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Herrera-De La Mata S, Ramírez-Suástegui C, Mistry H, Castañeda-Castro FE, Kyyaly MA, Simon H, Liang S, Lau L, Barber C, Mondal M, Zhang H, Arshad SH, Kurukulaaratchy RJ, Vijayanand P, Seumois G. Cytotoxic CD4 + tissue-resident memory T cells are associated with asthma severity. Med 2023; 4:875-897.e8. [PMID: 37865091 PMCID: PMC10964988 DOI: 10.1016/j.medj.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/03/2023] [Revised: 07/02/2023] [Accepted: 09/18/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Patients with severe uncontrolled asthma represent a distinct endotype with persistent airway inflammation and remodeling that is refractory to corticosteroid treatment. CD4+ TH2 cells play a central role in orchestrating asthma pathogenesis, and biologic therapies targeting their cytokine pathways have had promising outcomes. However, not all patients respond well to such treatment, and their effects are not always durable nor reverse airway remodeling. This observation raises the possibility that other CD4+ T cell subsets and their effector molecules may drive airway inflammation and remodeling. METHODS We performed single-cell transcriptome analysis of >50,000 airway CD4+ T cells isolated from bronchoalveolar lavage samples from 30 patients with mild and severe asthma. FINDINGS We observed striking heterogeneity in the nature of CD4+ T cells present in asthmatics' airways, with tissue-resident memory T (TRM) cells making a dominant contribution. Notably, in severe asthmatics, a subset of CD4+ TRM cells (CD103-expressing) was significantly increased, comprising nearly 65% of all CD4+ T cells in the airways of male patients with severe asthma when compared to mild asthma (13%). This subset was enriched for transcripts linked to T cell receptor activation (HLA-DRB1, HLA-DPA1) and cytotoxicity (GZMB, GZMA) and, following stimulation, expressed high levels of transcripts encoding for pro-inflammatory non-TH2 cytokines (CCL3, CCL4, CCL5, TNF, LIGHT) that could fuel persistent airway inflammation and remodeling. CONCLUSIONS Our findings indicate the need to look beyond the traditional T2 model of severe asthma to better understand the heterogeneity of this disease. FUNDING This research was funded by the NIH.
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Affiliation(s)
| | | | - Heena Mistry
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | | | - Mohammad A Kyyaly
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | - Hayley Simon
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Shu Liang
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK
| | - Clair Barber
- National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK
| | | | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | - Ramesh J Kurukulaaratchy
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK.
| | - Pandurangan Vijayanand
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Department of Medicine, University of California San Diego, La Jolla, CA 92037, USA; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK.
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Stevens JL, McKenna HT, Filipe H, Lau L, Fernandez BO, Murray AJ, Feelisch M, Martin DS. Perioperative redox changes in patients undergoing hepato-pancreatico-biliary cancer surgery. Perioper Med (Lond) 2023; 12:35. [PMID: 37430377 DOI: 10.1186/s13741-023-00325-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Tissue injury induces inflammation and the surgical stress response, which are thought to be central to the orchestration of recovery or deterioration after surgery. Enhanced formation of reactive oxygen and nitrogen species accompanies the inflammatory response and triggers separate but integrated reduction/oxidation (redox) pathways that lead to oxidative and/or nitrosative stress (ONS). Quantitative information on ONS in the perioperative period is scarce. This single-centre exploratory study investigated the effects of major surgery on ONS and systemic redox status and their potential associations with postoperative morbidity. METHODS Blood was collected from 56 patients at baseline, end of surgery (EoS) and the first postoperative day (day-1). Postoperative morbidity was recorded using the Clavien-Dindo classification and further categorised into minor, moderate and severe. Plasma/serum measures included markers of lipid oxidation (thiobarbituric acid-reactive substances; TBARS, 4-hydroxynonenal; 4-HNE, 8-iso-prostaglandin F2⍺; 8-isoprostanes). Total reducing capacity was measured using total free thiols (TFTs) and ferric-reducing ability of plasma (FRAP). Nitric oxide (NO) formation/metabolism was measured using cyclic guanosine monophosphate (cGMP), nitrite, nitrate and total nitroso-species (RxNO). Interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-⍺) were measured to evaluate inflammation. RESULTS Both oxidative stress (TBARS) and nitrosative stress (total nitroso-species) increased from baseline to EoS (+14%, P = 0.003 and +138%, P < 0.001, respectively), along with an increase in overall reducing capacity (+9%, P = 0.03) at EoS and protein-adjusted total free thiols (+12%, P = 0.001) at day-1 after surgery. Nitrite, nitrate and cGMP concentrations declined concomitantly from baseline to day-1. Baseline nitrate was 60% higher in the minor morbidity group compared to severe (P = 0.003). The increase in intraoperative TBARS was greater in severe compared to minor morbidity (P = 0.01). The decline in intraoperative nitrate was more marked in the minor morbidity group compared to severe (P < 0.001), whereas the cGMP decline was greatest in the severe morbidity group (P = 0.006). CONCLUSION In patients undergoing major HPB surgery, intraoperative oxidative and nitrosative stress increased, with a concomitant increase in reductive capacity. Baseline nitrate was inversely associated with postoperative morbidity, and the hallmarks of poor postoperative outcome include changes in both oxidative stress and NO metabolism.
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Affiliation(s)
- Jia L Stevens
- Division of Surgery and Interventional Science, Royal Free Hospital, University College London, London, NW3 2QG, UK.
- Royal Free Perioperative Research Group, Department of Anaesthesia, Royal Free Hospital, London, NW3 2QG, UK.
| | - Helen T McKenna
- Peninsula Medical School, University of Plymouth, John Bull Building, Plymouth, PL6 8BU, Devon, UK
| | - Helder Filipe
- Royal Free Perioperative Research Group, Department of Anaesthesia, Royal Free Hospital, London, NW3 2QG, UK
| | - Laurie Lau
- Clinical & Experimental Sciences and Integrative Physiology and Critical Illness Group, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Bernadette O Fernandez
- Clinical & Experimental Sciences and Integrative Physiology and Critical Illness Group, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Andrew J Murray
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, CB2 3EG, UK
| | - Martin Feelisch
- Clinical & Experimental Sciences and Integrative Physiology and Critical Illness Group, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Daniel S Martin
- Division of Surgery and Interventional Science, Royal Free Hospital, University College London, London, NW3 2QG, UK
- Peninsula Medical School, University of Plymouth, John Bull Building, Plymouth, PL6 8BU, Devon, UK
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Willner N, Prosperi-Porta G, Lau L, Fu A, Poulin A, Messika-Zeitoun D. Aortic valve stenosis progression rate according to baseline severity: A systematic review and meta-analysis. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.230] [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: 12/31/2022]
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de la Mata SH, Ramírez-Suástegui C, Mistry H, Kyyaly MA, Simon H, Liang S, Lau L, Barber C, Mondal M, Arshad SH, Kurukulaaratchy RJ, Vijayanand P, Seumois G. Cytotoxic CD4+ tissue-resident memory T cells are associated with asthma severity. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.109.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Patients with severe uncontrolled asthma represent a distinct endotype with persistent airway inflammation and remodeling that is refractory to corticosteroid treatment. To determine T cell subsets and effector molecules that drive pathogenesis of severe asthma, we performed single-cell transcriptome analysis of >50,000 airway CD4+ T cells isolated from bronchoalveolar lavage (BAL) samples from 30 patients with mild and severe asthma. We observed striking heterogeneity in the nature of CD4+ T cells present in asthmatics' airways with tissue-resident memory (TRM) cells making a dominant contribution. Notably, in severe asthmatics a subset of CD4+ TRM cells (CD103-expressing) was significantly increased, comprising nearly 65% of all CD4+ T cells in the airways of male patients with severe asthma when compared to mild asthma (13%). This subset was enriched for transcripts linked to T cell receptor (TCR) activation (HLA-DRB1, HLA-DPA1, CD40LG) and cytotoxicity (GZMB, GZMH), and following stimulation expressed high levels of transcripts encoding for pro-inflammatory non-TH2 cytokines (CCL3, CCL4, CCL5, TNF, LIGHT) that could fuel persistent airway inflammation and remodeling. Our findings indicate the need to look beyond the traditional T2 model of severe asthma to better understand the heterogeneity of this disease.
This work was supported by (i) NIH research grant R01HL114093 (PV) and equipment grants (S10RR027366 - BD FACSAria Fusion, and S10OD025052 - Illumina Novaseq 6000); the William K. Bowes Jr. Foundation (P.V.). The WATCH study is supported by the Southampton NIHR Biomedical Research Centre and the Southampton NIHR Clinical Research Facility which are funded by the NIHR and are a partnership between the University of Southampton and University Hospital Southampton NHS Foundation Trust.
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Affiliation(s)
| | | | | | | | | | | | - Laurie Lau
- 2Faculty of Med., Univ. of Southampton, United Kingdom, United Kingdom
| | - Clair Barber
- 2Faculty of Med., Univ. of Southampton, United Kingdom, United Kingdom
| | | | - Syed Hasan Arshad
- 2Faculty of Med., Univ. of Southampton, United Kingdom, United Kingdom
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Fong WCG, Kadalayil L, Lau L, Kurukulaaratchy RJ, Arshad SH. Blood cytokine profiles - Potential biomarkers for asthma persistence into adulthood? Pediatr Allergy Immunol 2022; 33:e13673. [PMID: 34587307 PMCID: PMC8724405 DOI: 10.1111/pai.13673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Wei Chern Gavin Fong
- The David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Newport, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Latha Kadalayil
- The David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Newport, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ramesh J Kurukulaaratchy
- The David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Newport, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Syed Hasan Arshad
- The David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Newport, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Lau L, Kandil I, Charlebois A, Chan K, Suh K, Fahed R, Garuba H, Law A, Chan V, Boodhwani M, Auclair F, Messika-Zeitoun D, Rubens F. IT TAKES A TEAM: IMPLEMENTATION OF A MULTIDISCIPLINARY ENDOCARDITIS HEART TEAM AT A CANADIAN TERTIARY CARE REFERRAL CENTRE. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.163] [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: 11/24/2022] Open
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Yusuh M, Lau L, Abdelwahab O, Garba K, Sirikhansaeng P, Birch B, Lwaleed B. The potential use of medical grade Manuka honey in the treatment of interstitial cystitis/ bladder pain syndrome. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01204-0] [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: 10/20/2022] Open
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8
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Azim A, Green B, Lau L, Rupani H, Jayasekera N, Bruce K, Howarth P. Peripheral airways type 2 inflammation, neutrophilia and microbial dysbiosis in severe asthma. Allergy 2021; 76:2070-2078. [PMID: 33411348 PMCID: PMC8629111 DOI: 10.1111/all.14732] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 05/11/2020] [Revised: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023]
Abstract
Background IL‐13 is considered an archetypal T2 cytokine central to the clinical disease expression of asthma. The IL‐13 response genes, which are upregulated in central airway bronchial epithelial of asthma patients, can be normalized by high‐dose inhaled steroid therapy in severe asthma. However, this is not the case within the peripheral airways. We have sought to further understand IL‐13 in the peripheral airways in severe asthma through bronchoalveolar analysis. Methods Bronchoalveolar lavage samples were collected from 203 asthmatic and healthy volunteers, including 78 with severe asthma. Inflammatory mediators were measured using a multiple cytokine immunoassay platform. This analysis was replicated in a further 59 volunteers, in whom 16S rRNA analysis of BAL samples was undertaken by terminal restriction fragment length polymorphism. Results Severe asthma patients with high BAL IL‐13, despite treatment with high‐dose inhaled corticosteroids, had more severe lung function and significantly higher BAL neutrophil percentages, but not BAL eosinophils than those with normal BAL‐13 concentrations. This finding was replicated in the second cohort, which further associated BAL IL‐13 and neutrophilia with a greater abundance of potentially pathogenic bacteria in the peripheral airways. Conclusion Our findings demonstrate a steroid unresponsive source of IL‐13 that is associated with BAL neutrophilia and bacterial dysbiosis in severe asthma. Our findings highlight the biological complexity of severe asthma and the importance of a greater understanding of the innate and adaptive immune responses in the peripheral airways in this disease.
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Affiliation(s)
- Adnan Azim
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
| | - Ben Green
- Portsmouth Hospitals NHS TrustQueen Alexandra Hospital London UK
| | - Laurie Lau
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
| | - Hitasha Rupani
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
| | | | - Kenneth Bruce
- Molecular Microbiology Research Laboratory Pharmaceutical Science Division King's College London London UK
| | - Peter Howarth
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
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Barber C, Lau L, Ward JA, Daniels T, Watson A, Staples KJ, Wilkinson TMA, Howarth PH. Sputum processing by mechanical dissociation: A rapid alternative to traditional sputum assessment approaches. Clin Respir J 2021; 15:800-807. [PMID: 33749082 DOI: 10.1111/crj.13365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sputum cytology is currently the gold standard to evaluate cellular inflammation in the airways and phenotyping patients with airways diseases. Sputum eosinophil proportions have been used to guide treatment for moderate to severe asthma. Furthermore, raised sputum neutrophils are associated with poor disease control and impaired lung function in both asthma and COPD and small airways disease in cystic fibrosis. However, induced-sputum analysis is subjective and resource heavy, requiring dedicated specialist processing and assessment; this limits its utility in most clinical settings. Indirect blood eosinophil measures have been adopted in clinical care. However, there are currently no good peripheral blood biomarkers of airway neutrophils. A resource-light sputum processing approach could thus help integrate induced sputum more readily into routine clinical care. New mechanical disruption (MD) methods can rapidly obtain viable single cell suspensions from sputum samples. AIMS The aim of this study was to compare MD sputum processing to traditional methods for cell viability, granulocyte proportions and sputum cytokine analysis. METHODS Sputum plugs were split and processed using traditional methods and the MD method, and samples were then compared. RESULTS The MD method produced a homogeneous cell suspension in 62 s; 70 min faster than the standard method used. No significant difference was seen between the cell viability (p = 0.09), or the concentration of eosinophils (p = 0.83), neutrophils (p = 0.99) or interleukin-8 (p = 0.86) using MD. CONCLUSION This cost-effective method of sputum processing could provide a more pragmatic, sustainable means of directly monitoring the airway milieu. Therefore, we recommend this method be taken forward for further investigation.
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Affiliation(s)
- Clair Barber
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton, UK
| | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jonathan A Ward
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Thomas Daniels
- Cystic Fibrosis Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Alastair Watson
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton, UK
| | - Karl J Staples
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton, UK
| | - Tom M A Wilkinson
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton, UK
| | - Peter H Howarth
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Cystic Fibrosis Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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10
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Amin J, Boche D, Clough Z, Teeling J, Williams A, Gao Y, Chudley L, Lau L, Smith F, Harris S, Holmes C. Peripheral immunophenotype in dementia with Lewy bodies and Alzheimer's disease: an observational clinical study. J Neurol Neurosurg Psychiatry 2020; 91:1219-1226. [PMID: 32968032 PMCID: PMC7569376 DOI: 10.1136/jnnp-2020-323603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/19/2020] [Accepted: 07/30/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Inflammation plays a key role in the aetiology and progression of Alzheimer's disease (AD). However, the immunophenotype of the second most common neurodegenerative cause of dementia, dementia with Lewy bodies (DLB), remains unclear. To date there have been no studies examining peripheral inflammation in DLB using multiplex immunoassay and flow cytometry concomitantly. We hypothesised that, using blood biomarkers, DLB would show an increased proinflammatory profile compared with controls, and that there would be a distinct profile compared with AD. METHODS 93 participants (31 with DLB, 31 with AD and 31 healthy older controls) completed a single study visit for neuropsychiatric testing and phlebotomy. Peripheral blood mononuclear cells were quantified for T and B cell subsets using flow cytometry, and serum cytokine concentrations were measured using multiplex immunoassay. RESULTS We detected reduced relative numbers of helper T cells and reduced activation of B cells in DLB compared with AD. Additionally, interleukin (IL)-1β was detected more frequently in DLB and the serum concentration of IL-6 was increased compared with controls. CONCLUSIONS Peripheral inflammation is altered in DLB compared with AD, with T cell subset analysis supporting a possible shift towards senescence of the adaptive immune system in DLB. Furthermore, there is a proinflammatory signature of serum cytokines in DLB. Identification of this unique peripheral immunophenotype in DLB could guide development of an immune-based biomarker and direct future work exploring potential immune modulation as a novel treatment.
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Affiliation(s)
- Jay Amin
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Memory Assessment and Research Centre, Southern Health NHS Foundation Trust, Southampton, UK
| | - Delphine Boche
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Zoe Clough
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Memory Assessment and Research Centre, Southern Health NHS Foundation Trust, Southampton, UK
| | - Jessica Teeling
- Faculty of Natural and Environmental Science, University of Southampton, Southampton, UK
| | - Anthony Williams
- Regional Clinical Immunology Laboratory, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yifang Gao
- Regional Clinical Immunology Laboratory, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lindsey Chudley
- Regional Clinical Immunology Laboratory, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Laurie Lau
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Florence Smith
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Scott Harris
- Medical Statistics, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Clive Holmes
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK .,Memory Assessment and Research Centre, Southern Health NHS Foundation Trust, Southampton, UK
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Lee S, Lau L, Lim K, Cole D. Incentives that influence low income Filipinos with Tuberculosis symptoms to change health-seeking behaviour: a randomized controlled trial. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.044] [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: 10/27/2022] Open
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Teixeira E, Papanagnou D, Lau L, Smith E, Berman M, Zhang X. 234 Feasibly Mitigating Provider Terror: Introducing a High-Fidelity, Tissue-Based Task Trainer for the Deliberate Practice of Emergent Hysterotomies. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.239] [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: 11/25/2022]
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13
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Lau L, Wiens E, Karlowsky JA, Keynan Y, Jassal D. P3530Clinical utility of echocardiography for the diagnosis of native valve infective endocarditis in staphylococcus aureus bacteremia. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- L Lau
- University of Manitoba, Winnipeg, Canada
| | - E Wiens
- University of Manitoba, Winnipeg, Canada
| | | | - Y Keynan
- University of Manitoba, Winnipeg, Canada
| | - D Jassal
- University of Manitoba, Winnipeg, Canada
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Liu S, Lau L, Nepomuceno R, Leon S, Ducas-Mowchun K, Toleva O, Allen D, Avery L, Fransoo R, Ducas J. STENT AND SHIP: SAFETY OF EARLY TRANSFER AFTER PCI OF STEMI PATIENTS FROM A SINGLE, REGIONAL CARDIAC CARE CENTRE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.242] [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: 10/18/2022] Open
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Walker WT, Jackson CL, Allan RN, Collins S, Kelso MJ, Rineh A, Yepuri NR, Nicholas B, Lau L, Johnston D, Lackie P, Faust SN, Lucas JS, Hall-Stoodley L. Primary ciliary dyskinesia ciliated airway cells show increased susceptibility to
Haemophilus influenzae
biofilm formation. Eur Respir J 2017; 50:50/3/1700612. [DOI: 10.1183/13993003.00612-2017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/04/2017] [Indexed: 11/05/2022]
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16
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Hou R, Garner M, Holmes C, Osmond C, Teeling J, Lau L, Baldwin DS. Peripheral inflammatory cytokines and immune balance in Generalised Anxiety Disorder: Case-controlled study. Brain Behav Immun 2017; 62:212-218. [PMID: 28161475 PMCID: PMC5373436 DOI: 10.1016/j.bbi.2017.01.021] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Previous investigations have demonstrated that major depression is associated with particular patterns of cytokine signalling. The primary aim of this study was to examine peripheral pro-inflammatory and anti-inflammatory cytokines and immune balance in Generalised Anxiety Disorder (GAD). METHODS A case-controlled cross-sectional study design was employed: 54 patients with GAD and 64 healthy controls were recruited. Participants completed self-report measures of anxiety and depression. Two pro-inflammatory and two anti-inflammatory cytokines were measured using multiplex technology. RESULTS Case-control logistic regression analyses revealed significant differences in serum levels of IL-10, TNF-α, and IFN-γ between GAD and control groups after adjusting for age, gender, body mass index, smoking and alcohol consumption: these group differences were independent of the presence or degree of depression. Comparison of pro-inflammatory to anti-inflammatory cytokine ratios indicated that there were significantly higher ratios of TNF-α/IL10, TNF-α/IL4, IFN-γ/IL10, and IFN-γ/IL4 in the GAD group compared to the control group. CONCLUSIONS This study is the first to investigate both pro- and anti-inflammatory cytokines and their balance in patients with GAD in comparison to healthy controls. The findings indicate a relatively increased pro-inflammatory response and decreased anti-inflammatory response and provide the first demonstration of an altered cytokine balance in GAD. Serum cytokine levels in GAD were independent of the presence of depression.
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Affiliation(s)
- Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom.
| | - Matthew Garner
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton,Department of Psychology, University of Southampton
| | - Clive Holmes
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
| | - Clive Osmond
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton
| | | | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
| | - David S. Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton,University Department of Psychiatry and Mental Health, University of Cape Town
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Alangari AA, Morris K, Lwaleed BA, Lau L, Jones K, Cooper R, Jenkins R. Honey is potentially effective in the treatment of atopic dermatitis: Clinical and mechanistic studies. Immun Inflamm Dis 2017; 5:190-199. [PMID: 28474502 PMCID: PMC5418133 DOI: 10.1002/iid3.153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 12/24/2022]
Abstract
Introduction As manuka honey (MH) exhibits immunoregulatory and anti‐staphylococcal activities, we aimed to investigate if it could be effective in the treatment of atopic dermatitis (AD). Methods Adult volunteers with bilateral AD lesions were asked to apply MH on one site overnight for seven consecutive days and leave the contralateral site untreated as possible. Three Item Severity score was used to evaluate the response. Skin swabs were obtained from both sites before and after treatment to investigate the presence of staphylococci and enterotoxin production. In addition, the ability of MH and its methanolic and hexane extracts to down regulate IL4‐induced CCL26 protein release from HaCaT cells was evaluated by enzyme linked immunosorbent assay. Also, the ability of MH to modulate calcium ionophore‐induced mast cell degranulation was assessed by enzyme immunoassay. Results In 14 patients, AD lesions significantly improved post MH treatment versus pre‐treatment as compared to control lesions. No significant changes in the skin staphylococci were observed after day 7, irrespective of honey treatment. Consistent with the clinical observation, MH significantly down regulated IL4‐induced CCL26 release from HaCaT cells in a dose‐dependent manner. This effect was partially lost, though remained significant, when methanolic and hexane extracts of MH were utilized. In addition, mast cell degranulation was significantly inhibited following treatment with MH. Conclusions MH is potentially effective in the treatment of AD lesions based on both clinical and cellular studies through different mechanisms. This needs to be confirmed by randomized and controlled clinical trials.
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Affiliation(s)
- Abdullah A. Alangari
- Department of PediatricsCollege of MedicineKing Saud UniversityRiyadhSaudi Arabia
| | - Keith Morris
- Department of Biomedical SciencesCardiff Metropolitan UniversityCardiffUK
| | | | - Laurie Lau
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Ken Jones
- Department of Biomedical SciencesCardiff Metropolitan UniversityCardiffUK
| | - Rose Cooper
- Department of Biomedical SciencesCardiff Metropolitan UniversityCardiffUK
| | - Rowena Jenkins
- Department of Biomedical SciencesCardiff Metropolitan UniversityCardiffUK
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Arshad SH, Raza A, Lau L, Bawakid K, Karmaus W, Zhang H, Ewart S, Patil V, Roberts G, Kurukulaaratchy R. Pathophysiological characterization of asthma transitions across adolescence. Respir Res 2014; 15:153. [PMID: 25472820 PMCID: PMC4256730 DOI: 10.1186/s12931-014-0153-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/13/2014] [Indexed: 11/17/2022] Open
Abstract
Background Adolescence is a period of change, which coincides with disease remission in a significant proportion of subjects with childhood asthma. There is incomplete understanding of the changing characteristics underlying different adolescent asthma transitions. We undertook pathophysiological characterization of transitional adolescent asthma phenotypes in a longitudinal birth cohort. Methods The Isle of Wight Birth Cohort (N = 1456) was reviewed at 1, 2, 4, 10 and 18-years. Characterization included questionnaires, skin tests, spirometry, exhaled nitric oxide, bronchial challenge and (in a subset of 100 at 18-years) induced sputum. Asthma groups were “never asthma” (no asthma since birth), “persistent asthma” (asthma at age 10 and 18), “remission asthma” (asthma at age 10 but not at 18) and “adolescent-onset asthma” (asthma at age 18 but not at age 10). Results Participants whose asthma remitted during adolescence had lower bronchial reactivity (odds ratio (OR) 0.30; CI 0.10 -0.90; p = 0.03) at age 10 plus greater improvement in lung function (forced expiratory flow 25-75% gain: 1.7 L; 1.0-2.9; p = 0.04) compared to persistent asthma by age 18. Male sex (0.3; 0.1-0.7; p < 0.01) and lower acetaminophen use (0.4; 0.2-0.8; p < 0.01) independently favoured asthma remission, when compared to persistent asthma. Asthma remission had a lower total sputum cell count compared to never asthma (31.5 [25–75 centiles] 12.9-40.4) vs. 47.0 (19.5-181.3); p = 0.03). Sputum examination in adolescent-onset asthma showed eosinophilic airway inflammation (3.0%, 0.7-6.6), not seen in persistent asthma (1.0%, 0–3.9), while remission group had the lowest sputum eosinophil count (0.3%, 0–1.4) and lowest eosinophils/neutrophils ratio of 0.0 (Interquartile range: 0.1). Conclusion Asthma remission during adolescence is associated with lower initial BHR and greater gain in small airways function, while adolescent-onset asthma is primarily eosinophilic. Electronic supplementary material The online version of this article (doi:10.1186/s12931-014-0153-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Syed Hasan Arshad
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.
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Grainge C, Dennison P, Lau L, Davies D, Howarth P. Asthmatic and normal respiratory epithelial cells respond differently to mechanical apical stress. Am J Respir Crit Care Med 2014; 190:477-80. [PMID: 25127309 DOI: 10.1164/rccm.201401-0107le] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Green BJ, Wiriyachaiporn S, Grainge C, Rogers GB, Kehagia V, Lau L, Carroll MP, Bruce KD, Howarth PH. Potentially pathogenic airway bacteria and neutrophilic inflammation in treatment resistant severe asthma. PLoS One 2014; 9:e100645. [PMID: 24955983 PMCID: PMC4067344 DOI: 10.1371/journal.pone.0100645] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/29/2014] [Indexed: 01/06/2023] Open
Abstract
Background Molecular microbiological analysis of airway samples in asthma has demonstrated an altered microbiome in comparison to healthy controls. Such changes may have relevance to treatment-resistant severe asthma, particularly those with neutrophilic airway inflammation, as bacteria might be anticipated to activate the innate immune response, a process that is poorly steroid responsive. An understanding of the relationship between airway bacterial presence and dominance in severe asthma may help direct alternative treatment approaches. Objective We aimed to use a culture independent analysis strategy to describe the presence, dominance and abundance of bacterial taxa in induced sputum from treatment resistant severe asthmatics and correlate findings with clinical characteristics and airway inflammatory markers. Methods Induced sputum was obtained from 28 stable treatment-resistant severe asthmatics. The samples were divided for supernatant IL-8 measurement, cytospin preparation for differential cell count and Terminal Restriction Fragment Length Polymorphism (T-RFLP) profiling for bacterial community analysis. Results In 17/28 patients, the dominant species within the airway bacterial community was Moraxella catarrhalis or a member of the Haemophilus or Streptococcus genera. Colonisation with these species was associated with longer asthma disease duration (mean (SD) 31.8 years (16.7) vs 15.6 years (8.0), p = 0.008), worse post-bronchodilator percent predicted FEV1 (68.0% (24.0) vs 85.5% (19.7), p = 0.025) and higher sputum neutrophil differential cell counts (median (IQR) 80% (67–83) vs 43% (29–67), p = 0.001). Total abundance of these organisms significantly and positively correlated with sputum IL-8 concentration and neutrophil count. Conclusions Airway colonisation with potentially pathogenic micro-organisms in asthma is associated with more severe airways obstruction and neutrophilic airway inflammation. This altered colonisation may have a role in the development of an asthma phenotype that responds less well to current asthma therapies.
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Affiliation(s)
- Benjamin J. Green
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Surasa Wiriyachaiporn
- Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, King's College London, London, United Kingdom
| | - Christopher Grainge
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
- Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Geraint B. Rogers
- Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, King's College London, London, United Kingdom
- SAHMRI Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia
| | - Valia Kehagia
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Laurie Lau
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Mary P. Carroll
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Kenneth D. Bruce
- Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, King's College London, London, United Kingdom
| | - Peter H. Howarth
- Academic Unit of Clinical and Experimental Sciences; NIHR Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
- * E-mail:
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Perbal B, Trackman P, Castellot J, Brigstock D, Takigawa M, Lau L, Leask A. Report on the 7(th) international workshop on the CCN family of genes : October 16-19, 2013-Nice, France. J Cell Commun Signal 2014; 8:71-6. [PMID: 24553917 DOI: 10.1007/s12079-014-0227-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 11/25/2022] Open
Abstract
In this report, chairs of the 7th International Workshop on the CCN family of Genes, review the progress made in understanding the biological functions of CCN proteins (CCN1, CCN2, CCN3, CCN4, CCN5 and CCN6) with a particular focus on their implications in various pathological conditions, including cancer, fibrosis, diabetes, and cardiovascular diseases.
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Affiliation(s)
- B Perbal
- International CCN Society, Nice, France,
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22
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Grainge C, Dulay V, Ward J, Sammut D, Davies E, Green B, Lau L, Cottey L, Haitchi HM, Davies DE, Howarth PH. Resistin-like molecule-β is induced following bronchoconstriction of asthmatic airways. Respirology 2013; 17:1094-100. [PMID: 22758223 DOI: 10.1111/j.1440-1843.2012.02215.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Resistin-like molecule-β (RELM-β) is a necessary and sufficient stimulus for airway remodelling in animal models of asthma, but until recently, its role in human disease had not been investigated. The hypothesis that RELM-β expression would increase with increasing asthma severity and further increase following acute bronchoconstrictor challenges has been examined. METHODS Bronchial biopsies from healthy subjects and patients with mild and severe asthma were immunostained for RELM-β, as were airway biopsies obtained in mild asthmatics before and 4 days after repeated inhalation challenges with either allergen, methacholine or methacholine preceded by salbutamol as a control. Bronchial brushings were also evaluated for RELM-β mRNA. RESULTS RELM-β immunoreactivity, which co-localized to airway epithelial cells, increased with disease severity; healthy volunteers, median per cent epithelial area 1.98%, mild asthma 3.49% and severe asthma 5.89% (P < 0.001 between groups). RELM-β immunoreactivity significantly and inversely correlated in asthma with forced expiratory volume in 1 s % predicted (P = 0.005). Acute changes in immunoexpression were evident after repeated inhalation challenge with allergen (2.15 % to 4.35 % (P = 0.01)) and methacholine (4.21 % to 6.16 % (P = 0.01)) but did not change in the salbutamol/methacholine challenge group. These changes correlated with change in basement membrane thickness (r = 0.38, P = 0.02). Epithelial RELM-β gene expression was not altered in asthma. CONCLUSIONS RELM-β may play an important role not only in animal models of airway remodelling, but also in human airway pathology.
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Affiliation(s)
- Christopher Grainge
- Academic Unit of Clinical and Experimental Sciences, Southampton University Faculty of Medicine, NIHR Respiratory Biomedical Research Unit and Wellcome Trust Clinical Research Facility, Southampton, UK.
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Rudd N, Mutha V, Asrar Ul Haq M, Peiris R, Nguyen C, Nour D, Lau L, Al-Daher S, Barlis P, van Gaal W. LACE, CRUSADE, CADDILAC, TIMI-NSTEMI Scores Can Predict Unplanned Hospital Readmissions with ACS. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.104] [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: 11/27/2022]
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24
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Park JA, Sharif AS, Tschumperlin DJ, Lau L, Limbrey R, Howarth P, Drazen JM. Tissue factor-bearing exosome secretion from human mechanically stimulated bronchial epithelial cells in vitro and in vivo. J Allergy Clin Immunol 2012; 130:1375-83. [PMID: 22828416 DOI: 10.1016/j.jaci.2012.05.031] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 05/10/2012] [Accepted: 05/16/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Tissue factor (TF), a primary initiator of blood coagulation, also plays a pivotal role in angiogenesis. TF expression in the airways is associated with asthma, a disease characterized in part by subepithelial angiogenesis. OBJECTIVES To determine potential sources of TF and the mechanisms of its availability in the lung microenvironment. METHODS Normal human bronchial epithelial cells grown in air-liquid interface culture were subjected to a compressive stress of 30 cm H(2)O; this is comparable to that generated in the airway epithelium during bronchoconstriction in asthma. Conditioned media and cells were harvested to measure TF mRNA and TF protein. We also tested bronchoalveolar lavage fluid and airway biopsies from asthmatic patients and healthy controls for TF. RESULTS TF mRNA was upregulated 2.2-fold after 3 hours of stress compared with unstressed cells. Intracellular and secreted TF proteins were enhanced 1.6-fold and more than 50-fold, respectively, compared with those of control cells after the onset of compression. The amount of TF in the bronchoalveolar lavage fluid from patients with asthma was found at mean concentrations that were 5 times greater than those of healthy controls. Immunohistochemical staining of endobronchial biopsies identified epithelial localization of TF with increased expression in asthma. Exosomes isolated from the conditioned media of normal human bronchial epithelial cells and the bronchoalveolar lavage fluid of asthmatic subjects by ultracentrifugation contained TF. CONCLUSIONS Our in vitro and in vivo studies show that mechanically stressed bronchial epithelial cells are a source of secreted TF and that exosomes are potentially a key carrier of the TF signal.
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Affiliation(s)
- Jin-Ah Park
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA
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25
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Thwe L, Catchpoole D, Lau L, Byrne J. 756 Biomarker Analysis in Neuroblastomas Diagnosed Within a Single Institution. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71392-8] [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: 11/24/2022]
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Postlethwaite D, Mason I, Merchant M, Lau L. Subdermal contraceptive implant: “typical use” in a California managed care setting. Contraception 2012. [DOI: 10.1016/j.contraception.2011.11.058] [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: 11/29/2022]
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Rafie S, Kim G, Lau L, Brown C, Tang C, Monastersky Maderas N. Assessment and promotion of youth-friendly pharmacy practices in San Diego, CA. Contraception 2012. [DOI: 10.1016/j.contraception.2011.11.059] [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: 10/14/2022]
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Zhou X, White M, Lau L, Williams S, Bateman A, Abu E, Walls A. Anaphylaxis as a Potential Cause of Death in Heroin Users. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.759] [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: 11/29/2022]
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Khedr M, Abdelmotelb A, Lau L, Arno M, Zhou X, Walls A. Mast Cell Tryptase as a Stimulus for Upregulation of Adhesion Molecule Expression and Cytokine Release from Endothelial Cells. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.586] [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: 11/29/2022]
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Whitworth H, Zhou X, Lau L, Bodey K, Erlewyn-Lajeunesse M, Millinchamp F, Pedersen J, Lucas J, Walls A. Dipeptidyl Peptidase I as a Serum Marker of Allergic Reactions to Food. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brown T, Whitworth H, Zhou X, Lau L, Eren E, Walls A. Mast Cell Carboxypeptidase as a Confirmatory and Predictive Marker in Allergic Reactions to Drugs. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.567] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- F Fleiner
- Department of Otorhinolaryngology, Head and Neck Surgery, Consultation Service for Olfactory Disorders, Charité, University of Berlin, Berlin, Germany.
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Uller L, Leino M, Bedke N, Sammut D, Green B, Lau L, Howarth PH, Holgate ST, Davies DE. Double-stranded RNA induces disproportionate expression of thymic stromal lymphopoietin versus interferon-beta in bronchial epithelial cells from donors with asthma. Thorax 2010; 65:626-32. [PMID: 20627922 DOI: 10.1136/thx.2009.125930] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Thymic stromal lymphopoietin (TSLP) is an epithelial cell-derived cytokine that strongly activates dendritic cells and can initiate allergic inflammation. Since exposure to rhinovirus or double-stranded (ds) RNA (a surrogate of viral infection) induces TSLP expression in bronchial epithelial cells (BECs), this cytokine may link innate antiviral responses and the type 2 adaptive immune response. OBJECTIVE As BECs from donors with asthma have a deficient interferon (IFN) response to rhinovirus infection, a study was undertaken to test the hypothesis that their antiviral response shows a bias towards TSLP production. METHODS Primary BECs were grown from subjects with asthma and healthy volunteers. After exposure to dsRNA, interleukin (IL)-8, IFNbeta and TSLP mRNA and protein expression were measured by RT-qPCR and ELISA, respectively. RESULTS dsRNA dose-dependently increased IL-8 expression in BECs with no significant difference between the groups. However, BECs from subjects with asthma expressed less IFNbeta and more TSLP mRNA and protein in response to dsRNA than BECs from those without asthma (median (IQR) 57 (38-82) pg/ml vs 106 (57-214) pg/ml for IFNbeta (p<0.05) and 114 (86-143) pg/ml vs 65 (32-119) pg/ml for TSLP (p<0.05) in response to 10 microg/ml dsRNA for 24 h). Induction of TSLP mRNA by dsRNA was blocked by Toll-like receptor 3 or protein kinase inhibitors or by preventing de novo protein synthesis, but not by neutralisation of type I IFN receptors. CONCLUSION BECs from subjects with asthma are biased towards higher TSLP and lower IFNbeta production in response to dsRNA, suggesting that viral infection in asthma may lead to an altered mediator profile that biases towards a Th2 immune response.
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Affiliation(s)
- Lena Uller
- The Brooke Laboratories, Sir Henry Wellcome Laboratories, South Block, Southampton General Hospital, Southampton SO16 6YD, UK.
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Abstract
A central London genitourinary medicine clinic introduced a policy of transfer to general practitioners (GPs) the care of all patients on successful suppressive treatment of recurrent herpes simplex virus (HSV) infection. An audit showed the initiation of transfer of care to GPs was 65%.
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Affiliation(s)
- L Lau
- The Mortimer Market Centre, London, UK.
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Abstract
BACKGROUND Allergen inhalation challenge in asthma may induce both early (EAR) and late (LAR) asthmatic reactions. The EAR is IgE and mast cell dependent. The mechanism of the LAR is less well defined and we have hypothesized may be allergen dependent. The aim of this study was to investigate the allergen specificity of the LAR to allergen inhalation in asthma. METHODS In a randomized, double-blind, crossover design six asthmatic volunteers with dual sensitization to house dust mite (HDM) allergen and grass pollen (GP) allergen underwent inhalation allergen challenge with these separate allergens on two occasions separated by 14 days. Lung function changes were followed for 8-h postchallenge. Bronchial reactivity (histamine PC(20)) and airway inflammation, assessed by induced sputum differential cell count, were measured 24-h pre and postallergen challenge. The allergen inhalation challenges were matched to achieve the same magnitude of EAR. RESULTS Despite comparable group mean EAR percent falls in FEV(1) (25.8% following GP and 28.0% following HDM (P = 0.917), the LAR was statistically greater on the HDM challenge day (13.0%vs 22.8% [P = 0.046]) and was associated with a significant airway eosinophil recruitment (mean (SD) of 5.4 (4.8)% to 22.1 (18.2)% (P = 0.028) that was not evident on the GP allergen challenge day. CONCLUSIONS These findings identify the allergen specificity of the LAR and indicate that factors independent of IgE contribute to the LAR. Such findings have relevance both to the understanding of the allergen-induced airway responses in asthma and the need for homogeneity in inhaled-allergen challenge studies in asthma.
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Affiliation(s)
- M Hatzivlassiou
- Infection, Inflammation and Immunology Division, University of Southampton School of Medicine, Southampton General Hospital, UK
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McCavert M, O'Donnell ME, Campbell D, Loughrey A, Hannon RJ, Lau L. Spontaneous lower limb subcutaneous emphysema: a diagnostic dilemma. Br J Hosp Med (Lond) 2009; 69:712-4. [PMID: 19186618 DOI: 10.12968/hmed.2008.69.12.712] [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: 11/11/2022]
Affiliation(s)
- M McCavert
- Department of Surgery, University of Ulster
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Lau L, Hansford LM, Cheng LS, Hang M, Baruchel S, Kaplan DR, Irwin MS. Cyclooxygenase inhibitors modulate the p53/HDM2 pathway and enhance chemotherapy-induced apoptosis in neuroblastoma. Oncogene 2006; 26:1920-31. [PMID: 16983334 DOI: 10.1038/sj.onc.1209981] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [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: 11/09/2022]
Abstract
Cyclooxygenase-2 (COX-2) is upregulated in many tumors including neuroblastoma, and its overexpression has been implicated in resistance to p53-dependent apoptosis. Although p53 is rarely mutated in neuroblastoma, the p53 protein is rendered inactive via several mechanisms including sequestration in the cytoplasm. Here, we show that COX inhibitors inhibit the growth of neuroblastoma and when combined with low doses of chemotherapy, exert synergistic effects on neuroblastoma cells. Following COX inhibitor treatment, HDM2, which targets p53 for ubiquitin-mediated degradation, is downregulated, resulting in an attenuation of p53 ubiquitination and an increase in p53 half-life. The level of HDM2 phosphorylation at ser166, which influences both HDM2 and p53 subcellular distribution, is markedly diminished in response to COX inhibitors and is associated with increased p53 nuclear localization. Combining COX inhibitors with low-dose chemotherapy potentiates apoptosis and p53 stability, nuclear localization, and activity. p53 knockdown by siRNA resulted in the rescue of COX-inhibitor-treated cells, indicating that COX inhibitor-induced apoptosis is, at least in part, p53-dependent. Taken together, these results provide the first evidence that COX inhibitors enhance chemosensitivity in neuroblastoma via downregulating HDM2 and augmenting p53 stability and nuclear accumulation.
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Affiliation(s)
- L Lau
- Division of Hematology/Oncology, Cancer Research Program, Hospital for Sick Children, Toronto, Canada
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Howarth PH, Babu KS, Arshad HS, Lau L, Buckley M, McConnell W, Beckett P, Al Ali M, Chauhan A, Wilson SJ, Reynolds A, Davies DE, Holgate ST. Tumour necrosis factor (TNFalpha) as a novel therapeutic target in symptomatic corticosteroid dependent asthma. Thorax 2005; 60:1012-8. [PMID: 16166100 PMCID: PMC1747263 DOI: 10.1136/thx.2005.045260] [Citation(s) in RCA: 392] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tumour necrosis factor alpha (TNFalpha) is a major therapeutic target in a range of chronic inflammatory disorders characterised by a Th1 type immune response in which TNFalpha is generated in excess. By contrast, asthma is regarded as a Th2 type disorder, especially when associated with atopy. However, as asthma becomes more severe and chronic, it adopts additional characteristics including corticosteroid refractoriness and involvement of neutrophils suggestive of an altered inflammatory profile towards a Th1 type response, incriminating cytokines such as TNFalpha. METHODS TNFalpha levels in bronchoalveolar lavage (BAL) fluid of 26 healthy controls, 42 subjects with mild asthma and 20 with severe asthma were measured by immunoassay, and TNFalpha gene expression was determined in endobronchial biopsy specimens from 14 patients with mild asthma and 14 with severe asthma. The cellular localisation of TNFalpha was assessed by immunohistochemistry. An open label uncontrolled clinical study was then undertaken in 17 subjects with severe asthma to evaluate the effect of 12 weeks of treatment with the soluble TNFalpha receptor-IgG1Fc fusion protein, etanercept. RESULTS TNFalpha levels in BAL fluid, TNFalpha gene expression and TNFalpha immunoreative cells were increased in subjects with severe corticosteroid dependent asthma. Etanercept treatment was associated with improvement in asthma symptoms, lung function, and bronchial hyperresponsiveness. CONCLUSIONS These findings may be of clinical significance in identifying TNFalpha as a new therapeutic target in subjects with severe asthma. The effects of anti-TNF treatment now require confirmation in placebo controlled studies.
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Affiliation(s)
- P H Howarth
- Allergy and Inflammation Research, Division of Infection, Inflammation and Repair, School of Medicine, F Level South Block (810), Southampton General Hospital, Southampton SO16 6YD, UK
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Brigstock D, Lau L, Perbal B. Report and abstracts of the 3rd International Workshop on the CCN Family of Genes. St Malo, France, 20-23 October 2004. J Clin Pathol 2005; 58:463-78. [PMID: 15858115 PMCID: PMC1770667 DOI: 10.1136/jcp.2005.025759] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shaw PJ, Bleakley M, Lau L. Unrelated cord blood transplant as salvage following non-engraftment of unrelated marrow transplant? Bone Marrow Transplant 2005; 34:275-6. [PMID: 15156168 DOI: 10.1038/sj.bmt.1704557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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41
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Lau L, Shaw P. What is the significance of negative MIBG scan and urine catecholamines in children with neural crest tumors? J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8553] [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: 11/20/2022] Open
Affiliation(s)
- L. Lau
- Children's Hospital at Westmead, Sydney, Australia
| | - P. Shaw
- Children's Hospital at Westmead, Sydney, Australia
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Bartels U, Hargrave D, Lau L, Esquembre C, Humpl T, Bouffet E. [Analysis of paediatric neuro-oncological information on the Internet in German language]. Klin Padiatr 2004; 215:352-7. [PMID: 14677102 DOI: 10.1055/s-2003-45491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The fast growing internet offers easy access to medical information. So far there are limited data concerning the quality of this information. This study examined quality and readability of paediatric neuro-oncological information on the internet in german language. METHOD Using the search terms "medulloblastoma", "ependymoma", "craniopharyngeoma", "brainstem glioma" and "low grade astrocytoma" in six different search engines, the first 30 universal/uniform resource locators (URLs) of each search engine were assessed. Appropriate Web sites were evaluated in regards to quality using DISCERN-Instrument and checklist rating system. Readability was rated by Flesch Reading Ease score. RESULTS Out of 889,56 web sites remained evaluable. Most of the sites rated as poor to very poor (49 %), 30 % rated as fair and 21 % as good to very good. Readability was scored as very difficult with complex vocabulary content limiting the usefulness of good web sites. CONCLUSIONS Search-ing for childhood brain tumours via internet is time consuming and most often ineffective. There is a lack of high-quality and comprehensible information on childhood brain tumours on german web sites. Cooperation of scientific medical societies and the Federal Ministry of Health is essential to provide comprehensible and high-quality information on internet as an effective and supportive resource for patients and their relatives.
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Affiliation(s)
- U Bartels
- Division of Haematology-Oncology, The Hospital for Sick Children, Toronto, Kanada.
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Delvaux M, Henket M, Lau L, Kange P, Bartsch P, Djukanovic R, Louis R. Nebulised salbutamol administered during sputum induction improves bronchoprotection in patients with asthma. Thorax 2004; 59:111-5. [PMID: 14760148 PMCID: PMC1746927 DOI: 10.1136/thorax.2003.011130] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [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 Inhalation of hypertonic or even isotonic saline during sputum induction may cause bronchospasm in susceptible patients with asthma, despite premedication with 400 microg inhaled salbutamol delivered by pressurised metered dose inhaler (pMDI). The bronchoprotection afforded by additional inhaled salbutamol administered through the ultrasonic nebuliser during sputum induction was investigated. METHODS Twenty patients with moderate to severe asthma underwent sputum induction by inhaling saline 4.5% (or 0.9% if post-bronchodilation forced expiratory volume in 1 second (FEV1) <65% predicted) for 10 minutes according to two protocols given 1 week apart in random order. At visit A the patients received 400 microg salbutamol administered through a pMDI+spacer 20 minutes before induction while at visit B the premedication was supplemented by 1500 microg nebulised salbutamol inhaled throughout the induction procedure. Both the investigator and the patients were blind to the nebulised solution used. FEV1 was recorded during sputum induction at 1, 3, 5, and 10 minutes. Sputum cell counts and histamine, tryptase and albumin levels in the supernatants were determined. RESULTS The mean (SE) maximal reduction in FEV1 over the 10 minute period of sputum induction was 11.7 (2.8)% at visit A, which was significantly greater than at visit B (2.6 (1.2)%; mean difference 9% (95% CI 2.7 to 15.4), p<0.01). Total and differential sputum cell counts as well as albumin, tryptase, and histamine levels did not differ between the two visits. CONCLUSION The addition of inhaled salbutamol through an ultrasonic nebuliser markedly improves bronchoprotection against saline induced bronchoconstriction in patients with moderate to severe asthma undergoing sputum induction without affecting cell counts and inflammatory markers.
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Affiliation(s)
- M Delvaux
- Department of Pneumology, CHU Sart-Tilman, Liege, Belgium
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Salib R, Salagean M, Lau L, DiGiovanna I, Brennan N, Scadding G, Howarth P. The anti-inflammatory response of anti-eotaxin monoclonal antibody CAT-213 on nasal allergen-induced cell infiltration and activation. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)81276-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- P Dure-Smith
- Jerry L. Pettis Memorial VAMC, Department of Radiology, Loma Linda University Medical Center, CA 92354, USA
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Bleakley M, Lau L, Shaw PJ, Kaufman A. Bone marrow transplantation for paediatric AML in first remission: a systematic review and meta-analysis. Bone Marrow Transplant 2002; 29:843-52. [PMID: 12058234 DOI: 10.1038/sj.bmt.1703528] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2001] [Accepted: 01/24/2002] [Indexed: 11/08/2022]
Abstract
For children with AML in CR1, the major consolidation therapies are BMT, ABMT and intensive chemotherapy. The relative effectiveness of these strategies is still debated. We conducted a systematic review and meta-analysis of trials to determine the effectiveness of BMT and ABMT in CR1 in paediatric AML. Eligible studies enrolled patients <21 years from 1985 to 2000 with AML in CR1. Two groups of studies were identified: (1) Those comparing the outcome of patients with and without a histocompatible family donor; and (2) Randomised controlled trials (RCT) comparing ABMT with non-myeloablative chemotherapy. The relative risk statistic was calculated for outcomes of interest in each trial. If there was no excessive heterogeneity between trials the results were pooled, and an overall relative risk and risk difference for treatment effect across trials were calculated. Results of the analysis showed that allocation to BMT reduced risk of relapse and improved disease-free and overall survival. For ABMT, heterogeneity of effect between RCTs prevented pooling of results. In conclusion, BMT from a histocompatible family donor improves patient outcome. Data are insufficient to determine whether this is true for all subgroups of AML, and whether ABMT is superior to non-myeloablative chemotherapy. An individual patient data meta-analysis is required to further evaluate the available data.
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Affiliation(s)
- M Bleakley
- Oncology Unit, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Lau L, Jan G, Chan TF. Preparation of patients for anaesthesia - achieving quality care. Hong Kong Med J 2002; 8:99-105. [PMID: 11937664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Implementation of anaesthesia begins with a preoperative assessment of the surgical patient and development of an anaesthetic plan. Preparation of the patient includes the preoperative assessment, review of preoperative tests, optimisation of medical conditions, adequate preoperative fasting, appropriate premedication, and the explanation of anaesthetic risk to patients. The goals of preoperative preparation are to reduce the morbidity of surgery, to increase the quality while decreasing the cost of perioperative care, and to return the patient to desirable functioning as quickly as possible. A knowledgeable anaesthesiologist is the 'final clinical gatekeeper', who coordinates perioperative management and ensures that the patient is in the optimal state for anaesthesia and surgery.
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Affiliation(s)
- L Lau
- Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Tsing Chung Koon Road, Hong Kong
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Cataldo D, Foidart JM, Lau L, Bartsch P, Djukanovic R, Louis R. Induced sputum: comparison between isotonic and hypertonic saline solution inhalation in patients with asthma. Chest 2001; 120:1815-21. [PMID: 11742907 DOI: 10.1378/chest.120.6.1815] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/01/2022] Open
Abstract
BACKGROUND Sputum induction by hypertonic saline solution inhalation is widely used to study airways secretions in patients with asthma. However, hypertonic saline solution is a potent indirect bronchoconstrictor. STUDY OBJECTIVES We studied the validity of isotonic saline solution (0.9%) inhalation as a means to induce sputum by comparing it to hypertonic saline solution (4.5%) inhalation. PATIENTS Sixteen patients with moderate-to-severe asthma reporting a clinical history of mucus hypersecretion. METHODS Subjects underwent sputum induction twice at 1-week intervals. Saline solution (hypertonic or isotonic) was inhaled for three periods of 5 min. The parameters assessed in sputum samples were cell counts, sodium, eosinophil cationic protein (ECP), and albumin concentrations, osmolality, and pro-matrix metalloproteinase (MMP)-9 activity by zymography. RESULTS The maximal fall in peak expiratory flow during sputum induction was greater after inhalation of hypertonic saline solution than after inhalation of isotonic saline solution (p < 0.01). Each subject produced analyzable sputum on both visits. There were no statistically significant differences in total and differential sputum cell counts, and the reproducibility coefficients were high for eosinophils and neutrophils when comparing the two methods. Likewise, sputum levels of ECP and albumin as well as sputum pro-MMP-9 activity were not different between the two methods, and were highly reproducible as shown by high intraclass coefficients (Ri) of correlation (0.72, 0.74, and 0.77 for ECP, albumin, and pro-MMP-9, respectively). Sputum sodium concentrations and osmolality were higher after inhalation of hypertonic saline solution (p < 0.05). CONCLUSION In patients with moderate-to-severe asthma reporting a clinical history of mucus hypersecretion, inducing sputum by isotonic or hypertonic saline solution inhalation leads to comparable results in eosinophil and neutrophil cell counts and fluid phase mediators/proteins.
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Affiliation(s)
- D Cataldo
- Department of Pneumology, University of Liège, Liège, Belgium.
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Ayer-Lelievre C, Brigstock D, Lau L, Pennica D, Perbal B, Yeger H. Report and abstracts on the first international workshop on the CCN family of genes. Mol Pathol 2001; 54:105-20. [PMID: 11322166 PMCID: PMC1187012 DOI: 10.1136/mp.54.2.105] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - D Brigstock
- Department of Surgery, Ohio State University, Colombus, Ohio 43205, USA
| | - L Lau
- Department of Molecular Genetics, University of Illinois, Chicago, IL 60607, USA
| | - D Pennica
- Department of Molecular Oncology, Genetech, San Francisco, CA 94080 USA
| | - B Perbal
- Laboratoire d'Oncologie Virale et Moleculaire,UFR de Biochimie,Université Paris 7-D. Diderot,2 Place Jussieu, 75005 Paris,
| | - H Yeger
- Department of Paediatric Laboratory Medicine,Hospital for Sick Children, Toronto, Ontario M5G 1XG, Canada
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Corne JM, Lau L, Scott SJ, Davies R, Johnston SL, Howarth PH. The relationship between atopic status and IL-10 nasal lavage levels in the acute and persistent inflammatory response to upper respiratory tract infection. Am J Respir Crit Care Med 2001; 163:1101-7. [PMID: 11316643 DOI: 10.1164/ajrccm.163.5.9902047] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [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: 11/16/2022] Open
Abstract
We examined the influence of atopy on virus-induced airway inflammation by comparing the nasal response to naturally acquired upper respiratory tract infection in atopic and nonatopic subjects by measurement of cytokine, chemokine, and mediator levels in nasal lavage from 44 adults (23 atopic) taken during the acute and the convalescent phases of the common cold. Nasal aspirates were examined for the presence of upper respiratory viruses by RT-PCR. In atopic and nonatopic subjects there were increased levels of IL-1beta, IL-6, IL-8, TNF-alpha, RANTES, sICAM-1, MPO, ECP, IL-10, and IFN-gamma in nasal lavage during the acute compared with the convalescent phase (p < 0.001). During the acute phase histamine levels were significantly higher in the atopic than in the nonatopic subjects (p < 0.05), whereas IL-10 levels were significantly greater in the nonatopic than in the atopic subjects (p < 0.05). At convalescence levels of IL-1beta, IL-6, sICAM-1, ECP, RANTES and albumin were significantly higher in the atopic group (p < 0.05). An upper respiratory tract virus was found in 27 volunteers (61%) during the acute stage and in two volunteers (4%) at convalescence. We conclude that virus-induced inflammatory changes within the nose are more prolonged in atopic than in nonatopic subjects and that this is associated with reduced IL-10 levels in atopic compared with nonatopic subjects during the acute phase of upper respiratory tract infection.
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Affiliation(s)
- J M Corne
- University Medicine, Southampton General Hospital, Southampton, United Kingdom
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