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Kobayashi Y, Chu HH, Bui DV, Yun Y, Nguyen LM, Mitani A, Suzuki K, Asako M, Kanda A, Iwai H. The Neutralization of the Eosinophil Peroxidase Antibody Accelerates Eosinophilic Mucin Decomposition. Cells 2023; 12:2746. [PMID: 38067174 PMCID: PMC10706369 DOI: 10.3390/cells12232746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Eosinophilic airway inflammation, complicated by bronchial asthma and eosinophilic chronic rhinosinusitis (ECRS), is difficult to treat. The disease may become refractory when eosinophilic mucin associated with eosinophil peroxidase (EPX) and autoantibodies fills in the paranasal sinus and small airway. This study investigated the functional role of an anti-EPX antibody in eosinophilic mucin of ECRS in eosinophilic airway inflammation. Eosinophilic mucin was obtained from patients with ECRS. The effects of the anti-EPX antibody on dsDNA release from eosinophils and eosinophilic mucin decomposition were evaluated. Immunofluorescence or enzyme-linked immunosorbent assays were performed to detect the anti-EPX antibody and its supernatant and serum levels in eosinophilic mucin, respectively. The serum levels of the anti-EPX antibody were positively correlated with sinus computed tomography score and fractionated exhaled nitrogen oxide. Patients with refractory ECRS had higher serum levels of the anti-EPX antibody than those without. However, dupilumab treatment decreased the serum levels of the anti-EPX antibody. Immunoglobulins (Igs) in the immunoprecipitate of mucin supernatants enhanced dsDNA release from eosinophils, whereas the neutralization of Igs against EPX stopped dsDNA release. Furthermore, EPX antibody neutralization accelerated mucin decomposition and restored corticosteroid sensitivity. Taken together, the anti-EPX antibody may be involved in the formulation of eosinophilic mucin and be used as a clinical marker and therapeutic target for intractable eosinophilic airway inflammation.
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Affiliation(s)
- Yoshiki Kobayashi
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Hanh Hong Chu
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Dan Van Bui
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Yasutaka Yun
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Linh Manh Nguyen
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Akitoshi Mitani
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Kensuke Suzuki
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
| | - Mikiya Asako
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Akira Kanda
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
- Allergy Center, Kansai Medical University Hospital, Osaka 573-1010, Japan
| | - Hiroshi Iwai
- Airway Disease Section, Department of Otorhinolaryngology, Kansai Medical University, Osaka 573-1010, Japan; (H.H.C.); (D.V.B.); (Y.Y.); (L.M.N.); (A.M.); (K.S.); (M.A.); (A.K.); (H.I.)
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Nall RW, Beloate LN, Meyerink ME, Penaloza T, Doolittle J, Froeliger B, Kalivas PW, Garcia-Keller C. Assessing combined effects of varenicline and N-acetylcysteine on reducing nicotine seeking in rats. Addict Biol 2022; 27:e13151. [PMID: 35229943 PMCID: PMC10777539 DOI: 10.1111/adb.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
Nicotine addiction is a chronic relapsing brain disorder, and cigarette smoking is the leading cause of preventable death in the United States. Currently, the most effective pharmacotherapy for smoking cessation is Varenicline (VRN), which reduces both positive and negative reinforcement by nicotine. Clinically, VRN attenuates withdrawal symptoms and promotes abstinence, but >50% of smokers relapse within 3 months following a quit attempt. This may indicate that VRN fails to ameliorate components of nicotine-induced neuroplasticity that promote relapse vulnerability. Animal models reveal that glutamate dysregulation in the nucleus accumbens is associated with nicotine relapse. N-acetylcysteine (NAC) normalizes glutamate transmission and prolongs cocaine abstinence. Thus, combining VRN and NAC may promote and maintain, respectively, nicotine abstinence. In rats, we found that VRN effectively reduced nicotine self-administration and seeking in early abstinence, but not seeking later in abstinence. In contrast, NAC reduced seeking only later in abstinence. Because VRN and NAC are sometimes associated with mild adverse effects, we also evaluated a sequential approach combining subthreshold doses of VRN during self-administration and early abstinence with subthreshold doses of NAC during late abstinence. As expected, subthreshold VRN did not reduce nicotine intake. However, subthreshold VRN and NAC reduced seeking in late abstinence, suggesting a combined effect. Overall, our results suggest that combining subthreshold VRN and NAC is a viable and drug-specific approach to promote abstinence and reduce relapse while minimizing adverse effects. Our data also suggest that different components and time points in addiction engage the different neurocircuits targeted by VRN and NAC.
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Affiliation(s)
- Rusty W. Nall
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
- Department of Psychology, Jacksonville State University, 700 Pelham Rd. N., Jacksonville, AL, 36265
| | - Lauren N. Beloate
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA 16802
| | - Michael E. Meyerink
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
| | - Tiffany Penaloza
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
| | - Jade Doolittle
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
| | - Brett Froeliger
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
- Department of Psychiatry, Department of Psychological Sciences, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65201
| | - Peter W. Kalivas
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
| | - Constanza Garcia-Keller
- Department of Neuroscience, Medical University of South Carolina, 173 Ashley Ave, Charleston, SC 29425
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Paz C, Suárez E, Vence J. CFD transient simulation of the cough clearance process using an Eulerian wall film model. Comput Methods Biomech Biomed Engin 2016; 20:142-152. [DOI: 10.1080/10255842.2016.1206532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McClure EA, Gipson CD, Malcolm RJ, Kalivas PW, Gray KM. Potential role of N-acetylcysteine in the management of substance use disorders. CNS Drugs 2014; 28:95-106. [PMID: 24442756 PMCID: PMC4009342 DOI: 10.1007/s40263-014-0142-x] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
There is a clear and pressing need to expand pharmacotherapy options for substance use disorders (SUDs) in order to improve sustained abstinence outcomes. Preclinical literature has demonstrated the role of glutamate in addiction, suggesting that new targets for pharmacotherapy should focus on the restoration of glutamatergic function. Glutamatergic agents for SUDs may span multiple addictive behaviors and help demonstrate potentially overlapping mechanisms in addiction. The current review will focus specifically on N-acetylcysteine (NAC), a safe and well-tolerated glutamatergic agent, as a promising potential pharmacotherapy for the treatment of SUDs across several substances of abuse. Building on recently published reviews of the clinical efficacy of NAC across a broad range of conditions, this review will more specifically discuss NAC as a pharmacotherapy for SUDs, devoting particular attention to the safety and tolerability profile of NAC, the wealth of preclinical evidence that has demonstrated the role of glutamate dysregulation in addiction, and the limited but growing clinical literature that has assessed the efficacy of NAC across multiple substances of abuse. Preliminary clinical studies show the promise of NAC in terms of safety, tolerability, and potential efficacy for promoting abstinence from cocaine, nicotine, and cannabis. Results from randomized clinical trials have been mixed, but several mechanistic and methodological factors are discussed to refine the use of NAC in promoting abstinence and relapse prevention across several substances of abuse. Further preclinical and clinical investigation into the use of NAC for SUDs will be vital in addressing current deficits in the treatment of SUDs.
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Affiliation(s)
- Erin A. McClure
- Clinical Neuroscience Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty St., Suite 190, Charleston, SC 29407, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC 29425, USA
| | - Cassandra D. Gipson
- Department of Neurosciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 606, Charleston, SC 29425, USA
| | - Robert J. Malcolm
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC 29425, USA
| | - Peter W. Kalivas
- Department of Neurosciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 606, Charleston, SC 29425, USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC 29425, USA
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Dodd S, Dean O, Copolov DL, Malhi GS, Berk M. N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility. Expert Opin Biol Ther 2008; 8:1955-62. [DOI: 10.1517/14728220802517901] [Citation(s) in RCA: 268] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hosoe H, Kaise T, Ohmori K, Isohama Y, Kai H, Takahama K, Miyata T. Mucolytic and antitussive effects of erdosteine. J Pharm Pharmacol 1999; 51:959-66. [PMID: 10504037 DOI: 10.1211/0022357991773230] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
To investigate the influence of erdosteine, a new homocysteine-derived expectorant, on airway clearance we studied the effects of the drug on the viscosity of mucin, on the mucociliary transport rate in quails, on airway secretion in rats and on the cough reflex in guinea-pigs. The active metabolite of erdosteine, M1 (10 microM to 1 mM), significantly reduced the viscosity of porcine stomach mucin. Erdosteine by itself did not reduce viscosity. Erdosteine significantly promoted mucociliary transport in quails and increased airway secretion in rats. The effect was still apparent 24h after administration. Erdosteine significantly suppressed citric acid-induced cough reflexes in guinea-pigs but did not suppress mechanical stimuli-induced cough reflexes. Erdosteine suppressed the reduction of the recovery volume of bronchoalveolar lavage fluid and albumin leakage into the fluid in citric acid-exposed guinea-pigs. These results indicate that erdosteine removes sputum by reducing its viscosity, and by promoting mucociliary transport and sustained enhancement of airway secretion. It also suppressed the chemical stimulation-induced cough reflex and plasma leakage into the airway. These results suggest that erdosteine is an excellent expectorant with several modes of action.
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Affiliation(s)
- H Hosoe
- Drug Development Research Laboratories, Pharmaceutical Research Institute, Kyowa Hakko Kogyo Company Limited, Shizuoka, Japan
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Brown DT, Potsic WP, Marsh RR, Litt M. Drugs affecting clearance of middle ear secretions: a perspective for the management of otitis media with effusion. THE ANNALS OF OTOLOGY, RHINOLOGY & LARYNGOLOGY. SUPPLEMENT 1985; 117:3-15. [PMID: 2859825 DOI: 10.1177/00034894850940s201] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Otitis media with effusion (OME) is characterized by the production and accumulation in the middle ear of mucus secretions, whose physicochemical properties are an important feature in the etiology and treatment of the disease. Many types of pharmaceutical agents, including anti-inflammatory agents, antihistamines, antibiotics, and mucolytics, have been used in attempts to improve the clinical status of patients with OME. This study critically reviews the literature from the point of view of possible changes induced by these agents in the physicochemical properties of the secretions and hence their clearance from the middle ear. In vitro studies on mucociliary clearance of respiratory (tracheobronchial) secretions and middle ear effusions are cited as the basis for analyzing the important parameters expected to govern middle ear clearance and to determine the rationale for use (or nonuse) of various classes of drugs. It is expected that this analysis will prove useful in the design of properly controlled trials of such agents.
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Clarke SW, Lopez-Vidriero MT, Pavia D, Thomson ML. The effect of sodium 2-mercapto-ethane sulphonate and hypertonic saline aerosols on bronchial clearance in chronic bronchitis. Br J Clin Pharmacol 1979; 7:39-44. [PMID: 104724 PMCID: PMC1429616 DOI: 10.1111/j.1365-2125.1979.tb00894.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
1 The efficacy of a mucolytic agent, 2-mercapto-ethane sulphonate, administered in the form of an aerosol was evaluated in a group of eleven patients with chronic bronchitis in a controlled, double-blind, crossover study. 2 Saline aerosol isotonic (1.21M, 7.1%) to the drug was used as a placebo. 3 Approximately 1 ml drug/placebo was inhaled by the patients twice a day for 3 days and a final dose was given on the mornings of the drug/placebo trial runs. 4 There was no improvement in this group of patients in lung function or subjective well being attributable to the drug. 5 The viscosity of sputum, dry macromolecular weight and N-acetyl neuraminic acid/fucose ratio remained unaltered throughout the study. 6 An enhancement of tracheobronchial clearance was obtained following the administration of either placebo (31%) or drug aerosols (24%) Statistical significance (P less than 0.01) was only achieved for the placebo and was attributed to an increase in sputum volume.
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Richardson PS, Phipps RJ. The anatomy, physiology, pharmacology and pathology of tracheobronchial mucus secretion and the use of expectorant drugs in human disease. PHARMACOLOGY & THERAPEUTICS. PART B: GENERAL & SYSTEMATIC PHARMACOLOGY 1978; 3:441-79. [PMID: 32559 DOI: 10.1016/s0306-039x(78)90010-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Edwards GF, Steel AE, Scott JK, Jordan JW. S-carboxymethylcysteine in the fluidification of sputum and treatment of chronic airway obstruction. Chest 1976; 70:506-13. [PMID: 789027 DOI: 10.1378/chest.70.4.506] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The clinical results and changes in sputum found in both a short-term inpatient trial and a subsequent long-term outpatient investigation (three-month double-blind controlled study) of 82 patients with chronic bronchitis treated with a new mucolytic agent, S-carboxymethylcysteine (Mucodyne), are reported. Fluidification of sputum with reduction in certain measurements of the viscosity of morning sputum aliquots, associated with improvement in the ability to cough up bronchial secretions, significant increase in sputum volume output, and improvement in ventilation (as estimated by the forced expiratory volume in one second), were observed in both trials as dose-related responses, with an increase in the ease of expectoration and a reduction in cough frequency and dyspnea. Therapy with S-carboxymethylcysteine was well tolerated, and there were no serious adverse effects, either immediate or delayed. We suggest that the effect of the drug in fluidifying sputum may be due to a mucoregulatory mechanism which reverses the sputum macromolecular disturbances seen in chronic bronchitis.
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Marriott C, Richards JH. The effects of storage and of potassium iodide, urea, N-acetyl-cysteine and triton X-100 on the viscosity of bronchial mucus. BRITISH JOURNAL OF DISEASES OF THE CHEST 1974; 68:171-82. [PMID: 4425612 DOI: 10.1016/0007-0971(74)90035-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Kellaway IW, Padfield JM, Marriott CM. The interaction of penicillins with mixed phospholipid sols. II. Creep viscometry. Chem Phys Lipids 1973; 11:1-10. [PMID: 4722105 DOI: 10.1016/0009-3084(73)90047-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Abstract
Comparisons have been made between the effects of autonomic dysfunction and the pathophysiological changes in the exocrine secretions from patients with cystic fibrosis (Roberts, 1959). Cotton (1966) found that administration of tolazoline hydrochloride (an alpha-adrenergic blocker) to patients with cor pulmonale in the terminal stages of cystic fibrosis was associated with an improvement in the results of their lung function tests. This effect might have been due to an alteration of the abnormal viscosity of the bronchial mucus mediated via the autonomic nervous system, thus permitting easier expectoration. Measurement, by means of a Ferranti-Shirely cone and plate viscometer, of several different aspects of sputum viscosity is described. Tolazoline hydrochloride, administered to five patients with cystic fibrosis, was shown not to differ significantly from a placebo in its effect on sputum viscosity and dynamic lung volumes. We could not relate the improved lung function seen in Cotton's series to an autonomic effect of the drug on the physical properties of bronchial mucus in this condition.
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