Neuroendocrine cells initiate protective upper airway reflexes

Parasympathetic Airway Hyperreactivity Is Enhanced in Acute but Not Chronic Eosinophilic Asthma Mouse Models

Airway hyperreactivity in asthma is mediated by airway nerves, including sensory nerves in airway epithelium and parasympathetic nerves innervating airway smooth muscle. Isolating the function of these two nerve populations in vivo, to distinguish how each is affected by inflammatory processes and contributes to hyperreactivity in asthma, has been challenging. In this study, we used optogenetic activation of airway nerves in vivo to study parasympathetic contributions to airway hyperreactivity in two mouse models of asthma: 1) acute challenge with house dust mite antigen; and 2) chronic airway hypereosinophilia due to genetic IL-5 overexpression in airways. Overall airway hyperreactivity, as measured by bronchoconstriction to an inhaled agonist, was increased in both models. In contrast, optogenetic stimulation of isolated efferent parasympathetic nerves induced bronchoconstriction only in the acute house dust mite antigen challenge group. Using whole-mount tissue immunofluorescence and modeling software, we then measured, in three dimensions, the interactions between eosinophils and parasympathetic nerves in both models and found that eosinophils were more numerous and more proximal to airway parasympathetic nerves in antigen-challenged and IL-5-transgenic mice than in their respective controls but were not significantly different between the two asthma models. Thus, even though eosinophils were increased around nerves in both models, parasympathetic nerves only mediated airway hyperreactivity in the antigen-challenged mice. This study demonstrates divergent effects of acute versus chronic eosinophilia on parasympathetic airway nerve activity and points to eosinophil-nerve interactions as a key regulator of airway hyperreactivity in antigen challenged mice.

Channel synapse mediates neurotransmission of airway protective chemoreflexes

Neural reflexes to chemicals in the throat protect the airway from aspiration and infection. Mechanistic understanding of these reflexes remains premature, exemplified by chronic cough-a sensitized cough reflex-being a prevalent unmet clinical need. Here, in mice, a whole-body search for channel synapses-featuring CALHM1/3 channel-mediated neurotransmitter release-and single-cell transcriptomics uncovered subclasses of the Pou2f3+ chemosensory cell family in the throat communicating with vagal neurons via this synapse. They express G protein-coupled receptors (GPCRs) for noxious chemicals, T2Rs, which upon stimulation trigger swallow and cough-like expulsive reflexes in the hypopharynx and larynx, respectively. These reflexes were abolished by Calhm3 and Pou2f3 knockout and could be triggered by targeted optogenetic stimulation. Furthermore, aeroallergen exposure augmented CALHM3-dependent expulsive reflex. This study identifies Pou2f3+ epithelial cells with channel synapses as chemosensory end organs of airway protective reflexes and sites of their hyperresponsiveness, advancing mechanistic understanding of airway defense programs with distinct therapeutic potential.

Olfactory receptors and human diseases

Olfaction plays a crucial role in distinguishing odors, enabling organisms to seek benefits and evade hazards. Olfactory receptors (ORs), characterized by highly variable binding pockets, facilitate the detection of diverse odorants from both external and internal environments. Nasal ORs, expressed in olfactory sensory neurons (OSNs), are critical for olfactory cognition and associated neuronal plasticity. In contrast, extra-nasal ORs, expressed in extra-olfactory tissues, detect specific chemicals and modulate cellular processes such as proliferation, migration, inflammation, and apoptosis. Aberrant OR expression or dysfunction has been implicated in numerous human diseases, including anosmia, dementia, dermatopathies, obesity, infertility, cancers, respiratory disorders, atherosclerosis and viral infections. Olfactory training, such as aromatherapy, demonstrates significant therapeutic potential for anosmia, dementia and psychological distress. Natural or synthetic odorants have been applied for promoting hair regeneration and cutaneous wound healing. Conversely, overexpression of specific ORs in cancer cells may drive tumor progression. Additionally, ORs may mediate virus-host interactions during infection, owing to their structural variability. Collectively, OR-targeted agonists and antagonists (odorants) represent promising candidates for treating OR-associated pathologies.

Topical ATP Application in the Peripheral Swallowing-Related Regions Facilitates Triggering of the Swallowing Reflex Involving P2X3 Receptors

The swallowing reflex is a critical component of the digestive process, triggered when food or liquids pass from the oral cavity to the oesophagus. Although adenosine triphosphate (ATP) is involved in various physiological processes, its potential to trigger the swallowing reflex has not been fully explored. This study investigated the ability of ATP to induce the swallowing reflex and examined the involvement of the purinoreceptor P2X3 in this process. We observed that the topical application of exogenous ATP to the superior laryngeal nerve (SLN)-innervated swallowing-related regions dose-dependently facilitated the triggering of the swallowing reflex. P2X3 receptors were predominantly localized on nerve fibres within these regions, including intraepithelial and subepithelial nerves and those associated with taste-bud-like structures. In the nodose-petrosal-jugular ganglionic complex, approximately 40% of retrogradely traced SLN-afferent neurons expressed P2X3, with 59% being medium-sized, 30% small, and 11% large. Prior topical application of a P2X3 antagonist in SLN-innervated, swallowing-related regions significantly reduced the number of ATP-induced swallowing reflexes. Furthermore, topical application of a P2X3 receptor agonist more selective than ATP facilitated reflex triggering in a dose-dependent manner. These findings suggest that exogenous ATP facilitates the triggering of the swallowing reflex through the activation of P2X3 receptors. This activation excites afferent neurons that supply peripheral swallowing-related regions, stimulating the swallowing central pattern generator to facilitate the reflex. The current findings suggest the therapeutic potential of ATP or P2X3 agonists for dysphagia treatment and provide valuable physiological insights into the involvement of purinergic signaling in triggering the swallowing reflex.

Assessing agreement among non-invasive indicators for inspiratory effort during pressure support ventilation

Background

During pressure support ventilation (PSV), the accuracy of non-invasive indicators in diagnosing high or low inspiratory effort has been validated. However, the correlation and agreement of these indicators remain unclear. This study aims to investigate the correlation and agreement among non-invasive inspiratory effort indicators, and to compare characteristics of inspiratory effort in neurocritical and non-neurocritical patients.

Methods

This was a single-centre prospective observational study. We collected three non-invasive inspiratory effort indicators, pressure muscular index (PMI), the maximal negative swing of airway pressure during expiratory occlusion (ΔPocc), and the airway occlusion pressure during the first 100ms (P0.1). Cutoff values for these indicators derived from esophageal pressure-time product (PTPmus) were chosen for this study. The correlation and agreement of these indicators were analyzed using Spearman's rank correlation test and linear weighted Kappa analysis. Characteristics of PSV settings and inspiratory effort in neurocritical and non-neurocritical patients were compared.

Results

Ninety-seven patients were enrolled in this study. Correlation analysis showed a moderate correlation between PMI and ΔPocc (rho = -0.524, p < 0.001), ΔPocc and P0.1 (rho = 0.588, p < 0.001), while no correlation between PMI and P0.1 (rho = -0.140, p = 0.172). There was a moderate agreement between ΔPocc and P0.1 (k = 0.459, p < 0.001), a fair agreement between PMI and ΔPocc (k = 0.362, p < 0.001), but no agreement between PMI and P0.1 (k = 0.134, p = 0.072). The correlation of these indicators was similar in neurocritical patients compared with non-neurocritical patients, but agreement was poor.

Conclusion

The study showed that PMI and ΔPocc had moderate correlation and fair agreement, ΔPocc and P0.1 had moderate correlation and agreement, while PMI and P0.1 had no correlation and agreement.

Intrinsic electrical activity drives small-cell lung cancer progression

Elevated or ectopic expression of neuronal receptors promotes tumour progression in many cancer types1,2; neuroendocrine (NE) transformation of adenocarcinomas has also been associated with increased aggressiveness3. Whether the defining neuronal feature, namely electrical excitability, exists in cancer cells and impacts cancer progression remains mostly unexplored. Small-cell lung cancer (SCLC) is an archetypal example of a highly aggressive NE cancer and comprises two major distinct subpopulations: NE cells and non-NE cells4,5. Here we show that NE cells, but not non-NE cells, are excitable, and their action potential firing directly promotes SCLC malignancy. However, the resultant high ATP demand leads to an unusual dependency on oxidative phosphorylation in NE cells. This finding contrasts with the properties of most cancer cells reported in the literature, which are non-excitable and rely heavily on aerobic glycolysis. Additionally, we found that non-NE cells metabolically support NE cells, a process akin to the astrocyte-neuron metabolite shuttle6. Finally, we observed drastic changes in the innervation landscape during SCLC progression, which coincided with increased intratumoural heterogeneity and elevated neuronal features in SCLC cells, suggesting an induction of a tumour-autonomous vicious cycle, driven by cancer cell-intrinsic electrical activity, which confers long-term tumorigenic capability and metastatic potential.

A Single-Cell Atlas of the Upper Respiratory Epithelium Reveals Heterogeneity in Cell Types and Patterning Strategies

The upper respiratory tract, organized along the pharyngolaryngeal-to-tracheobronchial axis, is essential for homeostatic functions such as breathing and vocalization. The upper respiratory epithelium is frequently exposed to pollutants and pathogens, making this an area of first-line defense against respiratory injury and infection. The respiratory epithelium is composed of a rich array of specialized cell types, each with unique capabilities in immune defense and injury repair. However, the precise transcriptomic signature and spatial distribution of these cell populations, as well as potential cell subpopulations, have not been well defined. Here, using single cell RNAseq combined with spatial validation, we present a comprehensive atlas of the mouse upper respiratory epithelium. We systematically analyzed our rich RNAseq dataset of the upper respiratory epithelium to reveal 17 cell types, which we further organized into three spatially distinct compartments: the Tmprss11a + pharyngolaryngeal, the Nkx2-1 + tracheobronchial, and the Dmbt1 + submucosal gland epithelium. We profiled/analyzed the pharyngolaryngeal epithelium, composed of stratified squamous epithelium, and identified distinct regional signatures, including a Keratin gene expression code. In profiling the tracheobronchial epithelium, which is composed of a pseudostratified epithelium-with the exception of the hillock structure-we identified that regional luminal cells, such as club cells and basal cells, show varying gradients of marker expression along the proximal-distal and/or dorsal-ventral axis. Lastly, our analysis of the submucosal gland epithelium, composed of an array of cell types, such as the unique myoepithelial cells, revealed the colorful diversity of between and within cell populations. Our single-cell atlas with spatial validation highlights the distinct transcriptional programs of the upper respiratory epithelium and serves as a valuable resource for future investigations to address how cells behave in homeostasis and pathogenesis.

Highlights

- Defined three spatially distinct epithelial compartments, Tmprss11a + pharyngolaryngeal, Nkx2-1 + tracheobronchial, and Dmbt1 + submucosal gland, comprising 17 total cell types - Profiled Keratin gene expression code along proximal-distal and basal-luminal axes and highlighted "stress-induced" Keratins KRT6A and KRT17 at homeostasis - Demarcated expression gradients of Scgb1a1 + and Scgb3a2+ club cells along the proximal-distal axes - Specified submucosal gland cell heterogeneity including Nkx3-1+ mucin-producing cells, with ACTA2+ basal myoepithelial cells exhibiting gene profile for neuroimmune mediated signaling.

Evaluate the safety of a novel photohydrolysis technology used to clean and disinfect indoor air: A murine study

There is a pressing need to develop new technologies that continuously eliminates harmful pollutants and pathogens in occupied indoor spaces without compromising safety. This study was undertaken to test the safety of a novel air cleaning and disinfection technology called Advanced Photohydrolysis. Advanced Photohydrolysis generates a complex mixture of ions and molecules that are released into the air and has been shown to reduce airborne and surface pathogens. Mice (6-8-week-old) were exposed to therapeutic levels of Advanced Photohydrolysis for 90-days. During the study, the Advanced-Photohydrolysis-exposed and control mice were monitored for food consumption, body weight gain, and any overt adverse effects. In addition, at the conclusion of the study, the blood chemistry and hematology values of both groups were determined. Finally, the tissues of the conduction and respiratory portions of the airways of mice from both groups were examined for any pathological changes. The mice of both groups were found to be normal and healthy throughout the 90-day study; there were no differences in the behavior, food consumption and weight gain. Analysis of clinical chemistry values found no differences in hepatocellular function or other markers of cellular and organ function, and clinical hematology values were also unremarkable. Finally, and importantly, histopathology of the upper and lower airway tissues showed no deleterious effects. These results are the first to demonstrate directly the safety of Advanced Photohydrolysis on live mammals and encourage additional studies.

(Don't) take my breath away: Rare epithelial cells in our airways initiate reflexes to guard against harmful stimuli

Rare epithelial cells in our airways initiate reflexes to guard against harmful stimuli.

Sentinels of the airways

Epithelial cells in the larynx and trachea sense harmful cues and trigger protective reflexes.