Transition from normal to hypersecretory bronchial mucus in a canine model of bronchitis: changes in yield and composition

Quantification of mucin gene expression in tracheobronchial epithelium of healthy dogs and dogs with chronic bronchitis

OBJECTIVE

To develop a real-time PCR assay for the quantification of mucin gene expression in tracheobronchial brushing specimens from dogs and compare mucin gene expression in specimens from dogs with naturally occurring chronic bronchitis with that in specimens from healthy dogs.

ANIMALS

7 healthy dogs and 5 dogs with chronic bronchitis.

PROCEDURES

Primers that were designed to span the predicted intron-exon boundaries of a canine MUC5AC-like gene were used to develop a real-time PCR assay for quantification of expression of that gene. Total mRNA was isolated from tracheobronchial brushing specimens obtained from dogs with and without bronchitis during anesthesia; MUC5AC-like gene expression in those samples was quantified by use of the real-time PCR assay.

RESULTS

The PCR assay was sensitive and specific for the target sequence, the predicted amino acid sequence of which had greatest homology with human, porcine, and rat MUC5AC. The assay was able to quantify the target over a wide dynamic range. Dogs with chronic bronchitis had a 3.0-fold increase in the quantity of MUC5AC-like mRNA, compared with healthy dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

The ability to measure mucin gene expression from tracheobronchial brushing specimens collected from client-owned dogs during routine bronchoscopy should prove to be a useful tool for the study of bronchitis in dogs and expand the usefulness of airway inflammation in dogs as a model for bronchitis in humans.

Animal models of asthma and chronic bronchitis

Human asthma is characterized by three critical phenotypic traits: intermittent reversible airway obstruction, airway hyperresponsiveness and airway inflammation. In animal models of asthma, airway hyperresponsiveness is an important feature. This trait is characterized by an exaggerated bronchoconstrictor response that would have little physiological consequence in an otherwise unaffected or normal individual. In this article we explore two distinct facets of airway responsiveness. The first is the genetic basis for variations in airway responsiveness that occur in mice in the absence of any specific environmental manipulation. We demonstrate that standard genetic approaches can be successfully applied to the identification of regions of the mouse genome linked to the expression of airway hyperresponsiveness. The second topic addressed in this review is the change in airway responsiveness induced in rats by repeated exposure to sulphur dioxide gas. With daily exposure to high concentrations of sulphur dioxide gas, there is chronic injury and repair of epithelial cells. Over time, rats develop mucous hypersecretion, airway inflammation, increased airway resistance and airway hyperresponsiveness. This model has provided useful information on the mechanisms underlying the pathophysiological events that typify the chronic bronchitis in humans.

Monoclonal antibody-detectable carbohydrate epitopes of human nasal secretions are differentially expressed in tissue and diseases

To study the differential carbohydrate expression of airway secretions, we have produced a series of monoclonal antibodies that recognize human nasal secretory cell products. Mice were immunized with purified nasal secretion from patients with chronic sinusitis (CS) and hybridomas were selected by ELISA and immunohistochemical staining of the maxillary sinus mucosa from patients with CS. Eighteen antibodies were obtained. Antibody HCS 18 reacted with epithelial goblet cells, antibody HCS 4, 5, 6, and 16 stained submucosal gland cells, and antibody HCS 13 and 15 reacted with epithelial goblet cells, submucosal gland cells, and endothelial cells of vessels. The other eleven antibodies recognized epithelial goblet cells and submucosal gland cells. Cross-reactivity of these antibodies with secretory cells in other organs and in other species was determined and the different staining pattern was observed between upper and lower airway tissue, suggesting that secretory products from upper and lower airways may be different. Reactivity of the antibodies with nasal secretory cells was also examined in patients with perennial allergic rhinitis (AR) and normal subjects. Antibody HCS 18 weakly reacted with nasal glands in the tissue from CS and AR patients, but minimally reacted with gland cells in normal tissue. Antibody HCS 1 and 7 partially lost their reactivity with nasal epithelium of inferior turbinate from normal subjects and AR patients. These antibodies may be useful to study nasal secretions.

Heterogeneity of the composition and thickness of tracheal mucus in rats

Inability to preserve airway mucus in situ has limited our understanding of its structure and function. This light- and transmission electron-microscopic study of rat tracheal mucus used a nonaqueous fixative that retains mucus (epiphase) over a lucent layer (hypophase). The fixative is a 1% solution of osmium tetroxide dissolved in a perfluorocarbon. The mean thickness of rat tracheal epiphase was 5 microns, with significant variation (0.1-50 microns) around the tracheal circumference. Tracheal mucus was thickest at the trachealis muscle region and contained cells, cellular debris, and a variable amount of surfactant and lipid, estimated at 4-16% of the total epiphase in five rats, with a mean composition of 9%. Lipid was observed on the surface of the epiphase, embedded within mucus, and at the epiphase-hypophase interface. Refined study of developmental, physiological, and pathological alterations to the airway coat may benefit from this approach.

Abnormal mucous cell phenotype induced by neutrophil elastase in hamster bronchi

Bronchial mucous cell metaplasia (MCM) is a histologic component of chronic mucus hypersecretion. The hamster model of elastase-induced MCM appears to involve an irreversible conversion of Clara cells to mucous cells. The present study questioned whether the mucous cells seen in hamster bronchi exposed to neutrophil elastase produce and maintain a form of glycoconjugate secretory product different from that normally found in mucous cells or Clara cells. Ultrastructural cytochemistry using the gold-labeled lectin HPA revealed a difference in the cell surface and stored secretory granules of elastase-derived mucous cells compared to normal mucous cells and Clara cells at 3 weeks and 4 months following exposure. The results suggest that elastase irreversibly alters the glycoconjugate character of the Clara cells normally present so that they produce an abnormal form of mucus. Because secreted glycoconjugates can affect the rate of mucociliary clearance and receptor-mediated binding of microorganisms, this change in phenotype may be involved in the pathogenesis of diseases associated with chronic mucus hypersecretion in humans.

NO2 reactive absorption substrates in rat pulmonary surface lining fluids

Inhaled 'NO2 is absorbed by a free radical-dependent reaction mechanism that localizes the initial oxidative events to the extracellular space of the pulmonary surface lining layer (SLL). Because 'NO2 per se is eliminated upon absorption, most likely the SLL-derived reaction products are critical to the genesis of 'NO2-induced lung injury. We utilized analysis of the rate of 'NO2 disappearance from the gas phase to determine the preferential absorption substrates within rat SLL. SLL was obtained via bronchoalveolar lavage and was used either as the cell-free composite or after constituent manipulation [(i) dialysis, treatment with (ii) N-ethylmaleimide, (iii) ascorbate oxidase, (iv) uricase, or (v) combined ii + iii]. Specific SLL constituents were studied in pure chemical systems. Exposures were conducted under conditions where 'NO2 is the limiting reagent and disappears with first-order kinetics ([NO2]0 < or = 10 ppm). Reduced glutathione and ascorbate were the principle rat SLL absorption substrates. Nonsulfhydryl amino acids and dipalmitoyl phosphatidylcholine exhibited negligible absorption activity. Whereas uric acid and vitamins A and E displayed rapid absorption kinetics, their low SLL concentrations preclude appreciable direct interaction. Unsaturated fatty acids may account for < or = 20% of absorption. The results suggest that water soluble, low molecular weight antioxidants are the preferential substrates driving 'NO2 absorption. Consequently, their free radicals, produced as a consequence of 'NO2 exposure, may participate in initiating the 'NO2-induced cascade, which results in epithelial injury.

Species differences in the physical and transport properties of airway secretions

The clearance of airway secretions is vital in protecting the mammalian lung from pollution and infection. Diverse animal models have been used to study lung diseases associated with impaired secretion clearance. The extrapolation of data from animal models to humans is based on the assumption that there are structural and functional similarities in the airway epithelium and secretions. This manuscript reviews regulation of mucus secretion as well as the physical and transport properties of respiratory mucus. As tracheal size increases, the rigidity of airway secretions decreases, and rigidity is inversely correlated with mucociliary transportability. These differences are placed in the context of previously reported species and regional differences in transepithelial potential difference and the tracheobronchial epithelial cell population. Tracheal mucus transport velocity varies with the species studied and has been shown to positively correlate with tracheal surface area. A progressive increase in the rate of mucus transport from the small to the large airways has also been reported. The reduction in mucus rigidity from small to large airways could be one of the mechanisms responsible for velocity gradients, which facilitate mucociliary transport. Because airway dimensions, rather than anatomic level of the airway, may better predict epithelial secretory response, studies to assess the physiologic responses in human airways require the use of an animal model with a similar-sized airway.

Mucin gene expression in rat airways following infection and irritation

Airway mucus hypersecretion occurs in response to infection and irritation and poses an important and poorly understood clinical problem. In order to gain insight into its pathogenesis, we have focused on an mRNA encoding the major mucus glycoprotein, mucin. Northern blots showed that mucin mRNA was abundant in the intestine of specific pathogen free rats whereas it was undetectable in the airways of these rats until pathogen-free conditions were suspended and rats acquired Sendai (Parainfluenza I) virus infections. Airway mucin hybridization signals in rats that were both infected with Sendai virus and exposed to SO2 were more intense than those in rats with infection alone. These results suggest that pathogen-and irritant-induced hypersecretion may be partly controlled at the level of mucin mRNA.

Mucin in disease. Modification of mucin gene expression in airway disease

Mucus hypersecretion is a characteristic feature of several human airway diseases, including chronic bronchitis, cystic fibrosis, and asthma. Although its pathogenesis is poorly understood, hypersecretion apparently results from the abnormally large number of mucous cells found in hypersecretory airways. The factors giving rise to these mucous cells are unknown, but experimental evidence supports possible roles for both mitosis (mucous cell hyperplasia) and differentiation (mucous cell metaplasia). On the basis of the hypothesis that differentiation would require activation of mucin mRNA transcription, we have used mucin cDNA to monitor mucin mRNA levels in an animal model of chronic bronchitis. We first showed that a mucin gene (SMUC or MUC-2) cloned from the human intestine is also expressed in the human airways and is the same or homologous to genes expressed in other human mucin-producing organs. We next showed that a homologue of the SMUC gene is expressed in several animal species, including the rat. Finally, we showed that the induction of experimental chronic bronchitis by SO2 in rats is accompanied by the induction (from near zero baseline) of airway mucin mRNA. The induction by irritants of high steady-state levels of mucin mRNA may represent one of the early events in mucous cell differentiation and hypersecretion.

Bronchial mucus hypersecretion in acute quadriplegia. Macromolecular yields and glycoconjugate composition

In acute quadriplegia we have noted that about one in five patients develops unexplained production of markedly excessive and tenacious bronchial mucus. Spontaneous recovery from mucus hypersecretion usually occurs within weeks to months. Mucus samples collected from 12 patients have been found to be abnormal. Macromolecular contents of single aspirates yielded as much as 500 mg. Analytical ultracentrifuge analysis showed the mucus to contain considerable epithelial glycoprotein (GP) of typical buoyant density; its amino acid and carbohydrate compositions were characteristic of the GP from hypersecretory bronchial mucus such as in chronic bronchitis and cystic fibrosis. In five patients studied after recovery from hypersecretion, there tended to be relatively less GP. The mucus samples contained a high density glycoconjugate (GC): this had sugars of GP but also reacted positively with a monoclonal antibody to keratan sulfate. Its amino acid composition was different from that of GP: threonine was lower and glycine was higher than in GP. In mucus from one patient who died, chondroitin sulfate ABC and hyaluronic acid were identified as well. This suggests proteoglycans are involved in the pathophysiology of mucus hypersecretion. The sudden onset and spontaneous recovery of hypersecretion suggests that it is not due to gland hypertrophy. We speculate that in acute quadriplegia it is due to disturbed neuronal control of bronchial mucus gland secretion, perhaps related to initial disappearance and later reappearance of peripheral sympathetic nervous system tone.

Lipids in airway mucus of acute quadriplegic patients

Quadriplegic patients have difficulty in clearing lung mucus due to paralysis of muscles of respiration. In about 25% of these patients, excessive mucus in the airway necessitates tracheostomy, and in some patients it is fatal. In others there is spontaneous recovery. To determine if the excessive mucus results from secretion of abnormal mucus or from accumulation of normal mucus, we analyzed the lipids in mucus from eight quadriplegic patients. Lipids were separated from other constituents of the mucus by density gradient ultracentrifugation, extracted with chloroform-methanol (2:1), and examined by high-performance thin-layer chromatography (HPTLC). Cholesterol was the major neutral lipid; phosphatidylethanolamine, phosphatidylcholine, and sphingomyelin were the main phospholipids. Glycolipids were predominant, lactosylceramide (CDH) being the highest in amount. Two-dimensional HPTLC as well as high-performance lipid chromatography also revealed the presence of gangliosides: comparison with standards indicated the presence of GM1, GM2, GM3, and some unidentified gangliosides. In normal mucus, cholesterol is the predominant lipid; phospholipid is present in smaller amounts but glycolipids are not identified. Thus, results of our lipid analysis show that mucus from the quadriplegic patients is abnormal and similar to that in hypersecretory diseases such as chronic bronchitis and cystic fibrosis. Unlike these latter cases, hypersecretion in the quadriplegic has a rapid onset and, often, spontaneous recovery, suggesting that this is due to abnormal stimulation rather than an increase in the population of secretory cells.

Recovery of an epitope recognized by a novel monoclonal antibody from airway lavage during experimental induction of chronic bronchitis

Prolonged exposure of dogs to high concentrations of SO2 gas results in a syndrome with many of the characteristics of human chronic bronchitis, including cough and chronic mucous hypersecretion as well as airway obstruction. We developed and used a novel monoclonal antibody, GB-4B, raised against epithelial glycoprotein isolated from human hypersecretory mucus to probe airway lavage samples from dogs before and during prolonged exposure to SO2 gas. There were relatively low mean titers of the epitope recognized by GB-4B in airway lavage fluid as evidenced by enzyme-linked immunosorbent assay before exposure to SO2 gas. After 25 to 50 wk of SO2 exposure, the dogs showed a significant increase in pulmonary resistance and there was a significant increase in the titer of the epitope in the airway lavage fluid. Using the same antibody immunohistochemical analysis of airway tissues from SO2-exposed dogs revealed patchy staining of the mucous glands and airway secretory cells and dense staining along the airway surface; airway tissue from control dogs and one SO2-exposed dog whose lavage fluid did not contain the epitope showed little or no staining. These data demonstrate that similar mucin epitopes appear in airway lavage fluid under hypersecretory conditions in both animals and humans. The epitope may have utility as a marker of chronic mucous hypersecretion.

Hydrophobicity of mucin-like glycoproteins secreted by cultured tracheal epithelial cells: association with lipids

Confluent cultures of primary hamster tracheal surface epithelial cells are highly enriched with secretory cells resembling airway goblet cells. The cultures secrete lipids, most of which appear to be associated with high-molecular-weight mucinlike glycoproteins (HMW MLGP). In the present communication, we examined the nature of the association and analyzed the lipids associated with the secreted HMW MLGP. The HMW MLGP purified in the presence of 4 M guanidinium HCl were highly associated with lipids. When these HMW MLGP were gel filtered using a Sepharose CL-4B column in the presence of detergents, more than 97% of the associated lipids were dissociated from HMW MLGP and eluted in fractions with Kd = 0.70. On the other hand, when [3H]palmitic acid-labeled spent medium was gel filtered, column elution profiles varied among elution buffers, a major change being an appearance of a 3H peak at Kd = 0.70 in the presence of 50 mM sodium acetate, phosphate-buffered saline (PBS), or PBS/sodium dodecyl sulfate, but not with 4 M guanidinium HCl. Lipids associated with MMW MLGP under a "physiological" condition consisted of neutral, phospho-, and glycolipids. We conclude that (1) HMW MLGP secreted from cultured airway epithelial cells are extremely hydrophobic and associated with a variety of lipids, mostly via noncovalent binding, and (2) the degree of the lipid association seems to depend on the ionic environment of the solution.

Secretions from primary hamster tracheal surface epithelial cells in culture: mucin-like glycoproteins, proteoglycans, and lipids

Surface epithelial cells dissociated from hamster tracheas and grown on a thick collagen gel in the presence of 5% fetal bovine serum become highly enriched with secretory cells at confluence. In the present communication, we have analyzed secretory products from this primary hamster tracheal surface epithelial (HTSE) cell culture. The secreted glycoconjugates included high-molecular-weight mucin-like glycoproteins (HMW MLGP) and proteoglycans that comprised 22% and 5% of the total [3H]glycoconjugates secreted when [3H]glucosamine was added as a metabolic precursor. Among the proteoglycans were hyaluronic acids (53%), heparan sulfate proteoglycans (29%), and chrondroitin sulfate proteoglycans (18%). Chondroitin sulfates were mostly 4-sulfated. On the other hand, the secreted lipids included cholesterol, phospholipids, and glycolipids, and most of them were associated with HMW MLGP.