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Duan Y, Chen H, Liu D. Dose-dependent multi-organ injury following lipopolysaccharide gas inhalation. J Int Med Res 2024; 52:3000605241247707. [PMID: 38717029 PMCID: PMC11080761 DOI: 10.1177/03000605241247707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/31/2024] [Indexed: 05/12/2024] Open
Abstract
Lipopolysaccharide (LPS) is widely used to establish various animal models, including models of acute lung injury, cardiomyocyte damage, and acute kidney injury. Currently, there is no consensus on the diagnosis and treatment of LPS-induced disease. We herein present a case series of four patients who developed dose-dependent multi-organ injury, including acute lung injury and acute kidney injury, after inhaling LPS gas in a sealed room. These patients exhibited varying degrees of multi-organ injury characterized by inflammatory cell infiltration and secretion of proinflammatory cytokines. One patient showed progressive symptoms even with active treatment, leading to mild pulmonary fibrosis. This study emphasizes the importance of early diagnosis and treatment of significant LPS exposure and suggests personalized treatment approaches for managing LPS poisoning.
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Affiliation(s)
- Yang Duan
- The Seventh People’s Hospital of Chongqing, No. 1, Village 1, Lijiatuo Labor Union, Banan District, Chongqing, China
| | - Hengyi Chen
- The Seventh People’s Hospital of Chongqing, No. 1, Village 1, Lijiatuo Labor Union, Banan District, Chongqing, China
| | - Dan Liu
- The Seventh People’s Hospital of Chongqing, No. 1, Village 1, Lijiatuo Labor Union, Banan District, Chongqing, China
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Gress C, Vogel-Claussen J, Badorrek P, Müller M, Hohl K, Konietzke M, Litzenburger T, Seibold W, Gupta A, Hohlfeld JM. The effect of bradykinin 1 receptor antagonist BI 1026706 on pulmonary inflammation after segmental lipopolysaccharide challenge in healthy smokers. Pulm Pharmacol Ther 2023; 82:102246. [PMID: 37562641 DOI: 10.1016/j.pupt.2023.102246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/25/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Bradykinin 1 receptor (B1R) signalling pathways may be involved in the inflammatory pathophysiology of chronic obstructive pulmonary disease (COPD). B1R signalling is induced by inflammatory stimuli or tissue injury and leads to activation and increased migration of pro-inflammatory cells. Lipopolysaccharide (LPS) lung challenge in man is an experimental method of exploring inflammation in the lung whereby interference in these pathways can help to assess pharmacologic interventions in COPD. BI 1026706, a potent B1R antagonist, was hypothesized to reduce the inflammatory activity after segmental lipopolysaccharide (LPS) challenge in humans due to decreased pulmonary cell influx. METHODS In a monocentric, randomized, double-blind, placebo-controlled, parallel-group, phase I trial, 57 healthy, smoking subjects were treated for 28 days with either oral BI 1026706 100 mg bid or placebo. At day 21, turbo-inversion recovery magnitude magnetic resonance imaging (TIRM MRI) was performed. On the last day of treatment, pre-challenge bronchoalveolar lavage fluid (BAL) and biopsies were sampled, followed by segmental LPS challenge (40 endotoxin units/kg body weight) and saline control instillation in different lung lobes. Twenty-four hours later, TIRM MRI was performed, then BAL and biopsies were collected from the challenged segments. In BAL samples, cells were differentiated for neutrophil numbers as the primary endpoint. Other endpoints included assessment of safety, biomarkers in BAL (e.g. interleukin-8 [IL-8], albumin and total protein), B1R expression in lung biopsies and TIRM score by MRI as a measure for the extent of pulmonary oedema. RESULTS After LPS, but not after saline, high numbers of inflammatory cells, predominantly neutrophils were observed in the airways. IL-8, albumin and total protein were also increased in BAL samples after LPS challenge as compared with saline control. There were no significant differences in cells or other biomarkers from BAL in volunteers treated with BI 1026706 compared with those treated with placebo. Unexpectedly, neutrophil numbers in BAL were 30% higher and MRI-derived extent of oedema was significantly higher with BI 1026706 treatment compared with placebo, 24 h after LPS challenge. Adverse events were mainly mild to moderate and not different between treatment groups. CONCLUSIONS Treatment with BI 1026706 for four weeks was safe and well-tolerated in healthy smoking subjects. BI 1026706 100 mg bid did not provide evidence for anti-inflammatory effects in the human bronchial LPS challenge model. TRIAL REGISTRATION The study was registered on January 14, 2016 at ClinicalTrials.gov (NCT02657408).
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Affiliation(s)
- Christina Gress
- Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany
| | - Jens Vogel-Claussen
- German Center for Lung Research (BREATH), Hannover, Germany; Department of Diagnostic and Interventional Radiology, Hannover Medical School, Germany
| | - Philipp Badorrek
- Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Meike Müller
- Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany
| | - Kathrin Hohl
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | | | | | | | - Abhya Gupta
- Boehringer Ingelheim International GmbH, Biberach, Germany
| | - Jens M Hohlfeld
- Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany; Department of Respiratory Medicine, Hannover Medical School, Germany.
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3
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Liu X, Sun W, Ma W, Wang H, Xu K, Zhao L, He Y. Smoking related environmental microbes affecting the pulmonary microbiome in Chinese population. Sci Total Environ 2022; 829:154652. [PMID: 35307427 DOI: 10.1016/j.scitotenv.2022.154652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Smoking is a serious public health problem that affects human health conditions. Although there is evidence that microorganisms are associated with smoking-related lung diseases, the relationship between the rich lung microbiome of upper respiratory tract groups and smoking has not been studied. OBJECTIVE In this study, we investigated the effects of smoking on environmental microbes and lung microbiome in the Chinese population and provided clues for the role of smoking in the development of respiratory disease. METHODS Bronchoalveolar lavage fluid samples were collected from 55 individuals with a history of smoking. Microbial gene sequencing was carried out through NGS technology. We analyzed and compared the diversity, community structure, and species abundance of bronchoalveolar lavage microbiome between smokers and nonsmokers, to speculate the effects of smoking on the lung microbiome. RESULTS Smoking hardly affected the α diversity of microbial groups of bronchoalveolar lavage, but it had a huge influence on the microbiome composition. The relative abundance of Rothia, Actinomycetes, Haemophilus, Porphyrins, Neisseria, Acinetobacter, and Streptococcus genera had a remarkable increase in the smoking group. On the other hand, the relative abundance of Plusella and Veronella decreased significantly. CONCLUSION Smoking may change the environmental microbes and then alter the structure of the lung microbiome, which may lead to smoking-related diseases.
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Affiliation(s)
- Xinyue Liu
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Wenwen Sun
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Weiqi Ma
- SJTU-Yale Joint Center for Biostatistics and Data Science, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Wang
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Kandi Xu
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Lishu Zhao
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Yayi He
- School of Medicine, Tongji University, Shanghai 200092, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China.
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Khan MS, Coulibaly S, Matsumoto T, Yano Y, Miura M, Nagasaka Y, Shima M, Yamagishi N, Wakabayashi K, Watanabe T. Association of airborne particles, protein, and endotoxin with emergency department visits for asthma in Kyoto, Japan. Environ Health Prev Med 2018; 23:41. [PMID: 30153806 PMCID: PMC6114267 DOI: 10.1186/s12199-018-0731-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/13/2018] [Indexed: 01/23/2023] Open
Abstract
Background The health effects of biological aerosols on the respiratory system are unclear. The purpose of this study was to clarify the association of airborne particle, protein, and endotoxin with emergency department visits for asthma in Kyoto City, Japan. Methods We collected data on emergency department visits at a hospital in Kyoto from September 2014 to May 2016. Fine (aerodynamic diameter ≤ 2.5 μm) and coarse (≥ 2.5 μm) particles were collected in Kyoto, and protein and endotoxin levels were analyzed. The association of the levels of particles, protein, endotoxin, and meteorological factors (temperature, relative humidity, wind speed, and air pressure) with emergency department visits for asthma was estimated. Results There were 1 to 15 emergency department visits for asthma per week, and the numbers of visits increased in the autumn and spring, namely many weeks in September, October, and April. Weekly concentration of protein in fine particles was markedly higher than that in coarse particles, and protein concentration in fine particles was high in spring months. Weekly endotoxin concentrations in fine and coarse particles were high in autumn months, including September 2014 and 2015. Even after adjusting for meteorological factors, the concentrations of coarse particles and endotoxin in both particles were significant factors on emergency department visits for asthma. Conclusions Our results suggest that atmospheric coarse particles and endotoxin are significantly associated with an increased risk of asthma exacerbation. Electronic supplementary material The online version of this article (10.1186/s12199-018-0731-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammad Shahriar Khan
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Souleymane Coulibaly
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Takahiro Matsumoto
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Yoshitaka Yano
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Misasagi-Nakauchcho, Yamashinaku, Kyoto, 607-8414, Japan
| | - Makoto Miura
- Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashinaku, Kyoto, 607-8062, Japan
| | - Yukio Nagasaka
- Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashinaku, Kyoto, 607-8062, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Nobuyuki Yamagishi
- Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotogecho, Hirakata, Osaka, 573-0101, Japan
| | - Keiji Wakabayashi
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan.,Graduate Division of Nutritional and Environmental Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan
| | - Tetsushi Watanabe
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan.
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin in house dust with atopy and exercise-induced bronchospasm in children with asthma. Environ Res 2018; 164:302-309. [PMID: 29554621 DOI: 10.1016/j.envres.2018.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Received: 07/31/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Studies have reported protective and adverse associations between microbial exposure and childhood asthma. However, among children with asthma the relationships between endotoxin and exercise-induced bronchospasm (EIB) is less clear. OBJECTIVE We investigated the association between exposure to endotoxin in house dust with atopy and EIB in children with asthma. METHODS A cross-sectional survey was conducted among schoolchildren (aged 7-17 years) in the province of Saskatchewan, Canada. A subpopulation with asthma (n = 116) were identified from 335 participants using a validated asthma algorithm. We determined atopy among the asthma subpopulation by skin prick testing (SPT) while EIB was evaluated using exercise challenge testing (ECT). Dust samples were collected from mattress and play area floors, and endotoxin was measured in dust extracts. Logistic regression analyses were used to explore associations between endotoxin with atopy and EIB. RESULTS Among the 116 children with asthma, 99 completed SPT and all had completed ECT. Of these, 71/99 (71.7%) were atopic and 26/116 (22.4%) had EIB. Exposure to high play area endotoxin concentration [adjusted odds ratio (aOR) = 0.15, 95% CI: 0.03-0.85] and load (aOR = 0.11, 95% CI: 0.02-0.73) were negatively associated with atopy. In contrast, EIB was positively associated with high mattress endotoxin concentration (aOR = 6.01, 95% CI: 1.20-30.13). CONCLUSION Indoor microbial endotoxin exposure has varied associations with atopy and exercise-induced bronchospasm among children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4.
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
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6
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin and beta-(1 → 3)-D-glucan in house dust with asthma severity among schoolchildren. Respir Med 2018; 138:38-46. [PMID: 29724391 DOI: 10.1016/j.rmed.2018.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/13/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Asthma severity can be affected by microbial exposures. However, less is known about the specific indoor agents aggravating the disease in children. We examined the associations between indoor endotoxin and beta-(1 → 3)-D-glucan exposures and asthma severity in children with asthma. METHODS A clinical cross-sectional study of schoolchildren (aged 7-17 years) was conducted in the province of Saskatchewan, Canada. Children with asthma (n = 116) were identified from 335 participants using a combination of survey responses and objective clinical assessments. We then ascertained asthma severity based on recommended guidelines (continuous daytime asthma symptoms, frequent nighttime asthma symptoms, and ≤ 60% predicted FEV1). Levels of indoor endotoxin and beta-(1 → 3)-D-glucan were measured in dust samples obtained from play area floors and child's mattresses. RESULTS The study population of 116 children with asthma was comprised of 75.9% mild asthma and 24.1% moderate/severe asthma. Higher mattress endotoxin concentration was associated with increased odds of moderate/severe asthma [adjusted odds ratio (aOR) = 11.40, 95% confidence interval (CI): 1.45-89.43] while higher beta-(1 → 3)-D-glucan concentration (aOR = 0.16, 95% CI: 0.03-0.89) and load (aOR = 0.10, 95% CI: 0.02-0.72) in play areas were inversely associated with moderate/severe asthma. Furthermore, higher mattress endotoxin concentration was associated with lower FVC (p = 0.01) and FEV1 (p = 0.03). These associations were not seen for beta-(1 → 3)-D-glucan. CONCLUSION Our results showed differential effects of microbial exposures on childhood asthma severity and further highlight domestic endotoxin exposure effects on respiratory health outcomes in children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place Saskatoon, SK, S7N 2Z4, Canada; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Lexmond AJ, Singh D, Frijlink HW, Clarke GW, Page CP, Forbes B, van den Berge M. Realising the potential of various inhaled airway challenge agents through improved delivery to the lungs. Pulm Pharmacol Ther 2018; 49:27-35. [PMID: 29331645 DOI: 10.1016/j.pupt.2018.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
Abstract
Inhaled airway challenges provoke bronchoconstriction in susceptible subjects and are a pivotal tool in the diagnosis and monitoring of obstructive lung diseases, both in the clinic and in the development of new respiratory medicines. This article reviews the main challenge agents that are in use today (methacholine, mannitol, adenosine, allergens, endotoxin) and emphasises the importance of controlling how these agents are administered. There is a danger that the optimal value of these challenge agents may not be realised due to suboptimal inhaled delivery; thus considerations for effective and reproducible challenge delivery are provided. This article seeks to increase awareness of the importance of precise delivery of inhaled agents used to challenge the airways for diagnosis and research, and is intended as a stepping stone towards much-needed standardisation and harmonisation in the administration of inhaled airway challenge agents.
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Affiliation(s)
- Anne J Lexmond
- King's College London, Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, 150 Stamford Street, London SE1 9NH, United Kingdom; University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Dave Singh
- University of Manchester, Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, The Langley Building, Southmoor Road, Wythenshawe, Manchester M23 9QZ, United Kingdom
| | - Henderik W Frijlink
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Graham W Clarke
- hVIVO, Queen Mary BioEnterprises Innovation Centre, 42 New Road, London E1 2AX, United Kingdom; Imperial College, Department of Cardiothoracic Pharmacology, National Heart and Lung Institute, Guy Scadding Building, Cale Street, London SW3 6LY, United Kingdom
| | - Clive P Page
- King's College London, Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Ben Forbes
- King's College London, Institute of Pharmaceutical Science, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Hanzeplein 1, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Hanzeplein 1, 9700 RB Groningen, The Netherlands
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Malinovschi A, Ludviksdottir D, Tufvesson E, Rolla G, Bjermer L, Alving K, Diamant Z. Application of nitric oxide measurements in clinical conditions beyond asthma. Eur Clin Respir J 2015; 2:28517. [PMID: 26672962 PMCID: PMC4653314 DOI: 10.3402/ecrj.v2.28517] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/05/2015] [Indexed: 02/01/2023] Open
Abstract
Fractional exhaled nitric oxide (FeNO) is a convenient, non-invasive method for the assessment of active, mainly Th2-driven, airway inflammation, which is sensitive to treatment with standard anti-inflammatory therapy. Consequently, FeNO serves as a valued tool to aid diagnosis and monitoring in several asthma phenotypes. More recently, FeNO has been evaluated in several other respiratory, infectious, and/or immunological conditions. In this short review, we provide an overview of several clinical studies and discuss the status of potential applications of NO measurements in clinical conditions beyond asthma.
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Affiliation(s)
- Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden;
| | - Dora Ludviksdottir
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Ellen Tufvesson
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Lund University, Lund, Sweden
| | - Giovanni Rolla
- Department of Medical Sciences, Allergology and Clinical Immunology, University of Torino, Torino, Italy
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Lund University, Lund, Sweden
| | - Kjell Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Zuzana Diamant
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Lund University, Lund, Sweden.,Department of Clinical Pharmacy & Pharmacology, University Medical Centre Groningen, Groningen, The Netherlands.,Department of General Practice, University Medical Centre Groningen, Groningen, The Netherlands.,QPS Netherlands, Groningen, The Netherlands
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Kanchongkittiphon W, Mendell MJ, Gaffin JM, Wang G, Phipatanakul W. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. Environ Health Perspect 2015; 123:6-20. [PMID: 25303775 PMCID: PMC4286274 DOI: 10.1289/ehp.1307922] [Citation(s) in RCA: 240] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 10/09/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Previous research has found relationships between specific indoor environmental exposures and exacerbation of asthma. OBJECTIVES In this review we provide an updated summary of knowledge from the scientific literature on indoor exposures and exacerbation of asthma. METHODS Peer-reviewed articles published from 2000 to 2013 on indoor exposures and exacerbation of asthma were identified through PubMed, from reference lists, and from authors' files. Articles that focused on modifiable indoor exposures in relation to frequency or severity of exacerbation of asthma were selected for review. Research findings were reviewed and summarized with consideration of the strength of the evidence. RESULTS Sixty-nine eligible articles were included. Major changed conclusions include a causal relationship with exacerbation for indoor dampness or dampness-related agents (in children); associations with exacerbation for dampness or dampness-related agents (in adults), endotoxin, and environmental tobacco smoke (in preschool children); and limited or suggestive evidence for association with exacerbation for indoor culturable Penicillium or total fungi, nitrogen dioxide, rodents (nonoccupational), feather/down pillows (protective relative to synthetic bedding), and (regardless of specific sensitization) dust mite, cockroach, dog, and dampness-related agents. DISCUSSION This review, incorporating evidence reported since 2000, increases the strength of evidence linking many indoor factors to the exacerbation of asthma. Conclusions should be considered provisional until all available evidence is examined more thoroughly. CONCLUSION Multiple indoor exposures, especially dampness-related agents, merit increased attention to prevent exacerbation of asthma, possibly even in nonsensitized individuals. Additional research to establish causality and evaluate interventions is needed for these and other indoor exposures.
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Curths C, Wichmann J, Dunker S, Windt H, Hoymann HG, Lauenstein HD, Hohlfeld J, Becker T, Kaup FJ, Braun A, Knauf S. Airway hyper-responsiveness in lipopolysaccharide-challenged common marmosets (Callithrix jacchus). Clin Sci (Lond) 2014; 126:155-62. [PMID: 23879175 DOI: 10.1042/CS20130101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Animal models with a high predictive value for human trials are needed to develop novel
human-specific therapeutics for respiratory diseases. The aim of the present study was to examine
lung-function parameters in marmoset monkeys (Callithrix jacchus) that can be used
to detect pharmacologically or provocation-induced AHR (airway hyper-responsiveness). Therefore a
custom-made lung-function device that allows application of defined aerosol doses during measurement
was developed. It was hypothesized that LPS (lipopolysaccharide)-challenged marmosets show AHR
compared with non-challenged healthy subjects. Invasive plethysmography was performed in 12
anaesthetized orotracheally intubated and spontaneously breathing marmosets. Pulmonary data of
RL (lung resistance), Cdyn (dynamic
compliance), EF50 (mid-expiratory flow), Poes (oesophageal
pressure), MV (minute volume), respiratory frequency (f) and
VT (tidal volume) were collected. Measurements were conducted under
baseline conditions and under MCh (methacholine)-induced bronchoconstriction. The measurement was
repeated with the same group of animals after induction of an acute lung inflammation by
intratracheal application of LPS. PDs (provocative doses) of MCh to achieve a certain increase in
RL were significantly lower after LPS administration. AHR was
demonstrated in the LPS treated compared with the naïve animals. The recorded lung-function
data provide ground for pre-clinical efficacy and safety testing of anti-inflammatory substances in
the common marmoset, a new translational NHP (non-human primate) model for LPS-induced lung
inflammation.
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Johansson E, Reponen T, Vesper S, Levin L, Lockey J, Ryan P, Bernstein DI, Villareal M, Hershey GKK, Schaffer C, LeMasters G. Microbial content of household dust associated with exhaled NO in asthmatic children. Environ Int 2013; 59:141-147. [PMID: 23807177 PMCID: PMC3759577 DOI: 10.1016/j.envint.2013.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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] [Received: 11/07/2012] [Revised: 05/22/2013] [Accepted: 05/23/2013] [Indexed: 06/02/2023]
Abstract
Exhaled nitric oxide (eNO) is increasingly used as a non-invasive measure of airway inflammation. Despite this, little information exists regarding the potential effects of indoor microbial components on eNO. We determined the influence of microbial contaminants in house dust and other indoor environmental characteristics on eNO levels in seven-year-olds with and without a physician-diagnosis of asthma. The study included 158 children recruited from a birth cohort study, and 32 were physician-diagnosed as asthmatic. The relationship between eNO levels and exposures to home dust streptomycetes, endotoxin, and molds was investigated. Streptomycetes and endotoxin were analyzed both as loads and concentrations in separate models. Dog, cat, and dust mite allergens also were evaluated. In the multivariate exposure models, high streptomycetes loads and concentrations were significantly associated with a decrease in eNO levels in asthmatic (p<0.001) but not in healthy children. The presence of dog allergen, however, was associated with increased levels of eNO (p=0.001). Dust endotoxin was not significant. The relationship between eNO and indoor exposure to common outdoor molds was u-shaped. In non-asthmatic children, none of the exposure variables was significantly associated with eNO levels. To our knowledge, this is the first study demonstrating a significant association between microbial components in the indoor environment and eNO levels in asthmatic children. This study demonstrates the importance of simultaneously assessing multiple home exposures of asthmatic children to better understand opposing effects. Common components of the indoor Streptomyces community may beneficially influence airway inflammation.
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Affiliation(s)
- Elisabet Johansson
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Stephen Vesper
- US Environmental Protection Agency, 26 W. M. L. King Drive, Cincinnati, OH 45268, USA
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - James Lockey
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
- Department of Internal Medicine, University of Cincinnati, OH, USA
| | - Patrick Ryan
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - David I. Bernstein
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
- Department of Internal Medicine, University of Cincinnati, OH, USA
| | - Manuel Villareal
- Department of Internal Medicine, University of Cincinnati, OH, USA
| | | | - Chris Schaffer
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Grace LeMasters
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
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Ward MDW, Chung YJ, Copeland LB, Doerfler DL. A comparison of the allergic responses induced by Penicillium chrysogenum and house dust mite extracts in a mouse model. Indoor Air 2010; 20:380-391. [PMID: 20590919 DOI: 10.1111/j.1600-0668.2010.00660.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED A report by the Institute of Medicine suggested that more research is needed to better understand mold effects on allergic disease, particularly asthma development. We compared the ability of the fungal Penicillium chrysogenum (PCE) and house dust mite (HDM) extracts to induce allergic responses in BALB/c mice. The extracts were administered by intratracheal aspiration (IA) at several doses (0, 2.5, 5, 10, 20, 40, and 80 μg) four times over a 4-week period. Three days after the last IA exposure, serum and bronchoalveolar lavage fluid (BALF) were collected. The relative allergenicity of the extracts was evaluated based on the lowest dose able to induce a significant response compared to control (0 μg) and the robustness of the response. PCE induced the most robust response at the lowest dose for most endpoints examined: BALF total, macrophage, neutrophil, and eosinophil cell counts, and antigen-specific IgE. Taken together, our data suggest that PCE may induce a more robust allergic and inflammatory response at lower doses than HDM. PRACTICAL IMPLICATIONS Our data suggest that Penicillium chrysogenum is a robust allergen and may be a more potent allergen source than house dust mite (HDM) in this mouse model. Two critical factors in the development of human allergic disease, exposure levels and sensitization thresholds, are unknown for most allergens including molds/fungi. Human exposure levels are not within the scope of this article. However, the data presented suggest a threshold dose for the induction of allergic responsiveness to P. chrysogenum. Additionally, P. chrysogenum as well as other molds may play an important role in asthma development in our society.
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Affiliation(s)
- M D W Ward
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Liebers V, Raulf-Heimsoth M, Brüning T. Health effects due to endotoxin inhalation (review). Arch Toxicol 2008; 82:203-10. [DOI: 10.1007/s00204-008-0290-1] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Accepted: 01/30/2008] [Indexed: 12/16/2022]
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