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Chacón P, Vega-Rioja A, Doukkali B, Del Valle Rodriguez A, Fernández-Delgado L, Domínguez-Cereijo L, Segura C, Pérez-Machuca BM, Perkins JR, El Bekay R, Cornejo-García JA, Hajji N, Monteseirín J, Rivas-Pérez D. Human Neutrophils Couple Nitric Oxide Production and Extracellular Traps Formation in Allergic Asthma. Am J Respir Crit Care Med 2024. [PMID: 38445953 DOI: 10.1164/rccm.202305-0889oc] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 03/05/2024] [Indexed: 03/07/2024] Open
Abstract
RATIONALE Nitric oxide (NO) is elevated in the airways and serum of allergic asthmatic patients, suggesting an important role in asthma. NO production has been widely attributed to the canonical inducible nitric oxide synthase (iNOS). Much effort has been made to inhibit this enzyme with two outcomes: no asthma improvement; and partial NO reduction, suggesting the involvement of an iNOS-independent source. OBJECTIVES Neutrophils produce NO under inflammatory conditions and their role in asthma has been overlooked. The present study analyzes their possible role as source of NO. METHODS Our hypothesis was tested in 99 allergic patients with intermittent bronchial asthma and 26 healthy donors. NO production by blood and sputum neutrophils in response to allergens, anti-IgE, and anti-IgE receptors Abs was assessed by Griess, flow cytometry and confocal microscopy. Extracellular traps (ETs) formation, as a possible consequence of NO production, was quantified by western blot and confocal microscopy, and reactive oxygen species by luminol-enhanced chemiluminescence. RESULTS Among blood and sputum granulocytes from allergic asthmatic patients, only neutrophils, produce NO by an IgE-dependent mechanism. This production is independent of NOS, but dependent on a reaction between L-arginine and reactive oxygen species from NOX2. NO and ETosis are induced in parallel, and NO amplifies ETs formation, which is a key mediator in asthma. CONCLUSIONS Our findings reveal a novel role of neutrophils as the unique allergen/IgE-dependent NO source in allergic asthma enhancing ETs formation. These results suggest that NO produced by neutrophils needs further consideration in the treatment of allergic asthma.
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Affiliation(s)
- Pedro Chacón
- Hospital Universitario Virgen Macarena, 16582, UGC de Alergologia, Sevilla, Spain
| | - Antonio Vega-Rioja
- Hospital Universitario Virgen Macarena, 16582, UGC de Alergologia, Sevilla, Spain;
| | - Bouchra Doukkali
- Hospital Universitario Virgen Macarena, 16582, UGC de Alergologia, Sevilla, Spain
| | | | | | | | - Carmen Segura
- Hospital Universitario Virgen Macarena, 16582, UGC de Alergologia, Sevilla, Spain
| | | | - James R Perkins
- 3Department of Molecular Biology and Biochemistry, University of Málaga, Malaga, Spain
| | - Rajaa El Bekay
- Instituto de Investigación Biomédica de Málaga, 582139, Unidad de Gestión Clínica de Endocrinología y Nutrición, Malaga, Andalucía, Spain
| | | | - Nabil Hajji
- Imperial College London Faculty of Medicine, 4957, London, United Kingdom of Great Britain and Northern Ireland
| | - Javier Monteseirín
- 7Hospital Quirón Sagrado Corazón and Hospital Quirón Infanta-Luisa, Seville, Spain
| | - David Rivas-Pérez
- Universidad de Sevilla Facultad de Odontología, 321179, Sevilla, Andalucía, Spain
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Lineros R, Fernández-Delgado L, Vega-Rioja A, Chacón P, Doukkali B, Monteseirin J, Ribas-Pérez D. Associated Factors of Pneumonia in Individuals with Chronic Obstructive Pulmonary Disease (COPD) Apart from the Use of Inhaled Corticosteroids. Biomedicines 2023; 11:biomedicines11051243. [PMID: 37238914 DOI: 10.3390/biomedicines11051243] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/09/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Inhaled corticosteroids (ICSs) are widely used in chronic obstructive pulmonary disease (COPD) and in combination with long-acting β2 agonists (LABAs) to reduce exacerbations and improve patient lung function and quality of life. However, ICSs have been associated with an increased risk of pneumonia in individuals with COPD, although the magnitude of this risk remains unclear. Therefore, it is difficult to make informed clinical decisions that balance the benefits and adverse effects of ICSs in people with COPD. There may be other causes of pneumonia in patients with COPD, and these causes are not always considered in studies on the risks of using ICSs in COPD. We consider it very useful to clarify these aspects in assessing the influence of ICSs on the incidence of pneumonia and their role in the treatment of COPD. This issue has important implications for current practice and the evaluation and management of COPD, since COPD patients may benefit from specific ICS-based treatment strategies. Many of the potential causes of pneumonia in patients with COPD can act synergistically, so they can be included in more than one section.
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Affiliation(s)
- Rosario Lineros
- Unidad Salud Mental, Hospital Vázquez Díaz, 21080 Huelva, Spain
| | | | - Antonio Vega-Rioja
- UGC de Alergología, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
| | - Pedro Chacón
- UGC de Alergología, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
| | - Bouchra Doukkali
- UGC de Alergología, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
| | | | - David Ribas-Pérez
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41004 Seville, Spain
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Vega-Rioja A, Chacón P, Fernández-Delgado L, Doukkali B, del Valle Rodríguez A, Perkins JR, Ranea JAG, Dominguez-Cereijo L, Pérez-Machuca BM, Palacios R, Rodríguez D, Monteseirín J, Ribas-Pérez D. Regulation and directed inhibition of ECP production by human neutrophils. Front Immunol 2022; 13:1015529. [PMID: 36518751 PMCID: PMC9744134 DOI: 10.3389/fimmu.2022.1015529] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Neutrophils are involved in the pathophysiology of allergic asthma, where the Eosinophil Cationic Protein (ECP) is a critical inflammatory mediator. Although ECP production is attributed to eosinophils, we reported that ECP is also present in neutrophils from allergic patients where, in contrast to eosinophils, it is produced in an IgE-dependent manner. Given the key role of ECP in asthma, we investigated the molecular mechanisms involved in ECP production as well as the effects induced by agonists and widely used clinical approaches. We also analyzed the correlation between ECP production and lung function. Methods Neutrophils from allergic asthmatic patients were challenged with allergens, alone or in combination with cytokines, in the presence of cell-signaling inhibitors and clinical drugs. We analyzed ECP levels by ELISA and confocal microscopy. Lung function was assessed by spirometry. Results IgE-mediated ECP release is dependent on phosphoinositide 3-kinase, the extracellular signal-regulated kinase (ERK1/2) and the production of reactive oxygen species by NADPH-oxidase. Calcineurin phosphatase and the transcription factor NFAT are also involved. ECP release is enhanced by the cytokines interleukin (IL)-5 and granulocyte macrophage-colony stimulating factor, and inhibited by interferon-γ, IL-10, clinical drugs (formoterol, tiotropium and budesonide) and allergen-specific IT. We also found an inverse correlation between asthma severity and ECP levels. Conclusions Our results suggest the molecular pathways involved in ECP production and potential therapeutic targets. We also provide a new method to evaluate disease severity in asthmatic patients based on the quantification of in vitro ECP production by peripheral neutrophils.
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Affiliation(s)
- Antonio Vega-Rioja
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
| | - Pedro Chacón
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
| | | | - Bouchra Doukkali
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - James R. Perkins
- Departamento de Biología Molecular y Bioquímica. Facultad de Ciencias, Universidad de Málaga, Málaga, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Juan A. G. Ranea
- Departamento de Biología Molecular y Bioquímica. Facultad de Ciencias, Universidad de Málaga, Málaga, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | | | | | | | | | - Javier Monteseirín
- Hospital Quirón Sagrado Corazón and Hospital Quirón Infanta-Luisa, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
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Fernández-Delgado L, Vega-Rioja A, Ventura I, Chamorro C, Aroca R, Prados M, Bobadilla P, Rodríguez D, Palacios R, Monteseirín J. Allergens Induce the Release of Lactoferrin by Neutrophils from Asthmatic Patients. PLoS One 2015; 10:e0141278. [PMID: 26488881 PMCID: PMC4619071 DOI: 10.1371/journal.pone.0141278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/05/2015] [Indexed: 11/26/2022] Open
Abstract
Background Despite the evidence that Lactoferrin (Lf) is involved in allergic asthma processes, it is unknown whether neutrophils can be one of the main cellular sources of this key inflammatory mediator directly in response of an IgE mediated stimulus. The present study was undertaken to analyze this question. Methods Neutrophils from healthy subjects (n = 34) and neutrophils from allergic asthmatic patients (n = 102) were challenged in vitro with specific allergens to which the patients were sensitized, PAF, or agonist mAbs against IgE-receptors, and the levels of Lf were measured in the culture supernatant. The levels of serum IgE together with the severity of symptoms were also analyzed. Results Lf was released into the culture supernatant of neutrophils from allergic asthmatic patients in response to allergens and PAF. This response was highly allergen-specific, and did not happen in neutrophils from healthy donors. Allergen effect was mimicked by Abs against FcεRI and galectin-3 but not by FcεRII. The levels of released Lf correlated well with the levels of serum specific IgE and severity of asthma symptoms. These observations represent a novel view of neutrophils as an important source of Lf in allergic asthma. Importantly, the levels of released Lf by neutrophils could therefore be used to evaluate disease severity in allergic asthmatic patients.
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Affiliation(s)
- Lourdes Fernández-Delgado
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Antonio Vega-Rioja
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Inmaculada Ventura
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Cristina Chamorro
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Rocío Aroca
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Manuel Prados
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | | | - Javier Monteseirín
- Unidad de Gestión Clínica de Alergia Intercentros, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Departamento de Medicina. Facultad de Medicina. Universidad de Sevilla, Sevilla, Spain
- * E-mail:
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Monteseirín J, Fernández-Pineda I, Chacón P, Vega A, Bonilla I, Camacho MJ, Fernández-Delgado L, Conde J, Sobrino F. Myeloperoxidase release after allergen-specific conjunctival challenge. J Asthma 2005; 41:639-43. [PMID: 15584313 DOI: 10.1081/jas-200026407] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Allergen-specific conjunctival challenge is a fruitful and complete tool in evaluating pathophysiological phenomena of allergic inflammation. After challenge, a significant neutrophil infiltrate occurred in allergic subjects. The primary (azurophilic) granules of neutrophils contain a variety of enzymes that might potentiate inflammation, such as myeloperoxidase (MPO). It is not known whether allergen-specific conjunctival challenge (ASCC) is able to elicit MPO release. We also investigated the possible role of immunotherapy (IT) in the release of MPO. METHOD The groups studied included Dactylis glomerata-sensitive adult atopic patients suffering from seasonal allergic rhinoconjunctivitis, and healthy adult nonatopic volunteer controls. One group of allergic patients received no specific hyposensitization (not-IT allergic group). A second group of allergic patients had been immunotherapy-treated with Dactylis glomerata extract for the preceding three years and continued to receive a maintenance dose within the highest potency of the extract (IT-allergic group). ASCC with Dactylis glomerata was performed outside the pollen season in all subjects. Myeloperoxidase was assayed by MPO-enzyme immunoassay method. RESULTS Thirty minutes after challenge, myeloperoxidase levels in the non-immunotherapy allergic patients were significantly higher compared than in the healthy group (p<0.001). The levels of myeloperoxidase released in the immunotherapy allergic group were significantly lower than those in the nonimmunotherapy allergic group (p<0.001) and higher than those in nonallergic subjects (p<0.001). CONCLUSION These results indicate that after ASCC there is a release of MPO. Our study suggests that immunotherapy actively modifies the release of MPO after ASCC.
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Affiliation(s)
- J Monteseirín
- Department of Medicine, Regional Service of Immunology and Allergy, Hospital Universitario Virgen Macarena, Spain.
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