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Sokar SS, Afify EH, Osman EY. Dexamethasone and losartan combination treatment protected cigarette smoke-induced COPD in rats. Hum Exp Toxicol 2021; 40:284-296. [PMID: 32812458 DOI: 10.1177/0960327120950012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a dangerous prevalent smoking-related disease characterized by abnormal inflammation and oxidative stress and expected to be the third cause of death in the world next decade. Corticosteroids have low effects in decreasing numbers of inflammatory mediators specifically in long-term use. Our study designed to investigate the possible protective effects of combined dexamethasone (Dex) (2mg/kg) and losartan (Los) (30mg/kg angiotensin receptor blocker, it possesses antioxidant and anti-inflammatory properties in lung injury in mice) against cigarette -smoke (CS) induced COPD in rats compared with dexamethasone and losartan. Male Sprague Dawley rats (N = 40) divided into five groups (n = 8): control group, CS group, Dex group, Los group, and Dex +Los group. COPD induced in rats by CS exposure twice daily for 10 weeks. After the specified treatment period, bronchoalveolar lavage fluid (BALF) and lung tissue were collected for measurement of SOD, NO, MDA, ICAM-, MMP-9, CRP, NF-κB and histopathology scoring. Our results indicated that Los+Dex significantly prevent CS-induced COPD emphysema, congested alveoli, and elevation of lung injury parameters in BALF. They also showed a significant decrease in MDA, ICAM-1, MMP-9, CRP, and NF-κB and a significant increase in SOD and NO. In conclusion, adding Los to Dex potentiating their activity in inhibition the progression of COPD based on its activity on oxidative stress, inflammation, and NF-κB protein expression.
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Affiliation(s)
- Samia S Sokar
- Professor of Pharmacology and Toxicology, 68904Faculty of Pharmacy, Tanta University, Egypt
| | | | - Enass Y Osman
- Department of Pharmacology and Toxicology, 68904Faculty of Pharmacy, Tanta University, Egypt
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McDaniel DK, Ringel-Scaia VM, Morrison HA, Coutermarsh-Ott S, Council-Troche M, Angle JW, Perry JB, Davis G, Leng W, Minarchick V, Yang Y, Chen B, Reece SW, Brown DA, Cecere TE, Brown JM, Gowdy KM, Hochella MF, Allen IC. Pulmonary Exposure to Magnéli Phase Titanium Suboxides Results in Significant Macrophage Abnormalities and Decreased Lung Function. Front Immunol 2019; 10:2714. [PMID: 31849940 PMCID: PMC6892980 DOI: 10.3389/fimmu.2019.02714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/05/2019] [Indexed: 01/03/2023] Open
Abstract
Coal is one of the most abundant and economic sources for global energy production. However, the burning of coal is widely recognized as a significant contributor to atmospheric particulate matter linked to deleterious respiratory impacts. Recently, we have discovered that burning coal generates large quantities of otherwise rare Magnéli phase titanium suboxides from TiO2 minerals naturally present in coal. These nanoscale Magnéli phases are biologically active without photostimulation and toxic to airway epithelial cells in vitro and to zebrafish in vivo. Here, we sought to determine the clinical and physiological impact of pulmonary exposure to Magnéli phases using mice as mammalian model organisms. Mice were exposed to the most frequently found Magnéli phases, Ti6O11, at 100 parts per million (ppm) via intratracheal administration. Local and systemic titanium concentrations, lung pathology, and changes in airway mechanics were assessed. Additional mechanistic studies were conducted with primary bone marrow derived macrophages. Our results indicate that macrophages are the cell type most impacted by exposure to these nanoscale particles. Following phagocytosis, macrophages fail to properly eliminate Magnéli phases, resulting in increased oxidative stress, mitochondrial dysfunction, and ultimately apoptosis. In the lungs, these nanoparticles become concentrated in macrophages, resulting in a feedback loop of reactive oxygen species production, cell death, and the initiation of gene expression profiles consistent with lung injury within 6 weeks of exposure. Chronic exposure and accumulation of Magnéli phases ultimately results in significantly reduced lung function impacting airway resistance, compliance, and elastance. Together, these studies demonstrate that Magnéli phases are toxic in the mammalian airway and are likely a significant nanoscale environmental pollutant, especially in geographic regions where coal combustion is a major contributor to atmospheric particulate matter.
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Affiliation(s)
- Dylan K. McDaniel
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Veronica M. Ringel-Scaia
- Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Blacksburg, VA, United States
| | - Holly A. Morrison
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Sheryl Coutermarsh-Ott
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - McAlister Council-Troche
- Analytical Research Laboratory, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Jonathan W. Angle
- Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA, United States
| | - Justin B. Perry
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Grace Davis
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Weinan Leng
- National Center for Earth and Environmental Nanotechnology Infrastructure, Virginia Tech, Blacksburg, VA, United States
| | - Valerie Minarchick
- Department of Pharmaceutical Sciences, University of Colorado, Anschutz Medical, Aurora, CO, United States
| | - Yi Yang
- Key Laboratory of Geographic Information Science of the Ministry of Education, School of Geographic Sciences, East China Normal University, Shanghai, China
| | - Bo Chen
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sky W. Reece
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - David A. Brown
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Thomas E. Cecere
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Jared M. Brown
- Department of Pharmaceutical Sciences, University of Colorado, Anschutz Medical, Aurora, CO, United States
| | - Kymberly M. Gowdy
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | | | - Irving C. Allen
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
- Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Blacksburg, VA, United States
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Li N, Parrish M, Chan TK, Yin L, Rai P, Yoshiyuki Y, Abolhassani N, Tan KB, Kiraly O, Chow VTK, Engelward BP. Influenza infection induces host DNA damage and dynamic DNA damage responses during tissue regeneration. Cell Mol Life Sci 2015; 72:2973-88. [PMID: 25809161 PMCID: PMC4802977 DOI: 10.1007/s00018-015-1879-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/18/2015] [Accepted: 03/02/2015] [Indexed: 12/19/2022]
Abstract
Influenza viruses account for significant morbidity worldwide. Inflammatory responses, including excessive generation of reactive oxygen and nitrogen species (RONS), mediate lung injury in severe influenza infections. However, the molecular basis of inflammation-induced lung damage is not fully understood. Here, we studied influenza H1N1 infected cells in vitro, as well as H1N1 infected mice, and we monitored molecular and cellular responses over the course of 2 weeks in vivo. We show that influenza induces DNA damage to both, when cells are directly exposed to virus in vitro (measured using the comet assay) and also when cells are exposed to virus in vivo (estimated via γH2AX foci). We show that DNA damage, as well as responses to DNA damage persist in vivo until long after virus has been cleared, at times when there are inflammation associated RONS (measured by xanthine oxidase activity and oxidative products). The frequency of lung epithelial and immune cells with increased γH2AX foci is elevated in vivo, especially for dividing cells (Ki-67-positive) exposed to oxidative stress during tissue regeneration. Additionally, we observed a significant increase in apoptotic cells as well as increased levels of DNA double strand break (DSB) repair proteins Ku70, Ku86 and Rad51 during the regenerative phase. In conclusion, results show that influenza induces DNA damage both in vitro and in vivo, and that DNA damage responses are activated, raising the possibility that DNA repair capacity may be a determining factor for tissue recovery and disease outcome.
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Affiliation(s)
- Na Li
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
- Department of Microbiology, National University of Singapore, 5 Science Drive 2, Blk MD4, Level 3, Singapore, 117545 Singapore
| | - Marcus Parrish
- Department of Biological Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave., 16-743, Cambridge, MA 02139 USA
| | - Tze Khee Chan
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Clinical Research Center, MD11, 10 Medical Drive, Level 5, #05-09, Singapore, 117597 Singapore
| | - Lu Yin
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
| | - Prashant Rai
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
- Department of Microbiology, National University of Singapore, 5 Science Drive 2, Blk MD4, Level 3, Singapore, 117545 Singapore
| | - Yamada Yoshiyuki
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
| | - Nona Abolhassani
- Department of Biological Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave., 16-743, Cambridge, MA 02139 USA
| | - Kong Bing Tan
- Department of Pathology, Yong loo Lin School of Medicine, National University Health System and National University of Singapore, Lower Kent Ridge Road, Singapore, 119074 Singapore
| | - Orsolya Kiraly
- Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #03-10/11 Innovation Wing, #03-12/13/14 Enterprise Wing, Singapore, 138602 Singapore
| | - Vincent T. K. Chow
- Department of Microbiology, National University of Singapore, 5 Science Drive 2, Blk MD4, Level 3, Singapore, 117545 Singapore
| | - Bevin P. Engelward
- Department of Biological Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave., 16-743, Cambridge, MA 02139 USA
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Xu M, Cao FL, Zhang YF, Shan L, Jiang XL, An XJ, Xu W, Liu XZ, Wang XY. Tanshinone IIA therapeutically reduces LPS-induced acute lung injury by inhibiting inflammation and apoptosis in mice. Acta Pharmacol Sin 2015; 36:179-87. [PMID: 25544360 DOI: 10.1038/aps.2014.112] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/20/2014] [Indexed: 12/21/2022] Open
Abstract
AIM To study the effects of tanshinone IIA (TIIA) on lipopolysaccharide (LPS)-induced acute lung injury in mice and the underlying mechanisms. METHODS Mice were injected with LPS (10 mg/kg, i.p.), then treated with TIIA (10 mg/kg, i.p.). Seven hours after LPS injection, the lungs were collected for histological study. Protein, LDH, TNF-α and IL-1β levels in bronchoalveolar lavage fluid (BALF) and myeloperoxidase (MPO) activity in lungs were measured. Cell apoptosis and Bcl-2, caspase-3, NF-κB and HIF-1α expression in lungs were assayed. RESULTS LPS caused marked histological changes in lungs, accompanied by significantly increased lung W/D ratio, protein content and LDH level in BALF, and Evans blue leakage. LPS markedly increased neutrophil infiltration in lungs and inflammatory cytokines in BALF. Furthermore, LPS induced cell apoptosis in lungs, as evidenced by increased TUNEL-positive cells, decreased Bcl-2 content and increased cleaved caspase-3 content. Moreover, LPS significantly increased the expression of NF-κB and HIF-1α in lungs. Treatment of LPS-injected mice with TIIA significantly alleviated these pathological changes in lungs. CONCLUSION TIIA alleviates LPS-induced acute lung injury in mice by suppressing inflammatory responses and apoptosis, which is mediated via inhibition of the NF-κB and HIF-1α pathways.
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Shaghaghi H, Kadlecek S, Deshpande C, Siddiqui S, Martinez D, Pourfathi M, Hamedani H, Ishii M, Profka H, Rizi AR. Metabolic spectroscopy of inflammation in a bleomycin-induced lung injury model using hyperpolarized 1-(13) C pyruvate. NMR IN BIOMEDICINE 2014; 27:939-47. [PMID: 24865640 PMCID: PMC4110199 DOI: 10.1002/nbm.3139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 04/23/2014] [Accepted: 04/24/2014] [Indexed: 05/04/2023]
Abstract
Metabolic activity in the lung is known to change in response to external insults, inflammation, and cancer. We report measurements of metabolism in the isolated, perfused rat lung of healthy controls and in diseased lungs undergoing acute inflammation using hyperpolarized 1-(13) C-labeled pyruvate. The overall apparent activity of lactate dehydrogenase is shown to increase significantly (on average by a factor of 3.3) at the 7 day acute stage and to revert substantially to baseline at 21 days, while other markers indicating monocarboxylate uptake and transamination rate are unchanged. Elevated lung lactate signal levels correlate well with phosphodiester levels as determined with (31) P spectroscopy and with the presence of neutrophils as determined by histology, consistent with a relationship between intracellular lactate pool labeling and the density and type of inflammatory cells present. We discuss several alternate hypotheses, and conclude that the most probable source of the observed signal increase is direct uptake and metabolism of pyruvate by inflammatory cells and primarily neutrophils. This signal is seen in high contrast to the low baseline activity of the lung.
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Affiliation(s)
- Hoora Shaghaghi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
- Author to whom correspondence should be addressed: Submitting author: Hoora Shaghaghi, PhD University of Pennsylvania Department of Radiology 338 Stemmler Hall 3450 Hamilton Walk Philadelphia, PA 19104 215-662-6775
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Charuhas Deshpande
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sarmad Siddiqui
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Martinez
- Department of Pathology and Pathology Core Laboratory, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Mehrdad Pourfathi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Masaru Ishii
- Department of Otolaryngology, Johns Hopkins University, Baltimore, MD, United States
| | - Harrilla Profka
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - and Rahim Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
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Li JH, Xu M, Xie XY, Fan QX, Mu DG, Zhang Y, Cao FL, Wang YX, Zhao PT, Zhang B, Jin FG, Li ZC. Tanshinone IIA suppresses lung injury and apoptosis, and modulates protein kinase B and extracellular signal-regulated protein kinase pathways in rats challenged with seawater exposure. Clin Exp Pharmacol Physiol 2011; 38:269-77. [PMID: 21314841 DOI: 10.1111/j.1440-1681.2011.05498.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
1. Tanshinone IIA (TIIA) is one of the main active components of the Chinese herb, Danshen. In the present study, we investigated the role of apoptosis in seawater exposure-induced acute lung injury (ALI), and explored the effects of TIIA on lung injury, apoptosis, and protein kinase B (Akt) and extracellular signal-regulated protein kinase (ERK) pathways in seawater-challenged rats. The rats were randomly divided into four groups: (i) naive group, no drug was given; (ii) TIIA control group, TIIA (50 mg/kg) was given intraperitoneally; (iii) seawater (SW) group, seawater (4 mL/kg) was given; and (iv) TIIA/SW group, TIIA (50 mg/kg) was injected intraperitoneally 10 min after seawater instillation. 2. The results showed that TIIA treatment significantly improved seawater exposure-induced lung histopathological changes, alleviated the decrease in PaO(2) , and reduced lung oedema, vascular leakage and cell infiltration. As shown by terminal deoxynucleotidyl transferase-mediated nick end labelling (TUNEL) assay, seawater exposure induced apoptosis in lung tissue cells. Furthermore, seawater exposure also changed apoptosis-related factors Bcl-2 and caspase-3, and caused a reduction in the activation of Akt and ERK1/2 pathways. Furthermore, TIIA treatment decreased the number of apoptotic cells, reversed changes in Bcl-2 and caspase-3, and upregulated the activation of Akt and ERK1/2 in seawater-challenged rats. 3. In conclusion, the data suggest that apoptosis might play an important role in seawater exposure-induced lung injury and that TIIA could significantly attenuate the severity of ALI and apoptosis in seawater-challenged rats, which is possibly through modulation of Akt and ERK1/2 pathways.
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Affiliation(s)
- Jia-Huan Li
- Department of Respiration, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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Yang CH, Tsai PS, Wang TY, Huang CJ. Dexmedetomidine-ketamine combination mitigates acute lung injury in haemorrhagic shock rats. Resuscitation 2009; 80:1204-10. [PMID: 19608326 DOI: 10.1016/j.resuscitation.2009.06.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 05/17/2009] [Accepted: 06/13/2009] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY Upregulation of pulmonary inflammatory molecules is crucial in mediating the development of acute lung injury induced by haemorrhagic shock. Dexmedetomidine and ketamine possess potent anti-inflammatory capacity. We sought to elucidate whether dexmedetomidine, ketamine, or dexmedetomidine-ketamine combination could mitigate acute lung injury in haemorrhagic shock rats. METHODS Fifty adult male Sprague-Dawley rats were randomized to the sham-instrumented, haemorrhagic shock (HS), HS plus dexmedetomidine (HS-D), HS plus ketamine (HS-K), or HS plus dexmedetomidine-ketamine (HS-D+K) group (n=10 in each group). Haemorrhagic shock was induced by blood withdrawing and the mean blood pressure was maintained at 40-45mmHg for 120min. Resuscitation was then performed by infusion of shed blood/saline mixtures. After monitoring for another 8h, rats were sacrificed. RESULTS Histology findings and lung injury score analysis revealed moderate lung injury in rats of the HS, HS-D, and HS-K groups, whereas those of the HS-D+K group revealed mild lung injury. The effects of haemorrhagic shock on increasing cell number and protein concentration in bronchoalveolar lavage fluid as well as water content, leukocyte infiltration, and myeloperoxidase activity of lung tissues were significantly attenuated by dexmedetomidine-ketamine combination but not by dexmedetomidine or ketamine alone. Dexmedetomidine-ketamine combination, but not dexmedetomidine or ketamine alone, also significantly inhibited haemorrhagic shock-induced upregulation of pulmonary inflammatory molecules, including nitric oxide, prostaglandin E(2), chemokine (e.g., macrophage inflammatory protein-2), and cytokines [e.g., interleukin (IL)-1beta, and IL-6]. CONCLUSIONS Dexmedetomidine-ketamine combination mitigates acute lung injury in haemorrhagic shock rats.
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Affiliation(s)
- Chen-Hsien Yang
- Department of Anaesthesiology, Mackay Memorial Hospital, Taipei, Taiwan
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Coltri KC, Oliveira LL, Pinzan CF, Vendruscolo PE, Martinez R, Goldman MH, Panunto-Castelo A, Roque-Barreira MC. Therapeutic administration of KM+ lectin protects mice against Paracoccidioides brasiliensis infection via interleukin-12 production in a toll-like receptor 2-dependent mechanism. THE AMERICAN JOURNAL OF PATHOLOGY 2008; 173:423-32. [PMID: 18599609 DOI: 10.2353/ajpath.2008.080126] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
KM(+) is a mannose-binding lectin from Artocarpus integrifolia that induces interleukin (IL)-12 production by macrophages and protective T helper 1 immune response against Leishmania major infection. In this study, we performed experiments to evaluate the therapeutic activity of jackfruit KM(+) (jfKM(+)) and its recombinant counterpart (rKM(+)) in experimental paracoccidioidomycosis. To this end, jfKM(+) or rKM(+) was administered to BALB/c mice 10 days after infection with Paracoccidiodes brasiliensis. Thirty days postinfection, lungs from the KM(+)-treated mice contained significantly fewer colony-forming units and little to no organized granulomas compared to the controls. In addition, lung homogenates from the KM(+)-treated mice presented higher levels of nitric oxide, IL-12, interferon-gamma, and tumor necrosis factor-alpha, whereas higher levels of IL-4 and IL-10 were detected in the control group. With mice deficient in IL-12, Toll-like receptor (TLR) 2, TLR4, or TLR adaptor molecule MyD88, we demonstrated that KM(+) led to protection against P. brasiliensis infection through IL-12 production, which was dependent on TLR2. These results demonstrated a beneficial effect of KM(+) on the severity of P. brasiliensis infection and may expand its potential use as a novel immunotherapeutic molecule.
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Affiliation(s)
- Kely C Coltri
- Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, 14049-900-Ribeirão Preto, São Paulo, Brazil
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Abstract
Hypersensitivity pneumonitis (HP) is a group of immunologically mediated lung diseases caused by the inhalation of environmental agents in susceptible individuals. Most HP patients are non-smokers and have been exposed to organic dusts from vegetable or animal products. Some HP cases are associated with exposures to relatively simple chemical compounds. HP may present as an acute, subacute, or chronic disease and may follow various clinical courses. The type of exposure is thought to be more important in the clinical outcome than the nature of the antigen. A diagnosis of HP is often considered on the basis of clinical history of exposure with resulting respiratory symptoms, but the definitive diagnosis requires a constellation of clinical, radiologic, laboratory, and pathologic findings. The characteristic histologic triad in HP includes bronchiolitis, interstitial lymphocytic infiltration, and granulomas; however, biopsy in HP cases may lack the diagnostic triad and manifest as nonspecific interstitial pneumonia (NSIP). Avoiding exposure to the offending antigen(s) is usually sufficient to resolve symptoms and physiological abnormalities. Pulmonary fibrosis and physiological abnormalities occurring in chronic HP may be irreversible. Steroid therapy is helpful for symptomatic relief, but probably does not affect the long-term prognosis. Type III and type IV hypersensitivity reactions are involved in the pathogenesis; alveolar macrophages and T cells (Th-1 type) play a central role in the immune responses after antigen exposure via their increased interaction and secretion of regulatory mediators.
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Affiliation(s)
- Eunhee S Yi
- Department of Pathology, University of California, San Diego, School of Medicine, San Diego 92103-8720, CA, USA.
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