Sublingual Immunotherapy Attenuates Nasal Symptoms Upon Allergen Exposure in Murine Allergic Rhinitis Model via an Induction of IL-10 producing T cells in Submandibular Lymph Node

OBJECTIVE

Sublingual immunotherapy has been considered to be a painless and effective therapeutic treatment of patients with allergic rhinitis. Its mechanism of action has been elucidated, but there are still controversies among many reports between clinical efficacy and laboratory data. Therefore, its mechanism of action needs to be investigated further by using promising animal models such as rodents and monkeys.

MATERIALS AND METHODS

Bearing this in mind, in our present study, we successfully constructed an effective murine model for sublingual immunotherapy (SLIT) in allergic rhinitis in which mice were sublingually administered ovalbumin (OVA), followed by intraperitoneal (ip) sensitization and intranasal (i.n.) challenge of OVA.

RESULTS

To summarize our experimental data, nasal symptoms such as sneezing and nasal rubbing of sublingually treated mice were significantly attenuated in accordance with lower specific IgE antibodies in sera. Histological analysis of eosinophil recruitment in nasal mucosae reveals less allergic inflammation in sublingually treated mice. Interleukin-10 (IL-10) production and IL-10-specific mRNA gene expression of cultured submandibular lymph node (SMLN) cells with OVA, obtained from sublingually treated mice, were significantly higher than those of mice without sublingual treatment.

CONCLUSION

These results demonstrate that sublingually introduced antigens can actually attenuate nasal symptoms in a murine allergic rhinitis model upon allergen exposures. Furthermore, our immunological data might indicate an important role of IL-10 producing T cells in SMLN to control nasal allergic reaction.

Short treatment time and excellent treatment outcome in accelerated hyperfractionated radiotherapy for T1 glottic cancer

Accelerated hyperfractionated radiotherapy was performed as treatment for patients with T1 glottic cancer, and its utility was evaluated based on treatment outcomes and adverse effects. Fifty-eight men who had undergone radiotherapy were retrospectively reviewed. Tumor classification was Tis in 4 patients, T1a in 38, and T1b in 16. Histological examination revealed squamous cell carcinoma in 55 patients. Travel time from home to hospital was 0-1 hour for 24 patients, 1-2 hours for 9, and >2 hours for 25. Laser vaporization was performed prior to radiotherapy in 38 patients, and 19 patients received concurrent chemotherapy with an agent such as S-1. Patients were irradiated twice daily using an irradiation container. Most patients received a dose of 1.5 Gy/fraction up to a total of 60 Gy. The median overall treatment time was 30 days, with a median observation period of 59.6 months. A complete response was observed in all patients. The 5-year overall survival, disease-free survival, and local control rates were 97.2%, 93.2%, and 97.8%, respectively. Although grade 3 pharyngeal mucositis was observed in 2 patients, there were no other grade 3 or higher acute adverse events. As late toxicity, grade 2 laryngeal edema and grade 1 laryngeal hemorrhage were observed in 1 patient each, but no serious events such as laryngeal necrosis or laryngeal stenosis were observed. In conclusion, this treatment method brings excellent outcome and will substantially reduce the treatment duration among patients who need to stay at nearby hotels while undergoing treatment at hospitals in rural areas.

Japanese traditional medicine, Senn-kinn-naidaku-sann up-regulates Toll-like receptor 4 and reduces murine allergic rhinitis

OBJECTIVE

To determine the mechanisms by which a traditional herbal medicine, Senkinnaidakusan (SKNS), controls Th2 responses, we examined the production of IL-12 by murine macrophages treated with SKNS.

RESULTS

Treatment with SKNS significantly increased TLR4 mRNA in macrophages. Furthermore, pre-treatment with SKNS enhanced the production of IL-12 by macrophages stimulated with LPS. When SKNS was orally administered to C3H/HeN mice at the induction phase after OVA sensitization, the serum levels of OVA-specific immunoglobulin (Ig)E and IgG1 decreased, Interleukin (IL)-4 production by spleen T cells in response to OVA was significantly suppressed, while interferon (IFN)-gamma production was increased. After nasal challenge of OVA, eosinophilic infiltration in the nasal mucosa and the number of sneezes were significantly inhibited in SKNS-treated mice compared with control mice. Besides, expression of IL-5 in the nasal mucosa was also inhibited. Using another strain of mice, C3H/HeJ (TLR4 negative), there was no difference in OVA-specific Igs or splenic cytokine production between the SKNS treatment and non-treatment groups. The eosinophilic infiltration in the nasal mucosa, the number of sneezes and IL-5 expression in the nasal mucosa were also not effected even after SKNS treatment.

CONCLUSION

These results suggest that oral administration of SKNS inhibits Th2 responses by enhancement of IL-12 release from macrophages via up-regulation of TLR4 expression.

The central role of CD30L/CD30 interactions in allergic rhinitis pathogenesis in mice

CD30 ligand (CD30L) plays an important role in the amplification and/or activation of effector CD4(+) T cells, irrespective of Th cell subset. To examine the role of CD30L in allergic rhinitis, we evaluated an OVA model of allergic rhinitis in CD30L knock out (KO) mice on a BALB/c background sensitized with OVA. Symptoms of allergic rhinitis such as eosinophil infiltration into the nasal mucosa were drastically diminished in OVA-sensitized CD30L KO mice following intranasal challenge with OVA. The levels of OVA-specific IgE in the sera and the Th2 response in nasopharynx-associated lymphoid tissues and cervical LNs of CD30L KO mice were significantly lower than those of WT mice following intranasal challenge with OVA. Intranasal administration of CD30-Ig during the effector phase with OVA significantly prevented the development of allergic rhinitis in WT mice. These results suggest that CD30L plays an important role in allergic rhinitis and that the inhibition of CD30L/CD30 signaling might be useful as a novel biological therapy for allergic rhinitis.

[Clinical results of repeated intraperitoneal administration of CDDP in patients with ovarian cancer]

CDDP was intraperitoneally administered to 45 ovarian cancer patients (9 cases in Stage Ic, 9 cases in Stage II, 19 cases in Stage III and 8 cases in Stage IV) as the first line chemotherapy to examine response rates and cumulative survival rates by Kaplan-Meier method. Among 18 cases with measurable tumor, there were 5 CR cases, 6 PR cases, 4 NC cases and 3 PD cases. Eleven out of 18 responded, for a response rate of 61.1%. The 3- and 5-year survival rates were 88.9% and 88.9% in Stage I, 46.7% and 0% in Stage II, 48.6% and 41.7% in Stage III, and 0% and 0% in Stage IV, respectively. The 3- and 5-year survival rates in patients with residual tumor smaller than 2 cm in diameter after the first surgery in Stage III or IV were 76.9% and 61.4% respectively, in contrast to 11.5% and 11.5% in patients with residual tumor of 2 cm or larger in diameter. Thus, a significantly better prognosis was demonstrated in patients with residual tumor smaller than 2 cm. These results indicate that intraperitoneal administration of CDDP demonstrated high response rates and proved to be useful as the first line chemotherapy, yet did not manage to improve the long-term prognosis of patients with progressive cancer.

[Role of C-kinase in development and function of human placental chorionic tissue]

C-kinase is an intracellular protein kinase which is activated by Ca2+ and phospholipid, and plays a crucial role in signal transduction and cell proliferation. To clarify the possibility that C-kinase regulates the growth or maturation of placental tissues, I have purified C-kinase from human placental chorion by sequential column chromatography, determined the substrate specificity of the purified C-kinase, and then investigated the effects of various hormones on the phosphorylation of placental chorionic membrane proteins. The results were as follows: 1) pH optimum of C-kinase was 8.0, apparent Ka for Ca2+ was 1 X 10(-5) M and Ka for phosphatidylserine was 80 micrograms/ml. 2) One of the cytoskeletal proteins, filamin, was phosphorylated specifically by the purified C-kinase. 3) The C-kinase activity increased with placental growth. The enzyme activity in the 3rd. trimester of pregnancy was 5 times higher than that in the 1st. trimester. 4) C-kinase activity was inhibited by hCG and markedly stimulated by DHA or DHAS. These results suggest that C-kinase is involved in the specific functions of the placenta.

[Ca2+, phospholipid-dependent protein kinase (C-kinase) in the rat placental chorion]

C-kinase is one of the enzymes which phosphorylate cellular proteins, and is reported to be involved in transmission of the extracellular signals regarding hormones, etc. to inside the cell. This enzyme is widely distributed in many tissues and organs and several C-kinase-mediated cellular responses were reported. However, in the placenta, the presence of C-kinase has not been reported. In this paper we reported for the first time the purification of C-kinase from rat placental chorion and investigated the physiological functions of C-kinase. The results were as follows: A considerable amount of C-kinase was detected in the membrane fraction of rat placenta. C-kinase specifically phosphorylated several membrane proteins, and the phosphorylation pattern was different from those of mid pregnancy and late pregnancy. The C-kinase activity in late pregnancy was 6 times higher than that of mid pregnancy. Hemin and Polylysine inhibited partially-purified membrane-bound C-kinase. Substrate specificity C-kinase from rat placenta was similar to those from other organs.

Effects of linoleic acid and cations on the activity of a novel high-molecular weight protease, ingensin, from human placenta

A linoleic acid-sensitive protease, ingensin, was purified to homogeneity from human placenta. The physical properties of the placental ingensin were found to be very similar to those of skeletal muscle ingensin [Ishiura et al. (1985) FEBS Lett. 189, 119-123]. The purified ingensin was activated by linoleic acid and SDS. The linoleic acid-activated form was inhibited preferentially by divalent cations, whereas the SDS-activated form was inhibited by monovalent cations instead.