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Sagnelli C, Celia B, Monari C, Cirillo S, De Angelis G, Bianco A, Coppola N. Management of SARS-CoV-2 pneumonia. J Med Virol 2021; 93:1276-1287. [PMID: 32856728 PMCID: PMC7461283 DOI: 10.1002/jmv.26470] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has rapidly spread throughout the world since December 2019 to become a global public health emergency for the elevated deaths and hospitalizations in Intensive Care Units. The severity spectrum of SARS-CoV-2 pneumonia ranges from mild to severe clinical conditions. The clinical course of SARS-CoV-2 disease is correlated with multiple factors including host characteristics (genetics, immune status, age, and general health), viral load and, above all, the host distribution of the airways and lungs of the viral receptor cells. In this review, we will briefly summarize the current knowledge of the characteristics and management of coronavirus disease 2019-pneumonia. However, other studies are needed to better understand the pathogenetic mechanisms induced by SARS-Cov-2 infection, and to evaluate the long-term consequences of the virus on the lungs.
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Affiliation(s)
- Caterina Sagnelli
- Section of Infectious Diseases, Department of Mental health and Public MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Benito Celia
- Department of Translational Medical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Caterina Monari
- Section of Infectious Diseases, Department of Mental health and Public MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Salvatore Cirillo
- Department of Translational Medical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Giulia De Angelis
- Section of Infectious Diseases, Department of Mental health and Public MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Andrea Bianco
- Department of Translational Medical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Nicola Coppola
- Section of Infectious Diseases, Department of Mental health and Public MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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2
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Perrotta F, Corbi G, Mazzeo G, Boccia M, Aronne L, D'Agnano V, Komici K, Mazzarella G, Parrella R, Bianco A. COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging Clin Exp Res 2020; 32:1599-1608. [PMID: 32557332 PMCID: PMC7298699 DOI: 10.1007/s40520-020-01631-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/06/2020] [Indexed: 02/06/2023]
Abstract
The elderly may represent a specific cluster of high-risk patients for developing COVID-19 with rapidly progressive clinical deterioration. Indeed, in older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening respiratory failure and multisystemic involvement. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and polypharmacotherapy. Our review examines the pathogenesis and clinical implications of ageing in COVID-19 patients; finally, we discuss the evidence and controversies in the management in the long-stay residential care homes and aspects of end-of-life care for elderly patients with COVID-19.
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Affiliation(s)
- Fabio Perrotta
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy.
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy
- Italian Society of Gerontology and Geriatrics (SIGG), Florence, Italy
| | - Grazia Mazzeo
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
- COVID-19 Unit, Infectious Disease Department, University of Campania "L. Vanvitelli", 80131, Naples, Italy
| | - Matilde Boccia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Luigi Aronne
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Klara Komici
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy
- Italian Society of Gerontology and Geriatrics (SIGG), Florence, Italy
| | - Gennaro Mazzarella
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Roberto Parrella
- COVID Unit D, Department of Infectious Diseases, Cotugno Hospital, A.O.R.N. dei Colli, Naples, Italy
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
- COVID-19 Unit, Infectious Disease Department, University of Campania "L. Vanvitelli", 80131, Naples, Italy
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3
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Peters MC, Sajuthi S, Deford P, Christenson S, Rios CL, Montgomery MT, Woodruff PG, Mauger DT, Erzurum SC, Johansson MW, Denlinger LC, Jarjour NN, Castro M, Hastie AT, Moore W, Ortega VE, Bleecker ER, Wenzel SE, Israel E, Levy BD, Seibold MA. COVID-19-related Genes in Sputum Cells in Asthma. Relationship to Demographic Features and Corticosteroids. Am J Respir Crit Care Med 2020; 202:83-90. [PMID: 32348692 PMCID: PMC7328313 DOI: 10.1164/rccm.202003-0821oc] [Citation(s) in RCA: 307] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/29/2020] [Indexed: 01/18/2023] Open
Abstract
Rationale: Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ACE2 (angiotensin-converting enzyme 2), and TMPRSS2 (transmembrane protease serine 2) mediate viral infection of host cells. We reasoned that differences in ACE2 or TMPRSS2 gene expression in sputum cells among patients with asthma may identify subgroups at risk for COVID-19 morbidity.Objectives: To determine the relationship between demographic features and sputum ACE2 and TMPRSS2 gene expression in asthma.Methods: We analyzed gene expression for ACE2 and TMPRSS2, and for ICAM-1 (intercellular adhesion molecule 1) (rhinovirus receptor as a comparator) in sputum cells from 330 participants in SARP-3 (Severe Asthma Research Program-3) and 79 healthy control subjects.Measurements and Main Results: Gene expression of ACE2 was lower than TMPRSS2, and expression levels of both genes were similar in asthma and health. Among patients with asthma, male sex, African American race, and history of diabetes mellitus were associated with higher expression of ACE2 and TMPRSS2. Use of inhaled corticosteroids (ICS) was associated with lower expression of ACE2 and TMPRSS2, but treatment with triamcinolone acetonide did not decrease expression of either gene. These findings differed from those for ICAM-1, where gene expression was increased in asthma and less consistent differences were observed related to sex, race, and use of ICS.Conclusions: Higher expression of ACE2 and TMPRSS2 in males, African Americans, and patients with diabetes mellitus provides rationale for monitoring these asthma subgroups for poor COVID-19 outcomes. The lower expression of ACE2 and TMPRSS2 with ICS use warrants prospective study of ICS use as a predictor of decreased susceptibility to SARS-CoV-2 infection and decreased COVID-19 morbidity.
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Affiliation(s)
- Michael C. Peters
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
| | | | | | - Stephanie Christenson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
| | | | | | - Prescott G. Woodruff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
| | - David T. Mauger
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | | | | | - Loren C. Denlinger
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Nizar N. Jarjour
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mario Castro
- Division of Allergy, Immunology, and Pulmonary Medicine, University of Kansas, Kansas City, Kansas
| | - Annette T. Hastie
- Department of Internal Medicine, Pulmonary Section, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Wendy Moore
- Department of Internal Medicine, Pulmonary Section, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Victor E. Ortega
- Department of Internal Medicine, Pulmonary Section, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Eugene R. Bleecker
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Sally E. Wenzel
- Pulmonary, Allergy, and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elliot Israel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts; and
| | - Bruce D. Levy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts; and
| | - Max A. Seibold
- Center for Genes, Environment, and Health and
- Department of Pediatrics, National Jewish Health, Denver, Colorado
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado–Anschutz Medical Campus, Aurora, Colorado
| | - on behalf of the NHLBI Severe Asthma Research Program-3 Investigators
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
- Center for Genes, Environment, and Health and
- Department of Pediatrics, National Jewish Health, Denver, Colorado
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
- Department of Pathobiology, Cleveland Clinic, Cleveland, Ohio
- Department of Biomolecular Chemistry and
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Division of Allergy, Immunology, and Pulmonary Medicine, University of Kansas, Kansas City, Kansas
- Department of Internal Medicine, Pulmonary Section, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
- Pulmonary, Allergy, and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts; and
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado–Anschutz Medical Campus, Aurora, Colorado
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4
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Rossi GA, Pohunek P, Feleszko W, Ballarini S, Colin AA. Viral infections and wheezing-asthma inception in childhood: is there a role for immunomodulation by oral bacterial lysates? Clin Transl Allergy 2020; 10:17. [PMID: 32509272 PMCID: PMC7255835 DOI: 10.1186/s13601-020-00322-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/16/2020] [Indexed: 12/15/2022] Open
Abstract
Severe and recurrent infections of the respiratory tract in early childhood constitute major risk factors for the development of bronchial hyper-responsiveness and obstructive respiratory diseases in later life. In the first years of life, the vast majority of respiratory tract infections (RTI) leading to wheezing and asthma are of a viral origin and severity and recurrence are the consequence of a greater exposure to infectious agents in a period when the immune system is still relatively immature. Therefore, boosting the efficiency of the host immune response against viral infections seems to be a rational preventative approach. In the last decades it has been demonstrated that living in farm environments, i.e. early-life exposure to microbes, may reduce the risk of allergic and infectious disorders, increasing the immune response efficacy. These findings have suggested that treatment with bacterial lysates could promote a nonspecific immunomodulation useful in the prevention of recurrent RTIs and of wheezing inception and persistence. Experimental and clinical studies showing the reduction of RTI frequency and severity in childhood and elucidating the involved mechanisms can support this hypothesis.
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Affiliation(s)
- Giovanni A Rossi
- Department of Pediatrics, Pulmonary and Allergy Disease Unit and Cystic Fibrosis Center, G. Gaslini University Hospital, Largo G. Gaslini, 4, 16148 Genoa, Italy
| | - Petr Pohunek
- Dept of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, The Medical University of Warsaw, Warsaw, Poland
| | - Stefania Ballarini
- Medical Affairs Lead, Infectious Diseases, OM Pharma, a Vifor Pharma Company, Meyrin, Geneva, Switzerland
| | - Andrew A Colin
- Division of Pediatric Pulmonology, Miller School of Medicine, University of Miami, Miami, FL USA
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5
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Sun L, Girnary M, Wang L, Jiao Y, Zeng E, Mercer K, Zhang J, Marchesan JT, Yu N, Moss K, Lei YL, Offenbacher S, Zhang S. IL-10 Dampens an IL-17-Mediated Periodontitis-Associated Inflammatory Network. THE JOURNAL OF IMMUNOLOGY 2020; 204:2177-2191. [PMID: 32169848 DOI: 10.4049/jimmunol.1900532] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 02/04/2020] [Indexed: 02/05/2023]
Abstract
Emerging evidence suggests comprehensive immune profiling represents a highly promising, yet insufficiently tapped approach to identify potentially prognostic signatures for periodontitis. In this report, we agnostically identified a periodontitis-associated inflammatory expression network with multiple biomarkers identified within gingival crevicular fluid samples from study participants by applying principal component analysis. We identified an IL-17-dominated trait that is associated with periodontal disease and is inversely modified by the level of IL-10. IL-10 mitigated chemokine CXCL5 and CXCL1 expressions in IL-17-stimulated peripheral blood monocytic cells and peripheral blood monocytic cell-derived macrophages. Il10-deficient mice presented more bone loss, which was associated with more Il17 and IL-17-mediated chemokine and cytokine expression at the transcriptional levels in comparison with control wild-type mice in both the Porphyromonas gingivalis-induced experimental murine periodontitis and ligature-induced alveolar bone-loss models. The dampening effect of IL-10 on the excessive signaling of IL-17 appeared to be mediated by innate immune cells populations rather than by gingival epithelial cells, which are the major cell target for IL-17 signaling. Additionally, elevated IL-17 response in Il10-deficient mice specifically elicited an M1-skewing macrophage phenotype in the gingiva that was associated with the advanced bone loss in the ligature model. In summary, IL-17 dominated an inflammatory network characteristic of periodontitis, and IL-10 dampens this excessive IL-17-mediated periodontitis trait.
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Affiliation(s)
- Lu Sun
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Center for Oral and Systemic Diseases, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Oral and Craniofacial Biomedicine Program, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Mustafa Girnary
- Department of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Lufei Wang
- Oral and Craniofacial Biomedicine Program, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Yizu Jiao
- Doctor of Dental Surgery Program, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Erliang Zeng
- Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry, Iowa City, IA 52242
| | - Kyle Mercer
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA 52242.,Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242
| | - Jinmei Zhang
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242.,State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Julie T Marchesan
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Center for Oral and Systemic Diseases, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Department of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Ning Yu
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA 02142
| | - Kevin Moss
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Center for Oral and Systemic Diseases, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Department of Dental Ecology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; and
| | - Yu L Lei
- Department of Periodontics and Oral Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109
| | - Steven Offenbacher
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.,Center for Oral and Systemic Diseases, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Shaoping Zhang
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA 52242; .,Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242
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6
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Hung HM, Yang SL, Chen CJ, Chiu CH, Kuo CY, Huang KYA, Lin TY, Hsieh YC, Gong YN, Tsao KC, Huang YC. Molecular epidemiology and clinical features of rhinovirus infections among hospitalized patients in a medical center in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 52:233-241. [PMID: 30201131 DOI: 10.1016/j.jmii.2018.08.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Human rhinovirus (HRV) can cause severe illnesses in hospitalized patients. However, there are no studies regarding the prevalence of HRV infection, particularly the recently identified HRV-C, in hospitalized patients reported from Taiwan. METHODS Respiratory specimens collected from 487 hospitalized patients in designated wards between 2013 and 2014 in a medical center in northern Taiwan were retrospectively detected for HRV. Positive specimens were further determined for genotyping. Medical charts of the HRV-positive patients were reviewed retrospectively. RESULTS Totally, 76 patients (15.6%) were HRV positive, of which 60 were pediatric patients. HRV-A was identified in 41 (54%) patients, HRV-B in 6 patients (7.9%) and HRV-C in 29 patients (38%). A total of 47 different genotypes were identified. HRV infections were predominant during fall and winter seasons. 21.1% were affected by HRV alone and 78.9% were found to be co-infected with other microorganisms. The detection rate of HRV in children (18.6%) was significantly higher than in adults (9.6%). Compared with pediatric patients, adult patients were significantly associated with underlying disease, Pneumocystis jirovesii pneumonia co-infection, a diagnosis of pneumonia, fatal outcome, hospital acquisition of HRV, antibiotics administration and requiring intensive care, while pediatric patients were significantly associated with viral co-infection. CONCLUSIONS HRV was a common cause of respiratory tract infection in Taiwan, particularly in pediatric patients. Eighty percent of HRV-infected inpatients had other microorganisms co-infection. Adult patients were more likely to be associated with a severe respiratory disease entity.
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Affiliation(s)
- Huei-Min Hung
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Shu-Li Yang
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Jung Chen
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chen-Yen Kuo
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kuan-Ying A Huang
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yu-Chia Hsieh
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Chien Tsao
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yhu-Chering Huang
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
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7
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Restori KH, Srinivasa BT, Ward BJ, Fixman ED. Neonatal Immunity, Respiratory Virus Infections, and the Development of Asthma. Front Immunol 2018; 9:1249. [PMID: 29915592 PMCID: PMC5994399 DOI: 10.3389/fimmu.2018.01249] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/18/2018] [Indexed: 12/27/2022] Open
Abstract
Infants are exposed to a wide range of potential pathogens in the first months of life. Although maternal antibodies acquired transplacentally protect full-term neonates from many systemic pathogens, infections at mucosal surfaces still occur with great frequency, causing significant morbidity and mortality. At least part of this elevated risk is attributable to the neonatal immune system that tends to favor T regulatory and Th2 type responses when microbes are first encountered. Early-life infection with respiratory viruses is of particular interest because such exposures can disrupt normal lung development and increase the risk of chronic respiratory conditions, such as asthma. The immunologic mechanisms that underlie neonatal host-virus interactions that contribute to the subsequent development of asthma have not yet been fully defined. The goals of this review are (1) to outline the differences between the neonatal and adult immune systems and (2) to present murine and human data that support the hypothesis that early-life interactions between the immune system and respiratory viruses can create a lung environment conducive to the development of asthma.
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Affiliation(s)
- Katherine H Restori
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Bharat T Srinivasa
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Brian J Ward
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Elizabeth D Fixman
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada.,Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
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8
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Chaker AM. [Biologics in Rhinology - Forthcoming Personalized Concepts: the Future Starts Today]. Laryngorhinootologie 2018; 97:S142-S184. [PMID: 29905356 PMCID: PMC6541111 DOI: 10.1055/s-0043-123484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sinunasale Erkrankungen zählen mit zu den häufigsten chronischen Erkrankungen und führen zu einer erheblichen Störung der Lebensqualität, ein komorbides Asthma ist häufig. Trotz leitliniengerechter Therapie ist anzunehmen, dass mind. 20% der Patienten ihre Erkrankungssymptome nicht adäquat kontrollieren können. Neben den etablierten chirurgischen und konservativen Therapieoptionen finden sich nun vielversprechende Therapieansätze, die bspw. mittels therapeutischer Antikörper mechanistisch gezielt in die Pathophysiologie der Erkrankungen eingreifen können. Die Auswahl der geeigneten Patienten durch geeignete Biomarker und die richtige Therapie zum richtigen Stadium der Erkrankung anbieten zu können, ist das Ziel stratifizierter Medizin und eine wichtige Perspektive für die HNO.Chronic diseases of the nose and the paranasal sinuses are most common, frequently associated with bronchial asthma, and result in substantial reduction of quality of life. Despite optimal treatment according to guidelines, approx. 20 % of the patients will report inadequate control of symptoms. Apart from well established surgical and conservative approaches in therapy new therapeutic antibodies are available that aim specifically pathophysiological targets. The optimal allocation of effective therapy for patients using appropriate biomarkers at the most suitable timepoint is the hallmark of stratified medicine and an important perspective in ENT.
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Affiliation(s)
- Adam M. Chaker
- Klinik für Hals-Nasen-Ohrenheilkunde und Zentrum für Allergie und Umwelt, Klinikum rechts der Isar, Technische Universität München
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9
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Wark PAB, Ramsahai JM, Pathinayake P, Malik B, Bartlett NW. Respiratory Viruses and Asthma. Semin Respir Crit Care Med 2018; 39:45-55. [PMID: 29427985 PMCID: PMC7117086 DOI: 10.1055/s-0037-1617412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Asthma remains the most prevalent chronic respiratory disorder, affecting people of all ages. The relationship between respiratory virus infection and asthma has long been recognized, though remains incompletely understood. In this article, we will address key issues around this relationship. These will include the crucial role virus infection plays in early life, as a potential risk factor for the development of asthma and lung disease. We will assess the impact that virus infection has on those with established asthma as a trigger for acute disease and how this may influence asthma throughout life. Finally, we will explore the complex interaction that occurs between the airway and the immune responses that make those with asthma so susceptible to the effects of virus infection.
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Affiliation(s)
- Peter A B Wark
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - James Michael Ramsahai
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - Prabuddha Pathinayake
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - Bilal Malik
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia
| | - Nathan W Bartlett
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,School of Biomedical Sciences, The University of Newcastle, New South Wales, Australia
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10
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Incidental late diagnosis of cystic fibrosis following AH1N1 influenza virus pneumonia: a case report. J Med Case Rep 2017; 11:278. [PMID: 28964265 PMCID: PMC5623063 DOI: 10.1186/s13256-017-1430-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/20/2017] [Indexed: 12/23/2022] Open
Abstract
Background Cystic fibrosis is an autosomal recessive disorder characterized by chronic progressive multisystem involvement. AH1N1 virus infections caused classic influenza symptoms in the majority of cystic fibrosis patients while others experienced severe outcomes. Case presentation We report a case of late incidental cystic fibrosis diagnosis in a young Caucasian man suffering from respiratory failure following infection due to AH1N1 influenza virus. The patient was admitted to our department with fever, cough, and dyspnea at rest unresponsive to antibiotics Conclusions Late diagnosis of cystic fibrosis in uncommon. This report highlights the importance of early cystic fibrosis diagnosis to minimize risk of occurrence of potential life-threatening complications.
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Mazzella A, Santagata M, Cecere A, La Mart E, Fiorelli A, Tartaro G, Tafuri D, Testa D, Grella E, Perrotta F, Bianco A, Mazzarella G, Santini M. Descending necrotizing mediastinitis in the elderly patients. Open Med (Wars) 2016; 11:449-460. [PMID: 28352835 PMCID: PMC5329867 DOI: 10.1515/med-2016-0080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022] Open
Abstract
Descending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.
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Affiliation(s)
| | - Mario Santagata
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | - Atirge Cecere
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | - Ettore La Mart
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | | | | | - Domenico Tafuri
- Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Domenico Testa
- Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy
| | - Edoardo Grella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Fabio Perrotta
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Andrea Bianco
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy
| | - Gennaro Mazzarella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Second University of Naples, Italy
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12
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Song DJ. Rhinovirus and childhood asthma: an update. KOREAN JOURNAL OF PEDIATRICS 2016; 59:432-439. [PMID: 27895690 PMCID: PMC5118502 DOI: 10.3345/kjp.2016.59.11.432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/18/2015] [Accepted: 10/23/2015] [Indexed: 01/26/2023]
Abstract
Asthma is recognized as a complex disease resulting from interactions between multiple genetic and environmental factors. Accumulating evidence suggests that respiratory viral infections in early life constitute a major environmental risk factor for the development of childhood asthma. Respiratory viral infections have also been recognized as the most common cause of asthma exacerbation. The advent of molecular diagnostics to detect respiratory viruses has provided new insights into the role of human rhinovirus (HRV) infections in the pathogenesis of asthma. However, it is still unclear whether HRV infections cause asthma or if wheezing with HRV infection is simply a predictor of childhood asthma. Recent clinical and experimental studies have identified plausible pathways by which HRV infection could cause asthma, particularly in a susceptible host, and exacerbate disease. Airway epithelial cells, the primary site of infection and replication of HRV, play a key role in these processes. Details regarding the role of genetic factors, including ORMDL3, are beginning to emerge. This review discusses recent clinical and experimental evidence for the role of HRV infection in the development and exacerbation of childhood asthma and the potential underlying mechanisms that have been proposed.
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Affiliation(s)
- Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.; Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea
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13
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Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. Eur Respir J 2014; 45:774-89. [PMID: 25359340 DOI: 10.1183/09031936.00062714] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is evidence that respiratory viruses play a key role in the development and exacerbation of obstructive respiratory diseases in children. This review attempts to juxtapose the separate profiles and prototypes of pathogenetic mechanisms represented by the two most common amongst such viruses: respiratory syncytial virus (RSV) and human rhinovirus (HRV). RSV represents the most common agent of severe airway disease in infants and young children, and is predominant in winter months. Large epidemiological studies have revealed an unequivocal relationship between RSV infection and subsequent wheezing into childhood, thought to be related to long-term changes in neuroimmune control of the airways rather than allergic sensitisation. HRV is a highly diverse group of viruses that affect subjects of all ages, is ubiquitous and occurs year-round. In contrast to RSV, infections with HRV cause minimal cytotoxicity but induce a rapid production of cytokines and chemokines with amplification of the inflammatory response. The susceptibility to HRV-induced bronchiolitis and subsequent wheezing appears to be linked to individual predisposition since it is often associated with a family or personal history of asthma/atopy. Thus, RSV probably serves as an "inducer" rather than a "trigger". Conversely, HRVs seem to serve as a "trigger" rather than an "inducer" in predisposed individuals.
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Affiliation(s)
- Giovanni A Rossi
- Pulmonary and Allergy Disease Paediatric Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Andrew A Colin
- Division of Pediatric Pulmonology, Miller School of Medicine, University of Miami, Miami, FL, USA
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14
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Mazzarella G, Iadevaia C, Guerra G, Rocca A, Corcione N, Rossi G, Amore D, Brunese L, Bianco A. Intralobar pulmonary sequestration in an adult female patient mimicking asthma: a case report. Int J Surg 2014; 12 Suppl 2:S73-S77. [PMID: 25159547 DOI: 10.1016/j.ijsu.2014.08.376] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/22/2014] [Accepted: 06/15/2014] [Indexed: 01/01/2023]
Abstract
Pulmonary sequestration (PS) is a rare congenital broncho-pulmonary malformation. The main feature of this disease is that partial lung tissues separate from the main lung during the embryonic period, receiving blood supply from systemic circulation arteries. Pathogenesis of PS is not clear, and categorized into congenital and acquired PS. We report a case of a 38 year old woman smoker with medical history characterized by difficult to treat asthma with frequent exacerbations and infections since childhood. CT scan showed a partial PS of left lower lobe, supplied by an abnormal artery arising from supradiaphragmatic aortic diverticulum. Surgical treatment through a lung sequestrectomy and laterobasal segment resection was performed.
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Affiliation(s)
- Gennaro Mazzarella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/AORN Monaldi, Naples, Italy.
| | - Carlo Iadevaia
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/AORN Monaldi, Naples, Italy.
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Aldo Rocca
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Nadia Corcione
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/AORN Monaldi, Naples, Italy.
| | - Giovanni Rossi
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/AORN Monaldi, Naples, Italy.
| | - Dario Amore
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/AORN Monaldi, Naples, Italy.
| | - Luca Brunese
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Andrea Bianco
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
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15
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Rhinovirus-16 induced release of IP-10 and IL-8 is augmented by Th2 cytokines in a pediatric bronchial epithelial cell model. PLoS One 2014; 9:e94010. [PMID: 24705919 PMCID: PMC3976391 DOI: 10.1371/journal.pone.0094010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 03/12/2014] [Indexed: 01/01/2023] Open
Abstract
Background In response to viral infection, bronchial epithelial cells increase inflammatory cytokine release to activate the immune response and curtail viral replication. In atopic asthma, enhanced expression of Th2 cytokines is observed and we postulated that Th2 cytokines may augment the effects of rhinovirus-induced inflammation. Methods Primary bronchial epithelial cell cultures from pediatric subjects were treated with Th2 cytokines for 24 h before infection with RV16. Release of IL-8, IP-10 and GM-CSF was measured by ELISA. Infection was quantified using RTqPCR and TCID50. Phosphatidyl inositol 3-kinase (PI3K) and P38 mitogen activated protein kinase (MAPK) inhibitors and dexamethasone were used to investigate differences in signaling pathways. Results The presence of Th2 cytokines did not affect RV replication or viral titre, yet there was a synergistic increase in IP-10 release from virally infected cells in the presence of Th2 cytokines. Release of IL-8 and GM-CSF was also augmented. IP-10 release was blocked by a PI3K inhibitor and IL-8 by dexamethasone. Conclusion Th2 cytokines increase release of inflammatory cytokines in the presence of rhinovirus infection. This increase is independent of effects of virus replication. Inhibition of the PI3K pathway inhibits IP-10 expression.
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16
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Kwon JM, Shim JW, Kim DS, Jung HL, Park MS, Shim JY. Prevalence of respiratory viral infection in children hospitalized for acute lower respiratory tract diseases, and association of rhinovirus and influenza virus with asthma exacerbations. KOREAN JOURNAL OF PEDIATRICS 2014; 57:29-34. [PMID: 24578714 PMCID: PMC3935110 DOI: 10.3345/kjp.2014.57.1.29] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 02/19/2013] [Accepted: 04/14/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE In this study, we aimed to investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI) and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. METHODS We investigated the sources for acute LRTIs in children admitted to our hospital from May 2010 to April 2011. The 6 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction in 309 children; respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV), human metapneumovirus (hMPV), rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific Immunoglobulin E level measured using UniCAP (Pharmacia) was over 0.35 IU/mL. RESULTS RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infection was more prevalent in asthma exacerbations compared to other LRTIs. AV and hMPV were more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. CONCLUSION RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.
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Affiliation(s)
- Jang-Mi Kwon
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Deok Soo Kim
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Soo Park
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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17
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Bianco A, Mazzarella G, Turchiarelli V, Nigro E, Corbi G, Scudiero O, Sofia M, Daniele A. Adiponectin: an attractive marker for metabolic disorders in Chronic Obstructive Pulmonary Disease (COPD). Nutrients 2013; 5:4115-25. [PMID: 24128974 PMCID: PMC3820062 DOI: 10.3390/nu5104115] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/18/2013] [Accepted: 09/23/2013] [Indexed: 12/15/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a major factor linking COPD to metabolic alterations. Adipose tissue seems to interfere with systemic inflammation in COPD patients by producing a large number of proteins, known as “adipokines”, involved in various processes such as metabolism, immunity and inflammation. There is evidence that adiponectin is an important modulator of inflammatory processes implicated in airway pathophysiology. Increased serum levels of adiponectin and expression of its receptors on lung tissues of COPD patients have recently highlighted the importance of the adiponectin pathway in this disease. Further, in vitro studies have demonstrated an anti-inflammatory activity for this adipokine at the level of lung epithelium. This review focuses on mechanisms by which adiponectin is implicated in linking COPD with metabolic disorders.
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Affiliation(s)
- Andrea Bianco
- Department of Medicine and Health Sciences, University of Molise, Via Giovanni Paolo II, Loc. Tappino, Campobasso 86100, Italy; E-Mails: (V.T.); (G.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-0874-409-263; Fax: +39-0874-404-752
| | - Gennaro Mazzarella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Via Leonardo Bianchi, Monaldi Hospital, Naples 80131, Italy; E-Mail:
| | - Viviana Turchiarelli
- Department of Medicine and Health Sciences, University of Molise, Via Giovanni Paolo II, Loc. Tappino, Campobasso 86100, Italy; E-Mails: (V.T.); (G.C.)
| | - Ersilia Nigro
- CEINGE Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, Naples 80145, Italy; E-Mails: (E.N.); (O.S.); (A.D.)
- IRCCS–Fondazione SDN, Naples 80131, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Via Giovanni Paolo II, Loc. Tappino, Campobasso 86100, Italy; E-Mails: (V.T.); (G.C.)
| | - Olga Scudiero
- CEINGE Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, Naples 80145, Italy; E-Mails: (E.N.); (O.S.); (A.D.)
| | - Matteo Sofia
- Department of Respiratory Medicine, AO Monaldi, University of Naples Federico II, Via Leonardo Bianchi, Monaldi Hospital, Naples 80131, Italy; E-Mail:
| | - Aurora Daniele
- CEINGE Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, Naples 80145, Italy; E-Mails: (E.N.); (O.S.); (A.D.)
- IRCCS–Fondazione SDN, Naples 80131, Italy
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, Seconda Università degli Studi di Napoli, Via Vivaldi 43, Caserta 81100, Italy
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18
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Potential mechanisms linking atherosclerosis and increased cardiovascular risk in COPD: focus on Sirtuins. Int J Mol Sci 2013; 14:12696-713. [PMID: 23774840 PMCID: PMC3709808 DOI: 10.3390/ijms140612696] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/11/2013] [Accepted: 06/05/2013] [Indexed: 11/17/2022] Open
Abstract
The development of atherosclerosis is a multi-step process, at least in part controlled by the vascular endothelium function. Observations in humans and experimental models of atherosclerosis have identified monocyte recruitment as an early event in atherogenesis. Chronic inflammation is associated with ageing and its related diseases (e.g., atherosclerosis and chronic obstructive pulmonary disease). Recently it has been discovered that Sirtuins (NAD+-dependent deacetylases) represent a pivotal regulator of longevity and health. They appear to have a prominent role in vascular biology and regulate aspects of age-dependent atherosclerosis. Many studies demonstrate that SIRT1 exhibits anti-inflammatory properties in vitro (e.g., fatty acid-induced inflammation), in vivo (e.g., atherosclerosis, sustainment of normal immune function in knock-out mice) and in clinical studies (e.g., patients with chronic obstructive pulmonary disease). Because of a significant reduction of SIRT1 in rodent lungs exposed to cigarette smoke and in lungs of patients with chronic obstructive pulmonary disease (COPD), activation of SIRT1 may be a potential target for chronic obstructive pulmonary disease therapy. We review the inflammatory mechanisms involved in COPD-CVD coexistence and the potential role of SIRT1 in the regulation of these systems.
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19
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Barnes N, Pavord I, Chuchalin A, Bell J, Hunter M, Lewis T, Parker D, Payton M, Collins LP, Pettipher R, Steiner J, Perkins CM. A randomized, double-blind, placebo-controlled study of the CRTH2 antagonist OC000459 in moderate persistent asthma. Clin Exp Allergy 2011; 42:38-48. [DOI: 10.1111/j.1365-2222.2011.03813.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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20
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Amineva SP, Aminev AG, Gern JE, Palmenberg AC. Comparison of rhinovirus A infection in human primary epithelial and HeLa cells. J Gen Virol 2011; 92:2549-2557. [PMID: 21752966 DOI: 10.1099/vir.0.031302-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
HeLa cells are used to study the life cycles of many different viruses, including the human rhinoviruses (HRV) in the family Picornaviridae. Although the natural targets of HRV are human bronchial epithelial cells (hBE), it is generally more difficult to obtain and maintain the relevant primary cell cultures, relative to HeLa cells. Given that the HRV are now identified as a major cause of human asthma exacerbations, it becomes important to document how much of the virus biology learned from HeLa cells is common also to natural primary cells. When compared directly in matched infections using A01a virus, the kinetics of RNA replication, the synthesis and processing of viral proteins and the general subcellular localization of key non-structural proteins were resembled in hBE and HeLa cells. Viral-induced shutoff of host cell processes (e.g. nucleo-cytoplasmic trafficking) was also comparable.
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Affiliation(s)
- S P Amineva
- School of Medicine and Public Health, 600 Highland Avenue, University of Wisconsin, Madison, WI 53792, USA.,Institute for Molecular Virology, University of Wisconsin, 1525 Linden Drive, Madison, WI 53706, USA
| | - A G Aminev
- Institute for Molecular Virology, University of Wisconsin, 1525 Linden Drive, Madison, WI 53706, USA
| | - J E Gern
- School of Medicine and Public Health, 600 Highland Avenue, University of Wisconsin, Madison, WI 53792, USA
| | - A C Palmenberg
- Institute for Molecular Virology, University of Wisconsin, 1525 Linden Drive, Madison, WI 53706, USA
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Jartti T, Gern JE. Rhinovirus-associated wheeze during infancy and asthma development. CURRENT RESPIRATORY MEDICINE REVIEWS 2011; 7:160-166. [PMID: 23066381 DOI: 10.2174/157339811795589423] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Rhinovirus is commonly associated with bronchiolitis - only second to RSV during the first year life. The prevalence of HRV-bronchiolitis may be very high in predisposed infants. HRV diagnosis is almost exclusively based on PCR, which detects respiratory infections with or without symptoms. Two immunologic factors, interferon responses and atopy, have been associated with susceptibility to HRV-bronchiolitis in multiple studies. The current data supports the hypothesis that susceptibility to HRV-bronchiolitis is likely to be an early manifestation of biased immune responses, which are linked to both decreased viral defence and atopic airway inflammation. Prospective studies have consistently shown that early wheezing associated with HRV infection is closely associated with recurrent wheezing and the development of asthma in children. Collectively, these studies suggest that HRV infection in wheezing children could serve as a clinically useful marker for early identification of asthma prone children. The findings to date provide the rationale for future studies to incorporate rhinovirus illnesses into asthma risk indices.
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Affiliation(s)
- Tuomas Jartti
- Department of Pediatrics, Turku University Hospital, Turku, Finland
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22
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Abstract
Human rhinovirus (HRV) and respiratory syncytial virus (RSV) are commonly associated with bronchiolitis. The breaking point in the dominance is approximately 12 months--rhinovirus dominates in the older children. Predisposition may markedly increase the prevalence of HRV bronchiolitis. Especially, low interferon responses and atopy-related factors have been associated with HRV bronchiolitis. The former has been considered as a sign of poor antiviral defense, and the latter could be associated with atopic airway inflammation in wheezing children. Although recurrent wheezing is common after both RSV and HRV bronchiolitis, HRV bronchiolitis carries a markedly higher risk of persistent wheezing until 6 years of age and for childhood asthma. This association has been independent from atopy at 7.2 (median) years of age. The increased risk of asthma in adulthood after non-RSV bronchiolitis vs. RSV bronchiolitis in infancy (at the time when PCR was not available for HRV diagnosis) offers indirect evidence for the association between HRV bronchiolitis and chronic asthma.
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Affiliation(s)
- Tuomas Jartti
- Department of Pediatrics, Turku University Hospital, Turku, Finland.
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23
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Anderson VE, Nguyen Y, Weinberg JB. Effects of allergic airway disease on mouse adenovirus type 1 respiratory infection. Virology 2009; 391:25-32. [PMID: 19564030 DOI: 10.1016/j.virol.2009.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 05/26/2009] [Accepted: 06/02/2009] [Indexed: 12/01/2022]
Abstract
Virus infection may contribute to asthma pathogenesis. In turn, a Th2-polarized pulmonary environment may increase host susceptibility to infection. We used a cockroach antigen (CRA) model of allergic airway disease to test the hypothesis that Th2 cytokine overproduction increases susceptibility to mouse adenovirus type 1 (MAV-1). CRA sensitization led to upregulated lung expression of IL-4 and IL-13, lung cellular inflammation, and exaggerated airway mucus production. Following intranasal MAV-1 infection, lung cellular inflammation was more pronounced in CRA-sensitized mice than in unsensitized mice at 7 days post-infection but not at a later time point. CRA sensitization did not significantly suppress lung IFN-gamma expression, and lung IFN-gamma expression was upregulated in both CRA-sensitized mice and unsensitized mice over the course of MAV-1 infection. Despite CRA-induced differences in pulmonary inflammation, MAV-1 viral loads in lung and spleen and MAV-1 gene expression in the lung did not differ between CRA-sensitized and unsensitized mice. Our data therefore suggest that MAV-1 pathogenesis is not affected directly or indirectly by the Th2 polarization associated with allergic airway disease.
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Lopez-Souza N, Favoreto S, Wong H, Ward T, Yagi S, Schnurr D, Finkbeiner WE, Dolganov GM, Widdicombe JH, Boushey HA, Avila PC. In vitro susceptibility to rhinovirus infection is greater for bronchial than for nasal airway epithelial cells in human subjects. J Allergy Clin Immunol 2009; 123:1384-90.e2. [PMID: 19428098 DOI: 10.1016/j.jaci.2009.03.010] [Citation(s) in RCA: 155] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 03/04/2009] [Accepted: 03/05/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human rhinoviruses (HRVs) characteristically cause upper respiratory tract infection, but they also infect the lower airways, causing acute bronchitis and exacerbating asthma. OBJECTIVE Our purpose was to study ex vivo the differences in the response to HRV infection of nasal and bronchial epithelial cultures from the same healthy and asthmatic individuals using conditions favoring development of fully differentiated, pseudostratified mucociliary epithelium. METHODS Cells from the inferior turbinates and bronchial tree of 5 healthy and 6 asthmatic individuals were cultured at an air-liquid interface. Cultures were infected with HRV-16, and after 48 hours, the degree of infection was measured. RESULTS Baseline median transepithelial resistance was lower in human bronchial epithelial (HBE) cell cultures than in human nasal epithelial (HNE) cell cultures (195 Omega.cm2 [95% CI, 164-252] vs 366 Omega.cm2 [95% CI, 234-408], respectively; P < .01). Virus replicated more easily in HBE cells than in HNE cells based on virus shedding in apical wash (log tissue culture infective dose of 50%/0.1 mL = 2.0 [95% CI, 1.0-2.5] vs 0.5 [95% CI, 0.5-1.5], P < .01) and on a 20- to 30-fold greater viral load and number of infected cells in HBE cell cultures than in HNE cell cultures. The increases in expression of RANTES and double-stranded RNA-dependent protein kinase were greater in HBE cell cultures than in HNE cell cultures, as were the concentrations of IL-8, IL-1alpha, RANTES, and IP-10 in basolateral medium. However, no significant differences between asthmatic and healthy subjects (including IFN-beta1 expression) were found. CONCLUSIONS Differentiated nasal epithelial cells might have mechanisms of increased resistance to rhinovirus infection compared with bronchial epithelial cells. We could not confirm previous reports of increased susceptibility to HRV infection in epithelial cells from asthmatic subjects.
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Affiliation(s)
- Nilceia Lopez-Souza
- Department of Medicine, University of California, San Francisco, Calif., USA
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25
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Kim S, Nadel JA. Fibrinogen binding to ICAM-1 promotes EGFR-dependent mucin production in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol 2009; 297:L174-83. [PMID: 19429776 DOI: 10.1152/ajplung.00032.2009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Mucous hypersecretion is a serious feature of chronic airway diseases such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. Although mucins are produced via activation of an EGF receptor (EGFR) signaling cascade, the mechanisms leading to exaggerated mucin production in mucous hypersecretory diseases are unknown. Because expression of ICAM-1 and of the ICAM-1 ligand fibrinogen is increased in the airways of subjects with mucous hypersecretory diseases, we hypothesized that fibrinogen binding to ICAM-1 could increase EGFR-dependent mucin production in human airway (NCI-H292) epithelial cells. Consistent with this hypothesis, we found that an ICAM-1 neutralizing antibody and an ICAM-1(8-22) peptide that binds fibrinogen decreased mucin production induced by the EGFR ligand transforming growth factor (TGF)-alpha dose-dependently. Exogenous fibrinogen and a fibrinogen(117-133) peptide that binds ICAM-1 rescued mucin production in cells treated with the ICAM-1(8-22) peptide. Surprisingly, the ICAM-1(8-22) peptide increased EGFR phosphotyrosine and phospho-ERK1/2 in cells treated with TGF-alpha. The ICAM-1(8-22) peptide-induced increases in EGFR phosphotyrosine and phospho-ERK1/2 were prevented by exogenous fibrinogen, by the fibrinogen(117-133) peptide, and by selective inhibitors of phospholipase C (PLC), protein kinase C (PKC)-alpha/beta, and metalloproteases. These results suggest that fibrinogen binding to ICAM-1 promotes mucin production by decreasing TGF-alpha-induced EGFR and ERK1/2 activation and that the fibrinogen-ICAM-1-dependent decrease in EGFR and ERK1/2 activation occurs via inhibition of an early positive feedback pathway involving PLC- and PKC-alpha/beta-dependent metalloprotease activation and subsequent metalloprotease-dependent EGFR reactivation.
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Affiliation(s)
- Suil Kim
- Department of Medicine, Cardiovascular Research Institute, University of California,San Francisco, California 94143-0130, USA.
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Klinger A, Gebert A, Bieber K, Kalies K, Ager A, Bell EB, Westermann J. Cyclical expression of L-selectin (CD62L) by recirculating T cells. Int Immunol 2009; 21:443-55. [DOI: 10.1093/intimm/dxp012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Message SD, Johnston SL. Infections. ASTHMA AND COPD 2009. [PMCID: PMC7149941 DOI: 10.1016/b978-0-12-374001-4.00037-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This chapter reviews the epidemiological evidence implicating infectious pathogens as triggers and will discuss the mechanisms of interaction between the host–pathogen response and preexisting airway pathology that result in an exacerbation. Asthma is a multifaceted syndrome involving atopy, bronchial hyperreactivity, and IgE and non-IgE-mediated acute and chronic immune responses. The asthmatic airway is characterized by an infiltrate of eosinophils and of T-lymphocytes expressing the type 2 cytokines IL-4, IL-5, and IL-13. Trigger factors associated with acute exacerbations of asthma include exposure to environmental allergens, especially animals, molds, pollens and mites, cold, exercise, and drugs. The frequency of exacerbations is a major factor in the quality of life of patients with COPD. The typical clinical features of an exacerbation include increased dyspnea, wheezing, cough, sputum production, and worsened gas exchange. Although noninfectious causes of exacerbations such as allergy, air pollution, or inhaled irritants including cigarette smoke may be important, acute airway infections are the major precipitants. The infection and consequent host inflammatory response result in increased airway obstruction. The success of vaccination to prevent respiratory virus infections has been limited by significant variation within the major virus types causing disease. Currently much of the treatment of infective exacerbations of asthma and COPD is symptomatic, consisting of increased bronchodilators, either short-acting β 2—agonists in inhaled or intravenous form or anticholinergics or theophyllines, or supportive in the form of oxygen and in severe cases noninvasive or invasive ventilatory measures.
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Host immune responses to rhinovirus: mechanisms in asthma. J Allergy Clin Immunol 2008; 122:671-682. [PMID: 19014757 DOI: 10.1016/j.jaci.2008.08.013] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 08/15/2008] [Accepted: 08/18/2008] [Indexed: 11/22/2022]
Abstract
Viral respiratory infections can have a profound effect on many aspects of asthma including its inception, exacerbations, and, possibly, severity. Of the many viral respiratory infections that influence asthma, the common cold virus, rhinovirus, has emerged as the most frequent illness associated with exacerbations and other aspects of asthma. The mechanisms by which rhinovirus influences asthma are not fully established, but current evidence indicates that the immune response to this virus is critical in this process. Many airway cell types are involved in the immune response to rhinovirus, but most important are respiratory epithelial cells and possibly macrophages. Infection of epithelial cells generates a variety of proinflammatory mediators to attract inflammatory cells to the airway with a subsequent worsening of underlying disease. Furthermore, there is evidence that the epithelial airway antiviral response to rhinovirus may be defective in asthma. Therefore, understanding the immune response to rhinovirus is a key step in defining mechanisms of asthma, exacerbations, and, perhaps most importantly, improved treatment.
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Whiteman SC, Spiteri MA. IFN-gamma regulation of ICAM-1 receptors in bronchial epithelial cells: soluble ICAM-1 release inhibits human rhinovirus infection. JOURNAL OF INFLAMMATION-LONDON 2008; 5:8. [PMID: 18534017 PMCID: PMC2427029 DOI: 10.1186/1476-9255-5-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 06/05/2008] [Indexed: 11/10/2022]
Abstract
Background Intercellular adhesion molecule-1 (ICAM-1) is a critical target-docking molecule on epithelial cells for 90% of human rhinovirus (HRV) serotypes. Two forms of ICAM-1 exist, membranous (mICAM-1) and soluble (sICAM-1), both expressed by bronchial epithelial cells. Interferon-gamma (IFN-γ), a crucial Th-1 immuno-regulatory mediator, can modulate mICAM-1 expression; however its simultaneous effects on mICAM-1: sICAM-1 levels and their consequent outcome on cell infectivity have not been previously explored. Methods Primary normal human bronchial epithelial cells were pre-stimulated with IFN-γ (1 ng/ml for 24 h) and subsequently inoculated with HRV-14 or HRV-1b (TCID50 10 2.5). Epithelial surface ICAM-1 expression and soluble ICAM-1 release were measured at the protein and gene level by immunofluorescence and ELISA respectively; mRNA levels were semi-quantified using RT-PCR. Molecular mechanisms regulating ICAM-1 isoform expression and effects on epithelial cell infectivity were explored. Results In IFN-γ-biased cells infected with HRV-14, but not HRV-1b, mICAM-1 expression is down-regulated, with simultaneous induction of sICAM-1 release. This differential effect on HRV-14 receptor isoforms appears to be related to a combination of decreased IFN-γ-induced JAK-STAT signalling and proteolytic receptor cleavage of the membranous form in IFN-γ-biased HRV-14 infected cells. The observed changes in relative mICAM-1: sICAM-1 expression levels are associated with reduced HRV-14 viral titres. Conclusion These findings support the hypothesis that in epithelial cells conditioned to IFN-γ and subsequently exposed to HRV-14 infection, differential modulation in the ratio of ICAM-1 receptors prevails in favour of an anti-viral milieu, appearing to limit further target cell viral attachment and propagation.
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Hansbro NG, Horvat JC, Wark PA, Hansbro PM. Understanding the mechanisms of viral induced asthma: new therapeutic directions. Pharmacol Ther 2008; 117:313-53. [PMID: 18234348 PMCID: PMC7112677 DOI: 10.1016/j.pharmthera.2007.11.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 11/19/2007] [Indexed: 12/12/2022]
Abstract
Asthma is a common and debilitating disease that has substantially increased in prevalence in Western Societies in the last 2 decades. Respiratory tract infections by respiratory syncytial virus (RSV) and rhinovirus (RV) are widely implicated as common causes of the induction and exacerbation of asthma. These infections in early life are associated with the induction of wheeze that may progress to the development of asthma. Infections may also promote airway inflammation and enhance T helper type 2 lymphocyte (Th2 cell) responses that result in exacerbations of established asthma. The mechanisms of how RSV and RV induce and exacerbate asthma are currently being elucidated by clinical studies, in vitro work with human cells and animal models of disease. This research has led to many potential therapeutic strategies and, although none are yet part of clinical practise, they show much promise for the prevention and treatment of viral disease and subsequent asthma.
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Affiliation(s)
- Nicole G Hansbro
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health, The University of Newcastle, New South Wales 2308, Australia
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Kato A, Favoreto S, Avila PC, Schleimer RP. TLR3- and Th2 cytokine-dependent production of thymic stromal lymphopoietin in human airway epithelial cells. THE JOURNAL OF IMMUNOLOGY 2007; 179:1080-7. [PMID: 17617600 PMCID: PMC2220044 DOI: 10.4049/jimmunol.179.2.1080] [Citation(s) in RCA: 372] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Thymic stromal lymphopoietin (TSLP) is elevated in asthma and triggers dendritic cell-mediated activation of Th2 inflammatory responses. Although TSLP has been shown to be produced mainly by airway epithelial cells, the regulation of epithelial TSLP expression has not been extensively studied. We investigated the expression of TSLP in cytokine- or TLR ligand-treated normal human bronchial epithelial cells (NHBE). The mRNA for TSLP was significantly up-regulated by stimulation with IL-4 (5.5-fold) and IL-13 (5.3-fold), weakly up-regulated by TNF-alpha, TGF-beta, and IFN-beta, and not affected by IFN-gamma in NHBE. TSLP mRNA was only significantly up-regulated by the TLR3 ligand (dsRNA) among the TLR ligands tested (66.8-fold). TSLP was also induced by in vitro infection with rhinovirus. TSLP protein was detected after stimulation with dsRNA (120 +/- 23 pg/ml). The combination of TNF-alpha and IL-4 produced detectable levels of TSLP protein (40 +/- 13 pg/ml). In addition, TSLP was synergistically enhanced by a combination of IL-4 and dsRNA (mRNA; 207-fold, protein; 325 +/- 75 pg/ml). The induction of TSLP by dsRNA was dependent upon NF-kappaB and IFN regulatory factor 3 (IRF-3) signaling via TLR3 as indicated by a study with small interfering RNA. The potent topical glucocorticoid fluticasone propionate significantly suppressed dsRNA-dependent TSLP production in NHBE. These results suggest that the expression of TSLP is induced in airway epithelial cells by stimulation with the TLR3 ligand and Th2 cytokines and that this response is suppressed by glucocorticoid treatment. This implies that respiratory viral infection and the recruitment of Th2 cytokine producing cells may amplify Th2 inflammation via the induction of TSLP in the asthmatic airway.
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Affiliation(s)
| | | | | | - Robert P. Schleimer
- Address correspondence and reprint requests to Dr. Robert P. Schleimer, Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, 240 East Huron, Chicago, IL 60611. E-mail address:
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Roggen EL, Soni NK, Verheyen GR. Respiratory immunotoxicity: An in vitro assessment. Toxicol In Vitro 2006; 20:1249-64. [PMID: 16876979 DOI: 10.1016/j.tiv.2006.03.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Revised: 03/30/2006] [Accepted: 03/31/2006] [Indexed: 12/27/2022]
Abstract
As yet, in vitro assessment of the immunotoxic potency of respiratory agents is not possible. The complexity of the endpoint and the respiratory tract, and the limited availability of well-documented respiratory agents are the main reasons. The evidence that epithelial cells (ECs) are triggered by compounds to express in vitro surface proteins and soluble mediators, has stimulated their use for developing tests for respiratory immunotoxicity. A variety of airway ECs and EC-lines have been assessed, but the available information seems to point at human alveolar cells (e.g., A549) as the most convenient cell type. EC-based test formats with various degrees of complexity have been assessed. Sofar, promising results were obtained using a 3D model using the human A549 lung cell line. Dendritic cells (DCs) have been subjected to intensive research. However, currently available tests are not well suited to discern among the potency of sensitizers. Potential explanations include the lack of standardised protocols for the generation of DCs, no good standards for estimating the quality of in vitro derived DC-cultures, and limited dynamics of the currently used end-points. Alveolar macrophages (AMs) have so far received less attention. This may proof unjustified as macrophages may link innate responses to adaptive immunity. The observation that ECs, DCs and AMs affect each other, suggests that test formats are required combining at least two of these cell types if ranking of compounds according to their sensitising potency is the aim. In addition, the capacity of compounds to cross a cellular membrane is an important property of an immunotoxic compound, which can be assessed only in 3D reconstituted human tissue models. While promising data have been reported for the skin, immunocompetent 3D reconstituted human lung remains to be evaluated for respiratory immunotoxicity. Obviously, the success of any of these simplified test (as compared to the complexity of the immune response) is highly dependent on the availability of early stage biomarkers (expressed at mucosal barrier level) that are predictive for relevant immunotoxicity mechanisms occurring down-stream of the immune response. As yet, such biomarkers are not yet available.
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Affiliation(s)
- Erwin L Roggen
- Department of Protein Screening, Molecular Biotechnology, Novozymes AS Smoermosevej 11, 2880 Bagsvaerd, Denmark.
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Jartti T, Lehtinen P, Vanto T, Hartiala J, Vuorinen T, Mäkelä MJ, Ruuskanen O. Evaluation of the efficacy of prednisolone in early wheezing induced by rhinovirus or respiratory syncytial virus. Pediatr Infect Dis J 2006; 25:482-8. [PMID: 16732144 DOI: 10.1097/01.inf.0000215226.69696.0c] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The role of systemic corticosteroids in the treatment of early childhood wheezing in children is not clear. OBJECTIVE We sought to determine whether prednisolone is effective in rhinovirus-induced early wheezing. METHODS We conducted a controlled trial comparing oral prednisolone (2 mg/kg per day in three divided doses for 3 days) with placebo in 78 hospitalized children (mean age, 1.1 year; standard deviation, 0.7) experiencing their first or second episode of wheezing induced by rhinovirus or respiratory syncytial virus. Mixed viral infections were excluded. Our primary end point was the time until the patient was ready for discharge; secondary end points included oxygen saturation during hospitalization, duration of symptoms, occurrence of relapses during the next 2 months and blood eosinophil counts at discharge and 2 weeks later. RESULTS In multivariate regression analysis, prednisolone did not influence the time until ready for discharge, but it decreased relapses during the subsequent 2-month period in rhinovirus-affected children (prednisolone versus placebo, 22% versus 56%; odds ratio, 19.06; 95% confidence interval, 2.52-144.03; P = 0.004) and in children with blood eosinophils > or = 0.2 x 10/L (respectively, 24% versus 71%; odds ratio, 10.57; 95% confidence interval, 1.99-56.22; P = 0.006). Rhinovirus-affected children had more blood eosinophils on admission (mean, 0.44 versus 0.086 x 10/L), had a higher prevalence of atopy (44% versus 8%) and were older (mean, 1.4 versus 0.9 years, P < 0.001 for all) than respiratory syncytial virus-infected children. CONCLUSION Prednisolone reduced relapses during a 2-month period after first episodes of wheezing associated with rhinovirus infection or blood eosinophils > or = 0.2 x 10/L.
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Affiliation(s)
- Tuomas Jartti
- Department of Pediatrics, Turku University Hospital, Turku, Finland.
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Abstract
Bronchiolitis and asthma are common wheezing illnesses of childhood. Respiratory syncytial virus is the main causative agent of Bronchiolitis. Rhinovirus is the most common trigger of exacerbations of asthma, but also has been detected increasingly in doing children with Bronchiolitis. Reportedly, childhood asthma develops in 40% of children with a history of Bronchiolitis. No convincing link has been reported between Bronchiolitis and development of atopy, although atopy generally is regarded as the main risk factor for chronic asthma. This article focuses on the association between bronchiolitis and the development of asthma. The authors address the question how respiratory syncytial virus and rhinovirus infections in young children, together with genetics and immunologic immaturity, may contribute to the development of asthma.
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Affiliation(s)
- Tuomas Jartti
- Department of Pediatrics, Turku University Hospital, Finland
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Pelaia G, Vatrella A, Gallelli L, Renda T, Cazzola M, Maselli R, Marsico SA. Respiratory infections and asthma. Respir Med 2005; 100:775-84. [PMID: 16289785 PMCID: PMC7135443 DOI: 10.1016/j.rmed.2005.08.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Accepted: 08/24/2005] [Indexed: 02/08/2023]
Abstract
Respiratory tract infections caused by both viruses and/or atypical bacteria are involved in the pathogenesis of asthma. In particular, several viruses such as respiratory syncytial virus, rhinovirus and influenza/parainfluenza viruses may favour the expression of the asthmatic phenotype, being also implicated in the induction of disease exacerbations. Within this pathological context, a significant role can also be played by airway bacterial colonizations and infections due to Chlamydiae and Mycoplasms. All these microbial agents probably interfere with complex immunological pathways, thus contributing to induce and exacerbate asthma in genetically predisposed individuals.
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Affiliation(s)
- Girolamo Pelaia
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Italy
| | - Alessandro Vatrella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy
| | - Luca Gallelli
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Italy
| | - Teresa Renda
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Italy
| | - Mario Cazzola
- Unit of Pneumology and Allergology, Department of Respiratory Medicine, A. Cardarelli Hospital, Via del Parco Margherita 24, 80121 Napoli, Italy
- Corresponding author. Tel.: +81 404188 813486.
| | - Rosario Maselli
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Italy
| | - Serafino A. Marsico
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy
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Contoli M, Caramori G, Mallia P, Johnston S, Papi A. Mechanisms of respiratory virus-induced asthma exacerbations. Clin Exp Allergy 2005; 35:137-45. [PMID: 15725183 DOI: 10.1111/j.1365-2222.2005.02163.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M Contoli
- Research Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy.
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Lim S, Caramori G, Tomita K, Jazrawi E, Oates T, Chung KF, Barnes PJ, Adcock IM. Differential expression of IL-10 receptor by epithelial cells and alveolar macrophages. Allergy 2004; 59:505-14. [PMID: 15080831 DOI: 10.1111/j.1398-9995.2004.00455.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Interleukin (IL)-10 is a pleiotropic cytokine with a broad spectrum of immunosuppressive and anti-inflammatory effects. IL-10 secretion from alveolar macrophages is defective in patients with asthma and lower concentrations of IL-10 are found in bronchoalveolar lavage (BAL) from asthmatic patients than in normal control subjects. Reduced IL-10 may result in exaggerated and more prolonged inflammatory responses in asthmatic airways. IL-10 acting through the IL-10 receptor (IL-10R) stimulates the transcription factors STAT1 and STAT3. METHODS We investigated IL-10 and IL-10R expression in normal and asthmatic bronchial epithelium and BAL macrophages using reverse transcription-polymerase chain reaction, immunohistochemistry and Western blotting. The functional effect of IL-10 was examined using granulocyte-macrophage-colony stimulating factor, enzyme-linked immunosorbent assay and Western blotting for phosphorylated STAT1 and STAT3. RESULTS IL-10 was not expressed in epithelial cells; furthermore these cells did not express the IL-10R and had no functional response to exogenous IL-10. Bronchial epithelial cells expressed variable levels of phosphorylated STAT1 and STAT3 with no change in expression between normal subjects and asthmatics. IL-10 protein and IL-10R expression was detected in alveolar macrophages from all subjects. CONCLUSION Our study suggests that the bronchial epithelium is not a source of IL-10 and cannot respond to exogenous IL-10 because of a lack of IL-10R expression.
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Affiliation(s)
- S Lim
- Department of Thoracic Medicine, Imperial College School of Medicine, National Heart and Lung Institute, Dovehouse Street, London, UK
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Lopez-Souza N, Dolganov G, Dubin R, Sachs LA, Sassina L, Sporer H, Yagi S, Schnurr D, Boushey HA, Widdicombe JH. Resistance of differentiated human airway epithelium to infection by rhinovirus. Am J Physiol Lung Cell Mol Physiol 2004; 286:L373-81. [PMID: 14711802 DOI: 10.1152/ajplung.00300.2003] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Virtually all in vitro studies of the effects of rhinovirus on human airway epithelium have used cells grown under conditions known to produce low levels of differentiation. The relevance of the results to native epithelium is questionable. Here we grew primary cultures of human tracheal or nasal epithelium under three conditions. One condition produced pseudostratified, mucociliary cells virtually indistinguishable from native epithelium. The other two conditions produced undifferentiated squamous cells lacking cilia. Cells were infected for 6 h with rhinovirus-16. After a 24-h incubation period, we determined levels of viral RNA in the cells, numbers of infectious viral particles released in the mucosal medium, expression of a variety of epithelial cytokines and other proteins, release of IL-6 and IL-8, and transepithelial electrical resistance and voltage. After infection, levels of viral RNA in the poorly differentiated cells were 30 or 130 times those in the differentiated. Furthermore, expression of mRNA for inflammatory cytokines, release of infectious particles, and release of IL-6 and IL-8 were closely correlated with the degree of viral infection. Thus well-differentiated cells are much more resistant to viral infection and its functional consequences than are poorly differentiated cells from the same source.
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Affiliation(s)
- N Lopez-Souza
- Department of Human Physiology, University of California-Davis, Davis CA 95616-8664, USA
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Message SD, Johnston SL. Host defense function of the airway epithelium in health and disease: clinical background. J Leukoc Biol 2004; 75:5-17. [PMID: 12972516 PMCID: PMC7167170 DOI: 10.1189/jlb.0703315] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Respiratory infection is extremely common and a major cause of morbidity and mortality worldwide. The airway epithelium has an important role in host defense against infection and this is illustrated in this review by considering infection by respiratory viruses. In patients with asthma or chronic obstructive pulmonary disease, respiratory viruses are a common trigger of exacerbations. Rhinoviruses (RV) are the most common virus type detected. Knowledge of the immunopathogenesis of such RV-induced exacerbations remains limited, but information is available from in vitro and from in vivo studies, especially of experimental infection in human volunteers. RV infects and replicates within epithelial cells (EC) of the lower respiratory tract. EC are an important component of the innate-immune response to RV infection. The interaction between virus and the intracellular signaling pathways of the host cell results in activation of potentially antiviral mechanisms, including type 1 interferons and nitric oxide, and in the production of cytokines and chemokines [interleukin (IL)-1 beta, IL-6, IL-8, IL-11, IL-16, tumor necrosis factor alpha, granulocyte macrophage-colony stimulating factor, growth-regulated oncogene-alpha, epithelial neutrophil-activating protein-78, regulated on activation, normal T expressed and secreted, eotaxin 1/2, macrophage-inflammatory protein-1 alpha], which influence the subsequent induced innate- and specific-immune response. Although this is beneficial in facilitating clearance of virus from the respiratory tract, the generation of proinflammatory mediators and the recruitment of inflammatory cells result in a degree of immunopathology and may amplify pre-existing airway inflammation. Further research will be necessary to determine whether modification of EC responses to respiratory virus infection will be of therapeutic benefit.
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Affiliation(s)
- Simon D Message
- Department of Respiratory Medicine, Imperial College School of Medicine at St. Mary's, Norfolk Place, London W2 1PG, UK.
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The Efficacy of Azelastine in the Prophylaxis of Acute Upper Respiratory Tract Infections. ACTA ACUST UNITED AC 2003. [DOI: 10.1089/088318703322751327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Pathmanathan S, Krishna MT, Blomberg A, Helleday R, Kelly FJ, Sandström T, Holgate ST, Wilson SJ, Frew AJ. Repeated daily exposure to 2 ppm nitrogen dioxide upregulates the expression of IL-5, IL-10, IL-13, and ICAM-1 in the bronchial epithelium of healthy human airways. Occup Environ Med 2003; 60:892-6. [PMID: 14573722 PMCID: PMC1740417 DOI: 10.1136/oem.60.11.892] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Repeated daily exposure of healthy human subjects to NO2 induces an acute airway inflammatory response characterised by neutrophil influx in the bronchial mucosa AIMS To assess the expression of NF-kappaB, cytokines, and ICAM-1 in the bronchial epithelium. METHODS Twelve healthy, young non-smoking volunteers were exposed to 2 ppm of NO2/filtered air (four hours/day) for four successive days on separate occasions. Fibreoptic bronchoscopy was performed one hour after air and final NO2 exposures. Bronchial biopsy specimens were immunostained for NF-kappaB, TNF-alpha, eotaxin, Gro-alpha, GM-CSF, IL-5, -6, -8, -10, -13, and ICAM-1 and their expression was quantified using computerised image analysis. RESULTS Expression of IL-5, IL-10, IL-13, and ICAM-1 increased following NO2 exposure. CONCLUSION Upregulation of the Th2 cytokines suggests that repeated exposure to NO2 has the potential to exert a "pro-allergic" effect on the bronchial epithelium. Upregulation of ICAM-1 highlights an underlying mechanism for leucocyte influx, and could also explain the predisposition to respiratory tract viral infections following NO2 exposure since ICAM-1 is a major receptor for rhino and respiratory syncytial viruses.
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de Kluijver J, Evertse CE, Sont JK, Schrumpf JA, van Zeijl-van der Ham CJG, Dick CR, Rabe KF, Hiemstra PS, Sterk PJ. Are rhinovirus-induced airway responses in asthma aggravated by chronic allergen exposure? Am J Respir Crit Care Med 2003; 168:1174-80. [PMID: 12893645 DOI: 10.1164/rccm.200212-1520oc] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Airway inflammation in asthma may represent a favorable environment for respiratory viral infections, augmenting virus-induced exacerbations in asthma. We postulated that repeated low-dose allergen exposure preceding experimental rhinovirus 16 (RV16) infection increases the severity of RV-induced airway obstruction and inflammation. Thirty-six house dust mite-allergic patients with mild to moderate asthma participated in a three-arm, parallel, placebo-controlled, double-blind study. Patients inhaled a low dose of house dust mite allergen for 10 subsequent working days (Days 1-5 and 8-12) and/or were subsequently infected with RV16 (Days 15 and 16). Allergen exposure resulted in a significant fall in FEV1 (p < 0.001) and provocative concentration of histamine causing a 20% fall in FEV1 (p < 0.001) and an increase in exhaled nitric oxide (p < 0.001) and percentage of sputum eosinophils (p < 0.001). RV16 infection led to a fall in FEV1 (p = 0.02) and increases in the percentage of sputum neutrophils (p = 0.01), sputum interleukin-8 (p = 0.04), and neutrophil elastase (p = 0.04). Successive allergen exposure and RV16 infection had no synergistic or additive effect on any of the clinical or inflammatory outcomes. In conclusion, repeated low-dose allergen exposure and RV16 infection induce distinct inflammatory profiles within the airways in asthma without apparent interaction between these two environmental triggers. This suggests that preceding allergen exposure, at the used dose and duration, is not a determinant of the severity of RV-induced exacerbations in patients with mild to moderate asthma.
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Affiliation(s)
- Josephine de Kluijver
- Lung Function Laboratory, Department of Pulmonology, Leiden University Medical Center, P.O. Box 9600, NL-2300 RC Leiden, The Netherlands
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43
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Whiteman SC, Bianco A, Knight RA, Spiteri MA. Human rhinovirus selectively modulates membranous and soluble forms of its intercellular adhesion molecule-1 (ICAM-1) receptor to promote epithelial cell infectivity. J Biol Chem 2003; 278:11954-61. [PMID: 12551926 DOI: 10.1074/jbc.m205329200] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Human rhinoviruses are responsible for many upper respiratory tract infections. 90% of rhinoviruses utilize intercellular adhesion molecule-1 (ICAM-1) as their cellular receptor, which also plays a critical role in recruitment of immune effector cells. Two forms of this receptor exist; membrane-bound (mICAM-1) and soluble ICAM-1 (sICAM-1). The soluble receptor may be produced independently from the membrane-bound form or it may be the product of proteolytic cleavage of mICAM-1. The ratio of airway epithelial cell expression of mICAM-1 to the sICAM-1 form may influence cell infectivity and outcome of rhinovirus infection. We therefore investigated the effect of rhinovirus on expression of both ICAM-1 receptors in normal human bronchial epithelial cells. We observed separate distinct messenger RNA transcripts coding for mICAM-1 and sICAM-1 in these cells, which were modulated by virus. Rhinovirus induced mICAM-1 expression on epithelial cells while simultaneously down-regulating sICAM-1 release, with consequent increase in target cell infectivity. The role of protein tyrosine kinases was investigated as a potential mechanistic pathway. Rhinovirus infection induced rapid phosphorylation of intracellular tyrosine kinase, which may be critical in up-regulation of mICAM-1. Elucidation of the underlying molecular mechanisms involved in differential modulation of both ICAM-1 receptors may lead to novel therapeutic strategies.
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Affiliation(s)
- Suzanne C Whiteman
- Lung Injury and Inflammation Research, Directorate of Respiratory Medicine, North Staffordshire Hospital Trust, Stoke-on-Trent ST4 6QG, United Kingdom.
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44
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Abstract
Using sensitive diagnostic methodologies, epidemiologic studies during the past decade have allowed the identification of human rhinoviruses (RVs), generally recognized as "common cold viruses," as major asthma precipitants. This association was further established by evaluating the impact of RV infection in airway obstruction and inflammation during naturally acquired or experimentally induced RV colds. There is now strong evidence that RVs can infect and propagate not only in the upper but also in the lower airways. Bronchial and pulmonary epithelia infected by RVs are rich sources of inflammatory mediators, which may initiate or augment airway inflammation and obstruction. Furthermore, in an atopic environment, responses to the virus are skewed by and toward an "atopic," Th2-like balance, which may further enhance inflammation and exacerbate asthma.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Allergy Unit, Second Pediatric Clinic, University of Athens, 13 Levadias Street, 115 27 Goudi, Athens, Greece.
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45
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Kim S, Shim JJ, Burgel PR, Ueki IF, Dao-Pick T, Tam DCW, Nadel JA. IL-13-induced Clara cell secretory protein expression in airway epithelium: role of EGFR signaling pathway. Am J Physiol Lung Cell Mol Physiol 2002; 283:L67-75. [PMID: 12060562 DOI: 10.1152/ajplung.00404.2001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Previous work showed that the Th2 cytokine interleukin (IL)-13 induces goblet cell metaplasia via an indirect mechanism involving the expression and subsequent activation of epidermal growth factor receptor (EGFR). Because Clara cell secretory protein (CCSP) expression has been reported in cells that express mucins, we examined the effect of IL-13 on CCSP gene and protein expression in pathogen-free rat airways and in pulmonary mucoepidermoid NCI-H292 cells. Intratracheal instillation of IL-13 induced CCSP mRNA in epithelial cells without cilia within 8-16 h, maximal between 24 and 48 h; CCSP immunostaining increased in a time-dependent fashion, maximal at 48 h. The CCSP immunostaining was localized in nongranulated secretory cells and goblet cells and in the lumen. Pretreatment with the selective EGFR tyrosine kinase inhibitor BIBX1522, cyclophosphamide (an inhibitor of bone marrow leukocyte mobilization), or a blocking antibody to IL-8 prevented CCSP staining. Treatment of NCI-H292 cells with the EGFR ligand transforming growth factor-alpha, but not with IL-13 alone, induced CCSP gene and protein expression. Selective EGFR tyrosine kinase inhibitors, BIBX1522 and AG1478, prevented CCSP expression in NCI-H292 cells, but the platelet-derived growth factor receptor tyrosine kinase inhibitor AG1295 had no effect. These findings indicate that IL-13 induces CCSP expression via an EGFR- and leukocyte-dependent pathway.
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Affiliation(s)
- Suil Kim
- Cardiovascular Research Institute and Department of Medicine, University of California, San Francisco, California 94143-0130, USA
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46
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Kaminuma O, Fujimura H, Fushimi K, Nakata A, Sakai A, Chishima S, Ogawa K, Kikuchi M, Kikkawa H, Akiyama K, Mori A. Dynamics of antigen-specific helper T cells at the initiation of airway eosinophilic inflammation. Eur J Immunol 2001; 31:2669-79. [PMID: 11536165 DOI: 10.1002/1521-4141(200109)31:9<2669::aid-immu2669>3.0.co;2-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bronchial asthma is characterized by chronic eosinophilic inflammation of the bronchial mucosa in which Th2 cells play crucial roles. Ovalbumin-reactive Th2 clones were labeled with a fluorescent-probe then infused into unprimed mice to elucidate the dynamics of antigen-specific T cells involved in allergic inflammation. Infiltration of not only labeled antigen-specific T cells, but also unlabeled nonspecific CD4(+) T cells into the bronchial mucosa following inhaled antigen challenge was detectable under confocal microscopy and flow cytometry. Accordingly, labeled T cells in the spleen were decreased, whereas those in hilar lymph nodes were increased upon antigen challenge. Approximately 45% of antigen-specific T cells that migrated into the lungs bore CD25, while another early activation marker, CD69, was expressed on 80% of the migrated T cells. Accordingly, antigen challenge to the mice induced in situ proliferation of antigen-specific T cells as well as bronchial epithelial cells in the lungs. Expression of vascular cell adhesion molecule (VCAM)-1, but not intercellular adhesion molecule (ICAM)-1, on the vascular endothelium in the lungs was enhanced following antigen challenge. Nevertheless, treatment with anti-VCAM-1 antibody, and also anti-ICAM-1 antibody strongly suppressed the accumulation of T cells, suggesting that both VCAM-1 and ICAM-1 are essential for antigen-stimulated T cell mobilization into peripheral tissues. Our current study visualized the kinetics and the mechanism of antigen-specific T cell migration in response to local challenge with a protein antigen.
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Affiliation(s)
- O Kaminuma
- Discovery Research Laboratory, Tanabe Seiyaku Co., Ltd., Saitama, Japan.
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47
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Abstract
Clinical and experimental evidence suggests an important role for respiratory infections in the development of asthma attacks. Viral upper respiratory infections have been associated with 80% of asthma exacerbations in children and 50% of all asthma episodes in adults. Human rhinovirus has been implicated as the principal virus associated with asthma episodes. Separate studies indicate that atypical bacteria such as Chlamydia pneumoniae and Mycoplasma pneumoniae may precipitate asthma symptoms. Although not completely clarified, the intricate pathogenetic mechanisms by which viral infections promote asthma attacks have been extensively investigated in recent years. By contrast, it has not yet been established whether atypical bacterial infections are an epiphenomenon or a pathogenic event in asthma.
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Affiliation(s)
- E Micillo
- Institute of Respiratory Diseases, Second University of Naples, Italy
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48
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Abstract
Asthma is a complex inflammatory disease of the lung characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Inflammation in asthma consists of airway infiltration by mast cells, lymphocytes, and eosinophils. There is accumulating evidence that CD4+ lymphocytes with a Th2-cytokine pattern play a pivotal role in the pathogenesis of asthma. These cells orchestrate the recruitment and activation of the primary effector cells of the allergic response (mast cells and eosinophils), through the release of cytokines such as IL-4, IL-5, and IL-13. Allergic inflammation is also implicated in airway epithelium changes, although the mechanisms by which inflammatory cells and, in particular, T cells interact with the epithelium are not completely clarified. This paper explores the role of T cells in the allergic inflammation of asthma.
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Affiliation(s)
- G Mazzarella
- Institute of Respiratory Diseases S Marcatili, Second University of Naples, Italy.
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Marguet C, Dean TP, Warner JO. Soluble intercellular adhesion molecule-1 (sICAM-1) and interferon-gamma in bronchoalveolar lavage fluid from children with airway diseases. Am J Respir Crit Care Med 2000; 162:1016-22. [PMID: 10988123 DOI: 10.1164/ajrccm.162.3.9902101] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We have previously described that in bronchoalveolar lavage fluid (BALF), eosinophils characterize asthma and neutrophils are more prominent in infantile wheeze. In this study, we hypothesized that intercellular adhesion molecule 1 (ICAM-1) and interferon-gamma (IFN-gamma) would have a role in promoting migration of both cell types into the airway. To investigate this, we measured soluble (s) ICAM-1 in 68 BALFs from infants and young children with various respiratory problems. Children with asthma were characterized by significantly raised sICAM compared with those with chronic cough without wheeze (p = 0.05) or control subjects with no lower airway pathology (p = 0.045). The levels correlated with disease severity (evaluated with a symptom score) and with lymphocyte numbers. IFN-gamma levels were also raised in children with asthma compared with those with chronic cough (p = 0.05), but there was no correlation with disease activity. Infantile wheeze was characterized by a linear correlation between sICAM-1 and IFN-gamma (r = 0.55; p = 0.002). sICAM-1 levels in infantile wheeze correlated with the severity of the disease and lymphocyte numbers. IFN-gamma levels were elevated in the wheezers treated with inhaled steroids compared with untreated infants (p = 0.03). Although sICAM-1 levels were increased in those with severe cough, no characteristic inflammatory profile was found in the group with chronic cough. Our study suggests that ICAM-1 and IFN-gamma play a role in the activity of the inflammatory process in asthma in childhood and possibly in some infant wheezers, in whom IFN-gamma may be one of the factors increasing the expression of ICAM-1. The role of IFN-gamma, a T helper-1 cytokine, in children with asthma remains to be fully understood.
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Affiliation(s)
- C Marguet
- Pediatric Respiratory Disease Unit, Hôpital Ch. Nicolle, Rouen, France
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50
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Bianco A, Whiteman SC, Sethi SK, Allen JT, Knight RA, Spiteri MA. Expression of intercellular adhesion molecule-1 (ICAM-1) in nasal epithelial cells of atopic subjects: a mechanism for increased rhinovirus infection? Clin Exp Immunol 2000; 121:339-45. [PMID: 10931151 PMCID: PMC1905704 DOI: 10.1046/j.1365-2249.2000.01301.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since clinical experimental studies indicate that upper respiratory tract viral infections may exacerbate acute asthma symptoms in atopic/asthmatic individuals, we have investigated the expression and modulation of ICAM-1 on human nasal epithelial cells (HNEC) from normal and atopic subjects. ICAM-1 is the attachment molecule for the majority of serotypes of human rhinovirus (HRV), including HRV-14, and is also critical for the migration and activation of immune effector cells. Basal ICAM-1 expression was significantly higher in HNEC obtained by brushings from atopic compared with non-atopic subjects (P = 0.031), and was also significantly increased on atopic HNEC harvested in season compared with out of season (P < 0.05). Atopic HNEC showed further up-regulation in ICAM-1 expression when cultured with clinically relevant allergen (P = 0.032). ICAM-1 levels on normal HNEC were also increased by infection with HRV-14 (P < 0.05). Basal expression of ICAM-1 on atopic nasal polyp epithelial cells (EC) was significantly higher than on both normal and atopic nasal HNEC. This elevated nasal polyp ICAM-1 level was not increased further by allergen, although HRV infection resulted in a small significant increase. Recovered viral titres from HRV-infected nasal polyp EC were 1.5-fold higher than from infected normal nasal HNEC. The data are consistent with the hypothesis that allergen, by enhancing expression of the HRV attachment target on host cells, facilitates viral infection in atopic subjects; simultaneously HRV-induced increases in ICAM-1 levels would favour migration and activation of immune effector cells to the airway, resulting in enhanced atopic inflammation.
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Affiliation(s)
- A Bianco
- Lung Injury and Inflammation Research Group, Centre for Cell and Molecular Medicine, Keele University, and Department of Respiratory Medicine, North Staffordshire Hospital Trust, Stoke-on-Trent, UK
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