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Mei Z, Khalil MA, Guo Y, Li D, Banerjee A, Taheri M, Kratzmeier CM, Chen K, Lau CL, Luzina IG, Atamas SP, Kandasamy S, Kreisel D, Gelman AE, Jacobsen EA, Krupnick AS. Stress-induced eosinophil activation contributes to postoperative morbidity and mortality after lung resection. Sci Transl Med 2024; 16:eadl4222. [PMID: 39167663 DOI: 10.1126/scitranslmed.adl4222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 07/31/2024] [Indexed: 08/23/2024]
Abstract
Respiratory failure occurs more frequently after thoracic surgery than abdominal surgery. Although the etiology for this complication is frequently attributed to underlying lung disease present in patients undergoing thoracic surgery, this notion is often unfounded because many patients with normal preoperative pulmonary function often require prolonged oxygen supplementation even after minimal resection of lung tissue. Using a murine model of pulmonary resection and peripheral blood samples from patients undergoing resection of the lung or abdominal organs, we demonstrated that lung surgery initiates a proinflammatory loop that results in damage to the remaining lung tissue, noncardiogenic pulmonary edema, hypoxia, and even death. Specifically, we demonstrated that resection of murine lung tissue increased concentrations of the homeostatic cytokine interleukin-7, which led to local and systemic activation of type 2 innate lymphoid cells. This process activated lung-resident eosinophils and facilitated stress-induced eosinophil maturation in the bone marrow in a granulocyte-macrophage colony-stimulating factor-dependent manner, resulting in systemic eosinophilia in both mice and humans. Up-regulation of inducible nitric oxide synthase in lung-resident eosinophils led to tissue nitrosylation, pulmonary edema, hypoxia, and, at times, death. Disrupting this activation cascade at any stage ameliorated deleterious outcomes and improved survival after lung resection in the mouse model. Our data suggest that repurposing US Food and Drug Administration-approved eosinophil-targeting strategies may potentially offer a therapeutic intervention to improve outcomes for patients who require lung resection for benign or malignant etiology.
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Affiliation(s)
- Zhongcheng Mei
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - May A Khalil
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - Yizhan Guo
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Dongge Li
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - Anirban Banerjee
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - Mojtaba Taheri
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | | | - Kelly Chen
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - Christine L Lau
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
| | - Irina G Luzina
- Department of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Sergei P Atamas
- Department of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | | | - Daniel Kreisel
- Department of Pathology & Immunology, Washington University in St. Louis, St. Louis, MO 63110, USA
- Department of Surgery, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Andrew E Gelman
- Department of Pathology & Immunology, Washington University in St. Louis, St. Louis, MO 63110, USA
- Department of Surgery, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Elizabeth A Jacobsen
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Alexander Sasha Krupnick
- Department of Surgery, University of Maryland, Baltimore, MD 21201, USA
- Department of Microbiology and Immunology, University of Maryland, Baltimore, MD 21201, USA
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Aftabi Y, Amiri-Sadeghan A, Gilani N, Zahedi T, Khodayari MT, Faramarzi E, Seyedrezazadeh E, Ansarin K. Male-biased association of endothelial nitric oxide synthase Asp298Glu substitution ( NOS3-c.894G/T) with asthma risk and severity. J Asthma 2023:1-12. [PMID: 36971059 DOI: 10.1080/02770903.2023.2196689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The nitric-oxide pathway plays a crucial role in the pathogeneses of asthma and NOS3-encoded endothelial nitric oxide synthase is one of the main components of the pathway. Variants of NOS3 are known to contribute to asthma development and pathophysiology. METHODS We investigated the association of NOS3-c.894G/T (rs1799983) with asthma risk and severity by studying frequencies of its genotypes and alleles in 555 asthmatics (93 intermittent, 240 mild, 158 moderate, and 64 severe asthma cases) and 351 control participants using the PCR-FRLP method, logistic regression analysis and generalized ordered logit estimates. RESULTS GT genotype (ORadj: 1.39; CI: 1.04-1.85; p = 0.026), dominant model GT + TT (ORadj: 1.41; CI: 1.07-1.87; p = 0.015), and T allele (ORadj: 1.32; CI: 1.05-1.67; p = 0.018) was associated with increased ORs in asthmatics. Also, the frequency of GT + TT (ORadj: 1.55; CI: 1.01-2.38; p = 0.044) was significantly higher in males. Furthermore, GT genotype (ORadj: 1.39; CI: 1.04-1.85; p = 0.024), GT + TT (ORadj: 1.42; CI: 1.07-1.87; p = 0.014), and T allele (ORadj: 1.32; CI: 1.05-1.66; p = 0.018) in total population and GT + TT (ORadj: 1.56; CI: 1.02-2.37; p = 0.04) in males were significantly associated with increased risk of severe, moderate, mild, intermittent asthma vs. controls. Also, GT genotype (ORadj: 1.39; CI: 1.02-1.91; p = 0.039) was significantly more frequent in severe, moderate grades vs. lower severity grades in the total population. Frequencies of GT genotype (ORadj: 1.77; CI: 1.05-3.00; p = 0.032) and GT + TT (ORadj: 1.74; CI: 1.04-2.90; p = 0.036) in total population and GT genotype (ORadj: 2.40; CI: 1.16-4.97; p = 0.018) and GT + TT (ORadj: 2.30; CI: 1.12-4.74; p = 0.023) in male subpopulation were significantly higher in severe cases compared to lower grades. CONCLUSIONS NOS3-c.894G/T may be associated with asthma risk and its severer grades, with greater effects in men.
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Guida G, Carriero V, Bertolini F, Pizzimenti S, Heffler E, Paoletti G, Ricciardolo FLM. Exhaled nitric oxide in asthma: from diagnosis to management. Curr Opin Allergy Clin Immunol 2023; 23:29-35. [PMID: 36539380 DOI: 10.1097/aci.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Exhaled nitric oxide (FENO) is a noninvasive marker of eosinophilic airway inflammation, therefore, highly informative in asthma. Although FENO measurement is a potentially accessible tool to many physicians, recommendations regarding its clinical utility in diagnosing or tailoring treatment have not reached the expected diffusion. More recently FENO emerged as a biomarker for type-2 asthma phenotyping and a predictor of response to biologics. RECENT FINDINGS The physiological discoveries and relevant acquisitions in clinical practice regarding FENO in asthma are presented. The FENO story draw a wavy path, characterized by promising findings, exciting confirmations and periods of low visibility. FENO emerged as a tool to increase the probability of asthma diagnosis. FENO predicts response to inhaled glucocorticoids (ICS), favoring the development of tailored treatment strategies and unrevealing nonadherence to ICS in difficult-to-treat or uncontrolled asthma. Finally, FENO was associated with a more severe phenotype and became a consolidated biomarker of type-2 inflammation. SUMMARY FENO demonstrated to be a noninvasive and very reproducible test, encompassing many applications in the field of asthma management. Its routinely use, according to international guidelines, may improve the quality of patient assistance, from difficult-to-treat cases to biologic monitoring.
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Affiliation(s)
- Giuseppe Guida
- Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, Orbassano
- Department of Clinical and Biological Sciences, University of Turin, Turin
| | - Vitina Carriero
- Department of Clinical and Biological Sciences, University of Turin, Turin
| | | | - Stefano Pizzimenti
- Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, Orbassano
| | | | | | - Fabio L M Ricciardolo
- Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, Orbassano
- Department of Clinical and Biological Sciences, University of Turin, Turin
- Institute of Translational Pharmacology, National Research Council (IFT-CNR), section of Palermo, Italy
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Marcos MC, Cisneros Serrano C. What is the added value of FeNO as T2 biomarker? FRONTIERS IN ALLERGY 2022; 3:957106. [PMID: 36032508 PMCID: PMC9403133 DOI: 10.3389/falgy.2022.957106] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
There is increasing evidence about the role of nitric oxide in type 2 (T2) immune response. Fraction of exhaled nitric oxide (FeNO) is a product of airways inflammation and it is increased in patients with asthma. Since Gustaffson published the first article about this biomarker in the 1990s, interest has continued to grow. Compared with other T2 biomarkers such as blood eosinophil count, induced sputum, or serum periostin, FeNO has some remarkable advantages, including its not invasive nature, easy repeatability, and possibility to be performed even in patients with severe airway obstruction. It is considered as an indicator of T2 inflammation and, by the same token, a useful predictor for inhaled steroid response. It is difficult to determine the utility of nitric oxide (NO) for initial asthma diagnosis. In such a heterogenous disease, a single parameter would probably not be enough to provide a complete picture. There is also an important variability among authors concerning FeNO cutoff values and the percentage of sensibility and specificity for diagnosis. Its high specificity indicates a potential role to “rule in” asthma; however, its lower sensibility could suggest a lower capacity to “rule out” this pathology. For this reason, if a diagnosis of asthma is being considered, FeNO should be considered along with other tests. FeNO has also shown its utility to detect response to steroids, adherence to treatment, and risk of exacerbation. Even though there is not enough quality of evidence to establish overall conclusions, FeNO could be an alternative procedure to diagnose or exclude asthma and also a predictive tool in asthma treated with corticosteroids.
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Kozik AJ, Holguin F, Segal LN, Chatila TA, Dixon AE, Gern JE, Lozupone C, Lukacs N, Lumeng C, Molyneaux PL, Reisdorph N, Vujkovic-Cvijin I, Togias A, Huang YJ. Microbiome, Metabolism, and Immunoregulation of Asthma: An American Thoracic Society and National Institute of Allergy and Infectious Diseases Workshop Report. Am J Respir Cell Mol Biol 2022; 67:155-163. [PMID: 35914321 PMCID: PMC9348558 DOI: 10.1165/rcmb.2022-0216st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This report presents the proceedings from a workshop titled "Microbiome, Metabolism and Immunoregulation of Asthma" that was held virtually May 13 and 14, 2021. The workshop was jointly sponsored by the American Thoracic Society (Assembly on Allergy, Immunology, and Inflammation) and the National Institute of Allergy and Infectious Diseases. It convened an interdisciplinary group of experts with backgrounds in asthma immunology, microbiome science, metabolomics, computational biology, and translational pulmonary research. The main purpose was to identify key scientific gaps and needs to further advance research on microbial and metabolic mechanisms that may contribute to variable immune responses and disease heterogeneity in asthma. Discussions were structured around several topics, including 1) immune and microbial mechanisms of asthma pathogenesis in murine models, 2) the role of microbes in pediatric asthma exacerbations, 3) dysregulated metabolic pathways in asthma associated with obesity, 4) metabolism effects on macrophage function in adipose tissue and the lungs, 5) computational approaches to dissect microbiome-metabolite links, and 6) potential confounders of microbiome-disease associations in human studies. This report summarizes the major points of discussion, which included identification of specific knowledge gaps, challenges, and suggested directions for future research. These include questions surrounding mechanisms by which microbiota and metabolites shape host health versus an allergic or asthmatic state; direct and indirect influences of other biological factors, exposures, and comorbidities on these interactions; and ongoing technical and analytical gaps for clinical translation.
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Lin LM, Chang YJ, Yang KD, Lin CH, Chien JW, Kao JK, Lee MS, Chiang TI, Lin CY, Tsai YG. Small Airway Dysfunction Measured by Impulse Oscillometry and Fractional Exhaled Nitric Oxide Is Associated With Asthma Control in Children. Front Pediatr 2022; 10:877681. [PMID: 35783300 PMCID: PMC9247317 DOI: 10.3389/fped.2022.877681] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) are sensitive and non-invasive methods to measure airway resistance and inflammation, although there are limited population-based studies using IOS and FeNO to predict asthma control. OBJECTIVE This study aimed to investigate the utility of IOS and FeNO for assessing childhood asthma control in terms of small airway dysfunction and airway inflammation. METHODS This prospective observational cohort study enrolled 5,018 school children (aged 6-12 years), including 560 asthmatic children and 140 normal participants. FeNO, spirometry, IOS, bronchial dilation test, total IgE, and childhood asthma control test (C-ACT) were measured. FeNO, IOS, spirometry, and C-ACT results were correlated with childhood asthma with and without control. RESULTS Uncontrolled asthmatic children had abnormal FeNO, IOS, and spirometric values compared with control subjects (P < 0.05). IOS parameters with R5, R5-R20, X5, Ax, △R5, and FeNO can predict lower C-ACT scales by the areas under receiver operating characteristic curves (AUCs) (0.616, 0.625, 0.609, 0.622, 0.625, and 0.714). A combination of FeNO (>20 ppb) with IOS measure significantly increased the specificity for predicting uncontrolled asthma patients compared with FeNO alone (P < 0.01). A multiple regression model showed that small airway parameter (R5-R20) was the strongest risk factor [OR (95% CI): 87.26 (7.67-993.31)] for uncontrolled asthma patients. Poor control with lower C-ACT scales correlated with high FeNO (r = -0.394), R5 (r = -0.106), and R5-R20 (r = -0.129) in asthmatic children (P < 0.05). CONCLUSION A combined use of FeNO and IOS measurements strongly predicts childhood asthma with or without control.
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Affiliation(s)
- Liang-Mei Lin
- Respiratory Therapy Section for Children, Changhua Christian Children's Hospital, Changhua, Taiwan
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center and Big Data Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Kuender D Yang
- Departments of Pediatrics, Mackay Memorial Hospital, Taipei City, Taiwan.,Department of Microbiology and Immunology, National Defense Medical Center, Taipei City, Taiwan
| | - Ching-Hsiung Lin
- Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.,Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.,Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan
| | - Jien-Wen Chien
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Jun-Kai Kao
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.,Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.,Frontier Molecular Medical Research Center in Children, Changhua Christian Children Hospital, Changhua, Taiwan.,School of Medicine, Kaohsiung Medical University, Taichung, Taiwan
| | - Ming-Sheng Lee
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan
| | - Tsay-I Chiang
- College of Nursing, Hungkuang University, Taichung, Taiwan
| | - Ching-Yuang Lin
- Division of Pediatric Nephrology, Children's Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Giien Tsai
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.,School of Medicine, Kaohsiung Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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7
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Huang C, Li F, Wang J, Tian Z. Innate-like Lymphocytes and Innate Lymphoid Cells in Asthma. Clin Rev Allergy Immunol 2021; 59:359-370. [PMID: 31776937 DOI: 10.1007/s12016-019-08773-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Asthma is a chronic pulmonary disease, highly associated with immune disorders. The typical symptoms of asthma include airway hyperresponsiveness (AHR), airway remodeling, mucus overproduction, and airflow limitation. The etiology of asthma is multifactorial and affected by genetic and environmental factors. Increasing trends toward dysbiosis, smoking, stress, air pollution, and a western lifestyle may account for the increasing incidence of asthma. Based on the presence or absence of eosinophilic inflammation, asthma is mainly divided into T helper 2 (Th2) and non-Th2 asthma. Th2 asthma is mediated by allergen-specific Th2 cells, and eosinophils activated by Th2 cells via the secretion of interleukin (IL)-4, IL-5, and IL-13. Different from Th2 asthma, non-Th2 asthma shows little eosinophilic inflammation, resists to corticosteroid treatment, and occurs mainly in severe asthmatic patients. Previous studies of asthma primarily focused on the function of Th2 cells, but, with the discovery of non-Th2 asthma and the involvement of innate lymphoid cells (ILCs) in the pathogenesis of asthma, tissue-resident innate immune cells in the lung have become the focus of attention in asthma research. Currently, innate-like lymphocytes (ILLs) and ILCs as important components of the innate immune system in mucosal tissues are reportedly involved in the pathogenesis of or protection against both Th2 and non-Th2 asthma. These findings of the functions of different subsets of ILLs and ILCs may provide clues for the treatment of asthma.
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Affiliation(s)
- Chao Huang
- Institute of Immunology, University of Science and Technology of China, Hefei, 230027, Anhui, China
| | - Fengqi Li
- Institute of Molecular Health Sciences, ETH Zürich, 8093, Zürich, Switzerland
| | - Jian Wang
- Neuroimmunology and MS Research Section (NIMS), Neurology Clinic, University of Zürich, University Hospital Zürich, 8091, Zürich, Switzerland.
| | - Zhigang Tian
- Institute of Immunology, University of Science and Technology of China, Hefei, 230027, Anhui, China.
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8
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Kawasumi T, Takeno S, Ishikawa C, Takahara D, Taruya T, Takemoto K, Hamamoto T, Ishino T, Ueda T. The Functional Diversity of Nitric Oxide Synthase Isoforms in Human Nose and Paranasal Sinuses: Contrasting Pathophysiological Aspects in Nasal Allergy and Chronic Rhinosinusitis. Int J Mol Sci 2021; 22:7561. [PMID: 34299181 PMCID: PMC8304068 DOI: 10.3390/ijms22147561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
The human paranasal sinuses are the major source of intrinsic nitric oxide (NO) production in the human airway. NO plays several roles in the maintenance of physiological homeostasis and the regulation of airway inflammation through the expression of three NO synthase (NOS) isoforms. Measuring NO levels can contribute to the diagnosis and assessment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In symptomatic AR patients, pro-inflammatory cytokines upregulate the expression of inducible NOS (iNOS) in the inferior turbinate. Excessive amounts of NO cause oxidative damage to cellular components, leading to the deposition of cytotoxic substances. CRS phenotype and endotype classifications have provided insights into modern treatment strategies. Analyses of the production of sinus NO and its metabolites revealed pathobiological diversity that can be exploited for useful biomarkers. Measuring nasal NO based on different NOS activities is a potent tool for specific interventions targeting molecular pathways underlying CRS endotype-specific inflammation. We provide a comprehensive review of the functional diversity of NOS isoforms in the human sinonasal system in relation to these two major nasal disorders' pathologies. The regulatory mechanisms of NOS expression associated with the substrate bioavailability indicate the involvement of both type 1 and type 2 immune responses.
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Affiliation(s)
| | - Sachio Takeno
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan; (T.K.); (C.I.); (D.T.); (T.T.); (K.T.); (T.H.); (T.I.); (T.U.)
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9
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Ballow M, Haga CL. Reply to "Patient variability in severity of COVID-19 disease. Main suspect: vascular endothelium". THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2541-2542. [PMID: 34112485 PMCID: PMC8181745 DOI: 10.1016/j.jaip.2021.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Mark Ballow
- Department of Molecular Medicine, Scripps Research Institute, Jupiter, Fla.
| | - Christopher L Haga
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, St Petersburg, Fla
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10
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Ricciardolo FLM, Bertolini F, Carriero V, Högman M. Nitric oxide's physiologic effects and potential as a therapeutic agent against COVID-19. J Breath Res 2020; 15:014001. [PMID: 33080582 DOI: 10.1088/1752-7163/abc302] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 pneumonia, a pandemic that precipitates huge pressures on the world's social and economic systems. Disease severity varies among individuals. SARS-CoV-2 infection can be associated with e.g. flu-like symptoms, dyspnoea, severe interstitial pneumonia, acute respiratory distress syndrome, multiorgan dysfunction, and generalized coagulopathy. Nitric oxide (NO), is a small signal molecule that impacts pleiotropic functions in human physiology, which can be involved in the significant effects of COVID-19 infection. NO is a neurotransmitter involved in the neural olfactory processes in the central nervous system, and some infected patients have reported anosmia as a symptom. Additionally, NO is a well-known vasodilator, important coagulation mediator, anti-microbial effector and inhibitor of SARS-CoV replication. Exhaled NO is strongly related to the type-2 inflammatory response found in asthma, which has been suggested to be protective against SARS-CoV-2 infection. Several reports indicate that the use of inhaled NO has been an effective therapy during this pandemic since the ventilation-perfusion ratio in COVID-19 patients improved afterwards and they did not require mechanical ventilation. The aim of this mini-review is to summarize relevant actions of NO that could be beneficial in the treatment of COVID-19.
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Affiliation(s)
- Fabio Luigi Massimo Ricciardolo
- Department of Clinical and Biological Sciences, University of Turin, Rare Lung Disease Unit and Severe Asthma Centre, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
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11
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Correlation of Arterial CO 2 and Respiratory Impedance Values among Subjects with COPD. J Clin Med 2020; 9:jcm9092819. [PMID: 32878165 PMCID: PMC7564107 DOI: 10.3390/jcm9092819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory illness characterized by airflow limitation and chronic respiratory symptoms with a global prevalence estimated to be more than 10% in 2010 and still on the rise. Furthermore, hypercapnic subject COPD leads to an increased risk of mortality, morbidity, and poor QoL (quality of life) than normocapnic subjects. Series of studies showed the usefulness of the forced oscillation technique (FOT) to measure small airway closure. Traditional findings suggested that hypercapnia may not be the main treating targets, but recent findings suggested that blood stream CO2 may lead to a worse outcome. This study aimed to seek the relationship between CO2 and small airway closure by using FOT. Subjects with COPD (n = 124; hypercapnia 22 and normocapnia 102) were analyzed for all pulmonary function values, FOT values, and arterial blood gas analysis. Student’s t-test, Spearman rank correlation, and multi linear regression analysis were used to analyze the data. COPD subjects with hypercapnia showed a significant increase in R5, R20, Fres, and ALX values, and a greater decrease in X5 value than normocapnic patients. Also, multiple linear regression analysis showed R5 was associated with hypercapnia. Hypercapnia may account for airway closure among subjects with COPD and this result suggests treating hypercapnia may lead to better outcomes for such a subject group.
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12
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Wang Y, Du J, Jin H, Liao Y. Comorbidity of Neurally Mediated Syncope and Allergic Disease in Children. Front Immunol 2020; 11:1865. [PMID: 32983103 PMCID: PMC7485378 DOI: 10.3389/fimmu.2020.01865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Neurally mediated syncope (NMS) is the most common underlying disease of pediatric syncope, which generally includes vasovagal syncope (VVS), postural tachycardia syndrome (POTS), and situational syncope. Allergic diseases involving the respiratory system, digestive system, skin, and other systems are prevalent in children. In recent years, increasing attention has been paid to children with the comorbidity of NMS and allergic diseases. This article reviews the featured clinical manifestations and pathogenesis of the comorbidity according to the progress of related studies. Clinical studies have shown that the comorbidity rate of pediatric VVS and/or POTS with allergic diseases amounts to ~30-40%, referring to the whole population of children with VVS and/or POTS. Additionally, children with the comorbidity present some relatively special clinical characteristics. A series of mechanisms or regulatory factors relating to allergies, such as the imbalance of vasoactive elements, dysfunction of the autonomic nervous system (ANS), and autoimmunity may play a role in the development of the comorbidity. Moreover, 90% of children with cough syncope, a type of situational syncope, have a history of asthma, indicating a potential relationship between asthma and NMS. Further studies exploring the clinical characteristics and pathogenesis of the comorbidity are still needed to aid in the diagnosis and treatment of children with NMS.
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Affiliation(s)
- Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Research Unit of Clinical Diagnosis and Treatment of Pediatric Syncope and Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Research Unit of Clinical Diagnosis and Treatment of Pediatric Syncope and Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Liao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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13
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Menzies-Gow A, Mansur AH, Brightling CE. Clinical utility of fractional exhaled nitric oxide in severe asthma management. Eur Respir J 2020; 55:13993003.01633-2019. [PMID: 31949116 DOI: 10.1183/13993003.01633-2019] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/25/2019] [Indexed: 02/06/2023]
Abstract
Asthma is a chronic inflammatory disease of the airways, affecting over 350 million people worldwide and placing a significant burden on healthcare providers and wider society. Approximately 5-10% of asthma patients are diagnosed with severe asthma and typically are associated with increased risk of hospitalisation from exacerbations, increased morbidity, mortality and higher asthma-associated healthcare costs. Nitric oxide (NO) is an important regulator of immune responses and is a product of inflammation in the airways that is over-produced in asthma. Fractional exhaled NO (F eNO) is predominantly used as a predictor of response to inhaled corticosteroids (ICSs), to monitor adherence and as a diagnostic tool in ICS-naïve patients. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommend the use of F eNO for the initial diagnosis of patients with suspected asthma. In the USA, American Thoracic Society (ATS) guidelines recommend F eNO as part of the initial diagnosis of asthma and for monitoring of airway inflammation. F eNO has also been shown to be a predictive factor for asthma exacerbations, with higher levels being associated with a greater number of exacerbations. In addition, higher levels of F eNO have been shown to be associated with a decline in lung function. F eNO testing is a cost-effective procedure and has been shown to improve patient management when combined with standard assessment methods. Recent evidence suggests that F eNO may also be useful as a surrogate biomarker for the assessment and management of severe asthma and to predict responsiveness to some biological therapies.
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Affiliation(s)
| | - Adel H Mansur
- Dept of Respiratory Medicine, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Christopher E Brightling
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
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14
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Michaeloudes C, Bhavsar PK, Mumby S, Xu B, Hui CKM, Chung KF, Adcock IM. Role of Metabolic Reprogramming in Pulmonary Innate Immunity and Its Impact on Lung Diseases. J Innate Immun 2019; 12:31-46. [PMID: 31786568 DOI: 10.1159/000504344] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022] Open
Abstract
Lung innate immunity is the first line of defence against inhaled allergens, pathogens and environmental pollutants. Cellular metabolism plays a key role in innate immunity. Catabolic pathways, including glycolysis and fatty acid oxidation (FAO), are interconnected with biosynthetic and redox pathways. Innate immune cell activation and differentiation trigger extensive metabolic changes that are required to support their function. Pro-inflammatory polarisation of macrophages and activation of dendritic cells, mast cells and neutrophils are associated with increased glycolysis and a shift towards the pentose phosphate pathway and fatty acid synthesis. These changes provide the macromolecules required for proliferation and inflammatory mediator production and reactive oxygen species for anti-microbial effects. Conversely, anti-inflammatory macrophages use primarily FAO and oxidative phosphorylation to ensure efficient energy production and redox balance required for prolonged survival. Deregulation of metabolic reprogramming in lung diseases, such as asthma and chronic obstructive pulmonary disease, may contribute to impaired innate immune cell function. Understanding how innate immune cell metabolism is altered in lung disease may lead to identification of new therapeutic targets. This is important as drugs targeting a number of metabolic pathways are already in clinical development for the treatment of other diseases such as cancer.
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Affiliation(s)
- Charalambos Michaeloudes
- Experimental Studies and Cell and Molecular Biology, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom,
| | - Pankaj K Bhavsar
- Experimental Studies and Cell and Molecular Biology, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom
| | - Sharon Mumby
- Experimental Studies and Cell and Molecular Biology, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom
| | - Bingling Xu
- Respiratory and Critical Care Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Christopher Kim Ming Hui
- Respiratory and Critical Care Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Kian Fan Chung
- Experimental Studies and Cell and Molecular Biology, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom
| | - Ian M Adcock
- Experimental Studies and Cell and Molecular Biology, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom
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15
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Zhang Y, Xu B, Luan B, Zhang Y, Li Y, Xiong X, Shi H. Myeloid-derived suppressor cells (MDSCs) and mechanistic target of rapamycin (mTOR) signaling pathway interact through inducible nitric oxide synthase (iNOS) and nitric oxide (NO) in asthma. Am J Transl Res 2019; 11:6170-6184. [PMID: 31632585 PMCID: PMC6789223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Down-regulation of mechanistic target of rapamycin (mTOR) activity in myeloid-derived suppressor cells (MDSCs) has been shown to promote inducible nitric oxide (NO) synthase (iNOS) expression and NO production. Importantly, pharmacological inhibition of iNOS blocks MDSCs recruitment in immunological hepatic injury. As bronchial asthma is also an immune disease, whether mTOR could interact with MDSCs via iNOS and NO or not is unclear. OBJECTIVE The aim of this study was to determine whether mTOR could interact with MDSCs via iNOS and NO in asthma. METHODS Ovalbumin-induced asthma mouse model was established to perform our investigation, and asthmatic markers were evaluated by hematoxylin and eosin (H&E), immunohistochemistry (IHC), and periodic acid-Schiff (PAS) staining. The levels of iNOS and NO in serum were determined by enzyme linked immunosorbent assay (ELISA). Mice lung tissues were stained with antibodies against phosphorylated (p)-mTOR, and p-p70S6K, and yellow/brown staining was considered as giving a positive signal, meanwhile, the protein levels of p-mTOR, and p-p70S6K were also detected using western blot assay. Mice iNOS activity was determined by radioimmunoassay. RESULTS Tumor-derived MDSCs in asthmatic mice were regulated by mTOR and iNOS. mTOR pathway activation in asthmatic mice was regulated by iNOS and tumor-derived MDSCs. NO production in asthmatic mice was regulated by mTOR and tumor-extracted MDSCs. Positive correlation of iNOS with mTOR pathway and serum MDSCs was observed. CONCLUSION The data indicated that rapamycin, an inhibitor of mTOR, blocked iNOS and NO production during asthma onset. Thus, our results revealed potential novel targets for asthma therapy.
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Affiliation(s)
- Yanli Zhang
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Boyi Xu
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Bin Luan
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Yan Zhang
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Yanling Li
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Xiaorong Xiong
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
| | - Hongke Shi
- Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan Province, China
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16
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Emma R, Bansal AT, Kolmert J, Wheelock CE, Dahlen SE, Loza MJ, De Meulder B, Lefaudeux D, Auffray C, Dahlen B, Bakke PS, Chanez P, Fowler SJ, Horvath I, Montuschi P, Krug N, Sanak M, Sandstrom T, Shaw DE, Fleming LJ, Djukanovic R, Howarth PH, Singer F, Sousa AR, Sterk PJ, Corfield J, Pandis I, Chung KF, Adcock IM, Lutter R, Fabbella L, Caruso M. Enhanced oxidative stress in smoking and ex-smoking severe asthma in the U-BIOPRED cohort. PLoS One 2018; 13:e0203874. [PMID: 30240401 PMCID: PMC6150501 DOI: 10.1371/journal.pone.0203874] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/29/2018] [Indexed: 12/20/2022] Open
Abstract
Oxidative stress is believed to be a major driver of inflammation in smoking asthmatics. The U-BIOPRED project recruited a cohort of Severe Asthma smokers/ex-smokers (SAs/ex) and non-smokers (SAn) with extensive clinical and biomarker information enabling characterization of these subjects. We investigated oxidative stress in severe asthma subjects by analysing urinary 8-iso-PGF2α and the mRNA-expression of the main pro-oxidant (NOX2; NOSs) and anti-oxidant (SODs; CAT; GPX1) enzymes in the airways of SAs/ex and SAn. All the severe asthma U-BIOPRED subjects were further divided into current smokers with severe asthma (CSA), ex-smokers with severe asthma (ESA) and non-smokers with severe asthma (NSA) to deepen the effect of active smoking. Clinical data, urine and sputum were obtained from severe asthma subjects. A bronchoscopy to obtain bronchial biopsy and brushing was performed in a subset of subjects. The main clinical data were analysed for each subset of subjects (urine-8-iso-PGF2α; IS-transcriptomics; BB-transcriptomics; BBr-transcriptomics). Urinary 8-iso-PGF2α was quantified using mass spectrometry. Sputum, bronchial biopsy and bronchial brushing were processed for mRNA expression microarray analysis. Urinary 8-iso-PGF2α was increased in SAs/ex, median (IQR) = 31.7 (24.5-44.7) ng/mmol creatinine, compared to SAn, median (IQR) = 26.6 (19.6-36.6) ng/mmol creatinine (p< 0.001), and in CSA, median (IQR) = 34.25 (24.4-47.7), vs. ESA, median (IQR) = 29.4 (22.3-40.5), and NSA, median (IQR) = 26.5 (19.6-16.6) ng/mmol creatinine (p = 0.004). Sputum mRNA expression of NOX2 was increased in SAs/ex compared to SAn (probe sets 203922_PM_s_at fold-change = 1.05 p = 0.006; 203923_PM_s_at fold-change = 1.06, p = 0.003; 233538_PM_s_at fold-change = 1.06, p = 0.014). The mRNA expression of antioxidant enzymes were similar between the two severe asthma cohorts in all airway samples. NOS2 mRNA expression was decreased in bronchial brushing of SAs/ex compared to SAn (fold-change = -1.10; p = 0.029). NOS2 mRNA expression in bronchial brushing correlated with FeNO (Kendal's Tau = 0.535; p< 0.001). From clinical and inflammatory analysis, FeNO was lower in CSA than in ESA in all the analysed subject subsets (p< 0.01) indicating an effect of active smoking. Results about FeNO suggest its clinical limitation, as inflammation biomarker, in severe asthma active smokers. These data provide evidence of greater systemic oxidative stress in severe asthma smokers as reflected by a significant changes of NOX2 mRNA expression in the airways, together with elevated urinary 8-iso-PGF2α in the smokers/ex-smokers group. Trial registration ClinicalTrials.gov-Identifier: NCT01976767.
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Affiliation(s)
- Rosalia Emma
- Department of Clinical and Experimental Medicine - University of Catania, Catania, Italy
| | - Aruna T Bansal
- Acclarogen Ltd, St John's Innovation Centre, Cambridge, United Kingdom
| | - Johan Kolmert
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden.,Centre for Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Swen-Erik Dahlen
- Centre for Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Matthew J Loza
- Janssen Research & Development, LLC, Springhouse, Pennsylvania, United States of America
| | - Bertrand De Meulder
- European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL-INSERM, CIRI-UMR5308, Lyon, France
| | - Diane Lefaudeux
- European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL-INSERM, CIRI-UMR5308, Lyon, France
| | - Charles Auffray
- European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL-INSERM, CIRI-UMR5308, Lyon, France
| | - Barbro Dahlen
- Karolinska University Hospital & Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Per S Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Pascal Chanez
- Département des Maladies Respiratoires, CIC Nord, INSERM U1067 Aix Marseille Université Marseille, Marseille, France
| | - Stephen J Fowler
- Centre for Respiratory Medicine and Allergy, The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Clinic, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Ildiko Horvath
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Paolo Montuschi
- Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Norbert Krug
- Fraunhofer Institute for Toxicology and Experimental Medicine Hannover, Germany
| | - Marek Sanak
- Department of Medicine, Jagiellonian University Medical School, Krakow, Poland
| | - Thomas Sandstrom
- Dept of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Dominick E Shaw
- Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom
| | - Louise J Fleming
- National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - Ratko Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Peter H Howarth
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Florian Singer
- University Children's Hospital Bern, Bern, Switzerland.,University Children's Hospital Zurich, Zurich, Switzerland
| | - Ana R Sousa
- Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
| | - Peter J Sterk
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Julie Corfield
- AstraZeneca R&D, Mölndal, Sweden.,Areteva R&D, Nottingham, United Kingdom
| | - Ioannis Pandis
- Data Science Institute, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Kian F Chung
- National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - Ian M Adcock
- National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - René Lutter
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Lorena Fabbella
- Department of Clinical and Experimental Medicine - University of Catania, Catania, Italy
| | - Massimo Caruso
- Department of Clinical and Experimental Medicine - University of Catania, Catania, Italy.,Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
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17
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Niu Y, Chen R, Xia Y, Cai J, Lin Z, Liu C, Chen C, Peng L, Zhao Z, Zhou W, Chen J, Kan H. Personal Ozone Exposure and Respiratory Inflammatory Response: The Role of DNA Methylation in the Arginase-Nitric Oxide Synthase Pathway. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:8785-8791. [PMID: 29985591 DOI: 10.1021/acs.est.8b01295] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Little is known regarding the molecular mechanisms behind respiratory inflammatory response induced by ozone. We performed a longitudinal panel study with four repeated measurements among 43 young adults in Shanghai, China from May to October in 2016. We collected buccal samples and measured the fractional exhaled nitric oxide (FeNO) after 3-day personal ozone monitoring. In buccal samples, we measured concentrations of inducible nitric oxide synthase (iNOS) and arginase (ARG), and DNA methylation of NOS2A and ARG2. We used linear mixed-effect models to analyze the effects of ozone on FeNO, two enzymes and their DNA methylation. A 10 ppb increase in ozone (lag 0-8 h) was significantly associated with a 3.89% increase in FeNO, a 36.33% increase in iNOS, and a decrease of 0.36 in the average methylation (%5mC) of NOS2A. Ozone was associated with decreased ARG and elevated ARG2 methylation, but the associations were not significant. These effects were more pronounced among allergic subjects than healthy subjects. The effects were much stronger when using personal exposure monitoring than fixed-site measurements. Our study demonstrated that personal short-term exposure to ozone may result in acute respiratory inflammation, which may be mainly modulated by NOS2A hypomethylation in the arginase-nitric oxide synthase pathway.
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Affiliation(s)
- Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
- Shanghai Key Laboratory of Meteorology and Health , Shanghai 200030 , China
| | - Yongjie Xia
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Zhijing Lin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Chen Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health , Shanghai 200030 , China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
| | - Wenhao Zhou
- Department of Neonates, Children's Hospital , Fudan University , Shanghai 201102 , China
| | - Jianmin Chen
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Department of Environmental Science and Engineering , Fudan University , Shanghai 200433 , China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment , Fudan University , Shanghai 200032 , China
- Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development , Fudan University , Shanghai 200032 , China
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18
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Abstract
The history of nitric oxide (NO) in the respiratory field dates back to the beginning of the 1990s with the pioneering study by Lars Gustafsson et al describing the presence of endogenous NO in the exhaled breath of human beings. Soon after, independent studies showed that exhaled NO concentrations (FENO) is higher in asthmatics than in normal subjects. Not all asthmatics demonstrate a high FENO, reflecting the heterogeneity of asthma. High values of FENO are associated with over-expression of corticosteroid-sensitive iNOS isoform and allergic/eosinophilic inflammation. A major feature of elevated FENO in asthma is the prediction of inhaled corticosteroid (ICS) response, and FENO more than 50 ppb in adults is a strong indicator of likely ICS sensitivity. In addition, FENO values are elevated in asthma when asthma control deteriorates, identifying patients at risk of exacerbations, and, on the other hand, FENO reductions during ICS therapy precede improvement in respiratory symptoms and lung function, suggesting that FENO is a sensitive predictor of loss of asthma control. FENO also predicts the response to biological therapy (anti-IgE, -IL-5 and -IL-13 antibodies) in severe asthma but, interestingly, FENO values fall only after treatment with anti-IL-13 and -IL-4/IL-13 receptor antibodies. The use of FENO as a Type-2 inflammatory biomarker, in constellation with other Type-2 markers, could help to determine who might benefit from ICS and biological treatment. It remains to find out more precise cut-off values of FENO to identify potential ICS responders in specific phenotypes.
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19
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Watanabe T, Chibana K, Shiobara T, Tei R, Koike R, Nakamura Y, Arai R, Horigane Y, Shimizu Y, Takemasa A, Fukuda T, Wenzel SE, Ishii Y. Expression of intelectin-1 in bronchial epithelial cells of asthma is correlated with T-helper 2 (Type-2) related parameters and its function. Allergy Asthma Clin Immunol 2017; 13:35. [PMID: 28775743 PMCID: PMC5540302 DOI: 10.1186/s13223-017-0207-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/19/2017] [Indexed: 05/22/2024] Open
Abstract
Background Intelectin-1 (ITLN-1) is secreted by intestinal goblet cells and detectable in blood. Its expression is increased in IL-13-overexpressing mouse airways. However, its expression and function in human airways is poorly understood. Methods Distal and proximal bronchial epithelial cells (BECs) were isolated from bronchoscopic brushings of disease control (D-CON), COPD, inhaled corticosteroid-treated asthma (ST-Asthma) and inhaled corticosteroid-naïve asthma (SN-Asthma) patients. ITLN-1 mRNA expression in freshly isolated BECs, primary cultured BECs with or without IL-13 and inhibition effects of mometasone furoate (MF) were investigated by quantitative real-time PCR (qPCR). Correlations between ITLN-1 mRNA and Type-2 related parameters (e.g. FeNO, IgE, iNOS, CCL26, periostin and DPP4 mRNA) were analyzed. ITLN-1 protein distribution in asthmatic airway tissue was assessed by immunohistochemistry. Bronchial alveolar lavage (BAL) and serum ITLN-1 protein were measured by ELISA. The effect of recombinant human (rh) ITLN-1 on stimulated production of CXCL10 and phospho(p)-STAT1 expression examined in lung fibroblasts. Results ITLN-1 mRNA was expressed in freshly isolated BECs and was correlated with Type-2 related parameters. ITLN-1 protein was increased in goblet cells in SN-Asthmatics and increased in SN-Asthmatic BAL fluid. There were no any differences in serum ITLN-1 concentration between ST and SN-Asthma. IL-13 enhanced ITLN-1 expression and inhibited by MF from BECs in vitro, while rhITLN-1 inhibited CXCL10 production and p-STAT1 expression in HFL-1 cells. Conclusion ITLN-1 is induced by IL-13 and expressed mainly in goblet cells in untreated asthma where its levels correlate with known Type-2 related parameters. Further, ITLN-1 inhibits Type-1 chemokine expression. Electronic supplementary material The online version of this article (doi:10.1186/s13223-017-0207-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Taiji Watanabe
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kazuyuki Chibana
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Taichi Shiobara
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Rinna Tei
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Ryosuke Koike
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yusuke Nakamura
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Ryo Arai
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yukiko Horigane
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yasuo Shimizu
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Akihiro Takemasa
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Takeshi Fukuda
- Dokkyo Medical University School of Medicine, 880 Kitakobayashi Mibumachi, Shimotsugagun, Tochigi, 321-0293 Japan
| | - Sally E Wenzel
- Pulmonary Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, 3459 Fifth Ave., Pittsburgh, PA 15213 USA
| | - Yoshiki Ishii
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan
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20
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Tufvesson E, Andersson C, Weidner J, Erjefält JS, Bjermer L. Inducible nitric oxide synthase expression is increased in the alveolar compartment of asthmatic patients. Allergy 2017; 72:627-635. [PMID: 27647044 DOI: 10.1111/all.13052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Increased exhaled nitric oxide (NO) levels in asthma are suggested to be through inducible NO synthase (iNOS). The aim of this study was to investigate the expression of iNOS in bronchoalveolar lavage (BAL) cells and tissue from central and peripheral airways and compare it with the exhaled bronchial and alveolar NO levels in patients with asthma vs a control group. METHODS Thirty-two patients with asthma (defined as controlled or uncontrolled according to Asthma Control Test score cut-off: 20) and eight healthy controls were included. Exhaled NO was measured, and alveolar concentration and bronchial flux were calculated. iNOS was measured in central and peripheral lung biopsies, as well as BAL cells. Bronchoalveolar lavage macrophages were stimulated in vitro, and iNOS expression and NO production were investigated. RESULTS Expression of iNOS was increased in central airway tissue and the alveolar compartment in uncontrolled as compared to controlled asthmatics and healthy controls. There were no differences, however, in iNOS mRNA levels in total BAL cells in uncontrolled as compared to controlled asthma. Bronchoalveolar lavage cell mRNA levels of iNOS or iNOS expression in central and alveolar tissue did not relate to alveolar NO, nor to bronchial flux of NO. In vitro stimulation with leukotriene D4 increased iNOS mRNA levels and NO production in cultured BAL macrophages. CONCLUSION The levels of both bronchial and alveolar iNOS are increased in uncontrolled as compared to controlled asthma. However, levels of iNOS in BAL macrophages were not reflected by alveolar NO. Both central and distal iNOS levels may reflect responsiveness to steroid treatment.
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Affiliation(s)
- E. Tufvesson
- Respiratory Medicine and Allergology; Department of Clinical Sciences Lund; Lund University; Lund Sweden
| | - C. Andersson
- National Heart & Lung Institute; Imperial College; London UK
| | - J. Weidner
- Respiratory Medicine and Allergology; Department of Clinical Sciences Lund; Lund University; Lund Sweden
| | - J. S. Erjefält
- Airway inflammation; Department of Experimental Medical Science; Lund University; Lund Sweden
| | - L. Bjermer
- Respiratory Medicine and Allergology; Department of Clinical Sciences Lund; Lund University; Lund Sweden
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21
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Rosenkranz MA, Esnault S, Christian BT, Crisafi G, Gresham LK, Higgins AT, Moore MN, Moore SM, Weng HY, Salk RH, Busse WW, Davidson RJ. Mind-body interactions in the regulation of airway inflammation in asthma: A PET study of acute and chronic stress. Brain Behav Immun 2016; 58:18-30. [PMID: 27039241 PMCID: PMC5045317 DOI: 10.1016/j.bbi.2016.03.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/08/2016] [Accepted: 03/26/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Psychological stress has long been recognized as a contributing factor to asthma symptom expression and disease progression. Yet, the neural mechanisms that underlie this relationship have been largely unexplored in research addressing the pathophysiology and management of asthma. Studies that have examined the mechanisms of this relationship in the periphery suggest that it is the superimposition of acute stress on top of chronic stress that is of greatest concern for airway inflammation. METHODS We compared asthmatic individuals with high and low levels of chronic life stress in their neural and peripheral physiological responses to the Trier Social Stress Test and a matched control task. We used FDG-PET to measure neural activity during performance of the two tasks. We used both circulating and airway-specific markers of asthma-related inflammation to assess the impact of acute stress in these two groups. RESULTS Asthmatics under chronic stress had a larger HPA-axis response to an acute stressor, which failed to show the suppressive effects on inflammatory markers observed in those with low chronic stress. Moreover, our PET data suggest that greater activity in the anterior insula during acute stress may reflect regulation of the effect of stress on inflammation. In contrast, greater activity in the mid-insula and perigenual anterior cingulate seems to reflect greater reactivity and was associated with greater airway inflammation, a more robust alpha amylase response, and a greater stress-induced increase in proinflammatory cytokine mRNA expression in airway cells. CONCLUSIONS Acute stress is associated with increases in markers of airway inflammation in asthmatics under chronic stress. This relationship may be mediated by interactions between the insula and anterior cingulate cortex, that determine the salience of environmental cues, as well as descending regulatory influence of inflammatory pathways in the periphery.
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Affiliation(s)
- Melissa A. Rosenkranz
- Waisman Laboratory for Brain Imaging & Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, 1500 Highland Ave, Madison, Wisconsin 53705, USA
| | - Stephane Esnault
- Department of Medicine, University of Wisconsin-Madison, 600 Highland Ave, Madison, Wisconsin 53792, USA
| | - Bradley T. Christian
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705, USA
| | - Gina Crisafi
- Department of Medicine, University of Wisconsin-Madison, 600 Highland Ave, Madison, Wisconsin 53792, USA
| | - Lauren K. Gresham
- Waisman Laboratory for Brain Imaging & Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, 1500 Highland Ave, Madison, Wisconsin 53705, USA
| | - Andrew T. Higgins
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705, USA
| | - Mollie N. Moore
- Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St. Madison, Wisconsin 53706, USA
| | - Sarah M. Moore
- Department of Counseling Psychology, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, Wisconsin 53706, USA
| | - Helen Y. Weng
- Waisman Laboratory for Brain Imaging & Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, 1500 Highland Ave, Madison, Wisconsin 53705, USA,Osher Center for Integrative Medicine, University of California, San Francisco, 1701 Divisadero St #150, San Francisco, CA 94115, USA
| | - Rachel H. Salk
- Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St. Madison, Wisconsin 53706, USA
| | - William W. Busse
- Department of Medicine, University of Wisconsin-Madison, 600 Highland Ave, Madison, Wisconsin 53792, USA
| | - Richard J. Davidson
- Waisman Laboratory for Brain Imaging & Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, 1500 Highland Ave, Madison, Wisconsin 53705, USA,Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St. Madison, Wisconsin 53706, USA,Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA
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Potential of Inducible Nitric Oxide Synthase as a Therapeutic Target for Allergen-Induced Airway Hyperresponsiveness: A Critical Connection to Nitric Oxide Levels and PARP Activity. Mediators Inflamm 2016; 2016:1984703. [PMID: 27524861 PMCID: PMC4971330 DOI: 10.1155/2016/1984703] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/11/2016] [Accepted: 05/22/2016] [Indexed: 12/20/2022] Open
Abstract
Although expression of inducible NO synthase (iNOS) in the lungs of asthmatics and associated nitrosative damage are established, iNOS failed as a therapeutic target for blocking airway hyperresponsiveness (AHR) and inflammation in asthmatics. This dichotomy calls for better strategies with which the enzyme is adequately targeted. Here, we confirm iNOS expression in the asthmatic lung with concomitant protein nitration and poly(ADP-ribose) polymerase (PARP) activation. We show, for the first time, that iNOS is highly expressed in peripheral blood mononuclear cells (PBMCs) of asthmatics with uncontrolled disease, which did not correspond to protein nitration. Selective iNOS inhibition with L-NIL protected against AHR upon acute, but not chronic, exposure to ovalbumin or house dust mite (HDM) in mice. Supplementation of NO by nitrite administration significantly blocked AHR in chronically HDM-exposed mice that were treated with L-NIL. Protection against chronic HDM exposure-induced AHR by olaparib-mediated PARP inhibition may be associated with the partial but not the complete blockade of iNOS expression. Indeed, L-NIL administration prevented olaparib-mediated protection against AHR in chronically HDM-exposed mice. Our study suggests that the amount of iNOS and NO are critical determinants in the modulation of AHR by selective iNOS inhibitors and renews the potential of iNOS as a therapeutic target for asthma.
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Tomasiak-Lozowska MM, Rusak T, Misztal T, Bodzenta-Lukaszyk A, Tomasiak M. Reduced clot retraction rate and altered platelet energy production in patients with asthma. J Asthma 2016; 53:589-98. [PMID: 27145190 DOI: 10.3109/02770903.2015.1130151] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Asthma enhances the risk of pulmonary embolism. The mechanism of this phenomenon is unclear. METHODS We evaluated the kinetics of clot formation, clot retraction rate (CRR), clot volume at 40 min, the rate of lactate production (a marker of aerobic glycolysis in platelets in contracting clots), blood eosinophil count (EOS), nitric oxide in exhaled breath (FENO), and spirometry (FEV1) in 50 healthy controls and in 81 allergic asthmatics (41 subjects with steroid-naïve asthma and 40 with steroid-treated asthma). RESULTS Thromboelastometry revealed that only steroid-treated asthmatics had slightly activated coagulation. Compared with healthy controls, whole asthmatics demonstrated (p < 0.05) reduced CRR, higher clot volume at 40 minutes, higher FENO, decreased FEV1, elevated EOS, and augmented lactate production in retracting clots. Reduced CRR was observed also in the absence of native plasma. In whole study population (asthmatics and healthy controls), CRR positively correlated with spirometry (rS = 0.668, p = <0.001) and negatively with FENO (rS = -0.543; p < 0.001), EOS (rS = -0.367, p < 0.002), and lactate production (rS = -0.791; p < 0.001). However, in steroid-treated asthmatics, the CRR did not correlate with FENO and EOS. In all study patients lactate production negatively correlated with FEV1 and positively with FENO. CONCLUSION Collectively, this data is consistent with the hypothesis that, in asthmatics, reactive nitrogen species produced in the lungs may reduce platelet contractility (and CRR) through the diminution of platelet energy production. CRR inhibition would predispose asthmatics to pulmonary embolism.
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Affiliation(s)
| | - Tomasz Rusak
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
| | - Tomasz Misztal
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
| | - Anna Bodzenta-Lukaszyk
- a Department of Allergology and Internal Diseases , Medical University of Bialystok , Bialystok , Poland
| | - Marian Tomasiak
- b Department of Physical Chemistry , Medical University of Bialystok , Bialystok , Poland
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Ricciardolo F, Sorbello V, Bellezza Fontana R, Schiavetti I, Ciprandi G. Exhaled nitric oxide in relation to asthma control: A real-life survey. Allergol Immunopathol (Madr) 2016; 44:197-205. [PMID: 26589339 DOI: 10.1016/j.aller.2015.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/16/2015] [Accepted: 05/26/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness. OBJECTIVE The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting. METHODS Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO. RESULTS FeNO values were significantly higher in patients with poorly controlled asthma (p<0.01), asthma symptoms (p=0.015), wheezing (p<0.001), rhinitis diagnosis, (p=0.049) and rhinitis symptoms (p=0.019), but lower in patients with GERD (p=0.024) and pneumonia history (p=0.048). FeNO values increased in patients with the lowest corticosteroid dose (p=0.031). FeNO values>25ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9ppb was fairly predictive of (AUC 0.7) poorly controlled asthma. CONCLUSIONS FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control.
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25
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Dipeptidyl peptidase-4 is highly expressed in bronchial epithelial cells of untreated asthma and it increases cell proliferation along with fibronectin production in airway constitutive cells. Respir Res 2016; 17:28. [PMID: 26975422 PMCID: PMC4791890 DOI: 10.1186/s12931-016-0342-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/01/2016] [Indexed: 12/11/2022] Open
Abstract
Background Type 2 helper T-cell cytokines including IL-13 play a central role in the pathogenesis of bronchial asthma (BA). During the course of our research, our attention was drawn to dipeptidyl peptidase-4 (DPP4) as one of the molecules that were induced from bronchial epithelial cells (BECs) by IL-13 stimulation. DPP4 could become a new biomarker or therapeutic target. The aim of this study was to investigate the expression of DPP4 in the asthmatic airway, and its role in the pathophysiology of asthma. Methods BECs were isolated from patients with inhaled corticosteroid-treated asthma (stBA) and inhaled corticosteroid-naïve asthma (snBA) using bronchoscopy. DPP4 mRNA expression in freshly isolated BECs and primary cultured BECs with or without IL-13 stimulation was investigated by microarray analysis and quantitative real-time PCR (qPCR). The distribution of DPP4 protein was determined by immunostaining of transbronchial lung biopsy specimens from asthma patients. The effect of recombinant human (rh) DPP4 on the proliferation of lung fibroblasts (HFL-1) and bronchial smooth muscle cells (BSMCs) was examined, as well as its effect on the production of fibronectin (FN). Results DPP4 mRNA was strongly expressed in freshly isolated BECs in snBA, and its expression was significantly enhanced by IL-13 stimulation. DPP4 mRNA expression in BECs of snBA significantly correlated with exhaled nitric oxide. Biopsied tissues of the asthmatic airway revealed strong expression of DPP4 protein in BECs from snBA subjects. rhDPP4 stimulated the proliferation of HFL-1 and BSMCs, and it also enhanced production of FN from these airway cells. Conclusion DPP4 may be involved in the pathologic features of asthmatic airway inflammation and cell proliferation and FN production. Electronic supplementary material The online version of this article (doi:10.1186/s12931-016-0342-7) contains supplementary material, which is available to authorized users.
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26
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Grunig G, Baghdassarian A, Park SH, Pylawka S, Bleck B, Reibman J, Berman-Rosenzweig E, Durmus N. Challenges and Current Efforts in the Development of Biomarkers for Chronic Inflammatory and Remodeling Conditions of the Lungs. Biomark Insights 2016; 10:59-72. [PMID: 26917944 PMCID: PMC4756863 DOI: 10.4137/bmi.s29514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/14/2015] [Accepted: 10/18/2015] [Indexed: 02/06/2023] Open
Abstract
This review discusses biomarkers that are being researched for their usefulness to phenotype chronic inflammatory lung diseases that cause remodeling of the lung's architecture. The review focuses on asthma, chronic obstructive pulmonary disease (COPD), and pulmonary hypertension. Bio-markers of environmental exposure and specific classes of biomarkers (noncoding RNA, metabolism, vitamin, coagulation, and microbiome related) are also discussed. Examples of biomarkers that are in clinical use, biomarkers that are under development, and biomarkers that are still in the research phase are discussed. We chose to present examples of the research in biomarker development by diseases, because asthma, COPD, and pulmonary hypertension are distinct entities, although they clearly share processes of inflammation and remodeling.
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Affiliation(s)
- Gabriele Grunig
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.; Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Aram Baghdassarian
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Sung-Hyun Park
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Serhiy Pylawka
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - Bertram Bleck
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Joan Reibman
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | | | - Nedim Durmus
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
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27
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Silkoff PE, Strambu I, Laviolette M, Singh D, FitzGerald JM, Lam S, Kelsen S, Eich A, Ludwig-Sengpiel A, Hupp GC, Backer V, Porsbjerg C, Girodet PO, Berger P, Leigh R, Kline JN, Dransfield M, Calhoun W, Hussaini A, Khatri S, Chanez P, Susulic VS, Barnathan ES, Curran M, Das AM, Brodmerkel C, Baribaud F, Loza MJ. Asthma characteristics and biomarkers from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) longitudinal profiling study. Respir Res 2015; 16:142. [PMID: 26576744 PMCID: PMC4650115 DOI: 10.1186/s12931-015-0299-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/31/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Asthma is a heterogeneous disease and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. The purpose of the ADEPT study was to correlate clinical features and biomarkers with molecular characteristics, by profiling asthma (NCT01274507). This report presents for the first time the study design, and characteristics of the recruited subjects. METHODS Patients with a range of asthma severity and healthy non-atopic controls were enrolled. The asthmatic subjects were followed for 12 months. Assessments included history, patient questionnaires, spirometry, airway hyper-responsiveness to methacholine, fractional exhaled nitric oxide (FENO), and biomarkers measured in induced sputum, blood, and bronchoscopy samples. All subjects underwent sputum induction and 30 subjects/cohort had bronchoscopy. RESULTS Mild (n = 52), moderate (n = 55), severe (n = 51) asthma cohorts and 30 healthy controls were enrolled from North America and Western Europe. Airflow obstruction, bronchodilator response and airways hyperresponsiveness increased with asthma severity, and severe asthma subjects had reduced forced vital capacity. Asthma control questionnaire-7 (ACQ7) scores worsened with asthma severity. In the asthmatics, mean values for all clinical and biomarker characteristics were stable over 12 months although individual variability was evident. FENO and blood eosinophils did not differ by asthma severity. Induced sputum eosinophils but not neutrophils were lower in mild compared to the moderate and severe asthma cohorts. CONCLUSIONS The ADEPT study successfully enrolled asthmatics across a spectrum of severity and non-atopic controls. Clinical characteristics were related to asthma severity and in general asthma characteristics e.g. lung function, were stable over 12 months. Use of the ADEPT data should prove useful in defining biological phenotypes to facilitate personalized therapeutic approaches.
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Affiliation(s)
- P E Silkoff
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA.
| | - I Strambu
- Arensia Exploratory Medicine, Sos. Viilor 90, Bucharest, 050159, Romania.
| | - M Laviolette
- Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ), 2725, Chemin Ste-Foy, Québec, G1V 4G5, Canada.
| | - D Singh
- Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, University of Manchester, Southmoor Road, Manchester, M23 9QZ, UK.
| | - J M FitzGerald
- Institute for Heart and Lung Health, The Lung Centre, 7th Floor, Gordon, Canada. .,Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - S Lam
- Institute for Heart and Lung Health, The Lung Centre, 7th Floor, Gordon, Canada.,Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - S Kelsen
- Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad St., Philadelphia, PA, 19140, USA.
| | - A Eich
- IKF Pneumologie Frankfurt, Institut für klinische Forschung Pneumologie, Clinical Research Centre Respiratory Diseases, Schaumainkai 101-103, Stresemannallee, 360596, Frankfurt, Germany.
| | - A Ludwig-Sengpiel
- KLB Gesundheitsforschung Lübeck GmbH, Sandstr. 18, 23552, Lübeck, Germany.
| | - G C Hupp
- Yale Center for Asthma and Airway Disease, Division of Pulmonary and Critical Care and Sleep Medicine, Yale School of Medicine, TAC 441, 300 Cedar Street, New Haven, CT, 06520, USA.
| | - V Backer
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg University Hospital, Bispebjerg bakke 23, DK-2400, Copenhagen, NV, Denmark.
| | - C Porsbjerg
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg University Hospital, Bispebjerg bakke 23, DK-2400, Copenhagen, NV, Denmark.
| | - P O Girodet
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, F-33000, Bordeaux, France
| | - P Berger
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, F-33000, Bordeaux, France.
| | - R Leigh
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - J N Kline
- Division of Pulmonary, C ritical Care, and Occupational Medicine, University of Iowa, W219B GH UIHC, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - M Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham & Birmingham VA Medical Center, 422 THT, 1900 University Blvd, Birmingham, AL, 35294, USA.
| | - W Calhoun
- 4.116 John Sealy Annex, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0568, USA.
| | - A Hussaini
- Parexel International, Shelton Simmons (MD), 3001 S Hanover St #7, Brooklyn, MD, 21225, USA.
| | - S Khatri
- Department of Pulmonary and Critical Care, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
| | - P Chanez
- Department of Respiratory Diseases and CIC Nord AP-HM, UMR INSERM U1067 CNRS 7733, Aix-Marseille Université, Marseille, France.
| | - V S Susulic
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - E S Barnathan
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - M Curran
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - A M Das
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - C Brodmerkel
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - F Baribaud
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - M J Loza
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
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Comparison of arginase isoform expression in patients with different subtypes of chronic rhinosinusitis. The Journal of Laryngology & Otology 2015; 129:1194-200. [DOI: 10.1017/s0022215115002728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AbstractObjective:Although human paranasal sinuses are critical organs for nitric oxide production, little information is available regarding the role of arginase in alterations of arginine metabolism and nasal nitric oxide levels that may be informative for classifying chronic rhinosinusitis subtypes.Methods:The expression and localisation of arginase and nitric oxide synthase isoforms in paranasal sinus mucosa were examined, and the fractional exhaled nitric oxide was measured in chronic rhinosinusitis without nasal polyps (n=18) and chronic rhinosinusitis with nasal polyps (n = 27) patients.Results:Increased arginase-2 activities in chronic rhinosinusitis without nasal polyps patients were associated with significantly lower levels of nasal fractional exhaled nitric oxide. Chronic rhinosinusitis with nasal polyps patients showed significant NOS2 messenger RNA upregulation with concomitant higher levels of oral and nasal fractional exhaled nitric oxide.Conclusion:These results indicate that fractional exhaled nitric oxide is a valid marker for differentiating chronic rhinosinusitis phenotypes based on a delicate balance between arginase and nitric oxide synthase activities in nitric oxide production.
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Blankestijn MA, Boyle RJ, Gore R, Hawrylowicz C, Jarvis D, Knulst AC, Wardlaw AJ. Developments in the field of allergy in 2013 through the eyes of Clinical and Experimental Allergy. Clin Exp Allergy 2015; 44:1436-57. [PMID: 25346287 DOI: 10.1111/cea.12442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
2013 was another exciting year for allergy in general and Clinical and Experimental Allergy in particular. In the field of asthma and rhinitis, there continued to be a focus on heterogeneity and phenotypes with increasing use of biostatistical techniques to determine clusters of similar populations. Obesity- and aspirin-associated disease are intriguing associations with asthma which were explored in a number of papers. We published a number of excellent papers on mechanisms of airway inflammation and how this relates to physiology, pathology, genetics and biomarkers in both human and experimental model systems. In terms of mechanisms, there is less on individual cell types in allergic disease at the moment, but the immunology of allergic disease continued to fascinate our authors. Another area that was popular both in the mechanisms and in the epidemiology sections was early life events and how these lead to allergic disease, with an increasing focus on the role of the microbiome and how this influences immune tolerance. In the clinical allergy section, oral immunotherapy for food allergy is clearly a major topic of interest at the moment as was in vitro testing to distinguish between sensitization and allergic disease. There was less on inhalant allergy this year, but a good representation from the drug allergy community including some interesting work on non-IgE-mediated mechanisms. In the allergen section, important new allergens continue to be discovered, but the major focus as in the last couple of years was on working out how component-resolved approaches can improve diagnosis and management of food and venom allergy.
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Affiliation(s)
- M A Blankestijn
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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Takeno S, Yoshimura H, Kubota K, Taruya T, Ishino T, Hirakawa K. Comparison of nasal nitric oxide levels between the inferior turbinate surface and the middle meatus in patients with symptomatic allergic rhinitis. Allergol Int 2015; 63:475-483. [PMID: 24957116 DOI: 10.2332/allergolint.14-oa-0689] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 01/14/2014] [Accepted: 03/06/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Because of the anatomical complexity and the high output of the human nose, it has been unclear whether nasal nitric oxide (NO) serves as a reliable marker of allergic rhinitis (AR). We examined whether nasal NO levels in the inferior turbinate (IT) surface and the middle meatus (MM) differ in symptomatic AR patients. METHODS We measured fractional exhaled NO (FeNO) and nasal NO in normal subjects (n = 50) and AR patients with mild symptoms (n = 16) or moderate or severe symptoms (n = 27). Nasal NO measurements were obtained using an electrochemical analyzer connected to a catheter and an air-suction pump (flow rate 50mL/sec). RESULTS Compared to the normal subjects, the AR patients showed significantly higher nasal FeNO and nasal NO levels in the IT area. No significant difference in the MM area was observed among the three groups. The MM area showed higher NO levels than the IT area in all three groups. The ratio of nasal NO levels of the MM area to the IT area (MM/IT ratio) was significantly lower in the AR groups. The moderate/severe AR patients showed significantly higher nasal NO in the IT area (104.4 vs. 66.2ppb) and lower MM/IT ratios than those in the mild AR patients. The analysis of nasal brushing cells revealed significantly higher eosinophil cationic protein and nitrotyrosine levels in the AR groups. CONCLUSIONS Nasal NO assessment in the IT area directly reflects persistent eosinophilic inflammation and may be a valid marker to estimate the severity of AR.
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Affiliation(s)
- Sachio Takeno
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruka Yoshimura
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazunori Kubota
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takayuki Taruya
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Ishino
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Katsuhiro Hirakawa
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Modena BD, Tedrow JR, Milosevic J, Bleecker ER, Meyers DA, Wu W, Bar-Joseph Z, Erzurum SC, Gaston BM, Busse WW, Jarjour NN, Kaminski N, Wenzel SE. Gene expression in relation to exhaled nitric oxide identifies novel asthma phenotypes with unique biomolecular pathways. Am J Respir Crit Care Med 2015; 190:1363-72. [PMID: 25338189 DOI: 10.1164/rccm.201406-1099oc] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Although asthma is recognized as a heterogeneous disease associated with clinical phenotypes, the molecular basis of these phenotypes remains poorly understood. Although genomic studies have successfully broadened our understanding in diseases such as cancer, they have not been widely used in asthma studies. OBJECTIVES To link gene expression patterns to clinical asthma phenotypes. METHODS We used a microarray platform to analyze bronchial airway epithelial cell gene expression in relation to the asthma biomarker fractional exhaled nitric oxide (FeNO) in 155 subjects with asthma and healthy control subjects from the Severe Asthma Research Program (SARP). MEASUREMENTS AND MAIN RESULTS We first identified a diverse set of 549 genes whose expression correlated with FeNO. We used k-means to cluster the patient samples according to the expression of these genes, identifying five asthma clusters/phenotypes with distinct clinical, physiological, cellular, and gene transcription characteristics-termed "subject clusters" (SCs). To then investigate differences in gene expression between SCs, a total of 1,384 genes were identified that highly differentiated the SCs at an unadjusted P value < 10(-6). Hierarchical clustering of these 1,384 genes identified nine gene clusters or "biclusters," whose coexpression suggested biological characteristics unique to each SC. Although genes related to type 2 inflammation were present, novel pathways, including those related to neuronal function, WNT pathways, and actin cytoskeleton, were noted. CONCLUSIONS These findings show that bronchial epithelial cell gene expression, as related to the asthma biomarker FeNO, can identify distinct asthma phenotypes, while also suggesting the presence of underlying novel gene pathways relevant to these phenotypes.
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Affiliation(s)
- Brian D Modena
- 1 Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Asthma Institute at UPMC, Pittsburgh, Pennsylvania
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Ledford JG, Addison KJ, Foster MW, Que LG. Eosinophil-associated lung diseases. A cry for surfactant proteins A and D help? Am J Respir Cell Mol Biol 2015; 51:604-14. [PMID: 24960334 DOI: 10.1165/rcmb.2014-0095tr] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Surfactant proteins (SP)-A and SP-D (SP-A/-D) play important roles in numerous eosinophil-dominated diseases, including asthma, allergic bronchopulmonary aspergillosis, and allergic rhinitis. In these settings, SP-A/-D have been shown to modulate eosinophil chemotaxis, inhibit eosinophil mediator release, and mediate macrophage clearance of apoptotic eosinophils. Dysregulation of SP-A/-D function in eosinophil-dominated diseases is also not uncommon. Alterations in serum SP-A/-D levels are associated with disease severity in allergic rhinitis and chronic obstructive pulmonary disease. Furthermore, oligimerization of SP-A/-D, necessary for their proper function, can be perturbed by reactive nitrogen species, which are increased in eosinophilic disease. In this review, we highlight the associations of eosinophilic lung diseases with SP-A and SP-D levels and functions.
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Affiliation(s)
- Julie G Ledford
- 1 Department of Medicine, Division of Pulmonary, Allergy and Critical Care, and
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Traister RS, Uvalle CE, Hawkins GA, Meyers DA, Bleecker ER, Wenzel SE. Phenotypic and genotypic association of epithelial IL1RL1 to human TH2-like asthma. J Allergy Clin Immunol 2015; 135:92-9. [PMID: 25091434 PMCID: PMC4289095 DOI: 10.1016/j.jaci.2014.06.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 06/10/2014] [Accepted: 06/18/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Severe asthma remains poorly characterized, although it likely consists of at least 1 phenotype with features of TH2-like inflammation. IL1RL1, encoding both the IL-33 receptor, ST2L, and decoy receptor, sST2, has been genetically associated with asthma, though the mechanism for susceptibility remains unknown. OBJECTIVE Given previous data supporting a role for IL1RL1 in TH2 inflammation, we hypothesized that ST2L expression might be increased in TH2-like asthma and that expression levels would be associated with single nucleotide polymorphisms in IL1RL1, possibly explaining its genetic relationship with asthma. We also sought to evaluate the regulation of ST2L and sST2 in vitro. METHODS Endobronchial brushings and biopsies were obtained and expression of ST2L compared by severity levels, as well as by TH2-like biomarkers. Subjects were genotyped and the relationship of dichotomous expression of ST2L and sST2 to single nucleotide polymorphisms in IL1RL1 were determined. Epithelial cells were grown in air-liquid interface culture, and ST2L and sST2 responses to IFN-γ and IL-13 were evaluated. RESULTS ST2L expression was increased in severe asthma (P = .02) and associated with multiple indicators of TH2-like inflammation, including blood eosinophils (P = .001), exhaled nitric oxide (P = .003), and epithelial CLCA1 (P < .0001) and eotaxin-3 (P = .001) mRNA expression. Multiple single nucleotide polymorphisms in IL1RL1 were found in relation to dichotomous expression of both ST2L and sST2. sST2 expression was associated with IFN-γ expression in bronchoalveolar lavage, while inducing its expression in vitro in primary human epithelial cells. CONCLUSION Both pathologic and genetic approaches support a role for IL1RL1 in severe asthma, as well as TH2-lke asthma, suggesting that targeting this pathway may have therapeutic benefits.
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Affiliation(s)
| | - Crystal E Uvalle
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Gregory A Hawkins
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Deborah A Meyers
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Eugene R Bleecker
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sally E Wenzel
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
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Ray A, Oriss TB, Wenzel SE. Emerging molecular phenotypes of asthma. Am J Physiol Lung Cell Mol Physiol 2014; 308:L130-40. [PMID: 25326577 DOI: 10.1152/ajplung.00070.2014] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Although asthma has long been considered a heterogeneous disease, attempts to define subgroups of asthma have been limited. In recent years, both clinical and statistical approaches have been utilized to better merge clinical characteristics, biology, and genetics. These combined characteristics have been used to define phenotypes of asthma, the observable characteristics of a patient determined by the interaction of genes and environment. Identification of consistent clinical phenotypes has now been reported across studies. Now the addition of various 'omics and identification of specific molecular pathways have moved the concept of clinical phenotypes toward the concept of molecular phenotypes. The importance of these molecular phenotypes is being confirmed through the integration of molecularly targeted biological therapies. Thus the global term asthma is poised to become obsolete, being replaced by terms that more specifically identify the pathology associated with the disease.
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Affiliation(s)
- Anuradha Ray
- University of Pittsburgh Asthma Institute at UPMC, Pulmonary, Allergy and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Timothy B Oriss
- University of Pittsburgh Asthma Institute at UPMC, Pulmonary, Allergy and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sally E Wenzel
- University of Pittsburgh Asthma Institute at UPMC, Pulmonary, Allergy and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Xie M, Mustovich AT, Jiang Y, Trudeau JB, Ray A, Ray P, Hu H, Holguin F, Freeman B, Wenzel SE. IL-27 and type 2 immunity in asthmatic patients: association with severity, CXCL9, and signal transducer and activator of transcription signaling. J Allergy Clin Immunol 2014; 135:386-94. [PMID: 25312760 DOI: 10.1016/j.jaci.2014.08.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/23/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Severe asthma (SA) can involve both innate and type 2 cytokine-associated adaptive immunity. Although IL-27 has been reported to potentiate TH1 responses (including the chemokine CXCL9) and suppress TH2 responses, its function in asthmatic patients is unknown. OBJECTIVE We sought to evaluate IL-27 expression in human asthma alone and in combination with type 2 immunity to determine the relationship to disease severity and CXCL9 expression. We also sought to model these interactions in vitro in human bronchial epithelial cells. METHODS Bronchoalveolar lavage cells from 87 participants were evaluated for IL-27 mRNA and protein alone and in association with epithelial CCL26 (a marker of type 2 activation) in relation to asthma severity and CXCL9 mRNA. Human bronchial epithelial cells cultured at the air-liquid interface and stimulated with IL-27 (1-100 ng/mL) with or without IL-13 (1 ng/mL) were evaluated for CXCL9 expression by using quantitative real-time PCR and ELISA. Phosphorylated and total signal transducer and activator of transcription (STAT) 1/3 were detected by means of Western blotting. Small interfering RNA knockdown of STAT1 or STAT3 was performed. RESULTS Bronchoalveolar lavage cell IL-27 mRNA and protein levels were increased in asthmatic patients. Patients with evidence for type 2 pathway activation had higher IL-27 expression (P = .02). Combined IL-27 and CCL26 expression associated with more SA and higher CXCL9 expression (P = .004 and P = .007 respectively), whereas IL-27 alone was associated with milder disease. In vitro IL-13 augmented IL-27-induced CXCL9 expression, which appeared to be due to augmented STAT1 activation and reduced STAT3 activation. CONCLUSIONS IL-27, in combination with a type 2/CCL26 signature, identifies a more SA phenotype, perhaps through combined effects of IL-27 and IL-13 on STAT signaling. Understanding these interactions could lead to new targets for asthma therapy.
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Affiliation(s)
- Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Anthony T Mustovich
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Yi Jiang
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - John B Trudeau
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Anuradha Ray
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Prabir Ray
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Haizhen Hu
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Fernando Holguin
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Bruce Freeman
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Sally E Wenzel
- University of Pittsburgh Asthma Institute@UPMC, Pulmonary Allergy Critical Care Medicine Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
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Voraphani N, Gladwin MT, Contreras AU, Kaminski N, Tedrow JR, Milosevic J, Bleecker ER, Meyers DA, Ray A, Ray P, Erzurum SC, Busse WW, Zhao J, Trudeau JB, Wenzel SE. An airway epithelial iNOS-DUOX2-thyroid peroxidase metabolome drives Th1/Th2 nitrative stress in human severe asthma. Mucosal Immunol 2014; 7:1175-85. [PMID: 24518246 PMCID: PMC4130801 DOI: 10.1038/mi.2014.6] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 01/08/2014] [Indexed: 02/04/2023]
Abstract
Severe refractory asthma is associated with enhanced nitrative stress. To determine the mechanisms for high nitrative stress in human severe asthma (SA), 3-nitrotyrosine (3NT) was compared with Th1 and Th2 cytokine expression. In SA, high 3NT levels were associated with high interferon (IFN)-γ and low interleukin (IL)-13 expression, both of which have been reported to increase inducible nitric oxide synthase (iNOS) in human airway epithelial cells (HAECs). We found that IL-13 and IFN-γ synergistically enhanced iNOS, nitrite, and 3NT, corresponding with increased H(2)O(2). Catalase inhibited whereas superoxide dismutase enhanced 3NT formation, supporting a critical role for H(2)O(2), but not peroxynitrite, in 3NT generation. Dual oxidase-2 (DUOX2), central to H(2)O(2) formation, was also synergistically induced by IL-13 and IFN-γ. The catalysis of nitrite and H(2)O(2) to nitrogen dioxide radical (NO(2)(•)) requires an endogenous peroxidase in this epithelial cell system. Thyroid peroxidase (TPO) was identified by microarray analysis ex vivo as a gene distinguishing HAEC of SA from controls. IFN-γ induced TPO in HAEC and small interfering RNA knockdown decreased nitrated tyrosine residues. Ex vivo, DUOX2, TPO, and iNOS were higher in SA and correlated with 3NT. Thus, a novel iNOS-DUOX2-TPO-NO(2)(•) metabolome drives nitrative stress in HAEC and likely in SA.
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Affiliation(s)
- N Voraphani
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - MT Gladwin
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - AU Contreras
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - N Kaminski
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - JR Tedrow
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J Milosevic
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - ER Bleecker
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - DA Meyers
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - A Ray
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - P Ray
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - SC Erzurum
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - WW Busse
- Division of Allergy and Clinical Immunology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J Zhao
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - JB Trudeau
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - SE Wenzel
- University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Abstract
PURPOSE OF REVIEW This review focuses on the most recent studies investigating fractional nitric oxide concentration in exhaled breath (FeNO) as a useful biomarker for identifying specific phenotypes in asthma and as a tool for asthma diagnosis, monitoring and clinical decision-making. RECENT FINDINGS On the basis of the current literature, it has been highlighted that FeNO is a clinically relevant marker in various clinical aspects of asthma: FeNO is a predictor for developing asthma in persistent rhinitis or in infants with respiratory symptoms; FeNO contributes to identification of asthma phenotypes in both children and adults, also in relation to severity; FeNO is useful in monitoring the effectiveness of inhaled corticosteroids (including compliance) and biologic treatments like omalizumab; FeNO, in conjunction with symptom registration and lung function measurements, contributes to asthma diagnosis and optimizes asthma management. SUMMARY FeNO provides further information in distinguishing different phenotypes in asthma, allowing a much more appropriate control of the disease, especially in patients with difficult/severe asthma. In the future, it would be interesting to shed light on the hidden biological mechanisms responsible for low or normal FeNO values in symptomatic asthmatic patients.
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Mari A, Antonietta Ciardiello M, Passalacqua G, Vliagoftis H, Wardlaw AJ, Wickman M. Developments in the field of allergy in 2012 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy 2014; 43:1309-32. [PMID: 24118214 DOI: 10.1111/cea.12212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2012, we received 683 submissions and published 20 editorials, 38 reviews, 11 letters and 128 original articles. This represents an acceptance rate for original papers in the range of 20%. About 30% of original papers were triaged not to go out to review, either because the editors did not feel they had sufficient priority for publication or because the topic did not feel right for the readers of the journal. We place great emphasis on obtaining sufficient high-quality reviews to make our decisions on publication fair and consistent. Inevitably, however, there is a degree of luck about what gets published and which papers miss out, and we are always happy to receive an appeal on our decisions either at the triage stage or after review. This gives us the opportunity to revisit the decision and revise it or explain in more detail to the authors the basis for the decision. Once again in 2012, we were delighted by the quality of the papers submitted and the breadth and depth of research into allergic disease that it revealed. The pattern of papers submitted was similar in previous years with considerable emphasis on all aspects of asthma and rhinitis. We were particularly pleased with our special issue on severe asthma. Elucidating mechanisms using either animal models or patients has always been a major theme of the journal, and the excellent work in these areas has been summarized by Harissios Vliagoftis with a particularly interesting section on early-life events guiding the development of allergic disease, which understandably continue to be a major theme of research. Magnus Wickman summarized the papers looking at the epidemiology of allergic disease including work from birth cohorts, which are an increasingly rich source of data on risk factors for allergic disease, and two papers on the epidemiology of anaphylaxis. Giovanni Passalacqua discussed the papers in the clinical allergy section of the journal, and Adriano Mari who runs the excellent Allergome website discussed the papers looking at allergens including characterization and the relative usefulness of allergen arrays versus single extracts in diagnosis and management.
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Affiliation(s)
- A Mari
- Allergome, Allergy Data Laboratories s.c., Latina, Italy
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van der Valk RJ, Duijts L, Timpson NJ, Salam MT, Standl M, Curtin JA, Genuneit J, Kerhof M, Kreiner-Møller E, Cáceres A, Gref A, Liang LL, Taal HR, Bouzigon E, Demenais F, Nadif R, Ober C, Thompson EE, Estrada K, Hofman A, Uitterlinden AG, van Duijn C, Rivadeneira F, Li X, Eckel SP, Berhane K, Gauderman WJ, Granell R, Evans DM, St Pourcain B, McArdle W, Kemp JP, Smith GD, Tiesler CM, Flexeder C, Simpson A, Murray CS, Fuchs O, Postma DS, Bønnelykke K, Torrent M, Andersson M, Sleiman P, Hakonarson H, Cookson WO, Moffatt MF, Paternoster L, Melén E, Sunyer J, Bisgaard H, Koppelman GH, Ege M, Custovic A, Heinrich J, Gilliland FD, Henderson AJ, Jaddoe VW, de Jongste JC. Fraction of exhaled nitric oxide values in childhood are associated with 17q11.2-q12 and 17q12-q21 variants. J Allergy Clin Immunol 2014; 134:46-55. [PMID: 24315451 PMCID: PMC4334587 DOI: 10.1016/j.jaci.2013.08.053] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/21/2013] [Accepted: 08/28/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The fraction of exhaled nitric oxide (Feno) value is a biomarker of eosinophilic airway inflammation and is associated with childhood asthma. Identification of common genetic variants associated with childhood Feno values might help to define biological mechanisms related to specific asthma phenotypes. OBJECTIVE We sought to identify the genetic variants associated with childhood Feno values and their relation with asthma. METHODS Feno values were measured in children age 5 to 15 years. In 14 genome-wide association studies (N = 8,858), we examined the associations of approximately 2.5 million single nucleotide polymorphisms (SNPs) with Feno values. Subsequently, we assessed whether significant SNPs were expression quantitative trait loci in genome-wide expression data sets of lymphoblastoid cell lines (n = 1,830) and were related to asthma in a previously published genome-wide association data set (cases, n = 10,365; control subjects: n = 16,110). RESULTS We identified 3 SNPs associated with Feno values: rs3751972 in LYR motif containing 9 (LYRM9; P = 1.97 × 10(-10)) and rs944722 in inducible nitric oxide synthase 2 (NOS2; P = 1.28 × 10(-9)), both of which are located at 17q11.2-q12, and rs8069176 near gasdermin B (GSDMB; P = 1.88 × 10(-8)) at 17q12-q21. We found a cis expression quantitative trait locus for the transcript soluble galactoside-binding lectin 9 (LGALS9) that is in linkage disequilibrium with rs944722. rs8069176 was associated with GSDMB and ORM1-like 3 (ORMDL3) expression. rs8069176 at 17q12-q21, but not rs3751972 and rs944722 at 17q11.2-q12, were associated with physician-diagnosed asthma. CONCLUSION This study identified 3 variants associated with Feno values, explaining 0.95% of the variance. Identification of functional SNPs and haplotypes in these regions might provide novel insight into the regulation of Feno values. This study highlights that both shared and distinct genetic factors affect Feno values and childhood asthma.
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Affiliation(s)
- Ralf Jp van der Valk
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- School of Social and Community Medicine, University of Bristol, Uk
| | - Nicolas J Timpson
- School of Social and Community Medicine, University of Bristol, Uk
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, UK
| | - Muhammad T Salam
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - John A Curtin
- University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Marjan Kerhof
- University Medical Center Groningen, University of Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital
| | - Eskil Kreiner-Møller
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
| | - Alejandro Cáceres
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain
- Spanish consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Anna Gref
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Liming L Liang
- Department of Epidemiology, Harvard School of Public Health, Boston, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, USA
| | - H Rob Taal
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Emmanuelle Bouzigon
- Inserm, UMR 946, Genetic Variation and Human Diseases Unit, F-75010, Paris, France
- Univ Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, F- 75007, Paris, France
| | - Florence Demenais
- Inserm, UMR 946, Genetic Variation and Human Diseases Unit, F-75010, Paris, France
- Univ Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, F- 75007, Paris, France
| | - Rachel Nadif
- Inserm, Centre for research in Epidemiology and Population Health (CEPH), U1018, Respiratory and Environmental Epidemiology Team, F-94807, Villejuif, France
- Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France
| | - Carole Ober
- Department of Human Genetics, University of Chicago, Chicago, IL 60637
| | - Emma E Thompson
- Department of Human Genetics, University of Chicago, Chicago, IL 60637
| | - Karol Estrada
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - André G Uitterlinden
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cornélia van Duijn
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Xia Li
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - Sandrah P Eckel
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - Kiros Berhane
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - W James Gauderman
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - Raquel Granell
- School of Social and Community Medicine, University of Bristol, Uk
| | - David M Evans
- School of Social and Community Medicine, University of Bristol, Uk
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, UK
| | | | - Wendy McArdle
- School of Social and Community Medicine, University of Bristol, Uk
| | - John P Kemp
- School of Social and Community Medicine, University of Bristol, Uk
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, UK
| | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Uk
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, UK
| | - Carla Mt Tiesler
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Flexeder
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Angela Simpson
- University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Clare S Murray
- University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Oliver Fuchs
- Inselspital, Universitätsspital, Bern, Universitätklinik für Kinderheilkunde, Bern, Switzerland
- Dr. von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany
| | - Dirkje S Postma
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
| | - Maties Torrent
- Spanish consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- ib-salut, Area de Salut de Menorca, Balearic Islands, Spain
| | - Martin Andersson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Physiology, South Central Hospital, Stockholm, Sweden
| | - Patrick Sleiman
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hakon Hakonarson
- Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - William O Cookson
- National Heart and Lung Institute, Imperial College London, London SW3 6LY
| | - Miriam F Moffatt
- National Heart and Lung Institute, Imperial College London, London SW3 6LY
| | - Lavinia Paternoster
- School of Social and Community Medicine, University of Bristol, Uk
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, UK
| | - Erik Melén
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Sach's Children's Hospital, Stockholm, Sweden
| | - Jordi Sunyer
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain
- Spanish consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Pompeu Fabra University (UPF), Barcelona, Catalonia, Spain
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
| | - Gerard H Koppelman
- University Medical Center Groningen, University of Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Markus Ege
- Dr. von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany
| | - Adnan Custovic
- University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Frank D Gilliland
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
| | | | - Vincent Wv Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
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Acute glutathione depletion leads to enhancement of airway reactivity and inflammation via p38MAPK-iNOS pathway in allergic mice. Int Immunopharmacol 2014; 22:222-9. [PMID: 24978607 DOI: 10.1016/j.intimp.2014.06.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/28/2014] [Accepted: 06/15/2014] [Indexed: 01/12/2023]
Abstract
Glutathione (GSH) plays a major role in allergic airway responses through a variety of mechanism which include direct scavenging of oxidative species, being a reducing equivalent and regulation of cellular signaling through redox sensitive mechanisms. Therefore, the aim of the present study was to evaluate the role of acute GSH depletion on airway reactivity, inflammation and NO signaling in a mouse model of allergic asthma. Buthionine sulfoximine (BSO), an inhibitor of gamma-glutamylcysteine synthetase was used for depletion of GSH levels. Acute depletion of GSH with BSO worsened allergen induced airway reactivity and inflammation through increase in nitrosative stress as reflected by increased inducible NO synthase (iNOS) expression, total nitrates and nitrites (NOx), nitrotyrosine, protein carbonyls, and decreased total antioxidant capacity. Treatment with p38 mitogen-activated protein kinase (MAPK) and iNOS inhibitors attenuated the effects of GSH depletion on airway reactivity and inflammation through attenuation of nitrosative stress as evidenced by a decrease in NOx, nitrotyrosine, protein carbonyls and increase in total antioxidant capacity (TAC). In conclusion, these data suggest that acute depletion of glutathione is associated with alteration of airway responses through an increase in nitrosative stress in allergic airways of mice.
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Chien JW, Lin CY, Yang KD, Lin CH, Kao JK, Tsai YG. Increased IL-17A secreting CD4+ T cells, serum IL-17 levels and exhaled nitric oxide are correlated with childhood asthma severity. Clin Exp Allergy 2014; 43:1018-26. [PMID: 23957337 DOI: 10.1111/cea.12119] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 03/11/2013] [Accepted: 03/19/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND Measuring fractional exhaled nitric oxide (FeNO) is a simple and non-invasive method for assessing airway inflammation. IL-17 plays an important role in T cell-dependent inflammatory response that occurs in allergic asthma, it could act as a potent activator of inducible nitric oxide synthase (iNOS) to amplify FeNO levels. OBJECTIVES To evaluate the differences in the CD4(+) IL-17A(+) T cell counts, serum IL-17 levels, and FeNO levels in children with mild intermittent to moderate to severe persistent asthma classified by using the Global Initiative for Asthma (GINA). METHODS One hundred and twenty asthmatic children divided into the mild intermittent (n = 42), mild persistent (n = 42), and moderate to severe persistent (n = 36) groups, and 20 healthy controls were recruited for the study. Information obtained at visits included the assessment of asthma severity according to GINA guidelines and C-ACT, lung function parameters, FeNO levels, CD4(+) IL-17A(+) T cells counts from PBMCs, iNOS production by sputum cells and serum IL-17 levels. RESULTS Serum IL-17 and FeNO levels were significantly higher in mild to severe persistent asthmatic patients than in intermittent asthmatics or healthy controls (P < 0.05). The percentage of CD4(+) IL-17A(+) T cells was higher in moderate to severe persistent asthmatics than in mild asthmatics (P < 0.01). Moderate to severe asthmatics (n = 5) exhibited greater iNOS production in sputum cells than mild cases (n = 5). Decreased iNOS expression in sputum cells was noted in all subjects after IL-17 neutralizing antibody (P < 0.05). Serum IL-17 levels were positively correlated with FeNO (rho = 0.74; P < 0.01), negatively correlated with C-ACT (rho = -0.63; P < 0.01) in asthmatics. CONCLUSION AND CLINICAL RELEVANCE CD4(+) IL-17A(+) T cells counts and serum IL-17 levels in conjunction with augmented FeNO levels are systemic markers of childhood asthma, using these markers, prediction and potential therapeutics for persistent asthmatics may be developed.
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Affiliation(s)
- J-W Chien
- Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan
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42
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Wysocki K, Park SY, Bleecker E, Busse W, Castro M, Chung KF, Gaston B, Erzurum S, Israel E, Teague WG, Moore CG, Wenzel S. Characterization of factors associated with systemic corticosteroid use in severe asthma: data from the Severe Asthma Research Program. J Allergy Clin Immunol 2014; 133:915-8. [PMID: 24332222 PMCID: PMC4086875 DOI: 10.1016/j.jaci.2013.10.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 10/16/2013] [Accepted: 10/29/2013] [Indexed: 11/28/2022]
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Roos AB, Mori M, Grönneberg R, Österlund C, Claesson HE, Wahlström J, Grunewald J, Eklund A, Erjefält JS, Lundberg JO, Nord M. Elevated exhaled nitric oxide in allergen-provoked asthma is associated with airway epithelial iNOS. PLoS One 2014; 9:e90018. [PMID: 24587191 PMCID: PMC3938593 DOI: 10.1371/journal.pone.0090018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 12/03/2013] [Indexed: 01/01/2023] Open
Abstract
Background Fractional exhaled nitric oxide is elevated in allergen-provoked asthma. The cellular and molecular source of the elevated fractional exhaled nitric oxide is, however, uncertain. Objective To investigate whether fractional exhaled nitric oxide is associated with increased airway epithelial inducible nitric oxide synthase (iNOS) in allergen-provoked asthma. Methods Fractional exhaled nitric oxide was measured in healthy controls (n = 14) and allergic asthmatics (n = 12), before and after bronchial provocation to birch pollen out of season. Bronchoscopy was performed before and 24 hours after allergen provocation. Bronchial biopsies and brush biopsies were processed for nitric oxide synthase activity staining with nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d), iNOS immunostaining, or gene expression analysis of iNOS by real-time PCR. NADPH-d and iNOS staining were quantified using automated morphometric analysis. Results Fractional exhaled nitric oxide and expression of iNOS mRNA were significantly higher in un-provoked asthmatics, compared to healthy controls. Allergic asthmatics exhibited a significant elevation of fractional exhaled nitric oxide after allergen provocation, as well as an accumulation of airway eosinophils. Moreover, nitric oxide synthase activity and expression of iNOS was significantly increased in the bronchial epithelium of asthmatics following allergen provocation. Fractional exhaled nitric oxide correlated with eosinophils and iNOS expression. Conclusion Higher fractional exhaled nitric oxide concentration among asthmatics is associated with elevated iNOS mRNA in the bronchial epithelium. Furthermore, our data demonstrates for the first time increased expression and activity of iNOS in the bronchial epithelium after allergen provocation, and thus provide a mechanistic explanation for elevated fractional exhaled nitric oxide in allergen-provoked asthma.
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Affiliation(s)
- Abraham B. Roos
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- * E-mail:
| | - Michiko Mori
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Reidar Grönneberg
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Christina Österlund
- Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Erik Claesson
- Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden
| | - Jan Wahlström
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Johan Grunewald
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Anders Eklund
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Jonas S. Erjefält
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Jon O. Lundberg
- Department of Physiology and Pharmacology, Section of Pharmacological Nitric Oxide Research, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Nord
- Department of Medicine, Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden
- Safety Science, Global Regulatory Affairs & Patient Safety, AstraZeneca Global Medicines Development, Mölndal, Sweden
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Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, Adcock IM, Bateman ED, Bel EH, Bleecker ER, Boulet LP, Brightling C, Chanez P, Dahlen SE, Djukanovic R, Frey U, Gaga M, Gibson P, Hamid Q, Jajour NN, Mauad T, Sorkness RL, Teague WG. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2013; 43:343-73. [DOI: 10.1183/09031936.00202013] [Citation(s) in RCA: 2274] [Impact Index Per Article: 206.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wenzel SE. Complex phenotypes in asthma: current definitions. Pulm Pharmacol Ther 2013; 26:710-5. [PMID: 23880027 DOI: 10.1016/j.pupt.2013.07.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 06/15/2013] [Accepted: 07/10/2013] [Indexed: 01/13/2023]
Abstract
Asthma is increasingly recognized as a heterogeneous disease. However, identification of different subgroups or phenotypes has been complex and controversial. The convergence of both clinical and statistical approaches to grouping patients and their characteristics, in association with increasing recognition of molecular patterns is now beginning to move the field forward. Integration of efficacy data with targeted molecular therapies will eventually lead to more complete understanding of these "molecular phenotypes" and eventually lead to the identification of fully defined endotypes. This process should improve our ability to treat more complex and severe forms of asthma.
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Affiliation(s)
- Sally E Wenzel
- University of Pittsburgh Asthma Institute@UPMC, Division of Pulmonary Allergy and Critical Care Medicine, University of Pittsburgh, NW 931 Montefiore, 3459 Fifth Ave, Pittsburgh, PA 15213, USA.
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Galangin Abrogates Ovalbumin-Induced Airway Inflammation via Negative Regulation of NF-κB. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:767689. [PMID: 23762160 PMCID: PMC3677671 DOI: 10.1155/2013/767689] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/14/2013] [Accepted: 04/25/2013] [Indexed: 01/21/2023]
Abstract
Persistent activation of nuclear factor κB (NF-κB) has been associated with the development of asthma. Galangin, the active pharmacological ingredient from Alpinia galanga, is reported to have a variety of anti-inflammatory properties in vitro via negative regulation of NF-κB. This study aimed to investigate whether galangin can abrogate ovalbumin- (OVA-) induced airway inflammation by negative regulation of NF-κB. BALB/c mice sensitized and challenged with OVA developed airway hyperresponsiveness (AHR) and inflammation. Galangin dose dependently inhibited OVA-induced increases in total cell counts, eosinophil counts, and interleukin-(IL-) 4, IL-5, and IL-13 levels in bronchoalveolar lavage fluid, and reduced serum level of OVA-specific IgE. Galangin also attenuated AHR, reduced eosinophil infiltration and goblet cell hyperplasia, and reduced expression of inducible nitric oxide synthase and vascular cell adhesion protein-1 (VCAM-1) levels in lung tissue. Additionally, galangin blocked inhibitor of κB degradation, phosphorylation of the p65 subunit of NF-κB, and p65 nuclear translocation from lung tissues of OVA-sensitized mice. Similarly, in normal human airway smooth muscle cells, galangin blocked tumor necrosis factor-α induced p65 nuclear translocation and expression of monocyte chemoattractant protein-1, eotaxin, CXCL10, and VCAM-1. These results suggest that galangin can attenuate ovalbumin-induced airway inflammation by inhibiting the NF-κB pathway.
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Hsu J, Avila PC, Kern RC, Hayes MG, Schleimer RP, Pinto JM. Genetics of chronic rhinosinusitis: state of the field and directions forward. J Allergy Clin Immunol 2013; 131:977-93, 993.e1-5. [PMID: 23540616 PMCID: PMC3715963 DOI: 10.1016/j.jaci.2013.01.028] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 01/15/2023]
Abstract
The cause of chronic rhinosinusitis (CRS) remains unclear. Study of the genetic susceptibility to CRS might be a valuable strategy to understand the pathogenesis of this burdensome disorder. The purpose of this review is to critically evaluate the current literature regarding the genetics of CRS in a comprehensive fashion. The most promising findings from candidate gene studies include the cystic fibrosis transmembrane conductance regulator gene (CFTR), as well as genes involved in antigen presentation, innate and adaptive immune responses, tissue remodeling, and arachidonic acid metabolism. We also review the few hypothesis-independent genetic studies of CRS (ie, linkage analysis and pooling-based genome-wide association studies). Interpretation of the current literature is limited by challenges with study design, sparse replication, few functional correlates of associated polymorphisms, and inadequate examination of linkage disequilibrium or expression quantitative trait loci for reported associations. Given the relationship of CRS to other airway disorders with well-characterized genetic components (eg, asthma), study of the genetics of CRS deserves increased attention and investment, including the organization of large, detailed, and collaborative studies to advance knowledge of the mechanisms that underlie this disorder.
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Affiliation(s)
- Joy Hsu
- Division of Allergy-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL 60637, USA
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Foster MW, Thompson JW, Forrester MT, Sha Y, McMahon TJ, Bowles DE, Moseley MA, Marshall HE. Proteomic analysis of the NOS2 interactome in human airway epithelial cells. Nitric Oxide 2013; 34:37-46. [PMID: 23438482 DOI: 10.1016/j.niox.2013.02.079] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 01/22/2023]
Abstract
The cytokine-inducible isoform of nitric oxide synthase (NOS2) is constitutively expressed in human respiratory epithelia and is upregulated in inflammatory lung disease. Here, we sought to better define the protein interactions that may be important for NOS2 activity and stability, as well as to identify potential targets of NOS2-derived NO, in the respiratory epithelium. We overexpressed Flag-tagged, catalytically-inactive NOS2 in A549 cells and used mass spectrometry to qualitatively identify NOS2 co-immunoprecipitating proteins. Stable isotope labeling of amino acids in cell culture (SILAC) was used to quantify the coordinate effects of cytokine stimulation on NOS2-protein interactions. Multi-protein networks dominated the NOS2 interactome, and cytokine-inducible interactions with allosteric activators and with the ubiquitin-proteasome system were correlated with cytokine-dependent increases in NO metabolites and in NOS2 ubiquitination. The ubiquitin ligase scaffolding protein, FBXO45, was identified as a novel, direct NOS2 interactor. Similar to the SPRY domain-containing SOCS box (SPSB) proteins, FBXO45 requires Asn27 in the (23)DINNN(27) motif of NOS2 for its interaction. However, FBXO45 is unique from the SPSBs in that it recruits a distinct E3 ligase complex containing MYCBP2 and SKP1. Collectively, these findings demonstrate the general utility of interaction proteomics for defining new aspects of NOS2 physiology.
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Affiliation(s)
- Matthew W Foster
- Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Centers, Durham, NC 27710, United States.
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Modulation of Asthma Pathogenesis by Nitric Oxide Pathways and Therapeutic Opportunities. ACTA ACUST UNITED AC 2012; 9:e89-e94. [PMID: 23976894 DOI: 10.1016/j.ddmec.2012.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Asthma, a chronic airway inflammatory disease is typically associated with high levels of exhaled nitric oxide (NO). Over the past decades, extensive research has revealed that NO participates in a number of metabolic pathways that contribute to animal models of asthma and human asthma. In asthmatic airway, high levels of NO lead to greater formation of reactive nitrogen species (RNS), which modify proteins adversely affecting functional activities. In contrast, high levels of NO are associated with lower than normal levels of S-nitrosothiols, which serve a bronchodilator function in the airway. Detailed mechanistic studies have enabled the development of compounds that target NO metabolic pathways, and provide opportunities for novel asthma therapy. This review discusses the role of NO in asthma with the primary focus on therapeutic opportunities developed in recent years.
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Manzo ND, LaGier AJ, Slade R, Ledbetter AD, Richards JH, Dye JA. Nitric oxide and superoxide mediate diesel particle effects in cytokine-treated mice and murine lung epithelial cells--implications for susceptibility to traffic-related air pollution. Part Fibre Toxicol 2012; 9:43. [PMID: 23151036 PMCID: PMC3546033 DOI: 10.1186/1743-8977-9-43] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 10/31/2012] [Indexed: 12/19/2022] Open
Abstract
Background Epidemiologic studies associate childhood exposure to traffic-related air pollution with increased respiratory infections and asthmatic and allergic symptoms. The strongest associations between traffic exposure and negative health impacts are observed in individuals with respiratory inflammation. We hypothesized that interactions between nitric oxide (NO), increased during lung inflammatory responses, and reactive oxygen species (ROS), increased as a consequence of traffic exposure ─ played a key role in the increased susceptibility of these at-risk populations to traffic emissions. Methods Diesel exhaust particles (DEP) were used as surrogates for traffic particles. Murine lung epithelial (LA-4) cells and BALB/c mice were treated with a cytokine mixture (cytomix: TNFα, IL-1β, and IFNγ) to induce a generic inflammatory state. Cells were exposed to saline or DEP (25 μg/cm2) and examined for differential effects on
redox balance and cytotoxicity. Likewise, mice undergoing nose-only inhalation exposure to air or DEP
(2 mg/m3 × 4 h/d × 2 d) were assessed for differential effects on lung inflammation, injury, antioxidant levels,
and phagocyte ROS production. Results Cytomix treatment significantly increased LA-4 cell NO production though iNOS activation. Cytomix +
DEP-exposed cells incurred the greatest intracellular ROS production, with commensurate cytotoxicity, as these cells were unable to maintain redox balance. By contrast, saline + DEP-exposed cells were able to mount effective antioxidant responses. DEP effects were mediated by: (1) increased ROS including superoxide anion (O2˙-), related to increased xanthine dehydrogenase expression and reduced cytosolic superoxide dismutase activity; and (2) increased peroxynitrite generation related to interaction of O2˙- with cytokine-induced NO. Effects were partially reduced by superoxide dismutase (SOD) supplementation or by blocking iNOS induction. In mice, cytomix +
DEP-exposure resulted in greater ROS production in lung phagocytes. Phagocyte and epithelial effects were, by and large, prevented by treatment with FeTMPyP, which accelerates peroxynitrite catalysis. Conclusions During inflammation, due to interactions of NO and O2˙-, DEP-exposure was associated with nitrosative stress in surface epithelial cells and resident lung phagocytes. As these cell types work in concert to provide protection against inhaled pathogens and allergens, dysfunction would predispose to development of respiratory infection and allergy. Results provide a mechanism by which individuals with pre-existing respiratory inflammation are at increased risk for exposure to traffic-dominated urban air pollution.
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Affiliation(s)
- Nicholas D Manzo
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
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