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Wardlaw A, Howarth PH, Israel E, Taillé C, Quirce S, Mallett S, Bates S, Albers FC, Kwon N. Fungal sensitization and its relationship to mepolizumab response in patients with severe eosinophilic asthma. Clin Exp Allergy 2020; 50:869-872. [PMID: 32515118 PMCID: PMC7540511 DOI: 10.1111/cea.13680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Andrew Wardlaw
- Institute for Lung Health, University of Leicester, Leicester, UK
| | - Peter H Howarth
- Global Medical Franchise, GSK House, Brentford, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK.,Respiratory Medical Franchise, GSK, Brentford, UK
| | - Elliot Israel
- Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Camille Taillé
- AP-HP, Hôpital Bichat, Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Dépt Hospitalo-Universitaire FIRE, Université Paris Diderot, INSERM UMR, Paris, France
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), and CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | | | | | - Frank C Albers
- Respiratory Medical Franchise, GSK, Research Triangle Park, NC, USA
| | - Namhee Kwon
- Respiratory Medical Franchise, GSK, Brentford, UK
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Siddiqui S, Shikotra A, Richardson M, Doran E, Choy D, Bell A, Austin CD, Eastham-Anderson J, Hargadon B, Arron JR, Wardlaw A, Brightling CE, Heaney LG, Bradding P. Airway pathological heterogeneity in asthma: Visualization of disease microclusters using topological data analysis. J Allergy Clin Immunol 2018; 142:1457-1468. [PMID: 29550052 DOI: 10.1016/j.jaci.2017.12.982] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 11/16/2017] [Accepted: 12/04/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Asthma is a complex chronic disease underpinned by pathological changes within the airway wall. How variations in structural airway pathology and cellular inflammation contribute to the expression and severity of asthma are poorly understood. OBJECTIVES Therefore we evaluated pathological heterogeneity using topological data analysis (TDA) with the aim of visualizing disease clusters and microclusters. METHODS A discovery population of 202 adult patients (142 asthmatic patients and 60 healthy subjects) and an external replication population (59 patients with severe asthma) were evaluated. Pathology and gene expression were examined in bronchial biopsy samples. TDA was applied by using pathological variables alone to create pathology-driven visual networks. RESULTS In the discovery cohort TDA identified 4 groups/networks with multiple microclusters/regions of interest that were masked by group-level statistics. Specifically, TDA group 1 consisted of a high proportion of healthy subjects, with a microcluster representing a topological continuum connecting healthy subjects to patients with mild-to-moderate asthma. Three additional TDA groups with moderate-to-severe asthma (Airway Smooth MuscleHigh, Reticular Basement MembraneHigh, and RemodelingLow groups) were identified and contained numerous microclusters with varying pathological and clinical features. Mutually exclusive TH2 and TH17 tissue gene expression signatures were identified in all pathological groups. Discovery and external replication applied to the severe asthma subgroup identified only highly similar "pathological data shapes" through analyses of persistent homology. CONCLUSIONS We have identified and replicated novel pathological phenotypes of asthma using TDA. Our methodology is applicable to other complex chronic diseases.
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Affiliation(s)
- Salman Siddiqui
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
| | - Aarti Shikotra
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Matthew Richardson
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | | | | | - Alex Bell
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom; Department of Mathematics, University of Leicester, Leicester, United Kingdom
| | | | | | - Beverley Hargadon
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | | | - Andrew Wardlaw
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Christopher E Brightling
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Liam G Heaney
- Centre for Infection and Immunity, Health Sciences Building, Queens University Belfast, Belfast, United Kingdom
| | - Peter Bradding
- Department of Infection Immunity and Inflammation, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
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Berair R, Hartley R, Mistry V, Sheshadri A, Gupta S, Singapuri A, Gonem S, Marshall RP, Sousa AR, Shikotra A, Kay R, Wardlaw A, Bradding P, Siddiqui S, Castro M, Brightling CE. Associations in asthma between quantitative computed tomography and bronchial biopsy-derived airway remodelling. Eur Respir J 2017; 49:49/5/1601507. [PMID: 28461289 DOI: 10.1183/13993003.01507-2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/20/2017] [Indexed: 12/19/2022]
Abstract
Airway remodelling in asthma remains poorly understood. This study aimed to determine the association of airway remodelling measured on bronchial biopsies with 1) lung function impairment and 2) thoracic quantitative computed tomography (QCT)-derived morphometry and densitometry measures of proximal airway remodelling and air trapping.Subjects were recruited from a single centre. Bronchial biopsy remodelling features that were the strongest predictors of lung function impairment and QCT-derived proximal airway morphometry and air trapping markers were determined by stepwise multiple regression. The best predictor of air trapping was validated in an independent replication group.Airway smooth muscle % was the only predictor of post-bronchodilator forced expiratory volume in 1 s (FEV1) % pred, while both airway smooth muscle % and vascularity were predictors of FEV1/forced vital capacity. Epithelial thickness and airway smooth muscle % were predictors of mean segmental bronchial luminal area (R2=0.12; p=0.02 and R2=0.12; p=0.015), whereas epithelial thickness was the only predictor of wall area % (R2=0.13; p=0.018). Vascularity was the only significant predictor of air trapping (R2=0.24; p=0.001), which was validated in the replication group (R2=0.19; p=0.031).In asthma, airway smooth muscle content and vascularity were both associated with airflow obstruction. QCT-derived proximal airway morphometry was most strongly associated with epithelial thickness and airway smooth muscle content, whereas air trapping was related to vascularity.
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Affiliation(s)
- Rachid Berair
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.,These authors contributed equally to this work
| | - Ruth Hartley
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.,These authors contributed equally to this work
| | - Vijay Mistry
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Ajay Sheshadri
- Dept of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Sumit Gupta
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Sherif Gonem
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | | | | | - Aarti Shikotra
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Richard Kay
- Novartis Pharmaceuticals, Basel, Switzerland.,Medpace (UK) Ltd, Stirling, UK
| | - Andrew Wardlaw
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Peter Bradding
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Salman Siddiqui
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Mario Castro
- Dept of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher E Brightling
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
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Salzar RS, Treichler D, Wardlaw A, Weiss G, Goeller J. Experimental Investigation of Cavitation as a Possible Damage Mechanism in Blast-Induced Traumatic Brain Injury in Post-Mortem Human Subject Heads. J Neurotrauma 2017; 34:1589-1602. [PMID: 27855566 DOI: 10.1089/neu.2016.4600] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The potential of blast-induced traumatic brain injury from the mechanism of localized cavitation of the cerebrospinal fluid (CSF) is investigated. While the mechanism and criteria for non-impact blast-induced traumatic brain injury is still unknown, this study demonstrates that local cavitation in the CSF layer of the cranial volume could contribute to these injuries. The cranial contents of three post-mortem human subject (PMHS) heads were replaced with both a normal saline solution and a ballistic gel mixture with a simulated CSF layer. Each were instrumented with multiple pressure transducers and placed inside identical shock tubes at two different research facilities. Sensor data indicates that cavitation may have occurred in the PMHS models at pressure levels below those for a 50% risk of blast lung injury. This study points to skull flexion, the result of the shock wave on the front of the skull leading to a negative pressure in the contrecoup, as a possible mechanism that contributes to the onset of cavitation. Based on observation of intracranial pressure transducer data from the PMHS model, cavitation onset is thought to occur from approximately a 140 kPa head-on incident blast.
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Affiliation(s)
- Robert S Salzar
- 1 Center for Applied Biomechanics, the University of Virginia , Charlottesville, Virginia
| | | | | | - Greg Weiss
- 3 Applied Research Associates, Inc. , Littleton, Colorado
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Wright A, Mahaut-Smith M, Symon F, Sylvius N, Ran S, Bafadhel M, Muessel M, Bradding P, Wardlaw A, Vial C. Impaired P2X1 Receptor-Mediated Adhesion in Eosinophils from Asthmatic Patients. J Immunol 2016; 196:4877-84. [PMID: 27183585 DOI: 10.4049/jimmunol.1501585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 04/08/2016] [Indexed: 12/13/2022]
Abstract
Eosinophils play an important role in the pathogenesis of asthma and can be activated by extracellular nucleotides released following cell damage or inflammation. For example, increased ATP concentrations were reported in bronchoalveolar lavage fluids of asthmatic patients. Although eosinophils are known to express several subtypes of P2 receptors for extracellular nucleotides, their function and contribution to asthma remain unclear. In this article, we show that transcripts for P2X1, P2X4, and P2X5 receptors were expressed in healthy and asthmatic eosinophils. The P2X receptor agonist α,β-methylene ATP (α,β-meATP; 10 μM) evoked rapidly activating and desensitizing inward currents (peak 18 ± 3 pA/pF at -60 mV) in healthy eosinophils, typical of P2X1 homomeric receptors, which were abolished by the selective P2X1 antagonist NF449 (1 μM) (3 ± 2 pA/pF). α,β-meATP-evoked currents were smaller in eosinophils from asthmatic patients (8 ± 2 versus 27 ± 5 pA/pF for healthy) but were enhanced following treatment with a high concentration of the nucleotidase apyrase (17 ± 5 pA/pF for 10 IU/ml and 11 ± 3 pA/pF for 0.32 IU/ml), indicating that the channels are partially desensitized by extracellular nucleotides. α,β-meATP (10 μM) increased the expression of CD11b activated form in eosinophils from healthy, but not asthmatic, donors (143 ± 21% and 108 ± 11% of control response, respectively). Furthermore, α,β-meATP increased healthy (18 ± 2% compared with control 10 ± 1%) but not asthmatic (13 ± 1% versus 10 ± 0% for control) eosinophil adhesion. Healthy human eosinophils express functional P2X1 receptors whose activation leads to eosinophil αMβ2 integrin-dependent adhesion. P2X1 responses are constitutively reduced in asthmatic compared with healthy eosinophils, probably as the result of an increase in extracellular nucleotide concentration.
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Affiliation(s)
- Adam Wright
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom
| | - Martyn Mahaut-Smith
- Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Fiona Symon
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Nicolas Sylvius
- Core Biotechnology Services, University of Leicester, Leicester LE1 9HN, United Kingdom; and
| | - Shaun Ran
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Mona Bafadhel
- Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7FZ, United Kingdom
| | - Michelle Muessel
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Peter Bradding
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Andrew Wardlaw
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Catherine Vial
- Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospitals of Leicester National Health Service Trust, Leicester LE3 9QP, United Kingdom; Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 9HN, United Kingdom;
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Wan WYH, Hollins F, Haste L, Woodman L, Hirst RA, Bolton S, Gomez E, Sutcliffe A, Desai D, Chachi L, Mistry V, Szyndralewiez C, Wardlaw A, Saunders R, O'Callaghan C, Andrew PW, Brightling CE. NADPH Oxidase-4 Overexpression Is Associated With Epithelial Ciliary Dysfunction in Neutrophilic Asthma. Chest 2016; 149:1445-59. [PMID: 26836936 PMCID: PMC4893823 DOI: 10.1016/j.chest.2016.01.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Bronchial epithelial ciliary dysfunction is an important feature of asthma. We sought to determine the role in asthma of neutrophilic inflammation and nicotinamide adenine dinucleotide phosphate (NADPH) oxidases in ciliary dysfunction. METHODS Bronchial epithelial ciliary function was assessed by using video microscopy in fresh ex vivo epithelial strips from patients with asthma stratified according to their sputum cell differentials and in culture specimens from healthy control subjects and patients with asthma. Bronchial epithelial oxidative damage was determined by 8-oxo-dG expression. Nicotinamide adenine dinucleotide phosphate oxidase (NOX)/dual oxidase (DUOX) expression was assessed in bronchial epithelial cells by using microarrays, with NOX4 and DUOX1/2 expression assessed in bronchial biopsy specimens. Ciliary dysfunction following NADPH oxidase inhibition, using GKT137831, was evaluated in fresh epithelial strips from patients with asthma and a murine model of ovalbumin sensitization and challenge. RESULTS Ciliary beat frequency was impaired in patients with asthma with sputum neutrophilia (n = 11) vs those without (n = 10) (5.8 [0.6] Hz vs 8.8 [0.5] Hz; P = .003) and was correlated with sputum neutrophil count (r = -0.70; P < .001). Primary bronchial epithelial cells expressed DUOX1/2 and NOX4. Levels of 8-oxo-dG and NOX4 were elevated in patients with neutrophilic vs nonneutrophilic asthma, DUOX1 was elevated in both, and DUOX2 was elevated in nonneutrophilic asthma in vivo. In primary epithelial cultures, ciliary dysfunction did not persist, although NOX4 expression and reactive oxygen species generation was increased from patients with neutrophilic asthma. GKT137831 both improved ciliary function in ex vivo epithelial strips (n = 13), relative to the intensity of neutrophilic inflammation, and abolished ciliary dysfunction in the murine asthma model with no reduction in inflammation. CONCLUSIONS Ciliary dysfunction is increased in neutrophilic asthma associated with increased NOX4 expression and is attenuated by NADPH oxidase inhibition.
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Affiliation(s)
- Wing-Yan Heidi Wan
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Fay Hollins
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Louise Haste
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester
| | - Lucy Woodman
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Department of Infection, Immunity and Inflammation, RK Clinical Sciences Building, University of Leicester, Leicester
| | - Sarah Bolton
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Edith Gomez
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Amanda Sutcliffe
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Dhananjay Desai
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Latifa Chachi
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Vijay Mistry
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | | | - Andrew Wardlaw
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Ruth Saunders
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | | | - Peter W Andrew
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester
| | - Christopher E Brightling
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester.
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Siddiqui S, Shikotra A, Richardson M, Doran E, Choy D, Shelley M, Hargadon B, Arron J, Brightling C, Heaney L, Wardlaw A, Bradding P. S7 Airway Pathological Phenotypes and their Clinical Utility in Adult Asthma. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Natarajan S, Free R, Wardlaw A, Siddiqui S. P68 Phenotyping Infection Associated Asthma: A Case-Control Study. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wardlaw A. A special issue on risk factors for the development of allergic disease. Clin Exp Allergy 2015; 45:1-2. [PMID: 25546587 DOI: 10.1111/cea.12469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hanson A, Vali Y, Fisher-Black J, Woltmann G, Richardson M, Wardlaw A, Siddiqui S. P57 Factors Influencing Length Of Hospital Stay In Asthma Exacerbations: Results Of A Service Improvement Project. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Denning DW, Pashley C, Hartl D, Wardlaw A, Godet C, Del Giacco S, Delhaes L, Sergejeva S. Fungal allergy in asthma-state of the art and research needs. Clin Transl Allergy 2014; 4:14. [PMID: 24735832 PMCID: PMC4005466 DOI: 10.1186/2045-7022-4-14] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 03/19/2014] [Indexed: 01/31/2023] Open
Abstract
Sensitization to fungi and long term or uncontrolled fungal infection are associated with poor control of asthma, the likelihood of more severe disease and complications such as bronchiectasis and chronic pulmonary aspergillosis. Modelling suggests that >6.5 million people have severe asthma with fungal sensitizations (SAFS), up to 50% of adult asthmatics attending secondary care have fungal sensitization, and an estimated 4.8 million adults have allergic bronchopulmonary aspergillosis (ABPA). There is much uncertainty about which fungi and fungal allergens are relevant to asthma, the natural history of sensitisation to fungi, if there is an exposure response relationship for fungal allergy, and the pathogenesis and frequency of exacerbations and complications. Genetic associations have been described but only weakly linked to phenotypes. The evidence base for most management strategies in ABPA, SAFS and related conditions is weak. Yet straightforward clinical practice guidelines for management are required. The role of environmental monitoring and optimal means of controlling disease to prevent disability and complications are not yet clear. In this paper we set out the key evidence supporting the role of fungal exposure, sensitisation and infection in asthmatics, what is understood about pathogenesis and natural history and identify the numerous areas for research studies.
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Affiliation(s)
- David W Denning
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK ; Education and Research Centre, UHSM, Southmoor Road, Manchester M23 9LT, UK
| | - Catherine Pashley
- Leicester Institute for Lung Health and Respiratory Biomedical Research Unit, Department of Infection Immunity and Inflammation, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Domink Hartl
- Department of Pediatrics, Infectious Diseases & Immunology, University of Tübingen, Tübingen, Germany
| | - Andrew Wardlaw
- Leicester Institute for Lung Health and Respiratory Biomedical Research Unit, Department of Infection Immunity and Inflammation, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Cendrine Godet
- Department of Infectious Diseases, CHU la Milétrie, Poitiers, France
| | - Stefano Del Giacco
- Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy
| | - Laurence Delhaes
- Biology & Diversity of Emerging Eukaryotic Pathogens (BDEEP), Center for Infection and Immunity of Lille (CIIL), INSERM U1019, CNRS UMR8204, IFR142, Lille Pasteur Institute, Lille Nord de France University (EA4547), Lille, France ; Department of Parasitology-Mycology, Regional Hospital Center, Faculty of Medicine, Lille, France
| | - Svetlana Sergejeva
- Translational Immunology Group, Institute of Technology, Tartu University, Tartu, Estonia ; North Estonia Medical Centre, Tallinn, Estonia
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Agbetile J, Bourne M, Fairs A, Hargadon B, Desai D, Broad C, Morley J, Bradding P, Brightling C, Green R, Haldar P, Pashley C, Pavord I, Wardlaw A. S90 Effectiveness of Voriconazole In the Treatment of Aspergillus fumigatus Associated Asthma. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Wechsler ME, Fulkerson PC, Bochner BS, Gauvreau GM, Gleich GJ, Henkel T, Kolbeck R, Mathur SK, Ortega H, Patel J, Prussin C, Renzi P, Rothenberg ME, Roufosse F, Simon D, Simon HU, Wardlaw A, Weller PF, Klion AD. Novel targeted therapies for eosinophilic disorders. J Allergy Clin Immunol 2012; 130:563-71. [PMID: 22935585 DOI: 10.1016/j.jaci.2012.07.027] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 07/25/2012] [Accepted: 07/25/2012] [Indexed: 12/18/2022]
Abstract
Hypereosinophilic syndromes (HESs) are a diverse group of conditions characterized by clinical manifestations attributable to eosinophilia and eosinophilic infiltration of tissues. HESs are chronic disorders with significant morbidity and mortality. Although the availability of targeted chemotherapeutic agents, including imatinib, has improved quality of life and survival in some patients with HESs, additional agents with increased efficacy and decreased toxicity are sorely needed. The purpose of this review is to provide an overview of eosinophil biology with an emphasis on potential targets of pharmacotherapy and to provide a summary of potential eosinophil-targeting agents, including those in development, in clinical trials, or approved for other disorders.
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14
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Goeller J, Wardlaw A, Treichler D, O'Bruba J, Weiss G. Investigation of cavitation as a possible damage mechanism in blast-induced traumatic brain injury. J Neurotrauma 2012; 29:1970-81. [PMID: 22489674 DOI: 10.1089/neu.2011.2224] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cavitation was investigated as a possible damage mechanism for war-related traumatic brain injury (TBI) due to an improvised explosive device (IED) blast. When a frontal blast wave encounters the head, a shock wave is transmitted through the skull, cerebrospinal fluid (CSF), and tissue, causing negative pressure at the contrecoup that may result in cavitation. Numerical simulations and shock tube experiments were conducted to determine the possibility of cranial cavitation from realistic IED non-impact blast loading. Simplified surrogate models of the head consisted of a transparent polycarbonate ellipsoid. The first series of tests in the 18-inch-diameter shock tube were conducted on an ellipsoid filled with degassed water to simulate CSF and tissue. In the second series, Sylgard gel, surrounded by a layer of degassed water, was used to represent the tissue and CSF, respectively. Simulated blast overpressure in the shock tube tests ranged from a nominal 10-25 pounds per square inch gauge (psig; 69-170 kPa). Pressure in the simulated CSF was determined by Kulite thin line pressure sensors at the coup, center, and contrecoup positions. Using video taken at 10,000 frames/sec, we verified the presence of cavitation bubbles at the contrecoup in both ellipsoid models. In all tests, cavitation at the contrecoup was observed to coincide temporally with periods of negative pressure. Collapse of the cavitation bubbles caused by the surrounding pressure and elastic rebound of the skull resulted in significant pressure spikes in the simulated CSF. Numerical simulations using the DYSMAS hydrocode to predict onset of cavitation and pressure spikes during cavity collapse were in good agreement with the tests. The numerical simulations and experiments indicate that skull deformation is a significant factor causing cavitation. These results suggest that cavitation may be a damage mechanism contributing to TBI that requires future study.
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Affiliation(s)
- Jacques Goeller
- Advanced Technology and Research Corporation, Columbia, MD 21046, USA.
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Wardlaw A, Fairs A, Agbetile J, Pavord I, Pashley C. ABPA or AFAA: That Is the Question. Am J Respir Crit Care Med 2011. [DOI: 10.1164/ajrccm.183.9.1281a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Abbie Fairs
- University of Leicester
Leicester, United Kingdom
| | | | - Ian Pavord
- University of Leicester
Leicester, United Kingdom
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Burton A, Hargadon B, Murphy A, Brightling C, Pavord I, Wardlaw A, Bradding P, Green R. P20 The eligibility of patients with difficult asthma for omalizumab since the change to the treatment criteria. Thorax 2010. [DOI: 10.1136/thx.2010.150961.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Kulkarni NS, Hollins F, Sutcliffe A, Saunders R, Shah S, Siddiqui S, Gupta S, Haldar P, Green R, Pavord I, Wardlaw A, Brightling CE. Eosinophil protein in airway macrophages: a novel biomarker of eosinophilic inflammation in patients with asthma. J Allergy Clin Immunol 2010; 126:61-9.e3. [PMID: 20639010 DOI: 10.1016/j.jaci.2010.03.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 03/23/2010] [Accepted: 03/26/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Noneosinophilic asthma is common across asthma severities. However, in patients with moderate-to-severe disease, the absence of sputum eosinophilia cannot distinguish between asthmatic subjects with eosinophilic inflammation controlled by corticosteroids versus those in whom eosinophilic inflammation is not a component of the disease. OBJECTIVES We sought to develop a method to quantify eosinophil proteins in airway macrophages as a novel biomarker of eosinophilic airway inflammation. METHODS Eosinophil proteins in airway macrophages were assessed by means of flow cytometry, immunofluorescence, and cytoplasmic hue change after ingestion of apoptotic eosinophils. Airway macrophage median percentage of red-hued area in stained sputum cytospin preparations was assessed by means of image analysis from (1) subjects with mild-to-severe asthma, subjects with nonasthmatic eosinophilic bronchitis, and healthy control subjects; (2) subjects with eosinophilic severe asthma after treatment with prednisolone; and (3) subject with noneosinophilic asthma before corticosteroid withdrawal. RESULTS Eosinophil proteins were detected in airway macrophages, and cytoplasmic red hue increased after ingestion of apoptotic eosinophils. Airway macrophage percentage redhued area was increased in subjects with moderate-to-severe asthma compared with that seen in subjects with mild asthma and healthy control subjects, was similar in those with or without a sputum eosinophilia, and was increased after corticosteroid therapy. In asthmatic subjects without sputum eosinophilia, the airway macrophage percentage red-hued area was increased in subjects who did versus those who did not have sputum eosinophilia after corticosteroid withdrawal. CONCLUSIONS Eosinophil proteins can be reliably measured in airway macrophages. In combination with sputum eosinophilia, the macrophage eosinophil protein content might further define the asthma phenotype and provide an additional tool to direct therapy.
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Affiliation(s)
- Neeta S Kulkarni
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom.,Children's Community Health Service, Leicester City NHS Primary Care Trust
| | - Fay Hollins
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Amanda Sutcliffe
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Ruth Saunders
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Sachil Shah
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Salman Siddiqui
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Sumit Gupta
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Pranab Haldar
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Ruth Green
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Ian Pavord
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Andrew Wardlaw
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Christopher E Brightling
- Institute for Lung Health, Glenfield Hospital, Leicester, and the Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
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Simon D, Wardlaw A, Rothenberg ME. Organ-specific eosinophilic disorders of the skin, lung, and gastrointestinal tract. J Allergy Clin Immunol 2010; 126:3-13; quiz 14-5. [PMID: 20392477 PMCID: PMC2902687 DOI: 10.1016/j.jaci.2010.01.055] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 01/13/2010] [Accepted: 01/14/2010] [Indexed: 01/09/2023]
Abstract
Eosinophils are multifunctional leukocytes that increase in various tissues in patients with a variety of disorders. Locally, they can be involved in the initiation and propagation of diverse inflammatory responses. In this review the clinical association of eosinophils with diseases of the skin, lung, and gastrointestinal tract is summarized. An approach to determining the causal role of eosinophils in these diseases is presented. Recent findings concerning molecular diagnosis, cause, and treatment are discussed.
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Affiliation(s)
- Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew Wardlaw
- Institute for Lung Health, Department of Infection Immunity and Inflammation, University of Leicester, United Kingdom
| | - Marc E. Rothenberg
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Beghé B, Hall IP, Parker SG, Moffatt MF, Wardlaw A, Connolly MJ, Fabbri LM, Ruse C, Sayers I. Polymorphisms in IL13 pathway genes in asthma and chronic obstructive pulmonary disease. Allergy 2010; 65:474-81. [PMID: 19796199 DOI: 10.1111/j.1398-9995.2009.02167.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases involving an interaction between genetic and environmental factors. Interleukin-13 (IL13) has been suggested to have a role in both asthma and COPD. We investigated whether single nucleotide polymorphisms (SNPs) in the IL13 pathway may contribute to the susceptibility and severity of asthma and COPD in adults. METHODS Twelve SNPs in IL13 pathway genes -IL4, IL13, IL4RA, IL13RA1, IL13RA2 and STAT6- were genotyped in subjects with asthma (n = 299) and in subjects with COPD or healthy smokers (n = 992). Genetic association was evaluated using genotype and allele models for asthma severity, atopy phenotypes and COPD susceptibility. Linear regression was used to determine the effects of polymorphism on baseline lung function (FEV(1), FEV(1)/FVC). RESULTS In asthmatics, three IL13 SNPs - rs1881457(-1512), rs1800925(-1111) and rs20541(R130Q) - were associated with atopy risk. One SNP in IL4RA1 [rs1805010(I75V)] was associated with asthma severity, and several IL13 SNPs showed borderline significance. IL13 SNPs rs1881457(-1512) and rs1800925(-1111) were associated with better FEV(1) and FEV(1)/FVC in asthmatics. IL13 SNPs rs2066960(intron 1), rs20541(R130Q) and rs1295685(exon 4) were associated with COPD risk and lower baseline lung function in the recessive model. In females, but not in males, rs2250747 of the IL13RA1 gene was associated with COPD and lower FEV(1). CONCLUSION These data suggest that IL13 SNPs (promoter and coding region) and, to a lesser extent, IL4RA SNPs may contribute to atopy and asthma. We also provide tentative evidence that IL13 SNPs in the coding region may be of significance in COPD susceptibility.
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Affiliation(s)
- B Beghé
- Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Italy
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20
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21
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Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, Leiferman KM, Nutman TB, Pfab F, Ring J, Rothenberg ME, Roufosse F, Sajous MH, Sheikh J, Simon D, Simon HU, Stein ML, Wardlaw A, Weller PF, Klion AD. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol 2009; 124:1319-25.e3. [PMID: 19910029 PMCID: PMC2829669 DOI: 10.1016/j.jaci.2009.09.022] [Citation(s) in RCA: 392] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 08/26/2009] [Accepted: 09/03/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders defined by persistent blood eosinophilia > or =1.5 x 10(9)/L, absence of a secondary cause, and evidence of eosinophil-associated pathology. With the exception of a recent multicenter trial of mepolizumab (anti-IL-5 mAb), published therapeutic experience has been restricted to case reports and small case series. OBJECTIVE The purpose of the study was to collect and summarize baseline demographic, clinical, and laboratory characteristics in a large, diverse cohort of patients with HES and to review responses to treatment with conventional and novel therapies. METHODS Clinical and laboratory data from 188 patients with HES, seen between January 2001 and December 2006 at 11 institutions in the United States and Europe, were collected retrospectively by chart review. RESULTS Eighteen of 161 patients (11%) tested were Fip1-like 1-platelet-derived growth factor receptor alpha (FIP1L1-PDGFRA) mutation-positive, and 29 of 168 patients tested (17%) had a demonstrable aberrant or clonal T-cell population. Corticosteroid monotherapy induced complete or partial responses at 1 month in 85% (120/141) of patients with most remaining on maintenance doses (median, 10 mg prednisone equivalent daily for 2 months to 20 years). Hydroxyurea and IFN-alpha (used in 64 and 46 patients, respectively) were also effective, but their use was limited by toxicity. Imatinib (used in 68 patients) was more effective in patients with the FIP1L1-PDGFRA mutation (88%) than in those without (23%; P < .001). CONCLUSION This study, the largest clinical analysis of patients with HES to date, not only provides useful information for clinicians but also should stimulate prospective trials to optimize treatment of HES.
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MESH Headings
- Adolescent
- Adrenal Cortex Hormones/administration & dosage
- Adrenal Cortex Hormones/therapeutic use
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Benzamides
- Chemokine CCL17/blood
- Child
- Cyclosporine/administration & dosage
- Cyclosporine/therapeutic use
- Drug Therapy, Combination
- Eosinophils/drug effects
- Eosinophils/immunology
- Eosinophils/metabolism
- Female
- Humans
- Hydroxyurea/administration & dosage
- Hydroxyurea/therapeutic use
- Hypereosinophilic Syndrome/drug therapy
- Hypereosinophilic Syndrome/immunology
- Hypereosinophilic Syndrome/metabolism
- Imatinib Mesylate
- Interferon-alpha/administration & dosage
- Interferon-alpha/therapeutic use
- Interleukin-5/blood
- Male
- Middle Aged
- Oncogene Proteins, Fusion/immunology
- Oncogene Proteins, Fusion/metabolism
- Piperazines/administration & dosage
- Piperazines/therapeutic use
- Pyrimidines/administration & dosage
- Pyrimidines/therapeutic use
- Receptor, Platelet-Derived Growth Factor alpha/immunology
- Receptor, Platelet-Derived Growth Factor alpha/metabolism
- Retrospective Studies
- Tryptases/blood
- Young Adult
- mRNA Cleavage and Polyadenylation Factors/immunology
- mRNA Cleavage and Polyadenylation Factors/metabolism
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Affiliation(s)
- Princess U Ogbogu
- National Institute of Allergy and Infectious Diseases, Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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22
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Saunders R, Sutcliffe A, Kaur D, Siddiqui S, Hollins F, Wardlaw A, Bradding P, Brightling C. Airway smooth muscle chemokine receptor expression and function in asthma. Clin Exp Allergy 2009; 39:1684-92. [PMID: 19735481 PMCID: PMC2774481 DOI: 10.1111/j.1365-2222.2009.03310.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Chemokine receptors play an important role in cell migration and wound repair. In asthma, CCR3 and 7 are expressed by airway smooth muscle (ASM) and CCR7 has been implicated in the development of ASM hyperplasia. The expression profile of other chemokine receptors by ASM and their function needs to be further explored. OBJECTIVE We sought to investigate ASM chemokine receptor expression and function in asthma. METHODS ASM cells were derived from 17 subjects with asthma and 36 non-asthmatic controls. ASM chemokine receptor expression was assessed by flow cytometry and immunofluorescence. The function of chemokine receptors expressed by more than 10% of ASM cells was investigated by intracellular calcium measurements, chemotaxis, wound healing, proliferation and survival assays. RESULTS In addition to CCR3 and 7, CXCR1, 3 and 4 were highly expressed by ASM. These CXC chemokine receptors were functional with an increase in intracellular calcium following ligand activation and promotion of wound healing [CXCL10 (100 ng/mL) 34 +/- 2 cells/high-powered field (hpf) vs. control 29 +/- 1; P=0.03; n=8]. Spontaneous wound healing was inhibited by CXCR3 neutralizing antibody (mean difference 7 +/- 3 cells/hpf; P=0.03; n=3). CXC chemokine receptor activation did not modulate ASM chemotaxis, proliferation or survival. No differences in chemokine receptor expression or function were observed between ASM cells derived from asthmatic or non-asthmatic donors. CONCLUSIONS Our findings suggest that the chemokine receptors CXCR1, 3 and 4 modulate some aspects of ASM function but their importance in asthma is uncertain.
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Affiliation(s)
- R Saunders
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK
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23
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Siddiqui S, Cruse G, McKenna S, Monteiro W, Mistry V, Wardlaw A, Brightling C. IL-13 expression by blood T cells and not eosinophils is increased in asthma compared to non-asthmatic eosinophilic bronchitis. BMC Pulm Med 2009; 9:34. [PMID: 19602238 PMCID: PMC2716303 DOI: 10.1186/1471-2466-9-34] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 07/14/2009] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In asthma interleukin (IL)-13 is increased in the airway compared with non-asthmatic eosinophilic bronchitis. Whether this differential expression is specific to the airway or is more generalised is uncertain. METHODS We sought to examine IL-13 expression in peripheral blood T-cells and eosinophils in asthma and non-asthmatic eosinophilic bronchitis. Peripheral blood CD3+ cell and eosinophil intracellular IL-13 expression from subjects with asthma, non-asthmatic eosinophilic bronchitis and healthy controls was assessed. The effect of priming by asthmatic serum on the release of IL-13 by peripheral blood mononuclear cells from healthy subjects was examined and the serum from these subjects was analysed for a range of chemokines and cytokines. RESULTS The median (IQR)% intracellular IL-13 expression by CD3+ cells was increased in asthma [5.3 (2.7-9.8)%; n = 12] compared to non-asthmatic eosinophilic bronchitis [1.1 (0.5-3)%; n = 7] and healthy controls [1.7 (0.2-3%); n = 9] (p = 0.02), but was not significantly different in eosinophils across the groups. IL-13 released from healthy peripheral blood mononuclear cells (n = 10) was increased by asthmatic serum [117 (47.8-198)pg/ml] compared to control [78.5 (42.6-128)pg/ml; p = 0.02), but was not affected by non-asthmatic serum. CONCLUSION Our findings support the view that IL-13 expression is increased in peripheral blood-derived T cells in asthma and that asthmatic serum up-regulates IL-13 release from healthy peripheral blood mononuclear cells.
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Affiliation(s)
- Salman Siddiqui
- Institute of Lung Health, University of Leicester, Leicester, UK.
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24
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Saunders R, Siddiqui S, Kaur D, Doe C, Sutcliffe A, Hollins F, Bradding P, Wardlaw A, Brightling CE. Fibrocyte localization to the airway smooth muscle is a feature of asthma. J Allergy Clin Immunol 2008; 123:376-384. [PMID: 19081612 DOI: 10.1016/j.jaci.2008.10.048] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Revised: 10/22/2008] [Accepted: 10/31/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Airway smooth muscle (ASM) hyperplasia is a hallmark of asthma that is associated with disease severity and persistent airflow obstruction. OBJECTIVES We sought to investigate whether fibrocytes, a population of peripheral blood mesenchymal progenitors, are recruited to the ASM compartment in asthma. METHODS We assessed the number of fibrocytes in bronchial biopsy specimens and peripheral blood from subjects with mild-to-severe refractory asthma versus healthy control subjects. In vitro we investigated potential mechanisms controlling fibrocyte migration toward the ASM bundle. RESULTS Fifty-one subjects with asthma and 33 control subjects were studied. In bronchial biopsy specimens, the number of fibrocytes was increased in the lamina propria of subjects with severe refractory asthma (median [interquartile range] number, 1.9/mm(2) [1.7/mm(2)]) versus healthy control subjects (median [interquartile range] number, 0/mm(2) [0.3/mm(2)], P < .0001) and in the ASM bundle of subjects with asthma of all severities (subjects with severe asthma, median [interquartile range] number, 3.8/mm(2) [9.4/mm(2)]; subjects with mild-to-moderate asthma, median [interquartile range] number, 1.1/mm(2) [2.4/mm(2)]); healthy control subjects, (median [interquartile range] number, 0/mm(2) [0/mm(2)]); P = .0004). In the peripheral blood the fibrocyte number was also increased in subjects with severe refractory asthma (median [interquartile range] number, 1.4 x 10(4)/mL [2.6 x 10(4)/mL]) versus healthy control subjects (median [interquartile range] number, 0.4 x 10(4)/mL [1.0 x 10(4)/mL], P = .002). We identified that in vitro ASM promotes fibrocyte chemotaxis and chemokinesis (distance of migration after 4.5 hours, 31 microm [2.9 microm] vs 17 microm [2.4 microm], P = .0001), which was in part mediated by platelet-derived growth factor (mean inhibition by neutralizing antibody, 16% [95% CI, 2% to 32%], P = .03) but not by activation of chemokine receptors. CONCLUSION This study provides the first evidence that fibrocytes are present in the ASM compartment in asthma and that ASM can augment fibrocyte migration. The importance of fibrocytes in the development of ASM hyperplasia and airway dysfunction in asthma remains to be determined.
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Affiliation(s)
- Ruth Saunders
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Salman Siddiqui
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Davinder Kaur
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Camille Doe
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Amanda Sutcliffe
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Fay Hollins
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Peter Bradding
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Andrew Wardlaw
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
| | - Christopher E Brightling
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester
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25
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Thomas M, McKinley RK, Mellor S, Watkin G, Holloway E, Scullion J, Shaw DE, Wardlaw A, Price D, Pavord I. Breathing exercises for asthma: a randomised controlled trial. Thorax 2008; 64:55-61. [PMID: 19052047 DOI: 10.1136/thx.2008.100867] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effect of breathing modification techniques on asthma symptoms and objective disease control is uncertain. METHODS A prospective, parallel group, single-blind, randomised controlled trial comparing breathing training with asthma education (to control for non-specific effects of clinician attention) was performed. Subjects with asthma with impaired health status managed in primary care were randomised to receive three sessions of either physiotherapist-supervised breathing training (n = 94) or asthma nurse-delivered asthma education (n = 89). The main outcome was Asthma Quality of Life Questionnaire (AQLQ) score, with secondary outcomes including spirometry, bronchial hyper-responsiveness, exhaled nitric oxide, induced sputum eosinophil count and Asthma Control Questionnaire (ACQ), Hospital Anxiety and Depression (HAD) and hyperventilation (Nijmegen) questionnaire scores. RESULTS One month after the intervention there were similar improvements in AQLQ scores from baseline in both groups but at 6 months there was a significant between-group difference favouring breathing training (0.38 units, 95% CI 0.08 to 0.68). At the 6-month assessment there were significant between-group differences favouring breathing training in HAD anxiety (1.1, 95% CI 0.2 to 1.9), HAD depression (0.8, 95% CI 0.1 to 1.4) and Nijmegen (3.2, 95% CI 1.0 to 5.4) scores, with trends to improved ACQ (0.2, 95% CI 0.0 to 0.4). No significant between-group differences were seen at 1 month. Breathing training was not associated with significant changes in airways physiology, inflammation or hyper-responsiveness. CONCLUSION Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication.
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Affiliation(s)
- M Thomas
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK.
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26
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Saunders R, Sutcliffe A, Woodman L, Kaur D, Siddiqui S, Okayama Y, Wardlaw A, Bradding P, Brightling C. The airway smooth muscle CCR3/CCL11 axis is inhibited by mast cells. Allergy 2008; 63:1148-55. [PMID: 18699931 DOI: 10.1111/j.1398-9995.2008.01684.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Airway smooth muscle hyperplasia is a feature of asthma, and increases with disease severity. CCR3-mediated recruitment of airway smooth muscle progenitors towards the airway smooth muscle bundle has been proposed as one possible mechanism involved in airway smooth muscle hyperplasia. Mast cells are microlocalized to the airway smooth muscle bundle and whether mast cells influence CCR3-mediated migration is uncertain. METHODS We examined the expression of CCR3 by primary cultures of airway smooth muscle cells from asthmatics and nonasthmatics. CCR3 function was examined using intracellular calcium measurements, chemotaxis, wound healing, cell proliferation and survival assays. We investigated the recovery and function of both recombinant and airway smooth muscle-derived CCL11 (eotaxin) after co-culture with beta-tryptase and human lung mast cells. RESULTS Airway smooth muscle expressed CCR3. Airway smooth muscle CCR3 activation by CCL11 mediated intracellular calcium elevation, concentration-dependent migration and wound healing, but had no effect on proliferation or survival. Co-culture with beta-tryptase or mast cells degraded recombinant and airway smooth muscle-derived CCL11, and beta-tryptase inhibited CCL11-mediated airway smooth muscle migration. CONCLUSIONS CCL11 mediates airway smooth muscle migration. However co-culture with beta-tryptase or mast cells degraded recombinant and airway smooth muscle-derived CCL11 and inhibited CCL11-mediated airway smooth muscle migration. Therefore these findings cast doubt on the importance of the CCL11/CCR3 axis in the development of airway smooth muscle hyperplasia in asthma.
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Affiliation(s)
- R Saunders
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
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Mutalithas K, Watkin G, Willig B, Wardlaw A, Pavord ID, Birring SS. Improvement in health status following bronchopulmonary hygiene physical therapy in patients with bronchiectasis. Respir Med 2008; 102:1140-4. [DOI: 10.1016/j.rmed.2008.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 03/10/2008] [Accepted: 03/12/2008] [Indexed: 10/21/2022]
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Siddiqui S, Mistry V, Doe C, Roach K, Morgan A, Wardlaw A, Pavord I, Bradding P, Brightling C. Airway hyperresponsiveness is dissociated from airway wall structural remodeling. J Allergy Clin Immunol 2008; 122:335-41, 341.e1-3. [PMID: 18572228 DOI: 10.1016/j.jaci.2008.05.020] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 05/07/2008] [Accepted: 05/09/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nonasthmatic eosinophilic bronchitis (EB) has emerged as a useful tool to study the structural and inflammatory mechanisms of airway hyperresponsiveness (AHR) in asthma. We have previously shown that vascular remodeling and reticular basement membrane (RBM) thickening are present in EB. However, it is not known whether other features of structural remodeling including increased airway smooth muscle (ASM) mass, matrix deposition, and glandular hyperplasia are also present in EB. OBJECTIVES We sought to determine whether structural remodeling occurs in EB and is associated with AHR and airflow limitation. METHODS Forty-two patients with asthma, 21 patients with EB, and 19 healthy volunteers were recruited. ASM area, RBM thickness, collagen 3 deposition, glandular area, mast cells, and granulocytes were assessed in bronchial biopsy samples. RESULTS Nonasthmatic eosinophilic bronchitis and asthma were associated with a significant increase in ASM mass and RBM thickness compared with healthy subjects. In contrast, we did not observe any significant differences in collagen 3 deposition in the lamina propria and ASM or the % area of glands in the lamina propria. Univariate analysis demonstrated that mast cell numbers in the ASM were the only feature of remodeling associated with AHR (beta = -0.51; P = .004). Stepwise linear regression revealed that a combination of mast cell numbers in the ASM (beta = -0.43) and disease duration (beta = -0.25; model-adjusted R(2) = 0.26; P = .027) best modeled AHR. CONCLUSION Mast cell localization to the ASM bundle, but not structural remodeling of the airway wall, is associated with AHR in asthma.
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Siddiqui S, Sutcliffe A, Shikotra A, Woodman L, Doe C, McKenna S, Wardlaw A, Bradding P, Pavord I, Brightling C. Vascular remodeling is a feature of asthma and nonasthmatic eosinophilic bronchitis. J Allergy Clin Immunol 2007; 120:813-9. [PMID: 17610943 DOI: 10.1016/j.jaci.2007.05.028] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 05/15/2007] [Accepted: 05/16/2007] [Indexed: 11/28/2022]
Abstract
RATIONALE Increased vascularity and expression of vascular endothelial growth factor (VEGF) are recognized features of the asthmatic airway. The association of vascular remodeling with airway hyperresponsiveness (AHR) is unclear. OBJECTIVE To assess vascular remodeling and sputum VEGF concentration in subjects with asthma, subjects with nonasthmatic eosinophilic bronchitis (EB), and healthy controls. METHODS In cohort 1, 19 patients with asthma (Global Initiative for Asthma [GINA] 1-2, n = 9; GINA 3-5, n = 10), 10 patients with EB, and 11 healthy matched controls were recruited. Expression of the endothelial marker EN4 was assessed in bronchial biopsy samples. Vessels were counted using the validated mean Chalkley count by a blind observer. For cohort 2, a second independent cohort of 31 patients with asthma (GINA 1-2, n = 11; GINA 3-5, n = 20), 14 patients with EB, and 15 matched controls was recruited. Induced sputum supernatant VEGF was measured by ELISA. RESULTS The mean chalkley count was significantly greater in GINA 3-5 asthma (5.2 [0.4]) and EB (4.8 [0.3]) compared with controls (3.5 [0.5]) and demonstrated a significant inverse correlation with the postbronchodilator FEV(1)% predicted in patients with asthma (R(2) = 0.28; P = .02). Sputum VEGF concentration was also increased in GINA 3-5 asthma (2365 [1361-4110] pg/g) and EB (4699 [2818-7834] pg/g) compared with controls (1094 [676-1774] pg/g) and was inversely related to postbronchodilator FEV(1)% predicted in asthma (R(2) = 0.2; P = .01). CONCLUSION Vascular remodeling is a feature of asthma, and EB and is inversely associated with the postbronchodilator FEV(1) in asthma, suggesting that vascular remodeling is associated with airflow obstruction but not AHR. CLINICAL IMPLICATIONS Vascular remodeling is dissociated from AHR in asthma and associated with airflow limitation.
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Affiliation(s)
- Salman Siddiqui
- Institute of Lung Health, University of Leicester, Leicester, United Kingdom
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Mutalithas K, Croudace J, Guillen C, Siddiqui S, Thickett D, Wardlaw A, Lammas D, Brightling C. Bronchoalveolar lavage invariant natural killer T cells are not increased in asthma. J Allergy Clin Immunol 2007; 119:1274-6. [PMID: 17399777 DOI: 10.1016/j.jaci.2007.02.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 02/12/2007] [Accepted: 02/12/2007] [Indexed: 10/23/2022]
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Kaur D, Saunders R, Berger P, Siddiqui S, Woodman L, Wardlaw A, Bradding P, Brightling CE. Airway smooth muscle and mast cell-derived CC chemokine ligand 19 mediate airway smooth muscle migration in asthma. Am J Respir Crit Care Med 2006; 174:1179-88. [PMID: 16959919 DOI: 10.1164/rccm.200603-394oc] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Airway smooth muscle (ASM) hyperplasia is a feature of asthma, and increases with disease severity. We hypothesized that this results from migration of ASM or progenitors in response to chemokines derived from ASM or mast cells within the ASM bundle. OBJECTIVES To examine expression of the chemokine receptor, CC chemokine receptor (CCR) 7, in vivo by ASM in patients with asthma and healthy control subjects, and by primary cultures of ASM and fibroblasts; to define expression of its ligands, CC chemokine ligand (CCL) 19 and CCL21, in bronchial biopsies, and primary cultures of ASM and mast cells; and to investigate CCR7's role in ASM migration and repair. METHODS ASM was isolated from bronchoscopy and resection tissue. Receptor and chemokine expression was examined by immunohistochemistry, immunofluorescence, flow cytometry, ELISA, and reverse transcriptase-polymerase chain reaction. CCR7 function was examined by intracellular calcium measurements, chemotaxis, wound healing assays, and measurement of cell proliferation. MEASUREMENTS AND MAIN RESULTS ASM, myofibroblasts, and fibroblasts expressed CCR7. CCL19, but not CCL21, was highly expressed in bronchial biopsies by mast cells and vessels in asthma of all severities, ASM in severe disease, and ex vivo ASM and mast cells. ASM CCR7 activation by CCL19-mediated intracellular calcium elevation and concentration-dependent migration, but not proliferation. Importantly, mast cell and ASM-derived CCL19 mediated ASM migration and repair. CONCLUSIONS The CCL19/CCR7 axis may play an important role in the development of ASM hyperplasia in asthma.
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Affiliation(s)
- Davinder Kaur
- Institute for Lung Health, and Department of Infection, Inflammation and Immunity, University of Leicester, Leicester, United Kingdom
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Davis RF, Dusanjh P, Majid A, Fletcher A, Wardlaw A, Siebert R, Dyer MJS, Harman KE. Eosinophilic cellulitis as a presenting feature of chronic eosinophilic leukaemia, secondary to a deletion on chromosome 4q12 creating the FIP1L1-PDGFRA
fusion gene. Br J Dermatol 2006; 155:1087-9. [PMID: 17034555 DOI: 10.1111/j.1365-2133.2006.07490.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wardlaw A. Allergy services in the UK. J Clin Pathol 2006; 59:892. [PMID: 16873577 PMCID: PMC1860443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Stewart D, Edwards J, Richardson D, Jones L, Burke B, Waller D, Zeigler-Heitbrock L, Wardlaw A, O’Byrne K. The inter-relationship of hypoxia and phospho-Akt in the pathobiology of malignant pleural mesothelioma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17057 Background: Poor outcomes with conventional oncological treatments for malignant pleural mesothelioma (MPM) have driven the imperative to advance understanding of the disease pathobiology. Carbonic Anhydrase (CA)-IX is a surrogate marker of hypoxia over-expressed in solid tumours. Protein Kinase B, or Akt, known to have important intracellular roles including resistance to apoptosis, is activated in human malignancies and upregulated in hypoxic conditions. This study examined the expression of CA-IX and phosphorylated Akt (pAkt) in tumour samples from patients with MPM, correlating expression with established prognostic factors. The role of pAkt in the survival of an MPM cell line exposed to hypoxic conditions was also examined. Methods: Full local regional ethics committee approval was obtained for this work. Tumour samples from 200 patients with MPM were stained using pAkt and CA-IX specific antibodies. The effect of hypoxia on Akt and pAkt was evaluated in the JU77 mesothelioma cell line in the presence or absence of the phosphatidylinositol-3-kinase inhibitor, LY294002. Results: There was a positive association between the level of CA-IX and pAkt staining, implying that intra-tumoural hypoxia may be a stimulus for Akt phosphorylation. On multivariate analysis increased expression of nuclear pAkt was found to be associated with a poor survival. In-vitro cell culture work showed that, although pAkt is expressed in normoxic conditions in the JU77 cell line, the rates of apoptosis were significantly increased in hypoxic conditions when the phosphorylation of Akt was blocked by LY294002. Conclusions: This work provides evidence for the anti-apoptotic role of pAkt in hypoxic conditions in solid human malignancies. Phospho-Akt may represent a novel therapeutic target in MPM. No significant financial relationships to disclose.
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Affiliation(s)
- D. Stewart
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - J. Edwards
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - D. Richardson
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - L. Jones
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - B. Burke
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - D. Waller
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - L. Zeigler-Heitbrock
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - A. Wardlaw
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
| | - K. O’Byrne
- Glenfield Hospital, Leicester, United Kingdom; University of Leicester, Leicester, United Kingdom; St James’s Hospital, Dublin, Ireland
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Larivée P, Eller J, Crimi N, Picado C, Wardlaw A, Ghaly L, Harris A. Efficacy and safety of one-puff, once-daily, evening treatment with mometasone furoate dry-powder inhaler 400 mcg compared with fluticasone propionate metered dose inhaler 125 mcg two puffs, twice daily in asthma patients switched from fluticasone propionate. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ruse C, Parker SG, Burton P, Wardlaw A. Genetic susceptibility to COPD. Thorax 2000; 55:723. [PMID: 10950722 PMCID: PMC1745824 DOI: 10.1136/thorax.55.8.722b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Taiwo FA, Brophy PM, Pritchard DI, Brown A, Wardlaw A, Patterson LH. Comparative metal content profiling of parasitic helminths by electron paramagnetic resonance spectrometry: significance for metalloprotein content. Int J Parasitol 2000; 30:29-33. [PMID: 10675741 DOI: 10.1016/s0020-7519(99)00167-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Variation in co-ordination geometries of metal ions bound to proteins imposes electronic states different from free (hydrated) ions in solution. Electron paramagnetic resonance spectroscopy has been used to analyse a selection of parasitic helminths for metal content as an initial step to determination of metallo-enzymes in their ES products under immune stress conditions. Characteristic paramagnetic resonance spectroscopy spectra show clear evidence for the presence of iron, copper, and manganese centres and in the selected parasites. The metals ions are identified as protein-bound as distinct from free metal ions present in aqueous solution, and distinguishable from parasite dietary components derived from host sources. Indication is given that superoxide dismutases may, in part, account for the metal ions observed. The use of electron paramagnetic resonance spectroscopy to identify specific protein-bound metals without prior isolation of the suspected protein is here applied.
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Affiliation(s)
- F A Taiwo
- School of Pharmacy and Pharmaceutical Sciences, De Montfort University, Leicester, UK.
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Taiwo FA, Brophy PM, Pritchard DI, Brown A, Wardlaw A, Patterson LH. Cu/Zn superoxide dismutase in excretory-secretory products of the human hookworm Necator americanus. An electron paramagnetic spectrometry study. Eur J Biochem 1999; 264:434-8. [PMID: 10491088 DOI: 10.1046/j.1432-1327.1999.00626.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
EPR spectrometry was used to investigate the effect of excretory/secretory product from Necator americanus on superoxide radical anions generated by xanthine/xanthine oxidase as a measure of excretory/secretory product superoxide dismutase activity. Using 1,1',5,5'-dimethylpyrollidine-N-oxide (DMPO) as a superoxide spin-trapping agent a 12-line EPR spectrum characteristic of the DMPO-OOH adduct was observed to decrease in the presence of excretory/secretory product. Superoxide dismutase activity was proportional to excretory/secretory protein concentration, was inhibited with cyanide treatment and was progressively destroyed with increasing time of heat denaturation of excretory/secretory product. Using a purpose-built chamber the superoxide dismutase activity of excretory/secretory product from live worms in culture was shown to accumulate with time to a maximum at 4 h. The electron paramagnetic resonance spectrum obtained for the frozen excretory/secretory product of N. americanus recorded at 77 K is typical of Cu(II) in a protein matrix. The results are consistent with the presence of an active Cu/Zn superoxide dismutase in excretory/secretory product from N. americanus and demonstrate a method for the unequivocal determination of the fate of superoxide anions in the presence of live worms.
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Affiliation(s)
- F A Taiwo
- School of Pharmacy, De Montfort University, Leicester, UK.
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Affiliation(s)
- A Wardlaw
- Department of Respiratory Medicine, Glenfield Hospital, Leicester
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Affiliation(s)
- A Wardlaw
- Department of Allergy and Clinical Immunology, National Heart & Lung Institute, London, U.K
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Abstract
A survey of patients attending anticoagulant clinics at a District General Hospital showed the maintenance dose of warfarin to increase with weight and decrease with age. A significant correlation was observed between age and weight considered together and the maintenance dose. It is proposed that consideration of age and weight may be of value when prescribing loading or starting doses of warfarin at initiation of therapy.
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