pathogenesis of airways diseases - will greatly improve the management and the diagnosis of these diseases.
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Anselmo-Lima WT, Sakano E, Tamashiro E, Nunes AAA, Fernandes AM, Pereira EA, Ortiz É, Pinna FDR, Romano FR, Padua FGDM, Mello Junior JF, Teles Junior J, Dolci JEL, Balsalobre Filho LL, Kosugi EM, Sampaio MH, Nakanishi M, Santos MCJD, Andrade NAD, Mion ODG, Piltcher OB, Fujita RR, Roithmann R, Voegels RL, Guimarães RES, Meirelles RC, Paula Santos R, Nakajima V, Valera FCP, Pignatari SSN. Rhinosinusitis: evidence and experience: October 18 and 19, 2013 - São Paulo. Braz J Otorhinolaryngol 2015; 81:S1-S49. [PMID: 25697512 PMCID: PMC10157818 DOI: 10.1016/j.bjorl.2015.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Wilma T Anselmo-Lima
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Eulália Sakano
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Edwin Tamashiro
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | | | - Érica Ortiz
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fábio de Rezende Pinna
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Fabrizio Ricci Romano
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | - João Teles Junior
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | | | | | - Olavo de Godoy Mion
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | - Renato Roithmann
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Richard Louis Voegels
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Roberto Campos Meirelles
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Victor Nakajima
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil
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Ban GY, Kim MY, Yoo HS, Nahm DH, Ye YM, Shin YS, Park HS. Clinical features of elderly chronic urticaria. Korean J Intern Med 2014; 29:800-6. [PMID: 25378979 PMCID: PMC4219970 DOI: 10.3904/kjim.2014.29.6.800] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 06/26/2014] [Accepted: 07/28/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/AIMS Chronic urticaria (CU) is defined as itchy wheals lasting 6 weeks or more. As the aged population increases worldwide, it is essential to identify the specific features of this disease in the elderly population. METHODS We investigated the prevalence and clinical features of CU in elderly patients. Medical records of 837 CU patients from the outpatient Allergy Clinic of Ajou University Hospital, Korea were analyzed retrospectively. Patients with chronic spontaneous urticaria according to the EAACI/GA2LEN/EDF/WAO guidelines were included. Patients older than 60 years were defined as elderly. RESULTS Of the 837 patients, 37 (4.5%) were elderly. In elderly versus nonelderly CU patients, the prevalence of atopic dermatitis (AD) was significantly higher (37.8% vs. 21.7%, respectively; p = 0.022), while that of aspirin intolerance was lower (18.9% vs. 43.6%, respectively; p = 0.003) in terms of comorbid conditions. The prevalences of serum specific immunoglobulin E antibodies to staphylococcal enterotoxin A and staphylococcal enterotoxin B were considerably higher in elderly CU patients with AD than in those without AD (37.5% vs. 0%, respectively). CONCLUSIONS Elderly patients with CU had a higher prevalence of AD. Therefore, there is a need to recognize the existence of AD in elderly CU patients.
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Affiliation(s)
- Ga-Young Ban
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Mi-Yea Kim
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hye-Soo Yoo
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Ho Nahm
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Yoo-Seob Shin
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
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Yang Y, Zhang N, Lan F, Van Crombruggen K, Fang L, Hu G, Hong S, Bachert C. Transforming growth factor-beta 1 pathways in inflammatory airway diseases. Allergy 2014; 69:699-707. [PMID: 24750111 DOI: 10.1111/all.12403] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 12/11/2022]
Abstract
Transforming growth factor-beta 1 (TGF-β1) has been reported being involved in the remodeling and immunosuppression processes of inflammatory airway diseases; understanding the regulation of TGF-β1 is therefore a key to unravel the pathomechanisms of these diseases. This review briefly summarizes the current knowledge on the influencing factors for driving TGF-β1 and its regulatory pathways in inflammatory airway diseases and discusses possible therapeutic approaches to TGF-β1 control. The factors include smoking and oxidative stress, prostaglandins (PGs), leukotrienes (LTs), bradykinin (BK), and microRNAs (miRs). Based on the summary, new innovative treatment strategies may be developed for inflammatory airway diseases with an impaired expression of TGF-β1.
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Affiliation(s)
- Y. Yang
- Department of Oto-Rhino-Laryngology; The First Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - N. Zhang
- Upper Airway Research Laboratory; Department of Oto-Rhino-Laryngology; Ghent University; Ghent Belgium
- Division of Nose, Throat and Ear Diseases; Clintec; Karolinska Institute; Stockholm Sweden
| | - F. Lan
- Upper Airway Research Laboratory; Department of Oto-Rhino-Laryngology; Ghent University; Ghent Belgium
- Division of Nose, Throat and Ear Diseases; Clintec; Karolinska Institute; Stockholm Sweden
| | - K. Van Crombruggen
- Upper Airway Research Laboratory; Department of Oto-Rhino-Laryngology; Ghent University; Ghent Belgium
- Division of Nose, Throat and Ear Diseases; Clintec; Karolinska Institute; Stockholm Sweden
| | - L. Fang
- Department of Oto-Rhino-Laryngology; The First Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - G. Hu
- Department of Oto-Rhino-Laryngology; The First Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - S. Hong
- Department of Oto-Rhino-Laryngology; The First Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - C. Bachert
- Upper Airway Research Laboratory; Department of Oto-Rhino-Laryngology; Ghent University; Ghent Belgium
- Division of Nose, Throat and Ear Diseases; Clintec; Karolinska Institute; Stockholm Sweden
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Świerczyńska-Krępa M, Sanak M, Bochenek G, Stręk P, Ćmiel A, Gielicz A, Plutecka H, Szczeklik A, Niżankowska-Mogilnicka E. Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: a double-blind study. J Allergy Clin Immunol 2014; 134:883-90. [PMID: 24767875 DOI: 10.1016/j.jaci.2014.02.041] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 02/23/2014] [Accepted: 02/28/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Numerous open trials have demonstrated the beneficial clinical effects of aspirin desensitization (AD) in patients with aspirin-induced asthma (AIA). These beneficial effects might be attributable to aspirin's potent anti-inflammatory properties, but that supposition requires further corroboration. OBJECTIVE We sought to compare the clinical and biochemical responses to chronic oral AD in 20 patients with AIA and 14 patients with aspirin-tolerant asthma (ATA). All of the patients had chronic rhinosinusitis and nasal polyposis, and these responses were investigated in a pilot, double-blind, placebo-controlled study. METHODS Twelve patients with AIA and 6 patients with ATA were randomly assigned to receive 624 mg of aspirin, and 8 patients with AIA and 8 patients with ATA received placebo. Both aspirin and placebo were administered once daily for 6 months. Nasal symptoms, Sino-Nasal Outcome Test (SNOT20) scores, peak nasal inspiratory flows, Asthma Control Questionnaire scores, spirometric parameters, peak expiratory flows, blood eosinophilia, and corticosteroid doses were assessed on a monthly basis. Levels of urinary leukotriene E4 and the stable plasma prostaglandin (PG) D2 metabolite 9α,11β-PGF2 were evaluated at baseline and after 1, 3, 5, and 6 months. RESULTS Only the patients with AIA subjected to AD reported improvements in smell and reductions in sneezing and nasal blockade. The SNOT20 and Asthma Control Questionnaire scores of these patients decreased, and their peak nasal inspiratory flows increased. The dosages of inhaled corticosteroids were reduced. There were no changes in leukotriene E(4) or 9α,11β-PGF(2) levels after AD. CONCLUSION The clinically beneficial effects of AD on nasal and bronchial symptoms occurred only in the patients with AIA.
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Affiliation(s)
| | - Marek Sanak
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Grażyna Bochenek
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Paweł Stręk
- Department of Otolaryngology, Jagiellonian University School of Medicine, Krakow, Poland
| | - Adam Ćmiel
- Department of Applied Mathematics, AGH University of Science and Technology, Krakow, Poland
| | - Anna Gielicz
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Hanna Plutecka
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Andrzej Szczeklik
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Ewa Niżankowska-Mogilnicka
- Division of Pulmonology, Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
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Abstract
BACKGROUND Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus associated with dysphagia in adults and refractory reflux syndromes in children. METHODS Immunological and genetic approaches have been used to better understand the pathophysiology of the underlying inflammation. RESULTS AND CONCLUSIONS Evidence has accumulated that EoE represents a T-helper (Th) 2-type inflammatory disease, in which allergens play a role in triggering the disease. The majority of the patients suffer from concurrent allergic rhinitis, asthma, and eczema, and have a history of atopy. The chronic inflammatory response in EoE is associated with tissue damage and remodeling, both of which lead to esophageal dysfunction and bolus impaction. The new insights into the pathophysiology have resulted in the development of the first pharmacological therapies of EoE.
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Affiliation(s)
- Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
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Immunoregulatory effects of bone marrow-derived mesenchymal stem cells in the nasal polyp microenvironment. Mediators Inflamm 2014; 2014:583409. [PMID: 24707116 PMCID: PMC3943259 DOI: 10.1155/2014/583409] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/20/2013] [Accepted: 12/26/2013] [Indexed: 12/21/2022] Open
Abstract
Nasal polyposis is a severe, chronic inflammatory condition of the paranasal sinuses and is frequently associated with asthma and aspirin sensitivity. Mesenchymal stem cells exhibit a potent immunosuppressive effect in several inflammatory conditions, and their role in nasal polyposis remains little explored. Hence, we investigated whether bone marrow-derived mesenchymal stem cells could modulate cell phenotype in the nasal polyp milieu. After coculture with mesenchymal stem cells, the frequency of these inflammatory cells was found to decrease. Furthermore, mesenchymal stem cells promoted strong inhibition of CD4+ and CD8+ T cell proliferation, increased the frequency of CD4+CD25+Foxp3 T cells, and changed the global cytokine profile from an inflammatory to an anti-inflammatory response. We believe that mesenchymal stem cells may be a very useful adjunct for investigation of the inflammatory process in nasal polyposis, contributing to better understanding of the inflammatory course of this condition.
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32
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Mechanisms of staphylococcal enterotoxin-induced emesis. Eur J Pharmacol 2014; 722:95-107. [DOI: 10.1016/j.ejphar.2013.08.050] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 06/11/2013] [Accepted: 08/03/2013] [Indexed: 01/16/2023]
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Stoeckle C, Simon HU. CD8(+) T cells producing IL-3 and IL-5 in non-IgE-mediated eosinophilic diseases. Allergy 2013; 68:1622-5. [PMID: 24410785 DOI: 10.1111/all.12311] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 01/18/2023]
Abstract
The cytokines IL-5, IL-3, and GM-CSF are crucial for eosinophil development, survival, and function. To better understand their role in non-IgE-mediated eosinophilic diseases, we investigated plasma levels of these cytokines as well as cytokine expression in peripheral blood T cells. While we did not find any evidence for an involvement of T-cell-derived GM-CSF, some of these patients did show an increased proportion of IL-5- or IL-3-producing CD4(+) T cells. However, in a significant proportion of patients, IL-5-producing CD8(+) T cells, so-called Tc2 cells, which in healthy donors can only be detected at very low levels, were prominent. Furthermore, increased IL-3 production by CD8(+) T cells was also observed, strongly supporting the notion that CD8(+) T cells, not just CD4(+) T cells, must also be considered as a potential source of the cytokines promoting eosinophilia.
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Affiliation(s)
- C. Stoeckle
- Institute of Pharmacology; University of Bern; Bern Switzerland
| | - H.-U. Simon
- Institute of Pharmacology; University of Bern; Bern Switzerland
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von Gunten S, Cortinas-Elizondo F, Kollarik M, Beisswenger C, Lepper PM. Mechanisms and potential therapeutic targets in allergic inflammation: recent insights. Allergy 2013; 68:1487-98. [PMID: 24215555 DOI: 10.1111/all.12312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 12/16/2022]
Abstract
Deeper insight into pathogenetic pathways and into the biological effects of immunomodulatory agents will help to optimize or adopt therapeutic strategies for atopic disorders. In this article, we highlight selected findings of potential therapeutic relevance that emerged from recent mechanistic studies with focus on molecular and cellular aspects of allergic inflammation. Furthermore, the often complex mechanisms of action of pleiotropic immunomodulatory agents, such as glucocorticoids, vitamin D, or intravenous immunoglobulin (IVIG), are discussed, as their dissection might reveal targets for novel therapeutics or lead to a more rational use of these compounds. Besides reporting novel evidence, this article points to areas of current debate or uncertainty and aims at stimulating scientific discussion and experimental work.
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Affiliation(s)
- S. von Gunten
- Institute of Pharmacology; University of Bern; Bern Switzerland
| | | | - M. Kollarik
- Department of Medicine; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Pathophysiology; Jessenius Medical School; Martin Slovakia
| | - C. Beisswenger
- Department of Internal Medicine V; University Hospital of Saarland; Homburg Germany
| | - P. M. Lepper
- Department of Internal Medicine V; University Hospital of Saarland; Homburg Germany
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Kim YM, Jin J, Choi JA, Cho SN, Lim YJ, Lee JH, Seo JY, Chen HY, Rha KS, Song CH. Staphylococcus aureus enterotoxin B-induced endoplasmic reticulum stress response is associated with chronic rhinosinusitis with nasal polyposis. Clin Biochem 2013; 47:96-103. [PMID: 24216216 DOI: 10.1016/j.clinbiochem.2013.10.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Staphylococcus aureus enterotoxin B (SEB) might participate in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the exact mechanism of polyp formation in CRSwNP remains unclear. Since the endoplasmic reticulum (ER) stress response is closely associated with chronic inflammation, we investigated the association between ER stress and SEB in the pathogenesis of CRSwNP. DESIGN AND METHODS Twenty-three CRSwNP patients with eosinophilic polyps (EP) or non-eosinophilic polyps (NEP) and 10 healthy subjects who were undergoing septoplasty were enrolled in this study. ER stress response was investigated using immunohistochemical staining and Western blotting. RESULTS We show in this study that there are significantly more SEB-positive cells and higher production of reactive oxygen species (ROS) in the epithelial layer of EP than NEP or control tissue. Both SEB and protein A were detected strongly in tissues from patients with CRSwNP. We observed SEB induced the ER stress response in RPMI 2650 cells. GRP78 elevation by SEB was reduced by ROS scavenger pretreatment. In addition, the induction of GRP78 and p47 phox was increased significantly in EP compared with NEP or control mucosa. CONCLUSIONS SEB may induce ER stress via ROS production in CRSwNP. Therefore, we suggest that SEB-induced ER stress may play important roles in the pathogenesis of nasal polyposis.
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Affiliation(s)
- Yong-Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-721, South Korea
| | - Jun Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-721, South Korea; Department of Otorhinolaryngology, Yanbian University Hospital, Jilin Yanji 133000, China
| | - Ji-Ae Choi
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea
| | - Soo-Na Cho
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea
| | - Yun-Ji Lim
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea
| | - Jung-Hwan Lee
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea
| | - Jee Yeon Seo
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea
| | - Hai Yue Chen
- Department of Pathology, Yanbian University Hospital, Jilin Yanji 133000, China
| | - Ki-Sang Rha
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-721, South Korea
| | - Chang-Hwa Song
- Department of Microbiology, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea; Infection Signaling Network Research, College of Medicine, Chungnam National University, Daejeon 301-747, South Korea.
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Pezato R, Bottura L, de Paula Santos R, Voegels RL, Bachi ALL, Gregório LC. Bone: the final frontier for Staphylococcus aureus penetration in chronic rhinosinusitis. J Otolaryngol Head Neck Surg 2013; 42:45. [PMID: 23870516 PMCID: PMC3722010 DOI: 10.1186/1916-0216-42-45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 07/11/2013] [Indexed: 12/01/2022] Open
Abstract
The superantigenic properties of Staphylococcus aureus have been implicated in increasing the inflammatory process in airway diseases. Local formation of IgE antibodies against staphylococcal enterotoxins by secondary lymphoid tissue in nasal polyps has been demonstrated. Staphylococcus aureus is known to colonize the nasal mucosa, and has been found invading the nasal submucosa and intracellularly. Objective To evaluate the limits of Staphylococcus aureus invasion in the upper airway. Material and methods Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied. A fluorescein-labeled PNA probe against Staphylococcus aureus was used to test for the presence of the bacterium in bone (after decalcification) and mucosa. Results We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone. In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.
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Affiliation(s)
- Rogério Pezato
- Department of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil.
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Affiliation(s)
- Hans-Uwe Simon
- Institute of Pharmacology, University of Bern; Bern; Switzerland
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Keinan D, Leigh NJ, Nelson JW, De Oleo L, Baker OJ. Understanding resolvin signaling pathways to improve oral health. Int J Mol Sci 2013; 14:5501-18. [PMID: 23528855 PMCID: PMC3634469 DOI: 10.3390/ijms14035501] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 12/15/2022] Open
Abstract
The discovery of resolvins has been a major breakthrough for understanding the processes involved in resolution of inflammation. Resolvins belong to a family of novel lipid mediators that possess dual anti-inflammatory and pro-resolution actions. Specifically, they protect healthy tissue during immune-inflammatory responses to infection or injury, thereby aiding inflammation resolution and promoting tissue healing. One of the major concerns in modern medicine is the management and treatment of oral diseases, as they are related to systemic outcomes impacting the quality of life of many patients. This review summarizes known signaling pathways utilized by resolvins to regulate inflammatory responses associated with the oral cavity.
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Affiliation(s)
- David Keinan
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mail:
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Noel J. Leigh
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Joel W. Nelson
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Laura De Oleo
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Olga J. Baker
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
- To whom correspondence should be addressed; E-Mail: ; Tel.: +1-716-829-3667; Fax: +1-716-829-3942
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