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Castellani M, Felaco P, Pandolfp F, Salini V, De Amicis D, Vecchiet J, Tetè S, Ciampoli C, Conti F, Cerulli G, Caraffa A, Antinolfi P, Cuccurullo C, Perrella A, Theoharides T, De Lutiis M, Kempuraj D, Shaik Y. Inflammatory Compounds: Neuropeptide Substance Pand Cytokines. EUR J INFLAMM 2017. [DOI: 10.1177/1721727x0900700202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Inflammatory diseases represent one of the major causes of morbidity and mortality throughout the world and they affect the functions of several tissues. The pathophysiology of these diseases involves release of many pro-inflammatory mediators such as cytokines/chemokines, histamine, C3a, C5a (complement components), bradykinin, leukotrienes (LTC4, LTD4, LTE4), PAF, and substance P, in addition to anti-inflammatory molecules. Recently, it has been demonstrated that neuroimmune interactions are important in the initiation and progress of inflammatory processes. Substance P is an 11-amino acid neuropeptide that is released from nerve endings in many tissues. It acts via membrane-bound NK1 receptors (NK1R). Inflammatory and neuropeptides such as substance P stimulate the release of chemokines, in particular IL-8, a potent neutrophil chemoattractant. Expression of IL-8 is regulated mainly by the transcription factors NF-kappaB, activating protein-1. Substance P plays an important role in immunological and inflammatory states, and it is a mediator of tissue injury, asthma, arthritis, allergy and autoimmune diseases. In this article, our studies revisited the interrelationship between these two powerful inflammatory compounds: substance P and cytokines. These observations suggest that these inflammatory molecules may represent a potential therapeutic target to treat several inflammatory states.
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Affiliation(s)
- M.L. Castellani
- Immunology Division, Medical School, University of Chieti-Pescara, Italy
| | - P. Felaco
- Division of Nephrology, University of Chieti, Italy
| | - F. Pandolfp
- Immunology Division, Medical School, University of Chieti-Pescara, Italy
| | - V. Salini
- Department of Human Dynamic, University of Chieti-Pescara, Italy
| | - D. De Amicis
- Department of Human Dynamic, University of Chieti-Pescara, Italy
| | - J. Vecchiet
- Clinic of Infectious Diseases, Medical School, University of Chieti-Pescara, Italy
| | - S. Tetè
- Dental School, University of Chieti-Pescara, Italy
| | - C. Ciampoli
- Dental School, University of Chieti-Pescara, Italy
| | - F. Conti
- Gynecology Division, University of Chieti, Italy
| | - G. Cerulli
- Orthopeadic Division, University of Perugia, Italy
| | - A. Caraffa
- Orthopeadic Division, University of Perugia, Italy
| | - P. Antinolfi
- Orthopeadic Division, University of Perugia, Italy
| | - C. Cuccurullo
- Division of Medical Pathology, University of Chieti, Italy
| | - A. Perrella
- Department of Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - T.C. Theoharides
- Department of Pharmacology and Experimental Therapeutics, Biochemistry and Internal Medicine Tufts University School of Medicine, Tufts-New England Medical Center, Boston, MA, USA
| | - M.A. De Lutiis
- Department of Biology, University of Chieti, Chieti, Italy
| | - D. Kempuraj
- Department of Pharmacology and Experimental Therapeutics, Biochemistry and Internal Medicine Tufts University School of Medicine, Tufts-New England Medical Center, Boston, MA, USA
| | - Y.B. Shaik
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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Ji H, Minuk GY, Peng Z, Chen Y, Pan C, Gong Y. Active immunization against transforming growth factor beta1 prevents hepatic fibrosis in a rat model of liver disease. Can J Physiol Pharmacol 2017; 95:743-749. [PMID: 28301738 DOI: 10.1139/cjpp-2016-0669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Transforming growth factor beta1 (TGF-β1) plays an important role in hepatic fibrogenesis. In this study, we documented the effects of active immunization against TGF-β1 on hepatic fibrosis in an animal model of chronic liver disease. BALB/c mice were immunized against 3 different peptides of TGF-β1 ligated into hepatitis B virus core protein (HBVc). Titers of TGF-β1 antibodies were documented by enzyme linked immunoassays and antibody activity by cell membrane receptor binding and proliferation assays. The most immunogenic recombinant HBVc + TGF-β1 peptide (HBVc + C) then served as a vaccine in Sprague-Dawley rats with dimethylnitrosamine-induced chronic liver disease. Hepatic fibrosis was documented by serum hyaluronic acid levels, liver histology, and reverse transcriptase polymerase chain reaction for hepatic collagen I (α1) and smooth muscle alpha actin mRNA expression. Relative to control rats vaccinated with HBVc alone, recombinant HBVc + C vaccinated animals had significantly lower serum hyaluronic acid levels, less histologic evidence of hepatic fibrosis, and reduced expression of collagen I (α1) and smooth muscle alpha actin mRNA in the liver. The results of this proof-of-concept study suggest that active immunization against TGF-β1 is a worthwhile strategy to pursue in efforts to prevent hepatic fibrosis associated with chronic liver disease.
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Affiliation(s)
- Hong Ji
- a College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada.,b Section of Hepatology, Department of Internal Medicine, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Gerald Y Minuk
- b Section of Hepatology, Department of Internal Medicine, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Zhikang Peng
- c Department of Pediatrics & Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Yongping Chen
- d The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, Zhejiang Province, China
| | - Chenwei Pan
- d The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, Zhejiang Province, China
| | - Yuewen Gong
- a College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada.,b Section of Hepatology, Department of Internal Medicine, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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He YH, Li Z, Ni MM, Zhang XY, Li MF, Meng XM, Huang C, Li J. Cryptolepine derivative-6h inhibits liver fibrosis in TGF-β1-induced HSC-T6 cells by targeting the Shh pathway. Can J Physiol Pharmacol 2016; 94:987-95. [PMID: 27295431 DOI: 10.1139/cjpp-2016-0157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Liver fibrosis is a worldwide problem with a significant morbidity and mortality. Cryptolepis sanguinolenta (family Periplocaceae) is widely used in West African countries for the treatment of malaria, as well as for some other diseases. However, the role of C. sanguinolenta in hepatic fibrosis is still unknown. It has been reported that Methyl-CpG binding protein 2 (MeCP2) had a high expression in liver fibrosis and played a central role in its pathobiology. Interestingly, we found that a cryptolepine derivative (HZ-6h) could inhibit liver fibrosis by reducing MeCP2 expression, as evidenced by the dramatic downregulation of α-smooth muscle actin (α-SMA) and type I collagen alpha-1 (Col1α1) in protein levels in vitro. Meanwhile, we also found that HZ-6h could reduce the cell viability and promote apoptosis of hepatic stellate cells (HSCs) treated with transforming growth factor beta 1(TGF-β1). Then, we investigated the potential molecular mechanisms and found that HZ-6h blocked Shh signaling in HSC-T6 cells, resulting in the decreased protein expression of Patched-1 (PTCH-1), Sonic hedgehog (Shh), and glioma-associated oncogene homolog 1 (GLI1). In short, these results indicate that HZ-6h inhibits liver fibrosis by downregulating MeCP2 through the Shh pathway in TGF-β1-induced HSC-T6 cells.
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Affiliation(s)
- Ying-Hua He
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Zeng Li
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Ming-Ming Ni
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Xing-Yan Zhang
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Ming-Fang Li
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Xiao-Ming Meng
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Cheng Huang
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Jun Li
- a School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China.,b Institute for Liver Diseases, Anhui Medical University, ILD-AMU, Hefei 230032, China.,c Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
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Mohamed DI, Elmelegy AASM, A. El-Aziz LF, Abdel kawy HS, AbdEl-Samad AA, El-Kharashi OA. Hepatoprotective effects of early pentoxifylline administration on hepatic injury induced by concanavalin A in rat. Can J Physiol Pharmacol 2014; 92:490-7. [DOI: 10.1139/cjpp-2014-0085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Tumor necrosis factor alpha (TNF-α) plays an important role in the pathogensis of hepatitis C virus (HCV) infection induced liver injury. This study aimed to evaluate the effects of TNF-α inhibition with pentoxifylline (PTX) on concanavalin A (Con A)-induced hepatic injury in rats. The rats were distributed among 3 groups: (i) control group (1 mL saline·week–1 by intravenous injection (i.v.)); (ii) Con A treatment group (20 mg Con A·(kg body mass)–1·week–1, i.v.), and (iii) rats treated with Con A and with PTX (200 mg PTX·(kg body mass)–1·day–1, per oral) group. Blood samples and livers were collected at the end of weeks 1, 2, 4, and 8 of Con A treatment. Portal pressure (PP) was measured at the end of week 8. The administration of PTX was found to confer significant protection against the injurious effects of Con A on the liver, by reducing serum levels of aspartate aminotransferase, alanine aminotransferase, hepatic TNF-α, and malondialdehyde. Histopathological examination revealed that treatment with PTX significantly suppressed early inflammation, reduced alpha smooth muscle actin, and the apoptosis of hepatocytes induced by Con A. Moreover, PTX significantly (P < 0.05) reduced PP, and quantitative analyses of the area of fibrosis induced by treatment with Con A showed a significant reduction at the end of week 8. We conclude that rats treated with PTX revealed a more or less normal hepatocyte architecture as well as marked improvement in fibrosis and PP.
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Affiliation(s)
- Doaa Ibrahim Mohamed
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Ouaguia L, Morales O, Mrizak D, Ghazal K, Boleslawski E, Auriault C, Pancré V, de Launoit Y, Conti F, Delhem N. Overexpression of Regulatory T Cells Type 1 (Tr1) Specific Markers in a Patient with HCV-Induced Hepatocellular Carcinoma. ISRN Hepatol 2013; 2013:928485. [PMID: 27335834 DOI: 10.1155/2013/928485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 07/24/2013] [Indexed: 01/14/2023]
Abstract
Hepatitis C virus (HCV) is an important causative agent of liver disease, but factors that determine the resolution or progression of infection are poorly understood. In this study, we suggested that existence of immunosuppressive mechanisms, supported by regulatory T cells and especially the regulatory T cell 1 subset (Tr1), may explain the impaired immune response during infection and thus the fibrosis aggravation to hepatocellular carcinoma (HCC). Using quantitative real-time PCR, we investigated the intra-hepatic presence of Tr1 cells in biopsies from a genotype 1b infected patient followed for an 18-year period from cirrhosis to HCC. We described a significant increase of gene expression in particular for the cytokines IL-10, TGF-β, and their receptors that were perfectly correlated with an increased expression of the Tr1 specific markers (combined expression of CD4, CD18, and CD49b). This was strongly marked since the patient evolved in the pathology and could explain the failure of the treatment. In conclusion, evidence of regulatory T cell installation in the liver of chronically infected patient with cirrhosis and HCC suggests for the first time a key role for these cells in the course of HCV infection.
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Moorman JP, Wang JM, Zhang Y, Ji XJ, Ma CJ, Wu XY, Jia ZS, Wang KS, Yao ZQ. Tim-3 pathway controls regulatory and effector T cell balance during hepatitis C virus infection. J Immunol 2012; 189:755-66. [PMID: 22706088 PMCID: PMC3392408 DOI: 10.4049/jimmunol.1200162] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hepatitis C virus (HCV) is remarkable at disrupting human immunity to establish chronic infection. Upregulation of inhibitory signaling pathways (such as T cell Ig and mucin domain protein-3 [Tim-3]) and accumulation of regulatory T cells (Tregs) play pivotal roles in suppressing antiviral effector T cell (Teff) responses that are essential for viral clearance. Although the Tim-3 pathway has been shown to negatively regulate Teffs, its role in regulating Foxp3(+) Tregs is poorly explored. In this study, we investigated whether and how the Tim-3 pathway alters Foxp3(+) Treg development and function in patients with chronic HCV infection. We found that Tim-3 was upregulated, not only on IL-2-producing CD4(+)CD25(+)Foxp3(-) Teffs, but also on CD4(+)CD25(+)Foxp3(+) Tregs, which accumulate in the peripheral blood of chronically HCV-infected individuals when compared with healthy subjects. Tim-3 expression on Foxp3(+) Tregs positively correlated with expression of the proliferation marker Ki67 on Tregs, but it was inversely associated with proliferation of IL-2-producing Teffs. Moreover, Foxp3(+) Tregs were found to be more resistant to, and Foxp3(-) Teffs more sensitive to, TCR activation-induced cell apoptosis, which was reversible by blocking Tim-3 signaling. Consistent with its role in T cell proliferation and apoptosis, blockade of Tim-3 on CD4(+)CD25(+) T cells promoted expansion of Teffs more substantially than Tregs through improving STAT-5 signaling, thus correcting the imbalance of Foxp3(+) Tregs/Foxp3(-) Teffs that was induced by HCV infection. Taken together, the Tim-3 pathway appears to control Treg and Teff balance through altering cell proliferation and apoptosis during HCV infection.
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Affiliation(s)
- Jonathan P. Moorman
- Hepatitis (HCV/HIV) Program, Department of Veterans Affairs, James H. Quillen VA Medical Center, Johnson City, Tennessee, United State of America
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
| | - Jia M. Wang
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
- Department of Biochemistry and Molecular Biology, Soochow University School of Medicine, Suzhou, China
| | - Ying Zhang
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
- Department of Infectious Diseases, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xiao J. Ji
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
- Department of Critical Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Cheng J. Ma
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
| | - Xiao Y. Wu
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
| | - Zhan S. Jia
- Department of Infectious Diseases, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Ke S. Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United State of America
| | - Zhi Q. Yao
- Hepatitis (HCV/HIV) Program, Department of Veterans Affairs, James H. Quillen VA Medical Center, Johnson City, Tennessee, United State of America
- Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, United State of America
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Hall CHT, Kassel R, Tacke RS, Hahn YS. HCV+ hepatocytes induce human regulatory CD4+ T cells through the production of TGF-beta. PLoS One 2010; 5:e12154. [PMID: 20730048 PMCID: PMC2921368 DOI: 10.1371/journal.pone.0012154] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 07/21/2010] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis C Virus (HCV) is remarkably efficient at establishing persistent infection and is associated with the development of chronic liver disease. Impaired T cell responses facilitate and maintain persistent HCV infection. Importantly, CD4+ regulatory T cells (Tregs) act by dampening antiviral T cell responses in HCV infection. The mechanism for induction and/or expansion of Tregs in HCV is unknown. Methodology/Principal Findings HCV-expressing hepatocytes were used to determine if hepatocytes are able to induce Tregs. The infected liver environment was modeled by establishing the co-culture of the human hepatoma cell line, Huh7.5, containing the full-length genome of HCV genotype 1a (Huh7.5-FL) with activated CD4+ T cells. The production of IFN-γ was diminished following co-culture with Huh7.5-FL as compared to controls. Notably, CD4+ T cells in contact with Huh7.5-FL expressed an increased level of the Treg markers, CD25, Foxp3, CTLA-4 and LAP, and were able to suppress the proliferation of effector T cells. Importantly, HCV+ hepatocytes upregulated the production of TGF-β and blockade of TGF-β abrogated Treg phenotype and function. Conclusions/Significance These results demonstrate that HCV infected hepatocytes are capable of directly inducing Tregs development and may contribute to impaired host T cell responses.
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Affiliation(s)
- Caroline H. T. Hall
- Department of Microbiology, Beirne B. Carter Center for Immunology Research, University of Virginia, Charlottesville, Virginia, United States of America
| | - Rachel Kassel
- Department of Microbiology, Beirne B. Carter Center for Immunology Research, University of Virginia, Charlottesville, Virginia, United States of America
| | - Robert S. Tacke
- Department of Microbiology, Beirne B. Carter Center for Immunology Research, University of Virginia, Charlottesville, Virginia, United States of America
| | - Young S. Hahn
- Department of Microbiology, Beirne B. Carter Center for Immunology Research, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Pathology, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail:
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Castellani M, Toniato E, Felaco P, Ciampoli C, De Amicis D, Orso C, Cucurullo C, Vecchiet J, Tetè S, Salini V, Caraffa A, Pandolfi F, Antinolfi P, Cerulli G, Conti F, Fulcheri M, Sabatino G, Boscolo P, Shaik Y. Impact of IL-32 on Histamine Release by Human Derived Umbilical Cord Blood Mast Cells. EUR J INFLAMM 2009. [DOI: 10.1177/1721727x0900700309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IL-32 is onae of the last important cytokines discovered, produced mainly by T cells, natural killer cells, and epithelial cells. Probably many other different cells are a source of IL-32, which has been found to be a powerful pro-inflammatory mediator. Here we studied the effect of IL-32 on histamine release by human-derived cord-blood mast cells. In these studies we found that IL-32 significantly stimulates the release of histamine only at high concentrations (100 ng/ml) while at 10 or 50 ng/ml it had no effect. These results were found for the first time and demonstrate that IL-32 may play an important role in allergic and inflammatory diseases.
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Affiliation(s)
| | - E. Toniato
- Immunology Division, University of Chieti, Chieti, Italy
| | - P. Felaco
- Division of Nephrology, University of Chieti, Chieti, Italy
| | - C. Ciampoli
- Clinic of Infectious Diseases, Medical School, University of Chieti-Pescara, Chieti, Italy
| | - D. De Amicis
- Department of Human Dynamics, University of Chieti-Pescara, Italy
| | - C. Orso
- Department of Human Dynamics, University of Chieti-Pescara, Italy
| | - C. Cucurullo
- Division of Medical Pathology, University of Chieti, Italy
| | - J. Vecchiet
- Clinical of Infectious Diseases, Medical School, University of Chieti-Pescara, Chieti, Italy
| | - S. Tetè
- Dental School, University of Chieti-Pescara, Chieti, Italy
| | - V. Salini
- Department of Human Dynamics, University of Chieti-Pescara, Italy
| | - A. Caraffa
- Orthopaedics Division, University of Perugia, Perugia, Italy
| | | | - P.L. Antinolfi
- Orthopaedics Division, University of Perugia, Perugia, Italy
| | - G. Cerulli
- Orthopaedics Division, University of Perugia, Perugia, Italy
| | - F. Conti
- Gynecology Division, University of Chieti, Chieti, Italy
| | - M. Fulcheri
- Department of Clinical Psychology, University of Chieti-Pescara, Italy
| | - G. Sabatino
- Department of Paediatrics, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - P. Boscolo
- Department of Biomedical Science, University of Chieti, Chieti, Italy
| | - Y.B. Shaik
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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