Human isolated airway contraction: interaction between air pollutants and passive sensitization

Use of human airway smooth muscle in vitro and ex vivo to investigate drugs for the treatment of chronic obstructive respiratory disorders

Isolated airway smooth muscle has been extensively investigated since 1840 to understand the pharmacology of airway diseases. There has often been poor predictability from murine experiments to drugs evaluated in patients with asthma or chronic obstructive pulmonary disease (COPD). However, the use of isolated human airways represents a sensible strategy to optimise the development of innovative molecules for the treatment of respiratory diseases. This review aims to provide updated evidence on the current uses of isolated human airways in validated in vitro methods to investigate drugs in development for the treatment of chronic obstructive respiratory disorders. This review also provides historical notes on the pioneering pharmacological research on isolated human airway tissues, the key differences between human and animal airways, as well as the pivotal differences between human medium bronchi and small airways. Experiments carried out with isolated human bronchial tissues in vitro and ex vivo replicate many of the main anatomical, pathophysiological, mechanical and immunological characteristics of patients with asthma or COPD. In vitro models of asthma and COPD using isolated human airways can provide information that is directly translatable into humans with obstructive lung diseases. Regardless of the technique used to investigate drugs for the treatment of chronic obstructive respiratory disorders (i.e., isolated organ bath systems, videomicroscopy and wire myography), the most limiting factors to produce high-quality and repeatable data remain closely tied to the manual skills of the researcher conducting experiments and the availability of suitable tissue.

Stressed out - The role of oxidative stress in airway smooth muscle dysfunction in asthma and COPD

The airway smooth muscle (ASM) surrounding the airways is dysfunctional in both asthma and chronic obstructive pulmonary disease (COPD), exhibiting; increased contraction, increased mass, increased inflammatory mediator release and decreased corticosteroid responsiveness. Due to this dysfunction, ASM is a key contributor to symptoms in patients that remain symptomatic despite optimal provision of currently available treatments. There is a significant body of research investigating the effects of oxidative stress/ROS on ASM behaviour, falling into the following categories; cigarette smoke and associated compounds, air pollutants, aero-allergens, asthma and COPD relevant mediators, and the anti-oxidant Nrf2/HO-1 signalling pathway. However, despite a number of recent reviews addressing the role of oxidative stress/ROS in asthma and COPD, the potential contribution of oxidative stress/ROS-related ASM dysfunction to asthma and COPD pathophysiology has not been comprehensively reviewed. We provide a thorough review of studies that have used primary airway, bronchial or tracheal smooth muscle cells to investigate the role of oxidative stress/ROS in ASM dysfunction and consider how they could contribute to the pathophysiology of asthma and COPD. We summarise the current state of play with regards to clinical trials/development of agents targeting oxidative stress and associated limitations, and the adverse effects of oxidative stress on the efficacy of current therapies, with reference to ASM related studies where appropriate. We also identify limitations in the current knowledge of the role of oxidative stress/ROS in ASM dysfunction and identify areas for future research.

Spatio-Temporal Characteristics of Tropospheric Ozone and Its Precursors in Guangxi, South China

The temporal and spatial distributions of tropospheric ozone and its precursors (NO2, CO, HCHO) are analyzed over Guangxi (GX) in South China. We used tropospheric column ozone (TCO) from the Ozone Monitoring Instrument (OMI) and Microwave Limb Sounder (MLS) onboard the Aura satellite (OMI/MLS), NO2 and HCHO from OMI and CO from the Measurements of Pollution in the Troposphere (MOPITT) instrument in the period 2005–2016. The TCO shows strong seasonality, with the highest value in spring and the lowest value observed in the monsoon season. The seasonal variation of HCHO is similar to that of TCO, while NO2 and CO show slightly different patterns with higher values in spring and winter compared to lower values in autumn and summer. The surface ozone, NO2 and CO observed by national air quality monitoring network sites are also compared with satellite-observed TCO, NO2 and CO, showing good agreement for NO2 and CO but a different seasonal pattern for ozone. Unlike TCO, surface ozone has the highest value in autumn and the lowest value in winter. To reveal the difference, the vertical profiles of ozone and CO from the measurement of ozone and water vapor by airbus in-service aircraft (MOZAIC) observations over South China are also examined. The seasonal averaged vertical profiles of ozone and CO show obvious enhancements at 2–6 km altitudes in spring. Furthermore, we investigate the dependence of TCO and surface ozone on meteorology and transport in detail along with the ECMWF reanalysis data, Tropical Rainfall Measuring Mission (TRMM) 3BV42 dataset, OMI ultraviolet index (UV index) dataset, MODIS Fire Radiative Power (FRP) and back trajectory. Our results show that the wind pattern at 800 hPa plays a significant role in determining the seasonality of TCO over GX, especially for the highest value in spring. Trajectory analysis, combined with MODIS FRP suggests that the air masses that passed through the biomass burning (BB) region of Southeast Asia (SEA) induced the enhancement of TCO and CO in the upper-middle troposphere in spring. However, the seasonal cycle of surface ozone is associated with wind patterns at 950 hPa, and the contribution of the photochemical effect is offset by the strong summer monsoon, which results in the maximum surface ozone concentration in post-monsoon September. The variations in the meteorological conditions at different levels and the influence of transport from SEA can account for the vertical distribution of ozone and CO. We conclude that the seasonal distribution of TCO results from the combined impact of meteorology and long-term transport.

Indoor Air Quality and Asthma: Has Unrecognized Exposure to Acrolein Confounded Results of Previous Studies?

Numerous contaminants in indoor air and their potential to cause or exacerbate asthma continue to be a subject of public health concern. Many agents are causally associated with or can exacerbate asthma, particularly in children. For formaldehyde, an established respiratory irritant based on numerous studies, the evidence for an association with asthma is still considered only limited or suggestive. However, there is no evidence that indicates increased sensitivity to sensory irritation to formaldehyde in people often regarded as susceptible such as asthmatics. Acrolein, but not formaldehyde, was significantly associated with asthma in a large cohort of children. This prompted an evaluation of this highly irritating chemical that had never previously been considered in the context of the indoor air/childhood asthma issue. Because acrolein is more potent than formaldehyde as a respiratory irritant and ubiquitous in indoor air, it is plausible that previous studies on potential risk factors and childhood asthma may be confounded by formaldehyde acting as an unrecognized proxy for acrolein.

Dynamics of airway response in lung microsections: a tool for studying airway-extra cellular matrix interactions

The biological configuration of extracellular matrix (ECM) plays a key role in how mechanical interactions of the airway with its parenchymal attachments affect the dynamics of airway responses in different pulmonary disorders including asthma, emphysema and chronic bronchitis. It is now recognized that mechanical interactions between airway tissue and ECM play a key regulatory role on airway physiology and kinetics that can lead to the reorganization and remodeling of airway connective tissue. A connective tissue is composed of airway smooth muscle cells (ASM) and the ECM, which includes variety of glycoproteins and therefore the extent of interactions between ECM and ASM affects airway dynamics during exacerbations of major pulmonary disorders. Measurement of the velocity and magnitude of airway closure or opening provide important insights into the functions of the airway contractile apparatus and the interactions with its surrounding connective tissues. This review highlights suitability of lung microsection technique in studying measurements of airway dynamics (narrowing/opening) and associated structural distortions in airway compartments.

Acrolein induction of oxidative stress and degranulation in mast cells

Increases in asthma worldwide have been associated epidemiologically with expanding urban air pollution. The mechanistic relationship between airway hyper-responsiveness, inflammation, and ambient airborne triggers remains ambiguous. Acrolein, a ubiquitous aldehyde pollutant, is a product of incomplete combustion reactions. Acrolein is abundant in cigarette smoke, effluent from industrial smokestacks, diesel exhaust, and even hot oil cooking vapors. Acrolein is a potent airway irritant and can induce airway hyper-responsiveness and inflammation in the lungs of animal models. In the present study, we utilized the mast cell analog, RBL-2H3, to interrogate the responses of cells relevant to airway inflammation and allergic responses as a model for the induction of asthma-like conditions upon exposure to acrolein. We hypothesized that acrolein would induce oxidative stress and degranulation in airway mast cells. Our results indicate that acrolein at 1 ppm initiated degranulation and promoted the generation of reactive oxygen species (ROS). Introduction of antioxidants to the system significantly reduced both ROS generation and degranulation. At higher levels of exposure (above 100 ppm), RBL-2H3 cells displayed signs of severe toxicity. This experimental data indicates acrolein can induce an allergic inflammation in mast cell lines, and the initiation of degranulation was moderated by the application of antioxidants.

Acrolein - a pulmonary hazard

Acrolein is a respiratory irritant that can be generated during cooking and is in environmental tobacco smoke. More plentiful in cigarette smoke than polycyclic aromatic hydrocarbons (PAH), acrolein can adduct tumor suppressor p53 (TP53) DNA and may contribute to TP53-mutations in lung cancer. Acrolein is also generated endogenously at sites of injury, and excessive breath levels (sufficient to activate metalloproteinases and increase mucin transcripts) have been detected in asthma and chronic obstructive pulmonary disease (COPD). Because of its reactivity with respiratory-lining fluid or cellular macromolecules, acrolein alters gene regulation, inflammation, mucociliary transport, and alveolar-capillary barrier integrity. In laboratory animals, acute exposures have lead to acute lung injury and pulmonary edema similar to that produced by smoke inhalation whereas lower concentrations have produced bronchial hyperreactivity, excessive mucus production, and alveolar enlargement. Susceptibility to acrolein exposure is associated with differential regulation of cell surface receptor, transcription factor, and ubiquitin-proteasome genes. Consequent to its pathophysiological impact, acrolein contributes to the morbidly and mortality associated with acute lung injury and COPD, and possibly asthma and lung cancer.

Quantitative assessments of indoor air pollution and respiratory health in a population-based sample of French dwellings

BACKGROUND

Various volatile organic compounds (VOCs) have been related to respiratory health effects, but have generally been assessed individually without taking into account the fact that such pollutants are highly correlated to one other.

AIMS

We investigated the effects of exposure to various VOC, and considered their combined effect on adult asthma and rhinitis.

METHOD

A national cross-sectional representative survey conducted by the Indoor Air Quality Observatory objectively assessed 20 VOCs in 490 main dwellings in France. A standardized questionnaire determined the prevalence of asthma and rhinitis among 1012 inhabitants of the dwellings (≥ 15 years). Marginal models for binary outcome were used to relate VOCs exposure to asthma and rhinitis, controlling for potential confounders. A global score representing the number of VOCs in each dwelling with an elevated concentration (using the 3(rd) quartile value of the distribution as a threshold value) was then derived as a measure of the combined effect of VOCs. Specific scores were built using a similar approach, grouping VOCs by family.

RESULTS

Asthma (8.6%) was significantly associated with N-undecane and 1,2,4-trimethylbenzene and rhinitis (38.3%) with ethylbenzene, trichloroethylene, m/p- and o-xylene. The global VOC score was associated with a significant risk of asthma and rhinitis (odds ratio (OR) of 1.40 and 1.22, respectively, for 5 additional VOCs with high exposure level). Both specific scores for aromatic hydrocarbons and aliphatic hydrocarbons were associated with a significantly risk of asthma (OR=1.12; 95% confidence interval (CI): 1.01-1.24 and OR=1.41; 95% CI=1.03-1.93, respectively). The specific VOC score for halogenated hydrocarbons was associated with a significant risk of rhinitis (OR=1.28; 95% CI: 1.07-1.54).

CONCLUSION

We have shown that high concentrations of VOCs in homes were associated with an increasing prevalence of asthma and rhinitis in adults.

Biphasic effect of extracellular ATP on human and rat airways is due to multiple P2 purinoceptor activation

Background

Extracellular ATP may modulate airway responsiveness. Studies on ATP-induced contraction and [Ca²⁺]_i signalling in airway smooth muscle are rather controversial and discrepancies exist regarding both ATP effects and signalling pathways. We compared the effect of extracellular ATP on rat trachea and extrapulmonary bronchi (EPB) and both human and rat intrapulmonary bronchi (IPB), and investigated the implicated signalling pathways.

Methods

Isometric contraction was measured on rat trachea, EPB and IPB isolated rings and human IPB isolated rings. [Ca²⁺]_i was monitored fluorimetrically using indo 1 in freshly isolated and cultured tracheal myocytes. Statistical comparisons were done with ANOVA or Student's t tests for quantitative variables and χ² tests for qualitative variables. Results were considered significant at P < 0.05.

Results

In rat airways, extracellular ATP (10^-6–10^-3 M) induced an epithelium-independent and concentration-dependent contraction, which amplitude increased from trachea to IPB. The response was transient and returned to baseline within minutes. Similar responses were obtained with the non-hydrolysable ATP analogous ATP-γ-S. Successive stimulations at 15 min-intervals decreased the contractile response. In human IPB, the contraction was similar to that of rat IPB but the time needed for the return to baseline was longer. In isolated myocytes, ATP induced a concentration-dependent [Ca²⁺]_i response. The contractile response was not reduced by thapsigargin and RB2, a P2Y receptor inhibitor, except in rat and human IPB. By contrast, removal of external Ca²⁺, external Na⁺ and treatment with D600 decreased the ATP-induced response. The contraction induced by α-β-methylene ATP, a P2X agonist, was similar to that induced by ATP, except in IPB where it was lower. Indomethacin and H-89, a PKA inhibitor, delayed the return to baseline in extrapulmonary airways.

Conclusion

Extracellular ATP induces a transient contractile response in human and rat airways, mainly due to P2X receptors and extracellular Ca²⁺ influx in addition with, in IPB, P2Y receptors stimulation and Ca²⁺ release from intracellular Ca²⁺ stores. Extracellular Ca²⁺ influx occurs through L-type voltage-dependent channels activated by external Na⁺ entrance through P2X receptors. The transience of the response cannot be attributed to ATP degradation but to purinoceptor desensitization and, in extrapulmonary airways, prostaglandin-dependent PKA activation.

The pulmonary biology of isoprostanes

Isoprostanes are widely recognized as useful markers of membrane lipid peroxidation. It seems to be less well appreciated, however, that they also elicit important biological responses, even though this was first shown at the same time that they were introduced as markers of oxidative stress. The past several years have seen the list of cells/tissues which are sensitive to isoprostanes grow considerably: in fact, as we summarize here, there is now evidence that essentially every cell type in the lung responds in some pathologically relevant way to isoprostanes. In this sense, they might well be considered as not just markers of oxidative stress and inflammation, but also as a novel group of inflammatory mediators. Moreover, in addition to their pathological effects, we summarize here the evidence which has led us to hypothesize that isoprostanes could play an important role in vascular smooth muscle physiology as "endothelium-derived hyperpolarizing factors."

Diarrhea and acaroid mites: A clinical study

AIM: To explore the characteristics of diarrhea caused by acaroid mites.

METHODS: Acaroid mites in fresh stools of 241 patients with diarrhea were separated by flotation in saturated saline. Meanwhile, skin prick test, total IgE and mite-specific IgE were detected in all patients.

RESULTS: The total positive rate of mites in stool samples of the patients was 17.01% (41/241), the positive rates of mites in male and female patients were 15.86% (23/145) and 18.75% (18/96), respectively, without significant difference (P > 0.05). The percentage of skin prick test as" +++", "++", "+", and "-" was 9.13% (22/241), 7.47% (18/241), 5.81% (14/241), 4.98% (12/241) and 72.61% (175/241), respectively. The serum levels of total IgE, mite-specific IgE in patients with and without mites in stool samples were (165.72 ± 78.55) IU/ml, (132.44 ± 26.80) IU/mL and (145.22 ± 82.47) IU/ml, (67.35 ± 45.28) IU/ml, respectively, with significant difference (P < 0.01). The positive rate of mites in stool samples in staffs working in traditional Chinese medicine storehouses or rice storehouses (experimental group) was 26.74% (23/86), which was significantly higher than that (11.61%, 18/155) in people engaged in other professions (χ² = 8.97, P < 0.01).

CONCLUSION: Acaroid mites cause diarrhea and increase serum levels of total IgE and mite-specific IgE of patients, and the prevalence of diarrhea caused by acaroid mites is associated with occupations rather than the gender of patients.

Combined effect of chronic hypoxia and in vitro exposure to gas pollutants on airway reactivity

This study investigated the interaction between exposure to air pollutants and chronic hypoxia (CH). We used a hypobaric chamber (14 days at barometric pressure 380 mmHg) to produce CH in rats. Exposure to various doses of acrolein or ozone did not modify the mechanical response to cholinergic agonists. Exposure to 3 microM/min acrolein did not alter epithelium-free trachea responsiveness. In contrast, direct exposure of freshly isolated myocytes to 2 and 3 microM/min acrolein enhanced the amplitude of the first intracellular [Ca(2+)] rise in response to 0.1 microM ACh and the calcium oscillation frequency in response to 10 microM ACh. CH alone did not alter smooth muscle cross-sectional area (SMA) or epithelium-plus-submucosa thickness. CH decreased maximal contractile response (maximal force normalized to SMA) but increased sensitivity (pEC(50)) to cholinergic agonists. We conclude that unlike in normoxic rats, exposure to air pollutants does not induce airway hyperresponsiveness in CH rats, although it increased calcium signaling. These results cannot be explained by change in smooth muscle accessibility, but may be linked to the effect of CH on calcium-contraction coupling.

Passive sensitization of human airways induces mast cell degranulation and release of tryptase

BACKGROUND

This study was designed to examine the effect of passive sensitization (PS) on human bronchial mast cells. PS with asthmatic serum induces a hyper-responsiveness to nonspecific agonists, and immunoglobulin (Ig)E binding mainly on mast cells.

METHODS

Bronchi dissected out from 19 lung specimens were incubated in normal or asthmatic serum. Immunohistochemistry was performed using monoclonal antibodies (MoAbs) directed against tryptase, chymase, or c-kit. Mast cells were classified as fully granulated (type I), partly (type II) or largely degranulated (type III). Tryptase was measured in supernatant using ELISA. Contractile response was recorded in a separated set of experiments using an organ bath system.

RESULTS

PS decreased both tryptase positive cells (47.9 +/- 10.0 vs. 26.7 +/- 4.8 cell/mm2, P = 0.003) and chymase positive cells (26.1 +/- 3.3 vs. 14.9 +/- 1.8 cell/mm2, P = 0.01), but did not alter the number of c-kit positive cell. PS decreased the proportion of type I (55.4 vs. 28.9%, P < 0.0001) and, concomitantly increased that of types II (23.2 vs. 41.0%, P < 0.0001) and III (21.4 vs. 30.1%, P = 0.04). Following PS, tryptase concentration significantly increased and the magnitude of histamine response, was correlated with the amount of type II mast cells.

CONCLUSION

PS of human isolated bronchi induces a mast cell degranulation related to in vitro hyper-responsiveness, along with a tryptase release.

Modulation of calcium homeostasis as a mechanism for altering smooth muscle responsiveness in asthma

Airway hyperresponsiveness remains a defining characteristic of asthma. Traditional views assert that airway smooth muscle is an important structural effector cell in the bronchi that modulates bronchomotor tone induced by contractile agonists. New evidence, however, suggests that abnormalities in airway smooth muscle functions, induced by variety of extracellular stimuli, may play an important role in the development of airway hyperresponsiveness. Studies using isolated bronchial preparations or cultured cells show that inflammatory mediators and cytokines may alter calcium homeostasis in airway smooth muscle and render the cells nonspecifically hyperreactive to agonists.

Human isolated bronchial smooth muscle contains functional ryanodine/caffeine-sensitive Ca-release channels

Human bronchial smooth muscle (HBSM) contraction is implicated in a variety of respiratory diseases, including asthma. Yet, the presence of an operative calcium-induced calcium release (CICR) mechanism, identified in various smooth muscles, has not been established in HBSM. We therefore studied Ca-releasing mechanisms in HBSM obtained at thoracotomy with special attention to ryanodine-sensitive receptor channels (RyRs). In freshly isolated bronchial myocytes, ryanodine (0.5 to 50 microM) and caffeine (1 to 25 mM) induced transient increases in the cytoplasmic calcium concentration ([Ca(2+)](i)). Higher ryanodine concentrations (> 100 microM) inhibited the caffeine-induced [Ca(2+)](i) response, which was also blocked in the presence of tetracaine (300 microM) or ruthenium red (200 microM), two potent CICR inhibitors. In HBSM strips, caffeine induced a transient contraction which, likewise, was inhibited by ryanodine and tetracaine. However, ryanodine (200 microM) modified neither the [Ca(2+)](i) response nor the contraction induced by K(+)-rich (110 mM) solution. Reverse transcriptase/polymerase chain reaction (RT-PCR) and RNase protection assay performed in HBSM have revealed the existence of mRNAs encoding only the type 3 RyR. We also characterized acetylcholine-induced [Ca(2+)](i) and contractile responses. None of these responses was altered by ryanodine or by tetracaine. These results demonstrate, for the first time, the existence of functional RyRs in HBSM cells which, owing to the type of isoform or the amount of protein expressed, are not involved, under physiologic conditions, in depolarization- or agonist-induced contraction.

Immune mechanisms of smooth muscle hyperreactivity in asthma

Asthma is characterized by bronchial hyperresponsiveness to a variety of bronchospasmogenic stimuli. To study the pathophysiologic mechanisms underlying the increased sensitivity and degree of maximal airway narrowing, various in vivo and in vitro models have been developed with methods of active and passive sensitization. These studies indicated a major role for alterations in the smooth muscle itself rather than neural dysfunction or airway inflammation as the underlying cause for the development of bronchial hyperresponsiveness. During the last years smooth muscle cells were found to exhibit not only the "classical" contractile phenotype but also a proliferative-synthetic phenotype, which is capable of producing proinflammatory cytokines, chemotaxins, and growth factors. Allergic sensitization can alter both contractile and secretory functions, thereby indicating that the smooth muscle cell could contribute directly to the persistence of airway inflammation in asthma. A better understanding of the changes within the smooth muscle cells and of the mechanisms that lead to their induction could contribute to the development of novel therapeutic approaches for the treatment of asthma.