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Nabeya D, Setoguchi M, Ueno S, Kinjo T. Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review. BMC Pulm Med 2023; 23:111. [PMID: 37024839 PMCID: PMC10078074 DOI: 10.1186/s12890-023-02402-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. METHODS Among the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction. RESULTS A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. CONCLUSIONS Cases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.
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Affiliation(s)
- Daijiro Nabeya
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Michika Setoguchi
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Shiho Ueno
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Takeshi Kinjo
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
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2
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Association of Acute Upper Respiratory Tract Infections with Sudden Sensorineural Hearing Loss: A Case-Crossover, Nationwide, Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010745. [PMID: 34682488 PMCID: PMC8535477 DOI: 10.3390/ijerph182010745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/03/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
The etiology of sudden sensorineural hearing loss (SSNHL) has been unclear until now. Understanding its potential etiology is crucial for the development of preventive medicine. In this study, we investigated the association between acute upper respiratory tract infections (URIs) and SSNHL risk. We conducted a case-crossover study by using the longitudinal health insurance database derived from the National Health Insurance Research Database in Taiwan. Individual acute URI between the case and control periods was reviewed. Multivariable conditional logistic regression models were used to estimate the adjusted odds ratios (aORs) of SSNHL risk associated with acute URIs after adjustments for potential confounders. In total, 1131 patients with SSNHL between 2010 and 2013 fulfilled our inclusion criteria and were included. The aOR (95% confidence interval [CI]) for SSNHL was 1.57 (1.20-2.05) in relation to acute URIs one month before the index date. Moreover, the aORs (95% CIs) of the female and young to middle-aged (≤65 years) populations were 1.63 (1.13-2.36) and 1.76 (1.29-2.40), respectively. In addition, the association between SSNHL and acute URIs was decreased over time. The aOR for SSNHL was 1.25 (1.01-1.56) in relation to acute URIs three months before the index date. Acute URIs increase SSNHL risk and are a potential risk factor for SSNHL. The establishment of a feasible health policy for the prevention of acute URIs is crucial for SSNHL prevention, particularly in female, and young to middle-aged populations.
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3
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Schuliga M, Read J, Knight DA. Ageing mechanisms that contribute to tissue remodeling in lung disease. Ageing Res Rev 2021; 70:101405. [PMID: 34242806 DOI: 10.1016/j.arr.2021.101405] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022]
Abstract
Age is a major risk factor for chronic respiratory diseases such as idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD) and certain phenotypes of asthma. The recent COVID-19 pandemic also highlights the increased susceptibility of the elderly to acute respiratory distress syndrome (ARDS), a diffuse inflammatory lung injury with often long-term effects (ie parenchymal fibrosis). Collectively, these lung conditions are characterized by a pathogenic reparative process that, rather than restoring organ function, contributes to structural and functional tissue decline. In the ageing lung, the homeostatic control of wound healing following challenge or injury has an increased likelihood of being perturbed, increasing susceptibility to disease. This loss of fidelity is a consequence of a diverse range of underlying ageing mechanisms including senescence, mitochondrial dysfunction, proteostatic stress and diminished autophagy that occur within the lung, as well as in other tissues, organs and systems of the body. These ageing pathways are highly interconnected, involving localized and systemic increases in inflammatory mediators and damage associated molecular patterns (DAMPs); along with corresponding changes in immune cell function, metabolism and composition of the pulmonary and gut microbiomes. Here we comprehensively review the roles of ageing mechanisms in the tissue remodeling of lung disease.
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Affiliation(s)
- Michael Schuliga
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Jane Read
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Darryl A Knight
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Providence Health Care Research Institute, Vancouver, British Columbia, Canada
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4
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Bloom CI, Johnston SL. Decline in respiratory and cardiac admissions during the COVID-19 pandemic: What is the role of common respiratory virus infections? Respirology 2021; 26:1010-1011. [PMID: 34427013 PMCID: PMC8662067 DOI: 10.1111/resp.14138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Chloe I Bloom
- National Heart and Lung Institute, Imperial College London, London, UK
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5
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Extracellular Vesicles and Asthma-More Than Just a Co-Existence. Int J Mol Sci 2021; 22:ijms22094984. [PMID: 34067156 PMCID: PMC8124625 DOI: 10.3390/ijms22094984] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 02/07/2023] Open
Abstract
Extracellular vesicles (EVs) are membranous structures, which are secreted by almost every cell type analyzed so far. In addition to their importance for cell-cell communication under physiological conditions, EVs are also released during pathogenesis and mechanistically contribute to this process. Here we summarize their functional relevance in asthma, one of the most common chronic non-communicable diseases. Asthma is a complex persistent inflammatory disorder of the airways characterized by reversible airflow obstruction and, from a long-term perspective, airway remodeling. Overall, mechanistic studies summarized here indicate the importance of different subtypes of EVs and their variable cargoes in the functioning of the pathways underlying asthma, and show some interesting potential for the development of future therapeutic interventions. Association studies in turn demonstrate a good diagnostic potential of EVs in asthma.
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6
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Owen JJ, Edgar SL, Elliott S, Kerley S, Jones TL, Neville D, Fogg C, Brown TP, Chauhan AJ, Shute JK. Urinary fibrinopeptide-A as a predictive biomarker of exacerbation in asthma. RESPIRATORY MEDICINE: X 2020. [DOI: 10.1016/j.yrmex.2020.100021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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7
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Lactobacillus casei CRL431 modulates hemostatic activation induced by protein malnourishment and pneumococcal respiratory infection. Appl Microbiol Biotechnol 2020; 104:10669-10683. [PMID: 33079228 DOI: 10.1007/s00253-020-10957-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 09/21/2020] [Accepted: 10/12/2020] [Indexed: 10/24/2022]
Abstract
Previously, we demonstrated that Lactobacillus casei CRL431, a well-known immunomodulatory bacterium, beneficially regulates coagulation activation, fibrin formation in lung, and the pro-inflammatory state induced by protein malnourishment and pneumococcal infection. In this study, we deepen in the understanding of the mechanisms involved in the immunoregulatory activity of L. casei CRL431 during a nutritional repletion process by evaluating (a) platelet and endothelial activation, (b) tissue factor (TF) expression, and (c) protease-activated receptor (PAR) activation in an experimental bacterial respiratory infection model in malnourished mice. Our findings demonstrate for the first time that the repletion diet supplemented with L. casei CRL431 was effective to normalize platelet counts in blood, modulate platelet activation and their recruitment into the lung, and regulate local and systemic TF expression and endothelial activation, which were affected by malnourishment. Streptococcus pneumoniae challenge induced local and systemic increase of platelet counts, PARs activation, P-selectin and TF expression, as well as endothelial activation in both well-nourished and malnourished mice. Malnourished animals evidenced the highest alterations of the parameters evaluated while the mice fed with the probiotic bacterium had similar behavior to normal controls but with lower PAR activation in lung. These results demonstrate that supplementation of repletion diet with L. casei CRL431 is effective to modulate alterations induced by malnourishment and pneumococcal infection, restraining coagulation activation, the inflammatory process, and lung damage. These observations contribute to set the basis for the application of probiotic functional foods to modulate the inflammation-hemostasis interactions altered by malnourishment or bacterial respiratory infections. KEY POINTS: • Pneumococcal infection increases pro-coagulant state induced by protein malnourishment. • Repletion with L. casei CRL431 modulates platelet, TF, and endothelial activation. • L. casei CRL431 improves immune-coagulative response in protein malnourishment.
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8
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Sabogal Piñeros YS, Dekker T, Smids B, Majoor CJ, Ravanetti L, Villetti G, Civelli M, Facchinetti F, Lutter R. Phosphodiesterase 4 inhibitors attenuate virus-induced activation of eosinophils from asthmatics without affecting virus binding. Pharmacol Res Perspect 2020; 8:e00557. [PMID: 32447834 PMCID: PMC7245579 DOI: 10.1002/prp2.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 11/11/2022] Open
Abstract
Acute respiratory virus infections, such as influenza and RSV, are predominant causes of asthma exacerbations. Eosinophils act as a double-edged sword in exacerbations in that they are activated by viral infections but also can capture and inactivate respiratory viruses. Phosphodiesterase type 4 (PDE4) is abundantly expressed by eosinophils and has been implicated in their activation. This exploratory study aims to determine whether these opposing roles of eosinophils activation of eosinophils upon interaction with virus can be modulated by selective PDE4 inhibitors and whether eosinophils from healthy, moderate and severe asthmatic subjects respond differently. Eosinophils were purified by negative selection from blood and subsequently exposed to RSV or influenza. Prior to exposure to virus, eosinophils were treated with vehicle or selective PDE4 inhibitors CHF6001 and GSK256066. After 18 hours of exposure, influenza, but not RSV, increased CD69 and CD63 expression by eosinophils from each group, which were inhibited by PDE4 inhibitors. ECP release, although not stimulated by virus, was also attenuated by PDE4 inhibitors. Eosinophils showed an increased Nox2 activity upon virus exposure, which was less pronounced in eosinophils derived from mild and severe asthmatics and was counteracted by PDE4 inhibitors. PDE4 inhibitors had no effect on binding of virus by eosinophils from each group. Our data indicate that PDE4 inhibitors can attenuate eosinophil activation, without affecting virus binding. By attenuating virus-induced responses, PDE4 inhibitors may mitigate virus-induced asthma exacerbations.
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Affiliation(s)
- Yanaika Shari Sabogal Piñeros
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Tamara Dekker
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Barbara Smids
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Christof J. Majoor
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lara Ravanetti
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Gino Villetti
- Corporate Pre‐Clinical R&DChiesi Farmaceutici S.p.A.ParmaItaly
| | | | | | - René Lutter
- Department of Experimental ImmunologyAmsterdam Infection & Immunity InstituteAmsterdamThe Netherlands
- Department of Respiratory MedicineAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
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9
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Alzghoul BN, Reddy R, Chizinga M, Innabi A, Zou B, Papierniak ES, Faruqi I. Pulmonary Embolism in Acute Asthma Exacerbation: Clinical Characteristics, Prediction Model and Hospital Outcomes. Lung 2020; 198:661-669. [PMID: 32424799 DOI: 10.1007/s00408-020-00363-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/11/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Little is known about the characteristics and impact of acute pulmonary embolism (PE) during episodes of asthma exacerbation. We aimed to characterize patients diagnosed with acute PE in the setting of asthma exacerbation, develop a prediction model to help identify future patients and assess the impact of acute PE on hospital outcomes. METHODS We included 758 patients who were treated for asthma exacerbation and underwent a computed tomographic pulmonary angiography (CTA) during the same encounter at a university-based hospital between June 2011 and October 2018. We compared clinical characteristics of patients with and without acute PE and developed a machine learning prediction model to classify the PE status based on the clinical variables. We used multivariable regression analysis to evaluate the impact of acute PE on hospital outcomes. RESULTS Twenty percent of the asthma exacerbation patients who underwent CTA had an acute PE. Factors associated with acute PE included previous history of PE, high CHA2DS2-VASc score, hyperlipidemia, history of deep vein thrombosis, malignancy, chronic systemic corticosteroids use, high body mass index and atrial fibrillation. Using these factors, we developed a random forest machine learning prediction model which had an 88% accuracy in classifying the acute PE status of the patients (area under the receiver operating characteristic curve = 0.899; 95% confidence interval: 0.885-0.913). Acute PE in asthma exacerbation was associated with longer hospital stay and intensive care unit stay. CONCLUSION It is important to consider acute PE, a potentially life-threatening event, in the setting of asthma exacerbation especially when other risk factors are present.
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Affiliation(s)
- Bashar N Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA. .,Department of Medicine, University of Florida, Gainesville, FL, USA.
| | - Raju Reddy
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Mwelwa Chizinga
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Ayoub Innabi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Baiming Zou
- Department of Biostatistics and School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Eric S Papierniak
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Ibrahim Faruqi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Box 100277, Gainesville, FL, 32608, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
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10
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Coden ME, Berdnikovs S. Eosinophils in wound healing and epithelial remodeling: Is coagulation a missing link? J Leukoc Biol 2020; 108:93-103. [DOI: 10.1002/jlb.3mr0120-390r] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/31/2020] [Accepted: 02/14/2020] [Indexed: 01/13/2023] Open
Affiliation(s)
- Mackenzie E. Coden
- Division of Allergy and Immunology Department of Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA
| | - Sergejs Berdnikovs
- Division of Allergy and Immunology Department of Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA
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11
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Licari A, Marseglia G, De Amici M, Ciprandi G. Pentraxin 3 and D-dimer in children with asthma: A real-world study. Clin Exp Allergy 2019; 49:550-551. [PMID: 30723958 DOI: 10.1111/cea.13364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Gianluigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Mara De Amici
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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12
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Girkin J, Maltby S, Singanayagam A, Bartlett N, Mallia P. In vivo experimental models of infection and disease. RHINOVIRUS INFECTIONS 2019. [PMCID: PMC7149593 DOI: 10.1016/b978-0-12-816417-4.00008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human and animal models continue to play a crucial role in research to understand host immunity to rhinovirus (RV) and identify disease mechanisms. Human models have provided direct evidence that RV infection is capable of exacerbating chronic respiratory diseases and identified immunological processes that correlate with clinical disease outcomes. Mice are the most commonly used nonhuman experimental RV infection model. Although semipermissive, under defined experimental conditions sufficient replication occurs to induce host immune responses that recapitulate immunity and disease during human infection. The capacity to use genetically modified mouse strains and drug interventions has shown the mouse model to be an invaluable research tool defining causal relationships between host immunity and disease and supporting development of new treatments. Used in combination the insights achieved from human and animal experimental infection models provide complementary insights into RV biology and yield novel therapeutic options to reduce the burden of RV-induced disease.
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13
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Mohning MP, Thomas SM, Barthel L, Mould KJ, McCubbrey AL, Frasch SC, Bratton DL, Henson PM, Janssen WJ. Phagocytosis of microparticles by alveolar macrophages during acute lung injury requires MerTK. Am J Physiol Lung Cell Mol Physiol 2017; 314:L69-L82. [PMID: 28935638 DOI: 10.1152/ajplung.00058.2017] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Microparticles are a newly recognized class of mediators in the pathophysiology of lung inflammation and injury, but little is known about the factors that regulate their accumulation and clearance. The primary objective of our study was to determine whether alveolar macrophages engulf microparticles and to elucidate the mechanisms by which this occurs. Alveolar microparticles were quantified in bronchoalveolar fluid of mice with lung injury induced by LPS and hydrochloric acid. Microparticle numbers were greatest at the peak of inflammation and declined as inflammation resolved. Isolated, fluorescently labeled particles were placed in culture with macrophages to evaluate ingestion in the presence of endocytosis inhibitors. Ingestion was blocked with cytochalasin D and wortmannin, consistent with a phagocytic process. In separate experiments, mice were treated intratracheally with labeled microparticles, and their uptake was assessed though microscopy and flow cytometry. Resident alveolar macrophages, not recruited macrophages, were the primary cell-ingesting microparticles in the alveolus during lung injury. In vitro, microparticles promoted inflammatory signaling in LPS primed epithelial cells, signifying the importance of microparticle clearance in resolving lung injury. Microparticles were found to have phosphatidylserine exposed on their surfaces. Accordingly, we measured expression of phosphatidylserine receptors on macrophages and found high expression of MerTK and Axl in the resident macrophage population. Endocytosis of microparticles was markedly reduced in MerTK-deficient macrophages in vitro and in vivo. In conclusion, microparticles are released during acute lung injury and peak in number at the height of inflammation. Resident alveolar macrophages efficiently clear these microparticles through MerTK-mediated phagocytosis.
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Affiliation(s)
- Michael P Mohning
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health , Denver, Colorado.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus , Aurora, Colorado
| | - Stacey M Thomas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health , Denver, Colorado
| | - Lea Barthel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health , Denver, Colorado
| | - Kara J Mould
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus , Aurora, Colorado
| | - Alexandria L McCubbrey
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health , Denver, Colorado.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus , Aurora, Colorado
| | | | - Donna L Bratton
- Department of Pediatrics, National Jewish Health , Denver, Colorado
| | - Peter M Henson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus , Aurora, Colorado.,Department of Pediatrics, National Jewish Health , Denver, Colorado
| | - William J Janssen
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health , Denver, Colorado.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus , Aurora, Colorado
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14
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Nieri D, Neri T, Petrini S, Vagaggini B, Paggiaro P, Celi A. Cell-derived microparticles and the lung. Eur Respir Rev 2017; 25:266-77. [PMID: 27581826 DOI: 10.1183/16000617.0009-2016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/19/2016] [Indexed: 12/20/2022] Open
Abstract
Cell-derived microparticles are small (0.1-1 μm) vesicles shed by most eukaryotic cells upon activation or during apoptosis. Microparticles carry on their surface, and enclose within their cytoplasm, molecules derived from the parental cell, including proteins, DNA, RNA, microRNA and phospholipids. Microparticles are now considered functional units that represent a disseminated storage pool of bioactive effectors and participate both in the maintenance of homeostasis and in the pathogenesis of diseases. The mechanisms involved in microparticle generation include intracellular calcium mobilisation, cytoskeleton rearrangement, kinase phosphorylation and activation of the nuclear factor-κB. The role of microparticles in blood coagulation and inflammation, including airway inflammation, is well established in in vitro and animal models. The role of microparticles in human pulmonary diseases, both as pathogenic determinants and biomarkers, is being actively investigated. Microparticles of endothelial origin, suggestive of apoptosis, have been demonstrated in the peripheral blood of patients with emphysema, lending support to the hypothesis that endothelial dysfunction and apoptosis are involved in the pathogenesis of the disease and represent a link with cardiovascular comorbidities. Microparticles also have potential roles in patients with asthma, diffuse parenchymal lung disease, thromboembolism, lung cancer and pulmonary arterial hypertension.
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Affiliation(s)
- Dario Nieri
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy Both authors contributed equally
| | - Tommaso Neri
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy Both authors contributed equally
| | - Silvia Petrini
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy
| | - Barbara Vagaggini
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy
| | - Pierluigi Paggiaro
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy
| | - Alessandro Celi
- Laboratorio di Biologia Cellulare Respiratoria, SVD Fisiopatologia Respiratoria e Riabilitazione, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, University of Pisa, Pisa, Italy
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15
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Sneeboer MMS, Fens N, van de Pol MA, Majoor CJ, Meijers JCM, Kamphuisen PW, Lutter R, Sterk PJ, Bel EHD. Loss of asthma control and activation of coagulation and fibrinolysis. Clin Exp Allergy 2016; 46:422-7. [PMID: 26509255 DOI: 10.1111/cea.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/19/2015] [Accepted: 10/24/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Epidemiologic studies have shown that patients with severe asthma have increased risk of pulmonary embolism, in particular patients with frequent asthma exacerbations. Therefore, we hypothesized that asthma exacerbations are associated with increased haemostatic activity. OBJECTIVE To investigate whether induced loss of asthma control is associated with changes in coagulation and fibrinolytic parameters in peripheral blood. METHODS We performed a prospective, inhaled steroid withdrawal study in 23 patients with moderate to moderately severe asthma, consisting of a baseline visit and a visit after loss of asthma control. During the visits, we measured asthma control questionnaire (ACQ), atopy, lung function, inflammatory markers (eosinophils and neutrophils), and haemostatic parameters in plasma. RESULTS Complete cessation of inhaled corticosteroids led to a loss of asthma control in 22 of 23 patients. We found increased asthma symptoms (ACQ 0.9 vs. 2.9, P < 0.01), significantly reduced lung function (forced expiratory volume in 1 s (FEV1) 3.51L vs. 3.13L, P < 0.01) and increased levels of eosinophils in plasma (0.26 × 10(E9)/L vs. 0.16 × 10(E9)/L, P = 0.03) in patients after loss of asthma control. However, we observed no significant changes in the coagulation and fibrinolysis parameters. CONCLUSION Loss of asthma control after cessation of inhaled corticosteroids does not lead to increased haemostatic activation in patients with moderate to moderately severe asthma. This suggests that more severe inflammation or additional risk factors are required for activation of coagulation or reduction of fibrinolysis in asthma.
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Affiliation(s)
- M M S Sneeboer
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - N Fens
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - M A van de Pol
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - C J Majoor
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - J C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - P W Kamphuisen
- Department of Vascular Medicine, University Medical Center Groningen, The Netherlands
| | - R Lutter
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - P J Sterk
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - E H D Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
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16
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Manuyakorn W, Mairiang D, Sirachainan N, Kadegasem P, Kamchaisatian W, Benjaponpitak S, Chuansumrit A. Blood Coagulation and Asthma Exacerbation in Children. Int Arch Allergy Immunol 2016; 170:75-83. [PMID: 27454316 DOI: 10.1159/000446775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 05/03/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recent studies have demonstrated the activation of coagulation pathways in asthmatic airways. This study aimed to determine systemic blood coagulation during asthma exacerbation compared with the stable state in children. METHODS Pediatric patients (aged between 5 and 15 years) suffering from asthma exacerbation were enrolled. von Willebrand factor (vWF), plasminogen activator inhibitor type-1 (PAI-1), protein C, D-dimer, prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), and C-reactive protein (CRP) levels were measured during asthma exacerbation and stable state. RESULTS A total of 22 patients were enrolled. The median vWF, PAI-1, and CRP during asthma exacerbation were significantly higher than those of the stable state: 147.5% (interquartile range, IQR: 111.05-196.57) versus 94% (IQR: 69.72-109.62, p < 0.001), 41.9 ng/ml (IQR: 21.91-48.61) versus 26.17 ng/ml (IQR: 15.89-34.44, p < 0.03), and 4.46 mg/l (IQR: 2.15-16.23) versus 0.87 mg/l (IQR: 0.20-3.89, p < 0.015), respectively. However, the median protein C during asthma exacerbation was significantly lower than that of the stable state: 99.5% (IQR: 86.75-117) versus 113% (IQR: 94-115.25), p = 0.01. No significant difference was found between the levels of D-dimer, F1 + 2, and TAT during asthma exacerbation and stable state. Ultimately, D-dimer was positively correlated with asthma exacerbation score (R = 0.466, p = 0.027). A significant correlation was observed between vWF and CRP (R = 0.527, p = 0.012). CONCLUSION Evidence was found of increased endothelial activation and increased PAI-1 during asthma exacerbation. This may emphasize the potential role of blood coagulation in asthma exacerbation.
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Affiliation(s)
- Wiparat Manuyakorn
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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17
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Jones TL, Owen J, Elliott S, Brown T, Reynish D, Mistry H, Kerley S, Matti S, Shute JK, Chauhan AJ. Physiological and biological predictors of length of stay and recovery in adults with acute asthma: An observational cohort study. CLINICAL RESPIRATORY JOURNAL 2016; 12:200-206. [PMID: 27330031 DOI: 10.1111/crj.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/25/2016] [Accepted: 06/18/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Asthma is a prevalent, chronic disease associated with significant risk to patients and cost to healthcare systems. Accurate estimates of length of stay and recovery are important for patient information, physician prognostication, and management of inpatient beds. OBJECTIVES To assess factors affecting length of stay and time to recovery in adults with acute asthma. METHODS We prospectively recruited adult asthmatic non-smokers admitted with an asthma exacerbation. Participants were assessed for demographics, symptoms, medications, bloods including blood count, clotting status, and cytokines. Results were analyzed for correlation and subsequently in a regression model. RESULTS One hundred twenty-six participants were recruited of which 75.4% were female. Mean age was 40.0 and mean length of stay was 3.98 days. Length of stay was associated with lower APTT ratio (<P = 0.001), oxygen requirement (P = 0.02), increased AST (P = 0.005), increasing age (P = 0.02), and lower %predicted FEV1 (P = 0.02). Longer time to recovery was associated with plasma IL-12 >1 pg/mL (P = 0.04). CONCLUSION Older participants with lower FEV1 and supplemental oxygen requirements are likely to remain in hospital longer. Activation of the "intrinsic" clotting pathway correlates with an increased length of stay as does a raised serum AST. Detectable IL-12 in plasma correlates with slower recovery and this may be due to poor response to corticosteroids.
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Affiliation(s)
- Thomas L Jones
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Jonathon Owen
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom.,Hampshire Hospitals NHS Foundation Trust, Hampshire, England
| | - Scott Elliott
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Thomas Brown
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Dominic Reynish
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Heena Mistry
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Sumita Kerley
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Salah Matti
- Hampshire Hospitals NHS Foundation Trust, Hampshire, England
| | - Janis K Shute
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Anoop J Chauhan
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
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18
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Grunig G, Baghdassarian A, Park SH, Pylawka S, Bleck B, Reibman J, Berman-Rosenzweig E, Durmus N. Challenges and Current Efforts in the Development of Biomarkers for Chronic Inflammatory and Remodeling Conditions of the Lungs. Biomark Insights 2016; 10:59-72. [PMID: 26917944 PMCID: PMC4756863 DOI: 10.4137/bmi.s29514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/14/2015] [Accepted: 10/18/2015] [Indexed: 02/06/2023] Open
Abstract
This review discusses biomarkers that are being researched for their usefulness to phenotype chronic inflammatory lung diseases that cause remodeling of the lung's architecture. The review focuses on asthma, chronic obstructive pulmonary disease (COPD), and pulmonary hypertension. Bio-markers of environmental exposure and specific classes of biomarkers (noncoding RNA, metabolism, vitamin, coagulation, and microbiome related) are also discussed. Examples of biomarkers that are in clinical use, biomarkers that are under development, and biomarkers that are still in the research phase are discussed. We chose to present examples of the research in biomarker development by diseases, because asthma, COPD, and pulmonary hypertension are distinct entities, although they clearly share processes of inflammation and remodeling.
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Affiliation(s)
- Gabriele Grunig
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.; Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Aram Baghdassarian
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Sung-Hyun Park
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Serhiy Pylawka
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - Bertram Bleck
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Joan Reibman
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | | | - Nedim Durmus
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
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19
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The inflammatory actions of coagulant and fibrinolytic proteases in disease. Mediators Inflamm 2015; 2015:437695. [PMID: 25878399 PMCID: PMC4387953 DOI: 10.1155/2015/437695] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/02/2015] [Accepted: 03/16/2015] [Indexed: 12/30/2022] Open
Abstract
Aside from their role in hemostasis, coagulant and fibrinolytic proteases are important mediators of inflammation in diseases such as asthma, atherosclerosis, rheumatoid arthritis, and cancer. The blood circulating zymogens of these proteases enter damaged tissue as a consequence of vascular leak or rupture to become activated and contribute to extravascular coagulation or fibrinolysis. The coagulants, factor Xa (FXa), factor VIIa (FVIIa), tissue factor, and thrombin, also evoke cell-mediated actions on structural cells (e.g., fibroblasts and smooth muscle cells) or inflammatory cells (e.g., macrophages) via the proteolytic activation of protease-activated receptors (PARs). Plasmin, the principle enzymatic mediator of fibrinolysis, also forms toll-like receptor-4 (TLR-4) activating fibrin degradation products (FDPs) and can release latent-matrix bound growth factors such as transforming growth factor-β (TGF-β). Furthermore, the proteases that convert plasminogen into plasmin (e.g., urokinase plasminogen activator) evoke plasmin-independent proinflammatory actions involving coreceptor activation. Selectively targeting the receptor-mediated actions of hemostatic proteases is a strategy that may be used to treat inflammatory disease without the bleeding complications of conventional anticoagulant therapies. The mechanisms by which proteases of the coagulant and fibrinolytic systems contribute to extravascular inflammation in disease will be considered in this review.
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20
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Abstract
Irrefutable clinical evidence demonstrates the activation of platelets in allergic diseases, including asthma, allergic rhinitis, and eczema. Indeed, experimental models of allergic disease have now shown that platelets play a fundamental role in the tissue recruitment of leucocytes following exposure to allergens. Furthermore, the extravascular presence of platelets in lungs of patients with asthma, and in animal models of allergic lung inflammation suggests that platelets may also contribute directly to allergic inflammation, through alterations in lung function, or by modulating processes involved in airway wall remodelling. Despite significant platelet activation in patients with allergic diseases, it is of note that these patients have been described as having a mild haemostastic defect, rather than an increased incidence of thrombosis. This suggests a dichotomy exists in platelet activation during inflammation compared to haemostasis, and that hitherto undiscovered platelet activation pathways might be exploited to create novel anti-inflammatory therapies without affecting the critical function of platelets in haemostasis.
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Affiliation(s)
- C Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
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21
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Li YF, Lin CC, Tai CK. Interaction of intercellular adhesion molecule 1 (ICAM1) polymorphisms and environmental tobacco smoke on childhood asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 11:6504-16. [PMID: 25003170 PMCID: PMC4078592 DOI: 10.3390/ijerph110606504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Asthma is a chronic disease that is particularly common in children. The association between polymorphisms of the gene encoding intercellular adhesion molecule 1 (ICAM1) and gene-environment interactions with childhood asthma has not been fully investigated. A cross-sectional study was undertaken to investigate these associations among children in Taiwan. The effects of two functional single-nucleotide polymorphisms (SNPs) of ICAM1, rs5491 (K56M) and rs5498 (K469E), and exposure to environmental tobacco smoke (ETS) were studied. Two hundred and eighteen asthmatic and 877 nonasthmatic children were recruited from elementary schools. It was found that the genetic effect of each SNP was modified by the other SNP and by exposure to ETS. The risk of asthma was higher for children carrying the rs5491 AT or TT genotypes and the rs5498 GG genotype (odds ratio = 1.68, 95% confidence interval 1.09–2.59) than for those with the rs5491 AA and rs5498 AA or AG genotypes (the reference group). The risk for the other two combinations of genotypes did not differ significantly from that of the reference group (p of interaction = 0.0063). The two studied ICAM1 SNPs were associated with childhood asthma among children exposed to ETS, but not among those without ETS exposure (p of interaction = 0.05 and 0.01 for rs5491 and rs5498, respectively). Both ICAM1 and ETS, and interactions between these two factors are likely to be involved in the development of asthma in childhood.
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Affiliation(s)
- Yu-Fen Li
- Institute of Biostatistics, China Medical University, 91 Hsieh-Shih Rd., Taichung 404, Taiwan; E-Mail:
| | - Che-Chen Lin
- Department of Public Health, China Medical University, 91 Hsieh-Shih Rd., Taichung 404, Taiwan; E-Mail:
| | - Chien-Kuo Tai
- Department of Life Science, National Chung Cheng University, 168 University Rd., Min-Hsiung Township, Chia-Yi County 621, Taiwan
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +886-5-272-0411 (ext. 66508); Fax: +886-5-272-2871
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