1
|
Mycroft K, Paplińska-Goryca M, Proboszcz M, Nejman-Gryz P, Krenke R, Górska K. Blood and Sputum Eosinophils of COPD Patients Are Differently Polarized than in Asthma. Cells 2023; 12:1631. [PMID: 37371101 DOI: 10.3390/cells12121631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Different eosinophil subpopulations have been identified in asthma and other eosinophilic disorders. However, there is a paucity of data on eosinophil subpopulations in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to compare eosinophil phenotypes in blood and induced sputum in patients with COPD, asthma and controls. Stable patients with mild-to-moderate COPD (n = 15) and asthma (n = 14) with documented blood eosinophilia ≥100 cells/µL in the year prior to the study and the control group (n = 11) were included to the study. The blood and sputum eosinophil phenotypes were analyzed by flow cytometry. IL-5, IL-13, CCL5 and eotaxin-3 levels were measured in the induced sputum. The marker expression on blood eosinophils was similar among control, asthma and COPD groups. The expressions of CD125, CD193, CD14 and CD62L were higher on blood than on sputum eosinophils in all three groups. We found increased levels of CD193+ and CD66b+ sputum eosinophils from COPD patients, and an elevated level of CD11b+ sputum eosinophils in asthma compared to COPD patients. The results of our study suggest that the profile of marker expression on COPD sputum eosinophils differed from other groups, suggesting a distinct phenotype of eosinophils of COPD patients than in asthma or healthy subjects.
Collapse
Affiliation(s)
- Katarzyna Mycroft
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Magdalena Paplińska-Goryca
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Małgorzata Proboszcz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Patrycja Nejman-Gryz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Rafał Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097 Warsaw, Poland
| |
Collapse
|
2
|
Ono J, Takai M, Kamei A, Ohta S, Nair P, Izuhara K, Dahlén SE, James A. A novel assay for improved detection of sputum periostin in patients with asthma. PLoS One 2023; 18:e0281356. [PMID: 36763690 PMCID: PMC9916630 DOI: 10.1371/journal.pone.0281356] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Serum periostin associates with type-2 inflammation in asthmatic airways, but also reflects whole body periostin levels originating from multiple sources. Less is known about sputum periostin as a biomarker in asthma as detection levels are low using currently available periostin assays. We aimed to investigate detection of sputum periostin using ELISA assays targeting different periostin epitopes and relate levels to clinical characteristics. METHODS Two ELISA systems were developed using antibodies detecting whole periostin or cleavage products, the molecular weight and amino acid sequences of which were confirmed. The ELISA assays were applied to sputum from 80 patients with mild-to-moderate and severe asthma enrolled in the European, multi-center study BIOAIR. Results were related to clinical characteristics. RESULTS Sputum was found to contain smaller periostin fragments, possibly due to proteolytic cleavage at a C-terminal site. Comparing ELISA methodology using antibodies against cleaved versus whole periostin revealed detectable levels in 90% versus 44% of sputum samples respectively. Sputum periostin showed associations with blood and sputum eosinophils. Furthermore, sputum, but not serum, periostin correlated with reduced lung function and sputum IL-13 and was reduced by oral corticosteroid treatment. CONCLUSIONS We present an ELISA method for improved analysis of sputum periostin by detecting cleavage products of the periostin protein. Using this assay, sputum periostin was detectable and associated with more disease-relevant parameters in asthma than serum periostin. Sputum periostin is worth considering as a phenotype-specific biomarker in asthma as its proximity to the airways may eliminate some of the confounding factors known to affect serum periostin.
Collapse
Affiliation(s)
- Junya Ono
- Shino-Test Corporation Ltd., Sagamihara, Japan
| | | | - Ayami Kamei
- Shino-Test Corporation Ltd., Sagamihara, Japan
| | - Shoichiro Ohta
- Department of Laboratory Medicine, Saga Medical School, Saga, Japan
| | - Parameswaran Nair
- Department of Medicine, Division of Respirology, McMaster University and Firestone Institute for Respiratory Health, St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Sven-Erik Dahlén
- Experimental Asthma and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna James
- Experimental Asthma and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | | |
Collapse
|
3
|
A sputum bioassay for airway eosinophilia using an eosinophil peroxidase aptamer. Sci Rep 2022; 12:22476. [PMID: 36577785 PMCID: PMC9797489 DOI: 10.1038/s41598-022-26949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Eosinophils are granulocytes that play a significant role in the pathogenesis of asthma and other airway diseases. Directing patient treatment based on the level of eosinophilia has been shown to be extremely effective in reducing exacerbations and therefore has tremendous potential as a routine clinical test. Herein, we describe the in vitro selection and optimization of DNA aptamers that bind to eosinophil peroxidase (EPX), a protein biomarker unique to eosinophils. Fifteen rounds of magnetic bead aptamer selection were performed prior to high throughput DNA sequencing. The top 10 aptamer candidates were assessed for EPX binding using a mobility shift assay. This process identified a lead aptamer candidate termed EAP1-05 with low nanomolar affinity and high specificity for EPX over other common sputum proteins. This aptamer sequence was further optimized through truncation and used to develop an easy-to-use colourimetric pull-down assay that can detect EPX over a concentration range from 1 - 100 nM in processed sputum. Forty-six clinical samples were processed using a new sputum dispersal method, appropriate for a rapid assessment assay, that avoids centrifugation and lengthy processing times. The assay showed 89% sensitivity and 96% specificity to detect eosinophilia (compared to gold standard sputum cytometry), with results being produced in under an hour. This assay could allow for an easy assessment of eosinophil activity in the airway to guide anti-inflammatory therapy for several airway diseases.
Collapse
|
4
|
Liou TG, Adler FR, Argel N, Asfour F, Brown PS, Chatfield BA, Daines CL, Durham D, Francis JA, Glover B, Heynekamp T, Hoidal JR, Jensen JL, Keogh R, Kopecky CM, Lechtzin N, Li Y, Lysinger J, Molina O, Nakamura C, Packer KA, Poch KR, Quittner AL, Radford P, Redway AJ, Sagel SD, Sprandel S, Taylor-Cousar JL, Vroom JB, Yoshikawa R, Clancy JP, Elborn JS, Olivier KN, Cox DR. Prospective multicenter randomized patient recruitment and sample collection to enable future measurements of sputum biomarkers of inflammation in an observational study of cystic fibrosis. BMC Med Res Methodol 2019; 19:88. [PMID: 31027503 PMCID: PMC6485181 DOI: 10.1186/s12874-019-0705-0] [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: 09/18/2018] [Accepted: 03/11/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Biomarkers of inflammation predictive of cystic fibrosis (CF) disease outcomes would increase the power of clinical trials and contribute to better personalization of clinical assessments. A representative patient cohort would improve searching for believable, generalizable, reproducible and accurate biomarkers. METHODS We recruited patients from Mountain West CF Consortium (MWCFC) care centers for prospective observational study of sputum biomarkers of inflammation. After informed consent, centers enrolled randomly selected patients with CF who were clinically stable sputum producers, 12 years of age and older, without previous organ transplantation. RESULTS From December 8, 2014 through January 16, 2016, we enrolled 114 patients (53 male) with CF with continuing data collection. Baseline characteristics included mean age 27 years (SD = 12), 80% predicted forced expiratory volume in 1 s (SD = 23%), 1.0 prior year pulmonary exacerbations (SD = 1.2), home elevation 328 m (SD = 112) above sea level. Compared with other patients in the US CF Foundation Patient Registry (CFFPR) in 2014, MWCFC patients had similar distribution of sex, age, lung function, weight and rates of exacerbations, diabetes, pancreatic insufficiency, CF-related arthropathy and airway infections including methicillin-sensitive or -resistant Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia complex, fungal and non-tuberculous Mycobacteria infections. They received CF-specific treatments at similar frequencies. CONCLUSIONS Randomly-selected, sputum-producing patients within the MWCFC represent sputum-producing patients in the CFFPR. They have similar characteristics, lung function and frequencies of pulmonary exacerbations, microbial infections and use of CF-specific treatments. These findings will plausibly make future interpretations of quantitative measurements of inflammatory biomarkers generalizable to sputum-producing patients in the CFFPR.
Collapse
Affiliation(s)
- Theodore G. Liou
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
- Intermountain Pediatric Cystic Fibrosis Center, Division of Pediatric Pulmonology, Department of Pediatrics, University of Utah, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Frederick R. Adler
- Departments of Mathematics, University of Utah, 155 South 1400 east, JWB 233, Salt Lake City, UT 84112 USA
- School of Biological Sciences, University of Utah, 257 South 1400 East, Salt Lake City, UT 84112 USA
| | - Natalia Argel
- Cystic Fibrosis Center, Phoenix Children’s Hospital, 1919 East Thomas Road, Phoenix, AZ 85016 USA
| | - Fadi Asfour
- Intermountain Pediatric Cystic Fibrosis Center, Division of Pediatric Pulmonology, Department of Pediatrics, University of Utah, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Perry S. Brown
- St. Luke’s Cystic Fibrosis Center of Idaho, 610 W. Hays Street, Boise, ID 83702 USA
| | - Barbara A. Chatfield
- Intermountain Pediatric Cystic Fibrosis Center, Division of Pediatric Pulmonology, Department of Pediatrics, University of Utah, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Cori L. Daines
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, University of Arizona Health Sciences, 1501 N. Campbell Avenue, Room 3301, PO Box 245073, Tucson, AZ 85724 USA
| | - Dixie Durham
- St. Luke’s Cystic Fibrosis Center of Idaho, 610 W. Hays Street, Boise, ID 83702 USA
| | - Jessica A. Francis
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
| | - Barbara Glover
- Cystic Fibrosis Center, 3006 S. Maryland Pkwy, Suite #315, Las Vegas, NV 89109 USA
| | - Theresa Heynekamp
- Adult Cystic Fibrosis Program, Division of Pulmonary, Critical Care and Sleep Medicine, DoIM MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131 USA
| | - John R. Hoidal
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
| | - Judy L. Jensen
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
| | - Ruth Keogh
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Room G36, Keppel Street, London, WC1E 7HT UK
| | - Carol M. Kopecky
- Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Aurora, CO 80045 USA
| | - Noah Lechtzin
- Division of Pulmonary and Critical Care and Sleep Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 601 N. Caroline St, Baltimore, MD 21287 USA
| | - Yanping Li
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
| | - Jerimiah Lysinger
- Montana Cystic Fibrosis Center, Billings Clinic, 2800 10th Avenue N, Billings, MT 59101 USA
| | - Osmara Molina
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, University of Arizona Health Sciences, 1501 N. Campbell Avenue, Room 3301, PO Box 245073, Tucson, AZ 85724 USA
| | - Craig Nakamura
- Cystic Fibrosis Center, 3006 S. Maryland Pkwy, Suite #315, Las Vegas, NV 89109 USA
| | - Kristyn A. Packer
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
| | - Katie R. Poch
- Division of Pulmonary and Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206 USA
| | - Alexandra L. Quittner
- Former: Department of Psychology, University of Miami, Miami, FL USA
- Present Address: Miami Children’s Research Institute, Nicklaus Children’s Hospital, 3100 SW 62nd Ave, Miami, FL 33155 USA
| | - Peggy Radford
- Cystic Fibrosis Center, Phoenix Children’s Hospital, 1919 East Thomas Road, Phoenix, AZ 85016 USA
| | - Abby J. Redway
- Adult Cystic Fibrosis Program, Division of Pulmonary, Critical Care and Sleep Medicine, DoIM MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131 USA
| | - Scott D. Sagel
- Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Aurora, CO 80045 USA
| | - Shawna Sprandel
- Montana Cystic Fibrosis Center, Billings Clinic, 2800 10th Avenue N, Billings, MT 59101 USA
| | - Jennifer L. Taylor-Cousar
- Division of Pulmonary and Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206 USA
- Division of Pulmonology, Department of Pediatrics, National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Jane B. Vroom
- Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, 26 North Mario Capecchi Drive, Salt Lake City, UT 84132 USA
- Intermountain Pediatric Cystic Fibrosis Center, Division of Pediatric Pulmonology, Department of Pediatrics, University of Utah, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Ryan Yoshikawa
- Cystic Fibrosis Center, 3006 S. Maryland Pkwy, Suite #315, Las Vegas, NV 89109 USA
| | - John P. Clancy
- Division of Pulmonary Medicine, Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229-3026 USA
| | - J. Stuart Elborn
- Faculty of Medicine, Health and Life Sciences, Queen’s University Belfast, 90 Lisburn Road, Belfast, BT9 6AG UK
| | - Kenneth N. Olivier
- Laboratory of Chronic Airway Infection, Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, 10 Center Drive MSC1454, Building 10-CRC, Room 1408A, Bethesda, MD 20892 USA
| | | |
Collapse
|
5
|
Soliman M, Steacy L, Thiele J, Adams D, Neighbour H, Ellis AK. Administering multiple cumulative allergen challenges: An alternative nasal allergen challenge protocol for the Allergic Rhinitis-Clinical Investigator Collaborative. Ann Allergy Asthma Immunol 2017; 117:326-8. [PMID: 27613467 DOI: 10.1016/j.anai.2016.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/11/2016] [Accepted: 06/23/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Mena Soliman
- Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
| | - Lisa Steacy
- Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada.
| | - Jenny Thiele
- Division of Allergy & Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Dan Adams
- Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
| | - Helen Neighbour
- Divisions of Clinical Immunology & Allergy and Respirology, Department of Medicine, Firestone Institute of Respiratory Health, The Research Institute at St. Joe's Hamilton and McMaster University, Hamilton, Ontario, Canada
| | - Anne K Ellis
- Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada; Division of Allergy & Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
6
|
Oreo KM, Gibson PG, Simpson JL, Wood LG, McDonald VM, Baines KJ. Sputum ADAM8 expression is increased in severe asthma and COPD. Clin Exp Allergy 2014; 44:342-52. [PMID: 24147597 DOI: 10.1111/cea.12223] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/02/2013] [Accepted: 10/07/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Severe asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases in which the mechanisms are not fully understood. A disintegrin and metalloproteinase domain 8 (ADAM8) is an enzyme expressed on most leucocytes and may be important for facilitating leucocyte migration in respiratory disease. OBJECTIVE To investigate ADAM8 mRNA and protein expression in asthma and COPD and its relationship between asthma severity and inflammatory phenotypes. METHODS Induced sputum was collected from 113 subjects with asthma (severe n = 31, uncontrolled n = 39 and controlled n = 35), 20 subjects with COPD and 21 healthy controls. Sputum ADAM8 mRNA expression was measured by qPCR, and soluble ADAM8 (sADAM8) protein was measured in the sputum supernatant by validated ELISA. RESULTS ADAM8 mRNA correlated with ADAM8 protein levels (r = 0.27, P < 0.01). ADAM8 mRNA (P = 0.004) and sADAM8 protein (P = 0.014) levels were significantly higher in both asthma and COPD compared with healthy controls. ADAM8 mRNA (P = 0.035) and sADAM8 protein (P = 0.002) levels were significantly higher in severe asthma compared with controlled asthma. Total inflammatory cell count (P < 0.01) and neutrophils (P < 0.01) were also elevated in severe asthmatic sputum. Although ADAM8 mRNA was significantly higher in eosinophilic and neutrophilic asthma (P < 0.001), sADAM8 did not differ between asthma inflammatory phenotypes. ADAM8 expression positively correlated with sputum total cell count and sputum neutrophils. CONCLUSIONS AND CLINICAL RELEVANCE ADAM8 expression is increased in both severe asthma and COPD and associated with sputum total cell count and neutrophils. ADAM8 may facilitate neutrophil migration to the airways in severe asthma and COPD.
Collapse
Affiliation(s)
- K M Oreo
- Virus Infections/Immunity Vaccines & Asthma, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Priority Research Centre for Asthma and Respiratory Diseases, The University of Newcastle, Callaghan, NSW, Australia; Severe Asthma Network, Woolcock Institute of Medical Research, Glebe, NSW, Australia; The University of Sydney, Camperdown/Darlington, NSW, Australia
| | | | | | | | | | | |
Collapse
|
7
|
Interference in immunoassays to support therapeutic antibody development in preclinical and clinical studies. Bioanalysis 2014; 6:1939-51. [DOI: 10.4155/bio.14.127] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
During preclinical and clinical studies, immunoassays are used to measure the concentration of the therapeutic antibody, anti-drug antibodies and soluble protein biomarkers. The reliability of these assays is crucial since the results are routinely used for safety assessment and dose selection. Furthermore, soluble protein biomarkers can provide information about target engagement, proof of mechanism, proof of principle and prediction of response. Study samples mostly consist of complex matrices that can exhibit considerable interference, resulting in inaccurate measurements. This perspective discusses the source of interference and strategies to mitigate or eliminate interference in immunoassays used during preclinical and clinical drug development of drugs with a focus on the development of therapeutic antibodies.
Collapse
|
8
|
Sputum biomarkers and the prediction of clinical outcomes in patients with cystic fibrosis. PLoS One 2012; 7:e42748. [PMID: 22916155 PMCID: PMC3416785 DOI: 10.1371/journal.pone.0042748] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 07/11/2012] [Indexed: 11/30/2022] Open
Abstract
Lung function, acute pulmonary exacerbations (APE), and weight are the best clinical predictors of survival in cystic fibrosis (CF); however, underlying mechanisms are incompletely understood. Biomarkers of current disease state predictive of future outcomes might identify mechanisms and provide treatment targets, trial endpoints and objective clinical monitoring tools. Such CF-specific biomarkers have previously been elusive. Using observational and validation cohorts comprising 97 non-transplanted consecutively-recruited adult CF patients at the Intermountain Adult CF Center, University of Utah, we identified biomarkers informative of current disease and predictive of future clinical outcomes. Patients represented the majority of sputum producers. They were recruited March 2004-April 2007 and followed through May 2011. Sputum biomarker concentrations were measured and clinical outcomes meticulously recorded for a median 5.9 (interquartile range 5.0 to 6.6) years to study associations between biomarkers and future APE and time-to-lung transplantation or death. After multivariate modeling, only high mobility group box-1 protein (HMGB-1, mean = 5.84 [log ng/ml], standard deviation [SD] = 1.75) predicted time-to-first APE (hazard ratio [HR] per log-unit HMGB-1 = 1.56, p-value = 0.005), number of future APE within 5 years (0.338 APE per log-unit HMGB-1, p<0.001 by quasi-Poisson regression) and time-to-lung transplantation or death (HR = 1.59, p = 0.02). At APE onset, sputum granulocyte macrophage colony stimulating factor (GM-CSF, mean 4.8 [log pg/ml], SD = 1.26) was significantly associated with APE-associated declines in lung function (−10.8 FEV1% points per log-unit GM-CSF, p<0.001 by linear regression). Evaluation of validation cohorts produced similar results that passed tests of mutual consistency. In CF sputum, high HMGB-1 predicts incidence and recurrence of APE and survival, plausibly because it mediates long-term airway inflammation. High APE-associated GM-CSF identifies patients with large acute declines in FEV1%, possibly providing a laboratory-based objective decision-support tool for determination of an APE diagnosis. These biomarkers are potential CF reporting tools and treatment targets for slowing long-term progression and reducing short-term severity.
Collapse
|
9
|
Kim CK, Choi J, Callaway Z, Iijima K, Volcheck G, Kita H. Increases in airway eosinophilia and a th1 cytokine during the chronic asymptomatic phase of asthma. Respir Med 2010; 104:1436-43. [PMID: 20709516 DOI: 10.1016/j.rmed.2010.03.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/25/2010] [Accepted: 03/25/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND Studies using allergen challenge models have suggested Th2 cytokines promote airway inflammation in asthma. We assessed mediators of airway inflammation during the chronic asymptomatic phase of asthma. METHODS Nine non-atopic asthma (NAA) patients, 19 atopic asthma (AA) patients, 20 atopic controls (AC), and 38 normal controls (NC) underwent sputum induction while asymptomatic. Sputum total cell counts and differentials were determined; levels of cytokines IL-4, IL-5, IL-13, GM-CSF, and IFN-gamma, and chemokines eotaxin (CCL11) and RANTES (CCL5) were measured by ELISA; and levels of eosinophil-derived neurotoxin (EDN) were measured by radioimmunoassay. RESULTS NAA patients showed higher % eosinophils and total eosinophils compared to AA. NAA and AA patients showed higher IFN-gamma and EDN levels compared to AC and NC, with no differences in IL-4, IL-5, or IL-13 levels among the four groups. GM-CSF levels were higher in AA patients compared to AC or NC. In NAA, AA, and AC patients, % eosinophils and EDN levels correlated positively with IFN-gamma, GM-CSF, eotaxin, and RANTES, but not with IL-5 levels. CONCLUSIONS Baseline airway inflammation of intrinsic and extrinsic asthma is characterized by eosinophilic inflammation and the Th1 cytokine, IFN-gamma. GM-CSF, instead of IL-5, and chemokines may coordinate airway eosinophilia during the chronic asymptomatic phase of asthma.
Collapse
Affiliation(s)
- Chang Keun Kim
- Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
10
|
Biomarkers in asthma and allergic rhinitis. Pulm Pharmacol Ther 2010; 23:468-81. [PMID: 20601050 DOI: 10.1016/j.pupt.2010.06.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 06/23/2010] [Indexed: 11/20/2022]
Abstract
A biological marker (biomarker) is a physical sign or laboratory measurement that can serve as an indicator of biological or pathophysiological processes or as a response to a therapeutic intervention. An applicable biomarker possesses the characteristics of clinical relevance (sensitivity and specificity for the disease) and is responsive to treatment effects, in combination with simplicity, reliability and repeatability of the sampling technique. Presently, there are several biomarkers for asthma and allergic rhinitis that can be obtained by non-invasive or semi-invasive airway sampling methods meeting at least some of these criteria. In clinical practice, such biomarkers can provide complementary information to conventional disease markers, including clinical signs, spirometry and PC(20)methacholine or histamine. Consequently, biomarkers can aid to establish the diagnosis, in staging and monitoring of the disease activity/progression or in predicting or monitoring of a treatment response. Especially in (young) children, reliable, non-invasive biomarkers would be valuable. Apart from diagnostic purposes, biomarkers can also be used as (surrogate) markers to predict a (novel) drug's efficacy in target populations. Therefore, biomarkers are increasingly applied in early drug development. When implementing biomarkers in clinical practice or trials of asthma and allergic rhinitis, it is important to consider the heterogeneous nature of the inflammatory response which should direct the selection of adequate biomarkers. Some biomarker sampling techniques await further development and/or validation, and should therefore be applied as a "back up" of established biomarkers or methods. In addition, some biomarkers or sampling techniques are less suitable for (very young) children. Hence, on a case by case basis, a decision needs to be made what biomarker is adequate for the target population or purpose pursued. Future development of more sophisticated sampling methods and quantification techniques, such as--omics and biomedical imaging, will enable detection of adequate biomarkers for both clinical and research applications.
Collapse
|
11
|
Bafadhel M, Saha S, Siva R, McCormick M, Monteiro W, Rugman P, Dodson P, Pavord I, Newbold P, Brightling C. Sputum IL-5 concentration is associated with a sputum eosinophilia and attenuated by corticosteroid therapy in COPD. Respiration 2009; 78:256-62. [PMID: 19478474 PMCID: PMC2754944 DOI: 10.1159/000221902] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 03/18/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Airway inflammation in chronic obstructive pulmonary disease (COPD) is predominately neutrophilic, but some subjects demonstrate eosinophilic airway inflammation. Whether these inflammatory phenotypes have differential cytokine and chemokine expression is unknown. OBJECTIVES To assess the sputum concentrations of cytokines and chemokines and their response to oral corticosteroid therapy in COPD subjects with or without a sputum eosinophilia. METHODS Cytokine and chemokine concentrations were measured using the meso-scale device platform. To assess validity, recovery of exogenous spikes was examined. The concentrations of the validated mediators were measured in COPD sputum from subjects with or without a sputum eosinophilia. In a subgroup with a sputum eosinophilia, the response to oral prednisolone 10 mg for 1 month was examined. RESULTS The recovery in sputum of exogenous spiked mediators was >80% in 11/26 cytokines and chemokines. In supernatants from eosinophilic (n = 39) versus non-eosinophilic (n = 59) sputa, the geometric mean (95% CI) concentration was increased for IL-5 [9.0 (4.5-18) pg/ml vs. 3.6 (2.7-6.3) pg/ml, p = 0.03]. IL-5 alone was correlated with sputum eosinophil counts (r = 0.33, p = 0.001), and was attenuated following treatment with prednisolone [n = 9; mean difference 2.3 pg/ml (0.2-4.3), p = 0.032]. CONCLUSION We have validated the use of the meso-scale device platform for cytokine and chemokine measurements in the sputum supernatants in COPD. Sputum IL-5 was associated with a sputum eosinophilia and was attenuated following oral corticosteroid therapy. Whether this cytokine is important in the pathogenesis of COPD in a subgroup of patients warrants further investigation.
Collapse
Affiliation(s)
| | - S. Saha
- Institute for Lung Health, Leicester, UK
| | - R. Siva
- Institute for Lung Health, Leicester, UK
| | | | | | - P. Rugman
- AstraZeneca R&D Charnwood, Loughborough, UK
| | - P. Dodson
- AstraZeneca R&D Charnwood, Loughborough, UK
| | | | - P. Newbold
- AstraZeneca R&D Charnwood, Loughborough, UK
| | | |
Collapse
|
12
|
Erin EM, Jenkins GR, Kon OM, Zacharasiewicz AS, Nicholson GC, Neighbour H, Tennant RC, Tan AJ, Leaker BR, Bush A, Jose PJ, Barnes PJ, Hansel TT. Optimized dialysis and protease inhibition of sputum dithiothreitol supernatants. Am J Respir Crit Care Med 2007; 177:132-41. [PMID: 17962642 DOI: 10.1164/rccm.200603-311oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Dithiothreitol (DTT) is commonly used to liquefy induced sputum samples before assessment of cytology, but causes reduction of disulfide bonds and denaturation of proteins. OBJECTIVES To process sputum supernatants containing DTT to enable quantification of cytokines and chemokines. METHODS A standard solution of 22 pooled chemokines and cytokines was incubated with DTT at the concentrations used during sputum liquefaction and then dialyzed under 20 different denaturant and redox conditions. MEASUREMENTS AND MAIN RESULTS After incubation of the standard solution with DTT there was loss of detectable protein mediators on immunoassay, but optimized dialysis permitted recovery of chemokines to 96 +/- 4% and cytokines to 91 +/- 6%. Optimized dialysis of DTT supernatants from subjects with asthma covering a range of severities (n = 35) was performed in the presence of a cocktail of protease inhibitors and demonstrated significantly elevated levels of the chemokine CXCL10 (IFN-gamma-inducible protein-10), CXCL8 (IL-8), and CCL3 (macrophage inflammatory protein-1alpha); with lower but significantly elevated levels of CCL2 (monocyte chemotactic protein-1), CCL11 (eotaxin), and CCL5 (regulated on activation, normal T-cell expressed and secreted) in severe asthma. In sputum from subjects with severe asthma there were also significantly elevated levels of IL-4, IL-5, IL-13, tumor necrosis factor-alpha, IL-6, granulocyte-macrophage colony-stimulating factor, and IL-12(p40). CONCLUSIONS The technique of optimized dialysis and protease inhibition of sputum DTT supernatants aids the detection of chemokines and cytokines. The detection of elevated levels of particular sputum chemokines and cytokines in individual patients may provide a rationale for specific therapies.
Collapse
Affiliation(s)
- Edward M Erin
- NHLI Clinical Studies Unit, Royal Brompton Hospital, Fulham Road, London SW3 6HP, UK
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Eckert R, Mchardy I, Yarbrough DK, He J, Qi F, Anderson MH, Shi W. Stability and activity in sputum of G10KHc, a potent anti-Pseudomonas antimicrobial peptide. Chem Biol Drug Des 2007; 70:456-60. [PMID: 17927719 DOI: 10.1111/j.1747-0285.2007.00580.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
G10KHc, a specifically targeted antimicrobial peptide developed in our laboratory, has shown rapid and selective killing activity against Pseudomonas aeruginosa in culture medium. Because of the major role played by this pathogen in cystic fibrosis, we sought to evaluate the utility of G10KHc under more physiologic conditions in vitro. In the current study, we found that robust G10KHc activity could be maintained in expectorated sputum if serine protease-dependent digestion associated with this fluid was inhibited, either by chemical antagonists or by the construction of a D-amino acid enantiomer of G10KHc. Further investigations revealed that specifically targeted antimicrobial peptide activity in sputum could be further enhanced when samples were treated with a combination of peptide and recombinant human DNase. Our results illustrate the importance of investigating combination therapy to treat cystic fibrosis, especially if protease-sensitive peptide-based agents, such as G10KHc, are to be developed as alternatives to, or in conjunction with, conventional small-molecule antibiotics.
Collapse
Affiliation(s)
- Randal Eckert
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095, USA
| | | | | | | | | | | | | |
Collapse
|
14
|
Dente FL, Carnevali S, Bartoli ML, Cianchetti S, Bacci E, Di Franco A, Vagaggini B, Paggiaro P. Profiles of proinflammatory cytokines in sputum from different groups of severe asthmatic patients. Ann Allergy Asthma Immunol 2006; 97:312-20. [PMID: 17042136 DOI: 10.1016/s1081-1206(10)60795-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Severe asthma represents a heterogeneous group of patients whose characteristics of airway inflammation are poorly known. OBJECTIVE To evaluate the sputum cytokine profiles of different phenotypes of severe asthma. METHODS Severe asthmatic patients (n = 45) were divided into 3 groups: frequent exacerbations, persistent bronchoconstriction, and both features. Two other groups (9 patients with untreated mild asthma and 10 control subjects) were also studied. Selected sputum portions were assayed for differential cell count, supernatant interleukin 5 (IL-5), granulocyte-macrophage colony-stimulating factor, IL-8, and eosinophil cationic protein. RESULTS There were no statistically significant differences among the 3 severe asthma groups in terms of sputum inflammatory cell percentages, IL-8 levels, and eosinophil cationic protein levels, although IL-8 levels tended to be higher in patients with persistent bronchoconstriction. Sputum concentrations of granulocyte-macrophage colony-stimulating factor and IL-5 were significantly higher in patients with frequent exacerbations compared with the other 2 groups. Levels of IL-5 and IL-8 were higher in severe asthmatic patients compared with mild asthmatic patients and controls, whereas sputum eosinophil percentages were intermediate between those of mild asthmatic patients and controls. CONCLUSIONS Proeosinophilic cytokine levels are increased in severe asthmatic patients with frequent exacerbations but not in severe asthmatic patients with persistent bronchoconstriction, suggesting that different cytokine profiles could be associated with different phenotypes of severe asthma.
Collapse
Affiliation(s)
- Federico L Dente
- Pulmonary Unit, Cardio-Thoracic Department, University of Pisa, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Nomura S, Kanazawa H, Asai K, Nomura N, Hirata K, Yoshikawa J. Potential mechanisms of improvement of airway hyperresponsiveness by inhaled corticosteroid therapy in asthmatic patients. J Asthma 2006; 43:113-7. [PMID: 16642575 DOI: 10.1080/02770900500498097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Recent clinical trials with administration of IL-5 antibodies to asthmatic patients have revealed reduction of eosinophilia but unaltered airway hyperresponsiveness (AHR). In contrast, inhaled corticosteroid (ICS) therapy eliminates both eosinophilia and AHR. This study was designed to examine the mechanisms by which ICS improves airway hyperresponsiveness in asthmatic patients. METHODS Clinical variables of asthma involving vascular permeability and IL-5 levels were examined in 23 asthmatic patients and 11 normal control subjects. After the first sputum induction, inhaled beclomethasone dipropionate (BDP 800 microg/day) was administered to asthmatic patients for 8 weeks, and sputum induction was repeated. RESULTS IL-5 levels in induced sputum and airway vascular permeability index were significantly higher in asthmatic patients. IL-5 was positively correlated with percentage of eosinophils in induced sputum, and negatively correlated with FEV1, but not correlated with PC20 methacholine. After BDP therapy, eosinophils, ECP, and IL-5 levels were significantly decreased to the same levels as in normal subjects. Conversely, PC20 methacholine and airway vascular permeability did not improve to the same levels as in normal subjects. Increase in PC20 methacholine from before to after BDP therapy was significantly correlated with decrease in airway permeability index, but not with decrease in IL-5 level. CONCLUSION Our results suggest a clear dissociation between IL-5 and AHR. ICS therapy improves AHR at least in part through decrease in airway vascular permeability.
Collapse
Affiliation(s)
- Saeko Nomura
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
| | | | | | | | | | | |
Collapse
|
16
|
Boot JD, Panzner P, Diamant Z. A critical appraisal of methods used in early clinical development of novel drugs for the treatment of asthma. Pulm Pharmacol Ther 2006; 20:201-19. [PMID: 16584905 DOI: 10.1016/j.pupt.2006.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 02/06/2006] [Accepted: 02/14/2006] [Indexed: 11/16/2022]
Abstract
Asthma is a heterogeneous disorder characterized by chronic airway inflammation, hyperresponsiveness and remodeling. Being the hallmark of asthma, airway inflammation has become the most important target for therapeutic agents. Consequently, during the past decade various semi-and non-invasive methods have been explored to sample the airway inflammation in asthma. In this review, we provide a practical overview of the current status of various sampling techniques including sputum induction, exhaled breath analysis, and bronchoprovocation tests (BPTs). We focus on their applicability for monitoring in clinical practice and in intervention trials in asthma.
Collapse
Affiliation(s)
- J D Boot
- Centre for Human Drug Research, Zernikedreef 10, 2333 CL Leiden, The Netherlands
| | | | | |
Collapse
|
17
|
Armstrong DS, Hook SM, Jamsen KM, Nixon GM, Carzino R, Carlin JB, Robertson CF, Grimwood K. Lower airway inflammation in infants with cystic fibrosis detected by newborn screening. Pediatr Pulmonol 2005; 40:500-10. [PMID: 16208679 DOI: 10.1002/ppul.20294] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Controversy exists over whether the lower airway inflammation that characterizes cystic fibrosis (CF) is initiated primarily by the genetic defect. To determine if inflammation precedes infection, we examined bronchoalveolar lavage (BAL) fluid cytology, cytokines (interleukin (IL)-1beta, IL-4, IL-5, IL-6, IL-8, IL-10, and tumor necrosis factor-alpha), and free neutrophil elastase activity from 70 CF (aged 1.5-71 months) children detected by newborn screening and 19 (aged 2.0-48 months) controls with chronic stridor. CF subjects were selected and categorized as pristine (13 aged </= 6 months, lacking prior respiratory symptoms and exposure to antibiotics, and without respiratory pathogens on BAL), infected (42 with viruses or >/= 10(5) colony-forming units/ml of pathogenic bacteria in BAL), and uninfected (15 aged > 6 months, asymptomatic, not taking antibiotics at bronchoscopy, and free of pathogens in their BAL). To further resolve if inflammation develops without infection, inflammatory mediators in paired annual BAL samples from 38 CF subjects were measured, and results were grouped according to whether BAL showed persistence (n = 6), acquisition (n = 8), clearance (n = 13), or absence (n = 11) of infection. While pristine, uninfected, and control subjects had similar BAL profiles, infected patients showed elevated inflammatory indices, including increased IL-10 (P < 0.001). Pristine subjects had the fewest signs of inflammation. Analysis of BAL pairs found differences between the four infection groups for changes in neutrophil percentages, IL-8 (P < 0.001), and free neutrophil elastase (P = 0.009). Infection was associated with elevated inflammatory mediators in BAL fluid. In contrast, minimal or reduced signs of inflammation accompanied absence of eradication of infection from BAL fluid. We conclude that in CF, infection initiates and sustains airway inflammation.
Collapse
Affiliation(s)
- David S Armstrong
- Department of Paediatrics, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Nishimaki K, Nawata J, Okada S, Hattori T, Ohno I. Neutrophil survival-enhancing activity in sputum from patients with diffuse panbronchiolitis. Respir Med 2005; 99:910-7. [PMID: 15939254 DOI: 10.1016/j.rmed.2004.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diffuse panbronchiolitis (DPB) is a life-threatening airway disease in which neutrophils persistently and massively emigrating to the airways cause progressive and irreversible tissue damage. However, the pathogenesis of the airway inflammation remains unclear. The failure of non-inflammatory removal of emigrating neutrophils due to delayed apoptosis has been proposed as a mechanism by which the neutrophilic inflammation persists. Therefore, we aimed to investigate whether an activity that delays neutrophil apoptosis is present at the inflamed sites in DPB. Neutrophils isolated from normal volunteers were cultured with sputum extracts of patients with DPB, and viability and apoptosis of neutrophil was evaluated for the culture period. Neutrophils cultured with sputum extracts for 2 and 3 days showed significantly enhanced survival compared to those with medium alone. The neutrophil survival-enhancing activity in sputum extracts was heat-labile and partially, but significantly, neutralized with anti-human GM-CSF, but not with anti-human G-CSF antibody. The enhancement of neutrophil survival was associated with an inhibition of apoptosis demonstrated by cytology, TUNEL assay and DNA fragmentation analysis. These results suggest that neutrophil apoptosis is prevented by survival-enhancing factors including GM-CSF in the airways of DPB, leading to neutrophil death by necrosis that causes further recruitment and activation of neutrophils.
Collapse
Affiliation(s)
- Katsushi Nishimaki
- Department of Respiratory and Infectious Diseases, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai 980-8574, Japan
| | | | | | | | | |
Collapse
|
19
|
Beier J, Beeh KM, Kornmann O, Buhl R. Induced sputum methodology: Validity and reproducibility of total glutathione measurement in supernatant of healthy and asthmatic individuals. ACTA ACUST UNITED AC 2004; 144:38-44. [PMID: 15252406 DOI: 10.1016/j.lab.2004.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Glutathione (GSH), a major antioxidant, has repeatedly been linked to the pathogenesis of pulmonary disease. The measurement of GSH in induced sputum (IS) offers a noninvasive tool for the study and monitoring of oxidative stress in airway diseases. In this study we assessed the validity and reproducibility of GSH quantification in IS from healthy subjects and individuals with mild asthma. We spectrophotometrically quantified total GSH in the IS of 31 healthy nonsmoking volunteers and 12 individuals with mild asthma. IS was processed with varying concentrations of dithiothreitol (DTT) in an effort to evaluate the effect of DTT on GSH measurements. We performed spiking experiments with defined concentrations of GSH and quantified the percentage of recovery and also analyzed the effect of induction time on GSH levels through sequential sampling of sputum portions (15, 30, and 45 minutes' induction). Finally we tested the reproducibility of GSH measurements at 2 separate time points (0 and 72 hours) and expressed it as an intraclass correlation coefficient (R(i)) with a coefficient of reliability (CR). Processing with DTT increased GSH values in IS (P <.05 for each DTT concentration > 0.001%). Recovery of GSH after spiking was complete, with a mean recovery of 102% +/- 4.8%. Increasing duration of induction led to an increase in sputum GSH (15 minutes, 10.2 +/- 2.3 micromol/L; 30 minutes, 18.4 +/- 3.5 micromol/L; 45 minutes, 26.1 +/- 4 micromol/L; P <.05 for all comparisons). Reproducibility of sputum GSH both in healthy subjects and asthmatic individuals was good (R(i) =.78, P <.001; and R(i) =.51, P =.003, respectively). With the use of standardized protocols for duration of induction and sample processing, sputum GSH measurement in healthy subjects and asthmatic individuals is valid and reproducible.
Collapse
Affiliation(s)
- Jutta Beier
- Pulmonary Department, Division of Internal Medicine, University Hospital Mainz, Mainz, Germany.
| | | | | | | |
Collapse
|
20
|
Hadjicharalambous C, Dent G, May RD, Handy RLC, Anderson IK, Davies DE, Djukanovic R. Measurement of eotaxin (CCL11) in induced sputum supernatants: validation and detection in asthma. J Allergy Clin Immunol 2004; 113:657-62. [PMID: 15100669 DOI: 10.1016/j.jaci.2004.01.757] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Induced sputum is widely used in asthma research; however, for many mediators, the detection methods have not been validated. OBJECTIVE We sought to optimize the method of detection of eotaxin, an important chemokine acting through the CCR3 receptor on eosinophils, basophils, and T(H)2 cells. METHODS Induced sputum from normal and asthmatic subjects was processed with dithioerythritol (DTE) or PBS; recovery of eotaxin was assessed by means of ELISA before and after spiking with recombinant eotaxin. Furthermore, the effects of removing DTE by means of ultrafiltration or the addition of protease inhibitors and high-speed centrifugation on endogenous levels and spiking recovery of eotaxin were assessed. RESULTS Endogenous eotaxin was undetectable in DTE-processed samples, with a mean of only 30% (SD, 13%) spike recovery. DTE had no effect on the immunoassay capture antibody but dramatically reduced the detection of recombinant eotaxin. Removal of DTE from sputum before immunoassay did not improve detection, although it restored the recovery of a subsequent eotaxin spike. In contrast, PBS-processed sputum resulted in an eotaxin spike recovery of 101% (SD, 20%). Addition of protease inhibitors or high-speed centrifugation had no effect on eotaxin detection. By using this optimized protocol, eotaxin levels in PBS-processed sputum samples were found to be significantly increased in asthmatic sputum (P<.05). CONCLUSION Measurement of eotaxin by means of immunoassay is adversely affected by DTE, possibly through irreversible denaturation of epitopes, which makes eotaxin undetectable by using the immunoassay antibody. Sputum samples should be processed into PBS for assessment of eotaxin, which is present at increased levels in asthmatic sputum.
Collapse
Affiliation(s)
- Chrystalleni Hadjicharalambous
- Department of Respiratory Cell and Molecular Biology, Division of Infection, Inflammation and Repair, University of Southampton School of Medicine, General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
21
|
Boniface S, Koscher V, Mamessier E, El Biaze M, Dupuy P, Lorec AM, Guillot C, Badier M, Bongrand P, Vervloet D, Magnan A. Assessment of T lymphocyte cytokine production in induced sputum from asthmatics: a flow cytometry study. Clin Exp Allergy 2003; 33:1238-43. [PMID: 12956745 DOI: 10.1046/j.1365-2222.2003.01762.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Asthma results from a bronchial inflammation in which Th2 lymphocytes play a pivotal role, as shown in invasive bronchial biopsies and broncho-alveolar lavages. Induced sputum (IS) is a non-invasive method of recovery of bronchial cells, which can be repeated in the same patients. However, lymphocyte activation has not been studied in IS to date, because of the low number of T cells recovered. Herein we took advantage of flow cytometry, a method suitable for the study of small cell populations, to assess T cell cytokine production in IS. OBJECTIVES (1) To assess induced sputum T cell cytokine production by flow cytometry in asthmatic subjects and controls. (2) To compare the T cell cytokine production between symptomatic and non-symptomatic asthmatics. METHODS Thirteen asthmatics and 19 controls were included. Sputum was induced by a hypertonic saline. Sputum cells were stimulated and intracellular IL-13 and IFN-gamma were detected in T cells by flow cytometry. RESULTS Stimulation induced an increase of IL-13 and IFN-gamma production by T cells. This increase was higher in asthmatics. IL-13-producing T cells were increased in asthmatics after stimulation. In symptomatic asthma, IFN-gamma-producing T cells were in higher proportion than in controlled asthma. CONCLUSION IS T cell cytokine production indicates a basic Th2 bias in asthma, accompanied during symptoms by a Th1-like activation. These results open the field for longitudinal studies of the variation of T cell activation in asthma.
Collapse
Affiliation(s)
- S Boniface
- UPRES EA 3287, Groupe de Recherche Clinique Pathologie respiratoire liée à l'environnement, Université de la Méditerranée, Service de Pneumo-Allergologie Hôpital Ste Marguerite, Marseilles, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Beeh KM, Beier J, Kornmann O, Meier C, Taeumer T, Buhl R. A single nasal allergen challenge increases induced sputum inflammatory markers in non-asthmatic subjects with seasonal allergic rhinitis: correlation with plasma interleukin-5. Clin Exp Allergy 2003; 33:475-82. [PMID: 12680863 DOI: 10.1046/j.1365-2222.2003.01632.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Seasonal allergic rhinitis (SAR) is a risk factor for asthma in affected individuals. Nasal allergic inflammation enhances bone-marrow eosinophil production, mainly via IL-5, and rhinitis patients have increased airway inflammation during the pollen season. OBJECTIVE To assess the impact of nasal allergy on sputum inflammatory markers. METHODS In an open-labelled, randomized, placebo-controlled cross-over study with 16 non-asthmatic SAR patients (median age 25 years, 56% males), the effect of a single nasal allergen challenge performed out of season on induced sputum inflammatory parameters was evaluated. SAR patients were identified by history, skin-prick test and specific IgE. All patients had normal lung function/bronchial hyper-responsiveness out of season and a negative asthma/wheezing history. Sputum cells and supernatant levels of ECP, sICAM, IL-5 and IL-10, and plasma levels of IL-5 and ECP, were measured before and 24 h after nasal allergen challenge. After a washout period of at least 4 weeks, the procedure was repeated with placebo challenge (diluent). RESULTS Nasal allergen challenge led to an increase in sputum ECP (pre = 60 +/- 12, post = 212 +/- 63 micro g/L, P = 0.02 vs. placebo), and sICAM (4.8 +/- 2.7 to 6.5 +/- 2.9 ng/mL, P = 0.02 vs. placebo), whereas IL-10 decreased after provocation (44 +/- 11 to 29 +/- 6 pg/mL, P = 0.06 vs. placebo). Sputum IL-5 was undetectable in all patients. The absolute number of blood and sputum eosinophils did not change significantly after allergen or placebo challenge (P > 0.07, both comparisons). Plasma levels of IL-5 increased after allergen challenge (8.7 +/- 2.9 to 14.5 +/- 3.9 pg/mL, P = 0.001), and the increase in plasma IL-5 was positively correlated with the rise in sputum ECP in a subgroup of 'responders' (n = 12, r = 0.71, P = 0.01). CONCLUSIONS A single nasal allergen challenge in SAR patients increased markers of allergic inflammation in the lower respiratory tract, possibly via pronounced activation of inflammatory cells through circulating immediate-type reaction cytokines like IL-5. These findings may provide additional explanatory data for the high susceptibility of SAR patients to incident asthma.
Collapse
Affiliation(s)
- K M Beeh
- Pulmonary Department, Internal Medicine, University Hospital Mainz, Mainz, Germany.
| | | | | | | | | | | |
Collapse
|
23
|
Pignatti P, Delmastro M, Perfetti L, Bossi A, Balestrino A, Di Stefano A, Pisati P, Balbi B, Moscato G. Is dithiothreitol affecting cells and soluble mediators during sputum processing? A modified methodology to process sputum. J Allergy Clin Immunol 2002; 110:667-8. [PMID: 12373281 DOI: 10.1067/mai.2002.128279] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
24
|
|