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Esnault S, Jarjour NN. Development of Adaptive Immunity and Its Role in Lung Remodeling. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:287-351. [PMID: 37464127 DOI: 10.1007/978-3-031-32259-4_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Asthma is characterized by airflow limitations resulting from bronchial closure, which can be either reversible or fixed due to changes in airway tissue composition and structure, also known as remodeling. Airway remodeling is defined as increased presence of mucins-producing epithelial cells, increased thickness of airway smooth muscle cells, angiogenesis, increased number and activation state of fibroblasts, and extracellular matrix (ECM) deposition. Airway inflammation is believed to be the main cause of the development of airway remodeling in asthma. In this chapter, we will review the development of the adaptive immune response and the impact of its mediators and cells on the elements defining airway remodeling in asthma.
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Targeting Leukotrienes as a Therapeutic Strategy to Prevent Comorbidities Associated with Metabolic Stress. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1274:55-69. [PMID: 32894507 DOI: 10.1007/978-3-030-50621-6_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Leukotrienes (LTs) are potent lipid mediators that exert a variety of functions, ranging from maintaining the tone of the homeostatic immune response to exerting potent proinflammatory effects. Therefore, LTs are essential elements in the development and maintenance of different chronic diseases, such as asthma, arthritis, and atherosclerosis. Due to the pleiotropic effects of LTs in the pathogenesis of inflammatory diseases, studies are needed to discover potent and specific LT synthesis inhibitors and LT receptor antagonists. Even though most clinical trials using LT inhibitors or antagonists have failed due to low efficacy and/or toxicity, new drug development strategies are driving the discovery for LT inhibitors to prevent inflammatory diseases. A newly important detrimental role for LTs in comorbidities associated with metabolic stress has emerged in the last few years and managing LT production and/or actions could represent an exciting new strategy to prevent or treat inflammatory diseases associated with metabolic disorders. This review is intended to shed light on the synthesis and actions of leukotrienes, the most common drugs used in clinical trials, and discuss the therapeutic potential of preventing LT function in obesity, diabetes, and hyperlipidemia.
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Abstract
Asthma is a heterogeneous inflammatory disease of the airways that is associated with airway hyperresponsiveness and airflow limitation. Although asthma was once simply categorized as atopic or nonatopic, emerging analyses over the last few decades have revealed a variety of asthma endotypes that are attributed to numerous pathophysiological mechanisms. The classification of asthma by endotype is primarily routed in different profiles of airway inflammation that contribute to bronchoconstriction. Many asthma therapeutics target G protein-coupled receptors (GPCRs), which either enhance bronchodilation or prevent bronchoconstriction. Short-acting and long-acting β 2-agonists are widely used bronchodilators that signal through the activation of the β 2-adrenergic receptor. Short-acting and long-acting antagonists of muscarinic acetylcholine receptors are used to reduce bronchoconstriction by blocking the action of acetylcholine. Leukotriene antagonists that block the signaling of cysteinyl leukotriene receptor 1 are used as an add-on therapy to reduce bronchoconstriction and inflammation induced by cysteinyl leukotrienes. A number of GPCR-targeting asthma drug candidates are also in different stages of development. Among them, antagonists of prostaglandin D2 receptor 2 have advanced into phase III clinical trials. Others, including antagonists of the adenosine A2B receptor and the histamine H4 receptor, are in early stages of clinical investigation. In the past decade, significant research advancements in pharmacology, cell biology, structural biology, and molecular physiology have greatly deepened our understanding of the therapeutic roles of GPCRs in asthma and drug action on these GPCRs. This review summarizes our current understanding of GPCR signaling and pharmacology in the context of asthma treatment. SIGNIFICANCE STATEMENT: Although current treatment methods for asthma are effective for a majority of asthma patients, there are still a large number of patients with poorly controlled asthma who may experience asthma exacerbations. This review summarizes current asthma treatment methods and our understanding of signaling and pharmacology of G protein-coupled receptors (GPCRs) in asthma therapy, and discusses controversies regarding the use of GPCR drugs and new opportunities in developing GPCR-targeting therapeutics for the treatment of asthma.
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Affiliation(s)
- Stacy Gelhaus Wendell
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
| | - Hao Fan
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
| | - Cheng Zhang
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
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Lee JS, Tae SS, Kim DY, Han SK, Kim WK, Dhong ES. Do IL-3/GM-CSF effect on the myofibroblastic differentiation of human adipose derived stromal cells? Exp Cell Res 2017; 355:67-82. [PMID: 28377320 DOI: 10.1016/j.yexcr.2017.03.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Capsular contracture is an incurable complication after silicone-based implant surgery. Myofibroblast is the predominant cell in the contracted capsule. We hypothesized that human adipose derive stromal cells (hASCs) together with fibroblast may show a similar phenotypic characteristics of myofibroblast after the treatment of inflammatory cytokines in vitro. MATERIALS AND METHODS Interleukin 3 (IL-3) and granulocyte macrophage colony stimulating factor (GM-CSF) were treated in the culture of hASCs and HDFs. Lyn peptide inhibitor was applied as an inhibitor. The changes of cell surface markers (CD105, CD73, CD34, CD45, CD31, CD325 and CD146) were assessed. The expression of various cytokines related to wound contraction were tested such as TGF-β, α-SMA, HGF, FGF, ENT-1, and TSP-1. Myo-D, α-SMA, and glial fibrillary acidic protein (GFAP) were evaluated by blotting and immunocytochemical staining. The collagen-gel contraction assay was performed for the functional contraction of myofibroblastic phenotype. RESULTS The expression of α-SMA, Myo-D and GFAP after the treatment of IL-3/GM-CSF showed similar results in hASCs and HDFs. Enhanced expression of TGF- β was observed in HDFs and the increase of ENT-1 and TSP-1 was significant in hASCs. Collagen-gel with HDFs contracted significantly within 24h after the treatment of IL-3/GM-CSF, and the contraction was inhibited by Lyn peptide inhibitor. But in hASCs, the gel-contraction was not significant. CONCLUSION IL-3/ GM-CSF effected on the myofibroblastic differentiation of hASCs as well as it did on HDFs. But hASCs did not show the phenotypic gel-contraction within 24h.
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Affiliation(s)
- Jae-Sun Lee
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Son-Seung Tae
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Deok-Yeol Kim
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Seung-Kyu Han
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Woo-Kyung Kim
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Eun-Sang Dhong
- Department of Plastic Surgery, Korea University, Guro Hospital, Seoul, Republic of Korea.
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Hong M, Chen J, Zhou H, Xu H, Ren G. Investigation of a solution-mediated phase transformation of pranlukast DMF solvate to hemihydrate. CRYSTAL RESEARCH AND TECHNOLOGY 2017. [DOI: 10.1002/crat.201700045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Minghuang Hong
- Laboratory of Pharmaceutical Crystal Engineering & Technology; School of Pharmacy; East China University of Science and Technology; 130 Meilong Road Shanghai 200237
| | - Jingyan Chen
- Laboratory of Pharmaceutical Crystal Engineering & Technology; School of Pharmacy; East China University of Science and Technology; 130 Meilong Road Shanghai 200237
| | - Hui Zhou
- Laboratory of Pharmaceutical Crystal Engineering & Technology; School of Pharmacy; East China University of Science and Technology; 130 Meilong Road Shanghai 200237
| | - Hao Xu
- Laboratory of Pharmaceutical Crystal Engineering & Technology; School of Pharmacy; East China University of Science and Technology; 130 Meilong Road Shanghai 200237
| | - Guobin Ren
- Laboratory of Pharmaceutical Crystal Engineering & Technology; School of Pharmacy; East China University of Science and Technology; 130 Meilong Road Shanghai 200237
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Syk J, Malinovschi A, Borres MP, Undén AL, Andreasson A, Lekander M, Alving K. Parallel reductions of IgE and exhaled nitric oxide after optimized anti-inflammatory asthma treatment. IMMUNITY INFLAMMATION AND DISEASE 2016; 4:182-190. [PMID: 27933161 PMCID: PMC4879464 DOI: 10.1002/iid3.103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/15/2016] [Accepted: 02/17/2016] [Indexed: 11/05/2022]
Abstract
Immunoglobulin E (IgE) is crucial for the development of airway inflammation in atopic asthma, and inhibition of IgE using monoclonal antibodies is now part of asthma therapy. However, the impact of ordinary anti-inflammatory treatment on IgE is unclear. The aim of this study was to investigate if optimization of treatment with inhaled corticosteroid (ICS) and leukotriene-receptor antagonist (LTRA) according to symptoms or exhaled nitric oxide (FENO) levels over a one-year period affects IgE concentrations. Altogether, 158 relatively well-controlled but multi-sensitized asthmatics (age 18-65 years), with ongoing ICS treatment at baseline, were included in this post hoc analysis of data from a randomized, controlled trial on FENO-guided asthma therapy. Asthma control and quality of life (Juniper ACQ and mAQLQ), FENO, and serum IgE were measured at baseline and after one year. Concentrations of IgE antibodies to six common perennial aeroallergens were summed up (perennial IgE). We found that perennial and total IgE decreased by 10.2% and 16.0% (P < .001 both comparisons). This was not related to allergen exposure, whereas the total use of ICS and LTRA during the year correlated with the reduction in perennial IgE (P = .030 and P = .013). The decrease in perennial and total IgE correlated significantly with the reduction in FENO (P < .003 and P < .001), and with improvements in ACQ and mAQLQ scores (P < 0.05, all comparisons). We conclude that one year of optimization of treatment with ICS and LTRA in patients with persistent atopic asthma resulted in significant decreases in total IgE and IgE antibodies; these decreases correlated with a reduction in FENO and improvements in asthma control and quality of life. Thus, IgE is reduced by ordinary asthma controller medications and the effect on IgE seems to be clinically important.
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Affiliation(s)
- Jörgen Syk
- Department of NeurobiologyCare Sciences and Society, Karolinska InstitutetStockholmSweden; Centre for Allergy Research, Karolinska InstitutetStockholmSweden
| | - Andrei Malinovschi
- Department of Medical Sciences Clinical Physiology, Uppsala University Uppsala Sweden
| | - Magnus P Borres
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Anna-Lena Undén
- Department of Neurobiology Care Sciences and Society, Karolinska Institutet Stockholm Sweden
| | - Anna Andreasson
- Department of NeurobiologyCare Sciences and Society, Karolinska InstitutetStockholmSweden; Stress Research InstituteStockholm UniversityStockholmSweden
| | - Mats Lekander
- Stress Research InstituteStockholm UniversityStockholmSweden; Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Kjell Alving
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Lee JH, Kim HJ, Kim YH. The Effectiveness of Anti-leukotriene Agents in Patients with COPD: A Systemic Review and Meta-analysis. Lung 2015; 193:477-86. [DOI: 10.1007/s00408-015-9743-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/05/2015] [Indexed: 11/29/2022]
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Furuta H, Mori S, Yoshihashi Y, Yonemochi E, Uekusa H, Sugano K, Terada K. Physicochemical and crystal structure analysis of pranlukast pseudo-polymorphs II: Solvate and cocrystal. J Pharm Biomed Anal 2015; 111:44-50. [PMID: 25854856 DOI: 10.1016/j.jpba.2015.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 03/06/2015] [Accepted: 03/09/2015] [Indexed: 11/25/2022]
Abstract
Pranlukast (PRS) is a leukotriene receptor antagonist for the treatment of bronchial asthma. In this study, six new solvates and one new cocrystal of PRS were characterized by PXRD, TG-DTA, DSC, vapor sorption analysis and the dissolution test. In addition, the crystal structures were determined by single crystal X-ray structure analysis. PRS was found to be a rare example of a promiscuous multicomponent crystal former. The crystal packing patterns of these crystals can be categorized into the sheet-like and channel-like patterns. The ethanol solvate (PRS/ethanol) and urea cocrystal (PRS/urea) were more stable than the others under humid conditions. PRS/ethanol showed an improved dissolution profile compared to PRS HH and PRS/urea.
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Affiliation(s)
- Hideaki Furuta
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
| | - Shintaro Mori
- Graduate School of Science and Engineering, Department of Chemistry and Materials Science, Tokyo Institute of Technology, 12-1-H62, Ookayama 2, Meguro-ku, Tokyo 152-8551, Japan
| | - Yasuo Yoshihashi
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
| | - Etsuo Yonemochi
- School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41, Ebara, Shinagawa, Tokyo 142-8501, Japan
| | - Hidehiro Uekusa
- Graduate School of Science and Engineering, Department of Chemistry and Materials Science, Tokyo Institute of Technology, 12-1-H62, Ookayama 2, Meguro-ku, Tokyo 152-8551, Japan
| | - Kiyohiko Sugano
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan.
| | - Katsuhide Terada
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
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Shi QJ, Wang H, Liu ZX, Fang SH, Song XM, Lu YB, Zhang WP, Sa XY, Ying HZ, Wei EQ. HAMI 3379, a CysLT2R antagonist, dose- and time-dependently attenuates brain injury and inhibits microglial inflammation after focal cerebral ischemia in rats. Neuroscience 2015; 291:53-69. [PMID: 25681271 DOI: 10.1016/j.neuroscience.2015.02.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/19/2015] [Accepted: 02/02/2015] [Indexed: 12/29/2022]
Abstract
Cysteinyl leukotrienes (CysLTs) induce inflammatory responses by activating their receptors, CysLT1R and CysLT2R. We have reported that CysLT2R is involved in neuronal injury, astrocytosis, and microgliosis, and that intracerebroventricular (i.c.v.) injection of the selective CysLT2R antagonist HAMI 3379 protects against acute brain injury after focal cerebral ischemia in rats. In the present study, we clarified features of the protective effect of intraperitoneally-injected HAMI 3379 in rats. We found that HAMI 3379 attenuated the acute brain injury 24 h after middle cerebral artery occlusion (MCAO) with effective doses of 0.1-0.4 mg/kg and a therapeutic window of ∼1h. It attenuated the neurological deficits, and reduced infarct volume, brain edema, and neuronal loss and degeneration 24 and 72h after MCAO. RNA interference with i.c.v. injection of CysLT2R short hairpin RNA (shRNA) attenuated the acute injury as well. Also, HAMI 3379 inhibited release of the cytokines IL-1β, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) into the serum and cerebrospinal fluid 24h after MCAO. Moreover, HAMI 3379 ameliorated the microglial activation and neutrophil accumulation in the ischemic regions, but did not affect astrocyte proliferation 72h after MCAO. In comparison, the CysLT1R antagonist pranlukast did not affect microglial activation and IFN-γ release, but inhibited astrocyte proliferation and reduced serum IL-4. Thus, we conclude that HAMI 3379 has a protective effect on acute and subacute ischemic brain injury, and attenuates microglia-related inflammation. CysLT2R antagonist(s) alone or in combination with CysLT1R antagonists may be a novel class of therapeutic agents in the treatment of ischemic stroke.
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Affiliation(s)
- Q J Shi
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China; Experimental Animal Center, Zhejiang Academy of Medical Sciences, 182 Tianmushan Road, Hangzhou 310013, China
| | - H Wang
- Department of Neurology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Z X Liu
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China
| | - S H Fang
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China
| | - X M Song
- Experimental Animal Center, Zhejiang Academy of Medical Sciences, 182 Tianmushan Road, Hangzhou 310013, China
| | - Y B Lu
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China
| | - W P Zhang
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China
| | - X Y Sa
- Experimental Animal Center, Zhejiang Academy of Medical Sciences, 182 Tianmushan Road, Hangzhou 310013, China
| | - H Z Ying
- Experimental Animal Center, Zhejiang Academy of Medical Sciences, 182 Tianmushan Road, Hangzhou 310013, China
| | - E Q Wei
- Department of Pharmacology, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, China.
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Liu M, Yokomizo T. The role of leukotrienes in allergic diseases. Allergol Int 2015; 64:17-26. [PMID: 25572555 DOI: 10.1016/j.alit.2014.09.001] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/18/2022] Open
Abstract
Leukotrienes (LTs), both LTB4 and the cysteinyl LTs (CysLTs) LTC4, LTD4 and LTE4, are implicated in a wide variety of inflammatory disorders. These lipid mediators are generated from arachidonic acid via multistep enzymatic reactions through which arachidonic acid is liberated from membrane phospholipids through the action of phospholipase A2. LTB4 and CysLTs exert their biological effects by binding to cognate receptors, which belong to the G protein-coupled receptor superfamily. LTB4 is widely considered to be a potent chemoattractant for most subsets of leukocytes, whereas CysLTs are potent bronchoconstrictors that have effects on airway remodeling. LTs play a central role in the pathogenesis of asthma and many other inflammatory diseases. This review will provide an update on the synthesis, biological function, and relevance of LTs to the pathobiology of allergic diseases, and examine the current and future therapeutic prospects of LT modifiers.
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Affiliation(s)
- Min Liu
- Department of Biochemistry, Juntendo University School of Medicine, Tokyo, Japan; Department of Respiratory Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Takehiko Yokomizo
- Department of Biochemistry, Juntendo University School of Medicine, Tokyo, Japan.
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Furuta H, Mori S, Yoshihashi Y, Yonemochi E, Uekusa H, Sugano K, Terada K. Physicochemical and crystal structure analysis of pranlukast pseudo-polymorphs I: anhydrates and hydrate. J Pharm Biomed Anal 2014; 107:11-6. [PMID: 25562844 DOI: 10.1016/j.jpba.2014.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 12/01/2014] [Accepted: 12/05/2014] [Indexed: 11/17/2022]
Abstract
Pranlukast (PRS) is a leukotriene receptor antagonist for the treatment of bronchial asthma. Pranlukast is formulated as a hemihydrate (HH) form in the drug product. Here, we report three new anhydrate forms of PRS (AH, form I-III). These polymorphs and PRS HH were characterized by PXRD, TG-DTA, simultaneous PXRD-DSC and vapor sorption analysis. In addition, the crystal structures of HH and AH-I were determined by single crystal X-ray structure analysis for the first time. HH transformed to AH-I, AH-II and AH-III as the temperature was increased from 25°C to 210°C. At 25°C, AH-I transformed to HH at above 5%RH. HH and AH-I possessed similar crystal packing patterns and molecular structures.
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Affiliation(s)
- Hideaki Furuta
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
| | - Shintaro Mori
- Graduate School of Science and Engineering, Department of Chemistry and Materials Science, Tokyo Institute of Technology, 12-1-H62, Ookayama 2, Meguro-ku, Tokyo 152-8551, Japan
| | - Yasuo Yoshihashi
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
| | - Etsuo Yonemochi
- School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41, Ebara, Shinagawa, Tokyo 142-8501, Japan
| | - Hidehiro Uekusa
- Graduate School of Science and Engineering, Department of Chemistry and Materials Science, Tokyo Institute of Technology, 12-1-H62, Ookayama 2, Meguro-ku, Tokyo 152-8551, Japan
| | - Kiyohiko Sugano
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan.
| | - Katsuhide Terada
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1, Miyama, Funabashi, Chiba 274-8510, Japan
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12
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Kawano T, Matsuse H, Tsuchida T, Fukahori S, Fukushima C, Nishino T, Kohno S. Cysteinyl leukotriene receptor antagonist regulates allergic airway inflammation in an organ- and cytokine-specific manner. Med Sci Monit 2014; 20:297-302. [PMID: 24561545 PMCID: PMC3937047 DOI: 10.12659/msm.889865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Cysteinyl leukotrienes (cys-LTs) are very important factors in the pathophysiology of bronchial asthma. Cys-LT receptor antagonists (LTRAs) decrease allergic airway inflammation. The aim of the present study was to determine the differential effects of LTRAs and corticosteroids on allergic airway inflammation and allergen-specific cytokine production from lymphoid tissues using a murine model of asthma. Material/Methods Four groups of female BALB/c mice [control (Cont); Dermatophagoides farinae allergen-sensitized (AS); pranlukast (Prl), an LTRA-treated AS; and dexamethasone (Dex)-treated AS] were examined. Lung pathology and cytokine production by prepared mononuclear cells isolated from mediastinal lymph nodes (MLNs) and spleen were compared among these groups. Results AS mice exhibited allergic airway inflammation and significant increases in allergen-specific Th1 and Th2 cytokines in MLNs and spleen. Prl-treated mice showed significant attenuation of allergic airway inflammation concomitant with reduction of Th2 cytokines and IFN-γ in MLNs but not in spleen. In contrast, Dex significantly decreased Th1 and Th2 cytokines in MLNs and also decreased them (except IL-13 and IL-2) in spleen. Conclusions The inflammatory effects of cys-LTs could differ in lymphoid organs. LTRAs potentially regulate allergic airway inflammation in an organ- and cytokine-specific manner, while systemic corticosteroid shows nonspecific effects.
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Affiliation(s)
- Tetsuya Kawano
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroto Matsuse
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoko Tsuchida
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Susumu Fukahori
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Chizu Fukushima
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoya Nishino
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shigeru Kohno
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Pathomthongtaweechai N, Soodvilai S, Chatsudthipong V, Muanprasat C. Pranlukast inhibits renal epithelial cyst progression via activation of AMP-activated protein kinase. Eur J Pharmacol 2014; 724:67-76. [DOI: 10.1016/j.ejphar.2013.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/01/2013] [Accepted: 12/04/2013] [Indexed: 02/06/2023]
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Lone AM, Taskén K. Proinflammatory and immunoregulatory roles of eicosanoids in T cells. Front Immunol 2013; 4:130. [PMID: 23760108 PMCID: PMC3671288 DOI: 10.3389/fimmu.2013.00130] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/17/2013] [Indexed: 01/08/2023] Open
Abstract
Eicosanoids are inflammatory mediators primarily generated by hydrolysis of membrane phospholipids by phospholipase A2 to ω-3 and ω-6 C20 fatty acids that next are converted to leukotrienes (LTs), prostaglandins (PGs), prostacyclins (PCs), and thromboxanes (TXAs). The rate-limiting and tightly regulated lipoxygenases control synthesis of LTs while the equally well-controlled cyclooxygenases 1 and 2 generate prostanoids, including PGs, PCs, and TXAs. While many of the classical signs of inflammation such as redness, swelling, pain, and heat are caused by eicosanoid species with vasoactive, pyretic, and pain-inducing effects locally, some eicosanoids also regulate T cell functions. Here, we will review eicosanoid production in T cell subsets and the inflammatory and immunoregulatory functions of LTs, PGs, PCs, and TXAs in T cells.
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Affiliation(s)
- Anna Mari Lone
- Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo and Oslo University Hospital , Oslo , Norway ; Biotechnology Centre, University of Oslo , Oslo , Norway ; K.G. Jebsen Inflammation Research Centre, University of Oslo , Oslo , Norway
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Ismail N, Jambari NN, Zareen S, Akhtar MN, Shaari K, Zamri-Saad M, Tham CL, Sulaiman MR, Lajis NH, Israf DA. A geranyl acetophenone targeting cysteinyl leukotriene synthesis prevents allergic airway inflammation in ovalbumin-sensitized mice. Toxicol Appl Pharmacol 2012; 259:257-62. [PMID: 22266348 DOI: 10.1016/j.taap.2012.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/27/2011] [Accepted: 01/03/2012] [Indexed: 11/18/2022]
Abstract
Asthma is associated with increased pulmonary inflammation and airway hyperresponsiveness. The current use of corticosteroids in the management of asthma has recently raised issues regarding safety and lack of responsiveness in 5-10% of asthmatic individuals. The aim of the present study was to investigate the therapeutic effect of a non-steroidal small molecule that has cysteinyl leukotriene (cysLT) inhibitory activity, upon attenuation of allergic lung inflammation in an acute murine model. Mice were sensitized with ovalbumin (OVA) and treated with several intraperitoneal doses (100, 20, 2 and 0.2mg/kg) of 2,4,6,-trihydroxy-3-geranylacetophenone (tHGA). Bronchoalveolar lavage was performed, blood and lung samples were obtained and respiratory function was measured. OVA sensitization increased pulmonary inflammation and pulmonary allergic inflammation was significantly reduced at doses of 100, 20 and 2mg/kg with no effect at the lowest dose of 0.2mg/kg. The beneficial effects in the lung were associated with reduced eosinophilic infiltration and reduced secretion of Th2 cytokines and cysLTs. Peripheral blood reduction of total IgE was also a prominent feature. Treatment with tHGA significantly attenuated altered airway hyperresponsiveness as measured by the enhanced pause (Penh) response to incremental doses of methacholine. These data demonstrate that tHGA, a synthetic non-steroidal small molecule, can prevent acute allergic inflammation. This proof of concept opens further avenues of research and development of tHGA as an additional option to the current armamentarium of anti-asthma therapeutics.
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Affiliation(s)
- Norazren Ismail
- Department of Biomedical Science, Putra Malaysia, Serdang, Selangor, Malaysia
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16
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Yamakawa Y, Ohtsuka Y, Ohtani K, Fujii T, Nagata S, Yamashiro Y, Shimizu T. Effects of leukotriene receptor antagonists on peripheral eosinophil counts and serum IgE levels in children with food allergy. Drugs R D 2011; 10:147-54. [PMID: 20945945 PMCID: PMC3586155 DOI: 10.2165/11586150-000000000-00000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although the efficacy of leukotriene receptor antagonists (LTRAs) for bronchial asthma is already established, their effect on food allergy remains unclear. OBJECTIVE To investigate the efficacy of LTRAs in children with food allergy. METHODS This retrospective study examined 65 children with food allergy who were aged between 3 and 36 months (mean 14 ± 9.6 months) from 2005 to 2008. Thirty-two children were treated as a dietary control group by avoiding any antigenic foods to which they had previously experienced adverse reactions. The remaining 33 children, designated the LTRA group, were treated with pranlukast (7 mg/kg bodyweight/day) in addition to maintaining dietary control. Clinical symptoms and laboratory data before and after 1 year of treatment were compared between the groups. RESULTS Allergic symptoms improved in both the dietary controlled and LTRA groups, and there was no significant difference observed in the clinical parameters examined between the groups after the 1-year trial. Peripheral eosinophil count, serum IgE, interleukin (IL)-4, IL-5, IL-6, and eosinophil cationic protein (ECP) levels in children with food allergy were above standardized values in both groups. Although both the dietary controlled and LTRA groups showed a decreased eosinophil count (-273 ± 232 vs -595 ± 295/μL; p < 0.05 and p < 0.001, respectively), only children treated with LTRA showed a significant decrease in serum IgE (-73.5 ± 115 IU/mL; p < 0.01); conversely, the control group exhibited a significant increase in serum IgE (+159 ± 138 IU/mL; p < 0.01). Furthermore, the LTRA group also showed a significant decrease in serum IL-4 (54.5 ± 31.0 to 27.3 ± 10.1 pg/mL), IL-5 (6.7 ± 5.2 to 5.0 ± 0.4 pg/mL), and ECP (45.4 ± 15.0 to 15.0 ± 9.8 μg/L) levels (p < 0.05 for each). CONCLUSION Early intervention with LTRAs may be effective in regulating eosinophil count and serum IgE, IL-4, IL-5, and ECP levels. These data support the potential effectiveness of LTRAs in young children with food allergy to prevent further allergic development.
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Affiliation(s)
- Yoko Yamakawa
- Department of Pediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
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17
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Kiwamoto T, Ishii Y, Morishima Y, Yoh K, Kikuchi N, Haraguchi N, Masuko H, Kawaguchi M, Nomura A, Sakamoto T, Takahashi S, Hizawa N. Blockade of cysteinyl leukotriene-1 receptors suppresses airway remodelling in mice overexpressing GATA-3. Clin Exp Allergy 2011; 41:116-28. [PMID: 20636401 DOI: 10.1111/j.1365-2222.2010.03571.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND We demonstrated previously that GATA-3 overexpression markedly enhanced allergen-induced airway inflammation and airway remodelling, including subepithelial fibrosis, and smooth muscle cell hyperplasia, in transgenic mice. OBJECTIVE Because cysteinyl leukotrienes (cysLTs) have been shown to be involved in such structural changes, the effects of a specific cysLT1 receptor antagonist, montelukast, were evaluated in a mouse model of chronic asthma. METHODS GATA-3-overexpressing mice and wild-type Balb/c mice were sensitized and repeatedly challenged by ovalbumin (OVA) or saline. The effects of montelukast on the development of airway remodelling were compared between the two mouse genotypes. RESULTS CysLTs in the lung were increased after repeated allergen challenges, and significantly enhanced in GATA-3-overexpressing mice. The enhanced cysLT levels were accompanied by the development of eosinophilia, smooth muscle cell hyperplasia, and increased stromal cell-derived factor-1 gene expression with a small increase in pro-collagen gene expression in OVA-challenged GATA-3-overexpressing mice, but not in wild-type mice. Montelukast significantly decreased lung cysLT levels and inhibited the GATA-3-overexpression-related airway remodelling, potently preventing smooth muscle cell hyperplasia, but partially suppressed the increased pro-collagen gene expression and eosinophilic inflammation. Increases in the levels of IL-4, IL-5, IL-13, and eotaxin in bronchial lavage and TGF-β gene expression in the lungs were induced by OVA in both mouse genotypes. Montelukast treatment also significantly reduced these levels to the levels seen after saline challenges in GATA-3-overexpressing mice. CONCLUSION Montelukast efficaciously prevented airway inflammation and remodelling in a GATA-3-overexpression antigen challenge mouse model by decreasing the cysLT-driven Th2 cytokine cycle of amplification of airway pathologies.
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Affiliation(s)
- T Kiwamoto
- Department of Respiratory Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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18
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Moore BB, Peters-Golden M. Opposing roles of leukotrienes and prostaglandins in fibrotic lung disease. Expert Rev Clin Immunol 2010; 2:87-100. [PMID: 20477090 DOI: 10.1586/1744666x.2.1.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Lung fibrosis is a devastating disease that involves a variable degree of inflammation, alveolar epithelial injury, fibroblast hyperplasia and the deposition of extracellular matrix. Standard therapies that consist of corticosteroids and immunosuppressive agents offer little benefit and most patients experience a progressive deterioration in lung function which is ultimately fatal within 2-5 years of diagnosis. New pathogenetic insights and therapeutic approaches are badly needed. Eicosanoids are lipid mediators derived from arachidonic acid metabolism, the best studied of which are prostaglandins and leukotrienes. Although these mediators are primarily known for their roles in asthma, pain, fever and vascular responses, they also exert relevant effects on immune and inflammatory cells as well as structural cells such as epithelial cells and fibroblasts - cell types which participate in fibrogenesis. In general, leukotrienes promote while prostaglandin E(2) opposes fibrogenic responses. Lung fibrosis is associated with increased production of leukotrienes and decreased production of prostaglandin E(2). Furthermore, responses to prostaglandin E(2) are altered in fibrotic conditions. This review highlights the role of this leukotriene/prostaglandin imbalance in the evolution of fibrotic lung disease, offers insights into the mechanisms that underlie the dysregulated responses and discusses approaches for therapeutic targeting of eicosanoids in these conditions.
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Affiliation(s)
- Bethany B Moore
- Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, 6220 MSRB III, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-0642, USA.
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19
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Caramori G, Groneberg D, Ito K, Casolari P, Adcock IM, Papi A. New drugs targeting Th2 lymphocytes in asthma. J Occup Med Toxicol 2008; 3 Suppl 1:S6. [PMID: 18315837 PMCID: PMC2259400 DOI: 10.1186/1745-6673-3-s1-s6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Asthma represents a profound worldwide public health problem. The most effective anti-asthmatic drugs currently available include inhaled beta2-agonists and glucocorticoids and control asthma in about 90-95% of patients. The current asthma therapies are not cures and symptoms return soon after treatment is stopped even after long term therapy. Although glucocorticoids are highly effective in controlling the inflammatory process in asthma, they appear to have little effect on the lower airway remodelling processes that appear to play a role in the pathophysiology of asthma at currently prescribed doses. The development of novel drugs may allow resolution of these changes. In addition, severe glucocorticoid-dependent and resistant asthma presents a great clinical burden and reducing the side-effects of glucocorticoids using novel steroid-sparing agents is needed. Furthermore, the mechanisms involved in the persistence of inflammation are poorly understood and the reasons why some patients have severe life threatening asthma and others have very mild disease are still unknown. Drug development for asthma has been directed at improving currently available drugs and findings new compounds that usually target the Th2-driven airway inflammatory response. Considering the apparently central role of T lymphocytes in the pathogenesis of asthma, drugs targeting disease-inducing Th2 cells are promising therapeutic strategies. However, although animal models of asthma suggest that this is feasible, the translation of these types of studies for the treatment of human asthma remains poor due to the limitations of the models currently used. The myriad of new compounds that are in development directed to modulate Th2 cells recruitment and/or activation will clarify in the near future the relative importance of these cells and their mediators in the complex interactions with the other pro-inflammatory/anti-inflammatory cells and mediators responsible of the different asthmatic phenotypes. Some of these new Th2-oriented strategies may in the future not only control symptoms and modify the natural course of asthma, but also potentially prevent or cure the disease.
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Affiliation(s)
- Gaetano Caramori
- Dipartimento di Medicina Clinica e Sperimentale, Centro di Ricerca su Asma e BPCO, Università di Ferrara, Ferrara, Italy
| | - David Groneberg
- Institute of Occupational Medicine, Charité- Universitätsmedizin Berlin, Free University and Humboldt University, Berlin, Germany
| | - Kazuhiro Ito
- Airway Disease Section, National Heart and Lung Institute, Imperial College of London, London, UK
| | - Paolo Casolari
- Dipartimento di Medicina Clinica e Sperimentale, Centro di Ricerca su Asma e BPCO, Università di Ferrara, Ferrara, Italy
| | - Ian M Adcock
- Airway Disease Section, National Heart and Lung Institute, Imperial College of London, London, UK
| | - Alberto Papi
- Dipartimento di Medicina Clinica e Sperimentale, Centro di Ricerca su Asma e BPCO, Università di Ferrara, Ferrara, Italy
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20
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Ichiyama T, Kajimoto M, Hasegawa M, Hashimoto K, Matsubara T, Furukawa S. Cysteinyl leukotrienes enhance tumour necrosis factor-alpha-induced matrix metalloproteinase-9 in human monocytes/macrophages. Clin Exp Allergy 2007; 37:608-14. [PMID: 17430359 DOI: 10.1111/j.1365-2222.2007.02692.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) is an important enzyme responsible for airway remodelling. Monocytes/macrophages have a cysteinyl leukotriene 1 (cysLT1) receptor, but its function is poorly understood. OBJECTIVE To elucidate the function of the cysLT1 receptor of human monocytes/macrophages in MMP-9 production. METHODS We examined the effect of cysLTs (LTC4, -D4 and -E4) on TNF-alpha-induced MMP-9 production in THP-1 cells, a human monocytic leukaemia cell line and peripheral blood CD14+ monocytes/macrophages. In addition, we examined the effect of pranlukast, a cysLT1 receptor antagonist, on the enhancement of TNF-alpha-induced MMP-9 production by cysLTs. RESULTS ELISA revealed that LTC4 and -D4, but not -E4, enhanced TNF-alpha-induced MMP-9 production in THP-1 cells and peripheral blood CD14+ monocytes/macrophages. Real-time polymerase chain reaction demonstrated that LTC4 and -D4, but not -E4, increased MMP-9 mRNA expression induced by TNF-alpha in THP-1 cells. Moreover, we demonstrated that pranlukast completely inhibited the enhancement of TNF-alpha-induced MMP-9 production by LTC4 and -D4 in THP-1 cells and peripheral blood CD14+ monocytes/macrophages. CONCLUSION LTC4 and -D4 enhanced the TNF-alpha-induced MMP-9 production via binding the cysLT1 receptor in human monocytes/macrophages. Pranlukast inhibited the enhancements by LTC4 and D4.
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Affiliation(s)
- T Ichiyama
- Department of Pediatrics, Yamaguchi University School of Medicine, Yamaguchi, Japan.
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21
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Or R, Gesundheit B, Resnick I, Bitan M, Avraham A, Avgil M, Sacks Z, Shapira MY. Sparing effect by montelukast treatment for chronic graft versus host disease: a pilot study. Transplantation 2007; 83:577-81. [PMID: 17353777 DOI: 10.1097/01.tp.0000255575.03795.df] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic graft versus host disease (GvHD) is a major complication after allogeneic stem cell transplantation (SCT), which is usually progression from acute GvHD. Chronic GvHD is the main cause of severe morbidity and mortality in long-term survivors after SCT. The cysteinyl leukotrienes (cysLTs) and eosinophils play an important role in the pathogenesis of GvHD, which is the rationale for the combined use of montelukast (Mk) in the treatment of this illness. METHODS Mk was administrated to 19 eligible patients with refractory chronic GvHD, in addition to their standard immunosuppressive regimens. Mk was given orally (10 mg once daily) for a mean period of 10 months (range, 2-21 months). Organ-specific response was determined by the new scoring criteria established by the National Institutes of Health consensus project. RESULTS Based on organ involvements endpoints, overall response to the combined therapy with Mk was observed in 15 of 19 (79%) patients. Significant improvement of skin liver and gastrointestinal was observed in 53%, 62%, and 46%, respectively. Generally, Mk was notably beneficial in milder stages of GvHD, which lead to earlier withdrawal of other immunosuppressive agents. Side effects of Mk administration were not documented, nor were cases of relapse of the basic disease. CONCLUSIONS Our preliminary prospective investigation supports the potential efficacy of Mk as a safe and toxicity-sparing supplement to standard therapy for patients with chronic GvHD. Future clinical studies are necessary to establish the optimal dose of Mk and its role in the symptomatic and prophylactic treatment of acute and chronic GvHD.
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Affiliation(s)
- Reuven Or
- Department of Bone Marrow Transplantation, Cancer Immunotherapy & Immunobiology Research Center, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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22
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Peters-Golden M, Gleason MM, Togias A. Cysteinyl leukotrienes: multi-functional mediators in allergic rhinitis. Clin Exp Allergy 2006; 36:689-703. [PMID: 16776669 PMCID: PMC1569601 DOI: 10.1111/j.1365-2222.2006.02498.x] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cysteinyl leukotrienes (CysLTs) are a family of inflammatory lipid mediators synthesized from arachidonic acid by a variety of cells, including mast cells, eosinophils, basophils, and macrophages. This article reviews the data for the role of CysLTs as multi-functional mediators in allergic rhinitis (AR). We review the evidence that: (1) CysLTs are released from inflammatory cells that participate in AR, (2) receptors for CysLTs are located in nasal tissue, (3) CysLTs are increased in patients with AR and are released following allergen exposure, (4) administration of CysLTs reproduces the symptoms of AR, (5) CysLTs play roles in the maturation, as well as tissue recruitment, of inflammatory cells, and (6) a complex inter-regulation between CysLTs and a variety of other inflammatory mediators exists.
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23
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Gibbons FK, Israel E, Deykin A, Schaub B, He HZ, Perkins DL, Finn PW. The combined effects of zafirlukast, prednisone, and inhaled budesonide on IL-13 and IFN-gamma secretion. J Clin Immunol 2006; 25:437-44. [PMID: 16160912 DOI: 10.1007/s10875-005-5625-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Accepted: 04/28/2005] [Indexed: 10/25/2022]
Abstract
Therapy for asthma often includes the combined use of glucocorticoids and leukotriene receptor antagonists. The short-term, combined effects of these drugs on cytokine secretion and lymphocyte proliferation are ill-defined. The aim of this study was to analyze allergen and mitogen-induced cytokine secretion and lymphocyte proliferation in asthmatics and to determine the effect of combined therapy on these immune responses. Peripheral blood mononuclear cells were isolated from mild, persistent adult asthmatics (n = 28) and analyzed for cat allergen (Fel d 1) and mitogen (phytohemagglutinin) induced IL-13 and IFN-gamma secretion and lymphocyte proliferation. Samples were analyzed before and after 10 days of therapy with oral zafirlukast, prednisone (0.5 mg/kg/day), and inhaled budesonide (1600 mcg/day). Both Fel d 1 and mitogen stimulation resulted in IL-13 and IFN-gamma secretion. Combination drug therapy resulted in a significant decrease in allergen-induced IFN-gamma secretion (p = 0.018) and allergen-specific lymphocyte proliferation (p = 0.02), while IL-13 secretion was unchanged (p = 0.109). This study indicates a role for Th1 cytokines as well as Th2 cytokines in the allergic response.
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Affiliation(s)
- Fiona K Gibbons
- Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, USA.
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24
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Stelmach I, Korzeniewska A, Stelmach W, Majak P, Grzelewski T, Jerzynska J. Effects of montelukast treatment on clinical and inflammatory variables in patients with cystic fibrosis. Ann Allergy Asthma Immunol 2005; 95:372-80. [PMID: 16279568 DOI: 10.1016/s1081-1206(10)61156-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In cystic fibrosis (CF), the inflammatory process contributes to progressive lung tissue damage. Cysteinyl leukotrienes have been found in the sputum of patients with CF at high concentrations sufficient to cause potent biological effects. OBJECTIVE To evaluate the effect of anti-inflammatory treatment with montelukast sodium in patients with CF. METHODS Twenty-six patients aged 6 to 18 years were recruited to this 20-week, randomized, double-blind, placebo-controlled, crossover trial. Patients received montelukast or placebo for 8 weeks in addition to their regular CF treatment. Before and after treatment, findings from spirometry, whole-body plethysmography, and the clinical wheezing and cough scales were evaluated. At the same time, serum and sputum samples were obtained for the measurement of eosinophil cationic protein, interleukin 10 (IL-10), IL-8, and myeloperoxidase levels. RESULTS Twenty-three patients completed the study. Compared with placebo use, montelukast treatment significantly improved forced expiratory volume in I second, peak expiratory flow, and forced expiratory flow between 25% and 75% and significantly decreased cough and wheezing scale scores (P < .001 for all). There were no significant changes in vital capacity, thoracic gas volume, airway resistance, and residual volume after treatment. Compared with placebo use, montelukast treatment decreased serum and sputum levels of eosinophil cationic protein and IL-8, decreased sputum levels of myeloperoxidase, and increased serum and sputum levels of IL-10 (P < .001 for all). CONCLUSIONS Montelukast may have measurable anti-inflammatory properties in patients with CF.
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Affiliation(s)
- Iwona Stelmach
- Department of Pediatrics and Allergy, M Curie Hospital, Zgierz, Poland.
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25
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Ichiyama T, Hasegawa M, Ueno Y, Makata H, Matsubara T, Furukawa S. Cysteinyl leukotrienes induce monocyte chemoattractant protein 1 in human monocytes/macrophages. Clin Exp Allergy 2005; 35:1214-9. [PMID: 16164450 DOI: 10.1111/j.1365-2222.2005.02323.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Monocytes/macrophages have a cysteinyl leukotriene 1 (CysLT1) receptor, but its function is poorly understood. Objective To elucidate the biological function of the CysLT1 receptor of human monocytes/macrophages. METHODS We examined the production of TNF-alpha, IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, monocyte chemoattractant protein 1 (MCP-1), macrophage colony-stimulating factor (M-CSF), and eotaxin induced by CysLTs (leukotriene (LT)C4, -D4, and -E4) in THP-1 cells, a human monocytic leukaemia cell line, and peripheral blood CD14+ monocytes/macrophages. Moreover, we examined the effect of CysLTs on the expression of beta-chemokine receptor 2B (CCR2B) as the receptor of MCP-1 by Western blot analysis. RESULTS ELISA revealed that CysLTs induced MCP-1 in THP-1 cells and peripheral blood CD14+ monocytes/macrophages, but not other cytokines. PCR demonstrated that CysLTs increased MCP-1 mRNA expression in THP-1 cells, and Western blotting showed that CysLTs increased the expression of CCR2B in THP-1 cells. Moreover, we demonstrated that pranlukast, a CysLT1 receptor antagonist, blocked MCP-1 production by CysLTs in THP-1 cells almost completely, and partially inhibited MCP-1 release by CysLTs in peripheral blood CD14+ monocytes/macrophages and CCR2B expression by CysLTs in THP-1 cells. CONCLUSION CysLTs induce MCP-1 and increase CCR2B expression in human monocytes/macrophages.
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Affiliation(s)
- T Ichiyama
- Department of Pediatrics, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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26
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Charbeneau RP, Peters-Golden M. Eicosanoids: mediators and therapeutic targets in fibrotic lung disease. Clin Sci (Lond) 2005; 108:479-91. [PMID: 15896193 DOI: 10.1042/cs20050012] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Fibrosis is a common end-stage sequella of a number of acute and chronic lung diseases. Current concepts of pathogenesis implicate dysregulated interactions between epithelial cells and mesenchymal cells. Although investigative efforts have documented important roles for cytokines and growth factors in the pathogenesis of fibrotic lung diseases, these observations have not as yet been translated into efficacious therapies, and there is a pressing need for new pathogenetic insights and therapeutic approaches for these devastating disorders. Eicosanoids are lipid mediators derived from arachidonic acid, the most studied of which are the prostaglandins and leukotrienes. Although they are primarily known for their roles in asthma, pain, fever and vascular responses, present evidence indicates that eicosanoids exert relevant effects on immune/inflammatory, as well as structural, cells pertinent to fibrogenesis. In general, leukotrienes promote, whereas prostaglandin E(2) opposes, fibrogenic responses. An imbalance of eicosanoids also exists in pulmonary fibrosis, which favours the production of leukotrienes over prostaglandin E(2). This review highlights the role of this imbalance in the evolution of fibrotic lung disease, discusses the mechanisms by which it may arise and considers approaches for therapeutic targeting of eicosanoids in these conditions.
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Affiliation(s)
- Ryan P Charbeneau
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109-0642, USA
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27
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Stelmach I, Majak P, Jerzynska J, Kuna P. The effect of treatment with montelukast on in vitro interleukin-10 production of mononuclear cells of children with asthma. Clin Exp Allergy 2005; 35:213-20. [PMID: 15725194 DOI: 10.1111/j.1365-2222.2005.02154.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The effects of leukotriene modifiers on IL-10 production have not been studied in children with asthma. OBJECTIVE The primary objective of this study was to determine the changes in IL-10 concentrations, clinical efficacy and peripheral blood eosinophil counts after treatment with montelukast. METHODS The study was conducted on 27 patients: 13 patients monoallergic to grass pollen during the pollen season (GPs group) and out of the pollen season (GPos group), and on 14 patients monoallergic to house dust mite (HDM) from May to September (HDM group). Main outcome measures were changes in concentrations of IL-10 in the supernatant after a 4-week treatment with montelukast. Measurements of asthma severity score, forced expiratory volume in 1 s (FEV1) and peripheral blood eosinophil counts were the secondary end-points. RESULTS Montelukast resulted in a within-group significant increase in IL-10 concentration in the supernatant in the GPs (54.0 vs. 125.5 pg/mL) and in the HDM (51.2 vs. 77.1 pg/mL) group. Montelukast had no effect on changes of IL-10 concentration in the supernatant from peripheral blood mononuclear cell (PBMC) culture after non-sensitizing allergen stimulation. Montelukast significantly improved asthma control and FEV1, and significantly decreased eosinophil blood count in the GPs and in the HDM group after a 4-week treatment. Montelukast did not lead to changes of all measured parameters within the GPos group. CONCLUSION Montelukast increased IL-10 concentration in supernatants from sensitizing allergen-stimulated PBMC culture obtained from children with asthma monoallergic to grass pollen during the pollen season, and from children with asthma monoallergic to HDM.
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Affiliation(s)
- I Stelmach
- Department of Pediatrics and Allergy, The M Curie Hospital, Zgierz, Poland.
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28
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Stelmach I, Bobrowska-Korzeniowska M, Majak P, Stelmach W, Kuna P. The effect of montelukast and different doses of budesonide on IgE serum levels and clinical parameters in children with newly diagnosed asthma. Pulm Pharmacol Ther 2005; 18:374-80. [PMID: 15939317 DOI: 10.1016/j.pupt.2005.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 02/14/2005] [Accepted: 02/18/2005] [Indexed: 11/22/2022]
Abstract
BACKGROUND Since IgE is considered to play a crucial role in allergic immune responses, the reduction of free IgE level has been an attractive target in the treatment of allergic diseases. The present study was conducted to determine the effects of a 6-month treatment with different doses of inhaled budesonide and montelukast sodium in children with newly diagnosed atopic asthma. METHODS In this randomized, double-blind, double-dummy trial, 51 children with newly diagnosed asthma and sensitivity to house-dust mites were randomly allocated to receive budesonide (in two different doses 400 or 800 mcg) or montelukast for 6 months. The primary end point was the level of serum total and specific IgE before and after treatment. The secondary end points were clinical parameters and forced expiratory volume in 1s (FEV1). RESULTS After 6 months of treatment, a high dose of inhaled corticosteroid and montelukast, significantly decreased levels of total and specific IgE. Medium dose of inhaled corticosteroid had no effect on total and specific IgE serum level. Clinical score and FEV1 significantly improved after 6 months of treatment with medium (P = 0.002) and high dose (P = 0.001) of inhaled budesonide and montelukast (P = 0.002). There were no differences between groups in changes of all clinical parameters after treatment. CONCLUSION Only high doses of inhaled corticosteroids and montelukast decreased the serum IgE levels. Perhaps long-term treatment with montelukast will be beneficial to asthma patients by decreasing IgE levels.
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Affiliation(s)
- Iwona Stelmach
- The M Curie Hospital, Department of Pediatrics and Allergy, Zgierz, Poland.
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Fukushima C, Matsuse H, Hishikawa Y, Kondo Y, Machida I, Saeki S, Kawano T, Tomari S, Obase Y, Shimoda T, Koji T, Kohno S. Pranlukast, a Leukotriene Receptor Antagonist, Inhibits Interleukin-5 Production via a Mechanism Distinct from Leukotriene Receptor Antagonism. Int Arch Allergy Immunol 2005; 136:165-72. [PMID: 15650315 DOI: 10.1159/000083325] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 09/30/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pranlukast, a cysteinyl leukotriene receptor 1 (CysLTR1) antagonist, inhibits not only airway smooth muscle contraction, but also allergic inflammation. The aim of this study was to determine the mechanism of pranlukast-induced interleukin-5 (IL-5) inhibition in allergic inflammation. METHODS Surgically resected human lung tissue was passively sensitized in vitro with mite-allergen-sensitized sera, followed by stimulation with mite allergen after pretreatment of the tissue with pranlukast, dexamethasone, or both. The IL-5 protein level in the culture medium was measured, and in situ hybridization of IL-5 and CysLTR1 mRNA was performed using lung tissues. RESULTS Pretreatment of lung tissues with pranlukast alone significantly decreased the amount of IL-5 protein in the culture medium by 40%. The combination of pranlukast and dexamethasone synergistically enhanced this effect. Quantitative in situ hybridization with image analysis revealed abundant expression of IL-5 mRNA in eosinophils, lymphocytes, and mast cells in sensitized and allergen-stimulated lung tissues. CysLTR1 mRNA was detected in macrophages, smooth muscle cells, eosinophils, and mast cells, but was less expressed in lymphocytes. Pranlukast-induced inhibition of IL-5 mRNA expression was noted in various cells, irrespective of their CysLTR1 mRNA expression status. In addition, cysteinyl leukotrienes per se failed to upregulate the IL-5 production. CONCLUSION Our results indicate that pranlukast inhibits IL-5 synthesis via a mechanism distinct from CysLTR1 antagonism.
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Affiliation(s)
- Chizu Fukushima
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
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Hernando SV, Rodríguez M, Ayala SJA, Costa GF, Chumilla VMA, García CM, Jiménez FJM, Lorente GS, Navarro GF, Orihuela CC, Ortuño MMP, Pelegrín LB. Montelukast in early childhood asthma. Predict value of IgG in clinical reply in children 2 to 5 years old? Allergol Immunopathol (Madr) 2004; 32:204-11. [PMID: 15324650 DOI: 10.1016/s0301-0546(04)79240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND According to current knowledge, asthma is basically an inflammatory process. Its causes and physiopathological mechanisms are various. The final result is a recurrent obstructive bronchial process, with sibilants and/or dypnea, which causes an upset in functional respiratory tests, among which the maximum respiratory peak flow meter diminished for the age, sex, and height of patient. AIMS Our aim is to evaluate if response to treatment with Montelukast has any link with immnuloglobin values (IgG, IgA, IgM, IgE) at start of treatment. MATERIALS AND METHODS Included in the study were 32 children, of whom 2 did not begin and 1 who did not provide personal data. There were 29 patients in total, 11 girls and 18 boys. Each made three visits: first where they were instructed, together with their parents, in how to manage the meter and where they received the peak flow meter, Vitalograph, and personal data sheet, where personal and family medical history were noted. The second visit was after 4 weeks, for a clinical assessment and the third visit after 8 weeks. The value register of the PEF would be made morning and night, noting the highest value of three measurements. IgG, IgA, IgM, IgA values were quantified before treatment began. The statistic package STATA 2001 was used in the treatment of data statistics. RESULTS Our between the value reached by the PEF after treatment and the IgG values at the beginning of treatment (0.712). In lesser measurement for IgA values (0.660). For each 100 mg/ml of increase in the value of IgG, an increase of 10 l/min in the PEF measurement before and following treatment with Montelukast was produced. CONCLUSIONS IgG values increase with age. Children with a greater IgG value at the beginning of treatment reached higher PEF values after same. It is not known if the results would be similar with another type of treatment and the way in which IgG influences the results. What appears to be confirmed by available studies is that this relation is found in a group of small children, the aim of our study.
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Affiliation(s)
- S V Hernando
- Unidad de Alergia Pediátrica, Servicio de Pediatría, Clínica Virgen de la Vega, Murcia, Spain.
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Ishinaga H, Takeuchi K, Kishioka C, Suzuki S, Basbaum C, Majima Y. Pranlukast inhibits NF-kappaB activation and MUC2 gene expression in cultured human epithelial cells. Pharmacology 2004; 73:89-96. [PMID: 15475658 DOI: 10.1159/000081294] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2004] [Accepted: 07/14/2004] [Indexed: 01/25/2023]
Abstract
Pranlukast is a selective cysteinyl leukotriene(1 )(cysLT(1)) receptor antagonist, and is now widely used in the treatment of asthma. The anti-asthmatic effect of pranlukast may be rendered not only by antileukotriene activity, but also by other pharmacological activity. This study was designed to investigate whether pranlukast had inhibitory effects on nuclear factor-kappaB (NF-kappaB) activation and mucin gene expression in cultured human epithelial cells. Luciferase assay was mainly used for analysis. Cultured epithelial cells were transfected with NF-kappaB luciferase vector, MUC2 or MUC5AC luciferase vectors. Lipopolysaccharide (LPS) significantly increased NF-kappaB activation in NCI-H292 cells, which was inhibited by the pretreatment by pranlukast in a dose-dependent manner. Either LTD(4) or pranlukast alone did not increase NF-kappaB activation in NCI-H292 cells. Pranlukast also inhibited NF-kappaB activation induced by phorbol 12-myristate 13-acetate (PMA). Pranlukast also significantly inhibited LPS-induced MUC2 mRNA expression by reverse transcription-polymerase chain reaction (RT-PCR) analysis in NCI-H292 cells. Pranlukast also inhibited LPS-induced MUC2 gene expression in HM3-MUC2 cells. However, pranlukast did not inhibit MUC5AC gene transcription activity induced by lipoteichoic acid (LTA) in NCI-H292 cells. These results suggest that pranlukast may inhibit NF-kappaB activation and MUC2 gene transcription through pathways distinct from cysLT(1) receptor antagonism in cultured human epithelial cells.
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Affiliation(s)
- Hajime Ishinaga
- Department of Otorhinolaryngology, Mie University School of Medicine, Tsu, Mie, Japan
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Gagro A, Aberle N, Rabatić S, Ajduk J, Jelacić J, Dekaris D. Effect of cysteinyl leukotriene receptor antagonist on CD11b and CD23 expression in asthmatic children. Clin Exp Allergy 2004; 34:939-44. [PMID: 15196283 DOI: 10.1111/j.1365-2222.2004.01978.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cysteinyl leukotrienes are potent pro-inflammatory mediators that contribute to the pathophysiologic features observed in allergic asthma. Inhibitors of leukotriene receptors represent novel therapy in asthma treatment. In addition to the protection from early asthmatic responses, these drugs have recently been shown to protect from late airway responses too. METHODS We studied the effect of treatment with an oral antagonist of cysteinyl leukotriene receptors on the increased expression of the low-affinity IgE receptor, CD23, on B cells, and of its ligands, CD11b and CD11c, on CD4(+) T cells and monocytes in peripheral blood of patients with allergic asthma. In this uncontrolled open-label study, 14 children with allergic asthma received montelukast, a cysteinyl leukotrine receptor antagonist, for a period of 6 weeks after demonstrating forced expiratory volume in 1 s (FEV(1)) of less than 80% of the predicted value. Samples of peripheral heparinized blood and sera were obtained before and after therapy completion. Three-colour immunofluorescence analysis was performed, and expression of CD11b and CD11c on CD4(+) T lymphocytes and monocytes as well as the expression of CD21 and CD23 on B cells were determined (n=12). Peripheral blood eosinophil count, changes in FEV(1) and peak expiratory flow rate (PEFR), asthma exacerbations, and as-needed use of beta-agonist were also monitored. RESULTS Montelukast improved FEV(1) and PEFR, and decreased peripheral eosinophil counts in all study patients. There was no significant change in the expression of CD21 and CD23 on B cells. The expression of CD11c on CD4(+) T cells and of both CD11b and CD11c on monocytes remained similar to the pretreatment expression. However, the percentage of CD11b(+)CD4(+) T lymphocytes significantly decreased after treatment with montelukast. This was accompanied by a significant decrease in the levels of total IgE. CONCLUSION The capacity of 6-week montelukast therapy to reduce the percentage of CD11b CD4(+) T cells might be a mechanism leading to the immune response modulation on this T cell subset interaction with CD23-expressing B cells and subsequent down-regulation of IgE synthesis.
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Affiliation(s)
- A Gagro
- Institute of Immunology, Zagreb, Croatia.
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Ohtsuka Y, Shimizu T, Fujii T, Sato T, Saito M, Nagata S, Takahashi H, Yamashiro Y. Pranlukast regulates tumour growth by attenuating IL-4 production in Kimura disease. Eur J Pediatr 2004; 163:416-7. [PMID: 15088141 DOI: 10.1007/s00431-004-1441-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2004] [Accepted: 03/03/2004] [Indexed: 10/26/2022]
Affiliation(s)
- Yoshikazu Ohtsuka
- Department of Paediatrics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421 Tokyo, Japan.
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Stamatiou PB, Chan CC, Monneret G, Ethier D, Rokach J, Powell WS. 5-Oxo-6,8,11,14-eicosatetraenoic Acid Stimulates the Release of the Eosinophil Survival Factor Granulocyte/Macrophage Colony-stimulating Factor from Monocytes. J Biol Chem 2004; 279:28159-64. [PMID: 15136573 DOI: 10.1074/jbc.m401537200] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Allergic diseases such as asthma are characterized by tissue eosinophilia induced by the combined effects of chemoattractants and cytokines. Lipid mediators are a major class of endogenous chemoattractants, among which 5-oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is the most potent for human eosinophils. In this study, we investigated the effects of 5-oxo-ETE on eosinophil survival by flow cytometry. We found that this compound could promote eosinophil survival in the presence of small numbers of contaminating monocytes, but not in their absence. The conditioned medium from monocytes treated for 24 h with 5-oxo-ETE also strongly promoted eosinophil survival, whereas the medium from vehicle-treated monocytes had no effect. An antibody against the granulocyte/macrophage colony-stimulating factor (GM-CSF) completely blocked the response of eosinophils to the conditioned medium from 5-oxo-ETE-treated monocytes, whereas an antibody against interleukin-5 had no effect. Furthermore, 5-oxo-ETE stimulated the release of GM-CSF from cultured monocytes in amounts compatible with eosinophil survival activity, with a maximal effect being observed after 24 h. This effect was concentration-dependent and could be observed at concentrations in the picomolar range. 5-Oxo-ETE and leukotriene B(4) had similar effects on GM-CSF release at low concentrations, but 5-oxo-ETE induced a much stronger response at concentrations of 10 nm or higher. This is the first report that 5-oxo-ETE can induce the release of any cytokine, suggesting that it could be an important mediator in allergic and other inflammatory diseases due both to its chemoattractant properties and to its potent effects on the synthesis of the survival factor GM-CSF.
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Affiliation(s)
- Panagiota B Stamatiou
- Meakins-Christie Laboratories, Department of Medicine, McGill University, 3626 St. Urbain Street, Montreal, Quebec H2X 2P2, Canada
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Kemp JP. Recent advances in the management of asthma using leukotriene modifiers. ACTA ACUST UNITED AC 2004; 2:139-56. [PMID: 14720013 DOI: 10.1007/bf03256645] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Asthma is a chronic inflammatory disease of the airways that affects approximately 100 million people worldwide. In order to reduce symptoms, improve pulmonary function, and decrease morbidity, current treatment guidelines emphasize the importance of controlling the underlying inflammation in patients with asthma. Leukotrienes are leukocyte-generated lipid mediators that promote airway inflammation. Recognition of the importance of leukotrienes in the pathogenesis of asthma has led to the development of leukotriene modifiers, the first new class of drugs for the treatment of asthma to become available in 25 years. Controlled clinical trials with the four currently used leukotriene modifiers (montelukast, zafirlukast, and zileuton in the US and pranlukast in Japan) have established their efficacy in improving pulmonary function, reducing symptoms, decreasing night-time awakenings, and decreasing the need for rescue medications. They exert anti-inflammatory effects that attenuate cellular infiltration and bronchial hyperresponsiveness and complement the anti-inflammatory properties of inhaled corticosteroids. In patients with moderate and severe asthma, they permit tapering of the corticosteroid dose. In patients with exercise-induced asthma, leukotriene modifiers limit the decline in and quicken the recovery of pulmonary functions without the tolerance issues seen with chronic long-acting beta(2)-adrenoceptor agonist use. In patients with aspirin (acetylsalicylic acid)-induced asthma, they improve pulmonary function and shift the dose response curve to the right, reducing the patient's response to aspirin. In patients with seasonal allergic rhinitis, with or without concomitant asthma, they improve nasal, eye, and throat symptoms as well as quality of life. Leukotriene modifiers are generally safe and well tolerated with adverse effect profiles similar to that of placebo. The one safety issue raised with leukotriene modifiers, Churg-Strauss Syndrome, appears to be the unmasking of an already present syndrome that is manifested when the leukotriene modifiers permit corticosteroid doses to be reduced. Although current treatment guidelines recommend their use in patients with mild persistent asthma, these guidelines were developed just as leukotriene modifiers were coming to the market, before much of the clinical efficacy data were published. Because asthma is a heterogeneous disease, the different asthma phenotypes respond differently to therapies; consequently asthma therapy needs to be individualized. Leukotriene modifiers increase the therapeutic options for patients with asthma and, based on recent data, it is expected that future guidelines will describe expanded uses for these agents in clinical circumstances where these drugs are effective.
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Affiliation(s)
- James P Kemp
- Department of Pediatrics, University of California School of Medicine, San Diego, California 92123, USA.
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Ueda T, Takeno S, Furukido K, Hirakawa K, Yajin K. Leukotriene receptor antagonist pranlukast suppresses eosinophil infiltration and cytokine production in human nasal mucosa of perennial allergic rhinitis. Ann Otol Rhinol Laryngol 2003; 112:955-61. [PMID: 14653364 DOI: 10.1177/000348940311201107] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate the influence of pranlukast on eosinophilic inflammation and cytokine production in human nasal mucosa. Twelve patients were treated with pranlukast, and samples were obtained from the nasal mucosa of the inferior turbinate. With respect to cell infiltration, a significant decrease was observed in the percentage of inflammatory cells (secreted eosinophil cationic protein [EG2] and neutrophil elastase) after treatment. The levels of cytokines and chemical mediators (interleukin [IL]-4, IL-5, RANTES [regulated on activation, normal T cell expressed and secreted], cysteinyl leukotrienes, IL-1beta, tumor necrosis factor-alpha, and IL-8) assessed by enzyme-linked immunosorbent assay and enzyme immunoassay were significantly decreased. These results indicate that pranlukast decreased the levels of a majority of the cytokines in nasal mucosa, leading to improvement in subjective nasal symptoms. Furthermore, these results support the hypothesis that pranlukast exerts its therapeutic action primarily by blocking the leukotriene receptors on eosinophils.
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Affiliation(s)
- Tsutomu Ueda
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Clinical Medical Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
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Kawano T, Matsuse H, Kondo Y, Machida I, Saeki S, Tomari S, Mitsuta K, Obase Y, Fukushima C, Shimoda T, Kohno S. Cysteinyl leukotrienes induce nuclear factor kappa b activation and RANTES production in a murine model of asthma. J Allergy Clin Immunol 2003; 112:369-74. [PMID: 12897744 DOI: 10.1067/mai.2003.1636] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND It has been demonstrated that both cysteinyl leukotrienes (cysLTs) and cytokines are involved in the pathophysiology of bronchial asthma. Nonetheless, the exact mechanism involved in the interaction between these 2 molecules has yet to be determined. OBJECTIVE The aim of the present study was to determine the effects of cysLTs on allergic airway inflammation and allergen-specific cytokine production in a murine model of asthma. METHODS Four groups of BALB/c mice (control mice, Dermatophagoides farinae allergen-sensitized mice, pranlukast cysLT receptor antagonist-treated allergen-sensitized mice, and dexamethasone-treated allergen-sensitized mice) were examined. RESULTS Allergen-sensitized mice exhibited increased airway responsiveness and inflammation. Pranlukast-treated mice showed significant attenuation of these changes concomitant with reduction of T(H)2 cytokine and IFN-gamma production by isolated lung mononuclear cells (MNCs). A much stronger inhibition of all cytokines was noted in dexamethasone-treated mice. Pranlukast also significantly inhibited production of RANTES and activation of nuclear factor kappa B (NF-kappa B) in the isolated lung MNCs. Leukotriene D(4) stimulated isolated lung MNCs to produce RANTES but not any other cytokines and also activated NF-kappa B in these cells. CONCLUSIONS Our results suggest that cysLTs activate NF-kappa B and induce RANTES production from isolated lung MNCs, which in turn might cause migration of eosinophils and activated T lymphocytes into the airway.
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Affiliation(s)
- Tetsuya Kawano
- Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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Tomari S, Matsuse H, Machida I, Kondo Y, Kawano T, Obase Y, Fukushima C, Shimoda T, Kohno S. Pranlukast, a cysteinyl leukotriene receptor 1 antagonist, attenuates allergen-specific tumour necrosis factor alpha production and nuclear factor kappa B nuclear translocation in peripheral blood monocytes from atopic asthmatics. Clin Exp Allergy 2003; 33:795-801. [PMID: 12801315 DOI: 10.1046/j.1365-2222.2003.01656.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The cysteinyl leukotriene receptor 1 (cysLTR1) antagonists are useful for oral treatment of bronchial asthma. The underlying mechanism of cysLTR1 antagonists on inhibition of inflammatory cytokine production is yet to be determined. OBJECTIVE The present study was designed to determine the effect of pranlukast, a cysLTR1 antagonist, on production of inflammatory cytokines by allergen-stimulated peripheral blood monocytes (PBM) from atopic asthmatics. METHODS PBM were obtained from normal control (n = 10) and Dermatophagoides farinae (Der f) allergen-sensitized atopic asthmatics (n = 12), and were cultured in the presence of Der f allergen. The production of TNF-alpha and nuclear-translocation of nuclear factor kappa B (NF-kappa B) was determined. In atopic asthmatics, pranlukast, tacrolimus or dexamethasone was added before stimulation by Der f. The additive effect of pranlukast and dexamethasone was also determined. RESULTS PBM from atopic asthmatics cultured with Der f exhibited a significant increase in TNF-alpha production and nuclear translocation of NF-kappa B compared with normal control (P < 0.01). Pranlukast, tacrolimus and dexamethasone significantly inhibited production of TNF-alpha and nuclear-translocation of NF-kappa B in PBM of atopic asthmatics (P < 0.01). An additive effect of pranlukast on low-dose dexamethasone was also demonstrated. However, LTD4 did not induce TNF-alpha production or NF-kappa B nuclear translocation. CONCLUSION Our results suggest that pranlukast may inhibit TNF-alpha production via suppression of NF-kappa B activation through pathways distinct from cysLTR1 antagonism.
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Affiliation(s)
- S Tomari
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
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Ichiyama T, Hasegawa S, Umeda M, Terai K, Matsubara T, Furukawa S. Pranlukast inhibits NF-kappa B activation in human monocytes/macrophages and T cells. Clin Exp Allergy 2003; 33:802-7. [PMID: 12801316 DOI: 10.1046/j.1365-2222.2003.01673.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pranlukast is a leukotriene 1 (LT1) receptor antagonist and is effective against bronchial asthma. Pranlukast inhibits contraction of the tracheal muscle, and thereby antagonizes the binding of LTC4, LTD4 and LTE4. However, the action of pranlukast on monocytes/macrophages and T cells is unknown. OBJECTIVE We examined whether or not pranlukast inhibits TNF-alpha-induced activation of nuclear transcription factor NF-kappa B, a factor that is essential for the expression of proinflammatory cytokines, on human monocytic 1.3% dimethylsulphoxide (DMSO)-differentiated U-937 cells, which have cysteinyl LT1 (CysLT1) receptors on their membranes, and T cells (Jurkat), which do not. METHODS We examined whether or not LTC4, LTD4 or LTE4 induced NF-kappa B activation in 1.3% DMSO-differentiated U-937 cells by Western blotting. The inhibitory effects of pranlukast and MK-571, which is an LTD4 receptor-selective antagonist, on TNF-alpha-induced NF-kappa B activation was evaluated by Western blotting and flow cytometry, and those on lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) production in peripheral blood mononuclear cells (PBMC) were evaluated by enzyme-linked immunosorbent assaying. RESULTS LTC4, LTD4 or LTE4 did not induce NF-kappa B activation in 1.3% DMSO-differentiated U-937 cells. Western blotting demonstrated that 10-5 M pranlukast inhibits NF-kappa B activation in 1.3% DMSO-differentiated U-937 and Jurkat cells by about 40% & 30%, respectively. Flow cytometry demonstrated that pranlukast and MK-571 inhibit NF-kappa B activation in 1.3% DMSO-differentiated U-937 and Jurkat cells in a dose-related manner. Moreover, 10-5 M pranlukast and MK-571 inhibited LPS-induced IL-6 production in PBMC by about 65% and 15%, respectively. CONCLUSION Pranlukast and MK-571 partially inhibited NF-kappa B activation in 1.3% DMSO-differentiated U-937 and Jurkat cells, and IL-6 release in PBMC. These findings are consistent with the idea that, independently of CysLT1 receptor antagonism, micromolar concentrations of pranlukast suppress the production of proinflammatory cytokines via inhibition of NF-kappa B activation in monocytes/macrophages and T cells, but the contribution of this effect to the anti-inflammatory activity of pranlukast at oral therapeutic doses in asthmatic patients is unclear.
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Affiliation(s)
- T Ichiyama
- Department of Pediatrics, Yamaguchi University School of Medicine, Yamaguchi and ONO Pharmaceutical Co. Ltd, Osaka, Japan.
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Suzuki M, Kato M, Kimura H, Fujiu T, Morikawa A. Inhibition of human eosinophil activation by a cysteinyl leukotriene receptor antagonist (pranlukast; ONO-1078). J Asthma 2003; 40:395-404. [PMID: 12870835 DOI: 10.1081/jas-120018709] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Eosinophils produce cysteinyl leukotrienes such as leukotriene C4 and D4 upon stimulation by platelet-activating factor or other mediators, and these cells themselves express cysteinyl leukotriene receptors. Pranlukast, a compound developed in Japan, antagonizes cysteinyl leukotriene receptors and inhibits contraction of airway smooth muscle, microvascular leakage into airways, and eosinophil infiltration. This agent can decrease symptoms of bronchial asthma, but its specific influences on effector functions of eosinophils important to the pathogenesis and exacerbation of asthma remain unknown. In the present study, we investigated the effect of pranlukast on human eosinophil functions. Eosinophils obtained from peripheral blood of normal volunteers were stimulated by platelet-activating factor, leukotriene D4, or phorbol ester. Superoxide anion generation was measured by reduction of cytochrome c. Expression of alphaMbeta2 was analyzed by flow cytometry. To evaluate eosinophil degranulation, eosinophil protein X, a toxic granule constituent, was measured by radioimmunoassay in sample supernatants. Pranlukast partially inhibited major eosinophil effector functions of superoxide anion generation and degranulation induced by platelet-activating factor, although at concentrations tested pranlukast failed to significantly reduce platelet-activating factor-induced alphaMbeta2 expression. Pranlukast completely inhibited leukotriene D4-induced superoxide generation and alphaMbeta2 expression. In contrast, pranlukast at 10(-6)M did not affect phorbol ester-induced superoxide generation at 120 minutes, degranulation, or alphaMbeta2 expression. The results suggested that inhibition by pranlukast of platelet-activating, factor-induced eosinophil effector functions such as superoxide generation and degranulation might result at least partly from antagonism of autocrine mechanisms involving cysteinyl leukotrienes produced in response to platelet-activating factor.
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Affiliation(s)
- Masato Suzuki
- Department of Pediatrics, Gunma University School of Medicine, Maebashi, Gunma, Japan
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Chibana K, Ishii Y, Asakura T, Fukuda T. Up-regulation of cysteinyl leukotriene 1 receptor by IL-13 enables human lung fibroblasts to respond to leukotriene C4 and produce eotaxin. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2003; 170:4290-5. [PMID: 12682264 DOI: 10.4049/jimmunol.170.8.4290] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cysteinyl leukotrienes (CysLTs) play an important role in eosinophilic airway inflammation. In addition to their direct chemotactic effects on eosinophils, indirect effects have been reported. Eotaxin is a potent eosinophil-specific chemotactic factor produced mainly by fibroblasts. We investigated whether CysLTs augment eosinophilic inflammation via eotaxin production by fibroblasts. Leukotriene (LT)C(4) alone had no effect on eotaxin production by human fetal lung fibroblasts (HFL-1). However, LTC(4) stimulated eotaxin production by IL-13-treated fibroblasts, thereby indirectly inducing eosinophil sequestration. Unstimulated fibroblasts did not respond to LTC(4), but coincubation or preincubation of fibroblasts with IL-13 altered the response to LTC(4). To examine the mechanism(s) involved, the expression of CysLT1R in HFL-1 was investigated by quantitative real-time PCR and flow cytometry. Only low levels of CysLT1R mRNA and no CysLT1R protein were expressed in unstimulated HFL-1. In contrast, stimulation with IL-13 at a concentration of 10 ng/ml for 24 h significantly up-regulated both CysLT1R mRNA and protein expression in HFL-1. The synergistic effect of LTC(4) and IL-13 on eotaxin production was abolished by CysLT1R antagonists pranlukast and montelukast. These findings suggest that IL-13 up-regulates CysLT1R expression, which may contribute to the synergistic effect of LTC(4) and IL-13 on eotaxin production by lung fibroblasts. In the Th2 cytokine-rich milieu, such as that in bronchial asthma, CysLT1R expression on fibroblasts might be up-regulated, thereby allowing CysLTs to act effectively and increase eosinophilic inflammation.
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Affiliation(s)
- Kazuyuki Chibana
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine, Tochigi, Japan
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Abstract
PURPOSE OF REVIEW Leukotriene modifiers have recognized utility in the management of asthma. The aim of this review is to put into context recent research findings that extend our understanding of cysteinyl leukotriene synthesis and actions in the pathogenesis of asthma and allergic disease. RECENT FINDINGS Previous literature has shown that T helper type 2 cytokines thought to favor asthma and allergic diseases upregulate leukotriene synthesis. Recent findings show that interleukins-4 and -13 also upregulate cysteinyl leukotriene 1 receptor expression. Conversely, the regulation of cytokine expression by leukotrienes has also been explored: cysteinyl leukotrienes upregulate type 2 cytokine expression and decrease type 1 cytokine expression, favoring an allergic phenotype. Genetic determinants of the expression of leukotriene-forming enzymes include polymorphisms of the 5-lipoxygenase and LTC(4) synthase promoters. Novel actions of leukotrienes continue to be recognized, and a role for leukotrienes in the development of airway remodeling accompanying chronic asthma is discussed. Mounting evidence implicates leukotrienes in the pathogenesis of asthma following viral infections. Finally, advances in the measurement of leukotrienes are reviewed. SUMMARY Leukotrienes and their receptors play an important role in the pathogenesis of asthma. Advances in our understanding of the synthesis and actions of these lipid mediators provide the scientific rationale for appropriate utilization of leukotriene modifiers and for envisioning novel leukotriene-based therapeutic approaches in the clinical management of asthma.
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Hamid Q, Tulic' MK, Liu MC, Moqbel R. Inflammatory cells in asthma: mechanisms and implications for therapy. J Allergy Clin Immunol 2003; 111:S5-S12; discussion S12-7. [PMID: 12532083 DOI: 10.1067/mai.2003.22] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recent clinical studies have brought asthma's complex inflammatory processes into clearer focus, and understanding them can help to delineate therapeutic implications. Asthma is a chronic airway inflammatory disease characterized by the infiltration of airway T cells, CD(+) (T helper) cells, mast cells, basophils, macrophages, and eosinophils. The cysteinyl leukotrienes also are important mediators in asthma and modulators of cytokine function, and they have been implicated in the pathophysiology of asthma through multiple mechanisms. Although the role of eosinophils in asthma and their contribution to bronchial hyperresponsiveness are still debated, it is widely accepted that their numbers and activation status are increased. Eosinophils may be targets for various pharmacologic activities of leukotriene receptor antagonists through their ability to downregulate a number of events that may be key to the effector function of these cells.
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Affiliation(s)
- Qutayba Hamid
- Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada
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Peters-Golden M, Sampson AP. Cysteinyl leukotriene interactions with other mediators and with glucocorticosteroids during airway inflammation. J Allergy Clin Immunol 2003; 111:S37-42; discussion S43-8. [PMID: 12532085 DOI: 10.1067/mai.2003.23] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Unexpected aspects of the antiasthmatic efficacy of leukotriene modifiers and glucocorticosteroids have been observed. For both classes, the observed effects may be partially explainable on the basis of underrecognized interactions involving leukotrienes. This review examines the interactions between leukotrienes and other mediators of asthma. It details the effects of glucocorticosteroids on leukotriene synthesis and on leukocyte populations in asthmatic airways. Unexpected controller effects of the leukotriene modifiers may reflect the fact that leukotrienes and other mediators of asthma, such as T(H)2 cytokines, positively influence each other's generation. The ability of the leukotriene modifiers to disrupt such extensive interactions means that other relevant mediators are targeted indirectly by leukotriene blockade. Among asthma therapies, the glucocorticosteroids have numerous anti-inflammatory activities, but their effects may be unpredictable. Many processes involved in inflammation appear to escape modulation by glucocorticosteroids, including leukotriene synthesis, and leukotriene generation is among them. Understanding whether glucocorticosteroids reduce cysteinyl leukotriene levels in the airway is important in determining the clinical value of combining glucocorticosteroid therapy with leukotriene modifier therapy.
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Affiliation(s)
- Marc Peters-Golden
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor 48109-0642, USA
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Sampson AP, Pizzichini E, Bisgaard H. Effects of cysteinyl leukotrienes and leukotriene receptor antagonists on markers of inflammation. J Allergy Clin Immunol 2003; 111:S49-59; discussion S59-61. [PMID: 12532086 DOI: 10.1067/mai.2003.24] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The understanding that asthma pathophysiology includes an inflammatory component has spurred the more aggressive use of anti-inflammatory therapies and created a need for effective tools to measure inflammation. Biomarkers of airway inflammation proposed are obtained by methods that are direct but highly invasive (bronchial biopsy, bronchoalveolar lavage), moderately direct, and less invasive (indirect sputum, exhaled air, breath condensate) or indirect and least invasive (blood, urine). Several studies described in this review have implicated the cysteinyl leukotrienes (CysLTs) as inflammatory mediators in a wide range of diseases, implying that their biological activities reach far beyond acute bronchoconstriction, the activity traditionally ascribed to them. The validity of examining sputum for "biomarkers" has improved the understanding of asthma pathophysiology, optimization of asthma treatment and management, and investigation of the relation between CysLTs and airway inflammation in asthma. Nitric oxide is also a surrogate marker of asthma and reflects airway inflammation. The anti-inflammatory effects of the leukotriene receptor antagonists and the markers of their activity continue to grow.
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Affiliation(s)
- Anthony P Sampson
- Respiratory Cell Division at Southampton General Hospital, Southampton, UK
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Holgate ST, Peters-Golden M, Panettieri RA, Henderson WR. Roles of cysteinyl leukotrienes in airway inflammation, smooth muscle function, and remodeling. J Allergy Clin Immunol 2003; 111:S18-34; discussion S34-6. [PMID: 12532084 DOI: 10.1067/mai.2003.25] [Citation(s) in RCA: 215] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A new paradigm for asthma pathogenesis is presented in which exaggerated inflammation and remodeling in the airways are a consequence of abnormal injury and repair responses arising from a subject's susceptibility to components of the inhaled environment. An epithelial-mesenchymal trophic unit becomes activated to drive pathologic remodeling and smooth muscle proliferation through complex cytokine interactions. Histamine, prostanoids, and cysteinyl leukotrienes (CysLTs) are potent contractile agonists of airway smooth muscle (ASM). The CysLTs appear to play a central role in regulating human ASM motor tone and phenotypic alterations, manifested as hypertrophy and hyperplasia in chronic severe asthma. The CysLTs augment growth factor-induced ASM mitogenesis through activation of CysLT receptors. Although they mediate their contractile effects by increasing phosphoinositide turnover and inducing increased cytosolic calcium, new data suggest that part of the contractile effect may be independent of calcium mobilization. Prostaglandin E(2), the predominant eicosanoid product of the airway epithelium, is a potent inhibitor of mitogenesis, collagen synthesis, and mesenchymal cell chemotaxis and therefore can suppress inflammation and fibroblast activation. The capacity of the epithelium for CysLT synthesis is inversely related to its ability to make PGE(2). The ASM is capable of expressing both leukotriene-synthesizing enzymes and CysLT receptors, and cytokines upregulate the receptor expression. This may be an explanation for the CysLTs promoting airway hyperresponsiveness in asthma. The CysLTs play an important role in the airway remodeling seen in persistent asthma that includes increases of airway goblet cells, mucus, blood vessels, smooth muscle, myofibroblasts, and airway fibrosis. Evidence from a mouse model of asthma demonstrated that CysLT(1) receptor antagonists inhibit the airway remodeling processes, including eosinophil trafficking to the lungs, eosinophil degranulation, T(H)2 cytokine release, mucus gland hyperplasia, mucus hypersecretion, smooth muscle cell hyperplasia, collagen deposition, and lung fibrosis.
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Affiliation(s)
- Stephen T Holgate
- Respiratory, Cell, and Molecular Biology Research Division, University of Southampton School of Medicine, Southampton, UK
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Mastalerz L, Nizankowska E, Sanak M, Mejza F, Pierzchalska M, Bazan-Socha S, Bestynska-Krypel A, Cmiel A, Szczeklik A. Clinical and genetic features underlying the response of patients with bronchial asthma to treatment with a leukotriene receptor antagonist. Eur J Clin Invest 2002; 32:949-55. [PMID: 12534456 DOI: 10.1046/j.1365-2362.2002.01088.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Treatment with antileukotriene drugs results in clinical improvement in many, though not all, patients with asthma. It can be hypothesized that the subpopulation of asthmatic patients, characterized by aspirin intolerance and cysteinyl-leukotriene overproduction, might profit most from antileukotriene treatment. MATERIALS AND METHODS We compared the clinical response to montelukast in two well-matched groups of patients with mild asthma: 26 aspirin-intolerant asthmatics (AIAs) and 33 aspirin-tolerant asthmatics (ATAs). We also searched for possible predictors of the clinical response among the parameters reflecting the expression and production of cysteinyl-leukotrienes (cys-LTs). This was an 8-week, single-blind, placebo-controlled trial. RESULTS Following a 3-week montelukast 10 mg day-1 treatment compared with placebo, there was a statistically significant reduction in the mean daytime and nocturnal asthma symptoms and beta 2-agonist use, as well as a significant improvement in the morning and evening peak expiratory flows and quality of life. Both groups showed a similar significant improvement in the parameters studied. Clinical response did not correlate with the baseline urinary LTE4 excretion level. Improvement of asthma was observed mostly in patients with a low baseline and non-IL-5 inducible expression of LTC4 synthase (LTC4S) mRNA in eosinophils. There was a trend toward a better response in carriers of LTC4S allele C, but no relationship to the CC10 genetic polymorphism. CONCLUSIONS No difference in the clinical response to the montelukast treatment was observed between the AIAs and the ATAs.
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Affiliation(s)
- L Mastalerz
- Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland
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