May 11, 2013

Role of plasmacytoid dendritic cell subsets in allergic asthma


Keywords:

  • allergic asthma;
  • allergy;
  • pDCs;
  • plasmacytoid dendritic cells;
  • tolerance

Abstract

Plasmacytoid dendritic cells (pDCs) are major type-I interferon-producing cells that play important roles in antiviral immunity and tolerance induction. These cells share a common DC progenitor with conventional DCs, and Fms-like tyrosine kinase-3 ligand is essential for their development. Several subsets of pDCs have been identified to date including CCR9+, CD9+, and CD2+ pDCs. Recently, three subsets of pDCs were described, namely CD8αβ, CD8α+β, and CD8α+β+ subsets. Interestingly, CD8α+β and CD8α+β+ but not CD8αβ pDCs were shown to have tolerogenic effects in experimentally induced allergic asthma. These tolerogenic effects were shown to be mediated by the generation of FOXP3+ regulatory T cells through retinoic acid and the induction of retinaldehyde dehydrogenase enzymes. These newly described subsets of pDCs show high potentials for novel therapeutic approaches for the treatment of allergic diseases. In this review, we will address the new progress in our understanding of pDC biology with respect to allergic disease, in particular allergic asthma.
Plasmacytoid dendritic cells (pDCs) are the major type-I interferon-producing cells that are implicated in antiviral immunity and immunological tolerance [1-6]. Since their first discovery in 1958, there has been a substantial improvement in our understanding of these cells [7]. In the steady state, pDCs show plasma cell-like morphology and express CD11c, CD45R, PDCA-1, Siglec-H, but not CD11b in mice, and CD4, CD45RA, CD303, and CD123, but not CD11c in humans [1, 8-10]. Under inflammatory conditions and upon activation, pDCs show a classical DC morphology with dendrites [11]. These cells sense pathogens through Toll-like receptor-7 and -9 leading to their rapid and robust secretion of type-I interferons (IFNs) [12, 13]. This unique capacity of pDCs to secrete high levels of IFN-α is crucial for innate antiviral immunity [14-16].
In adaptive immunity, pDCs play major roles in the induction of immunological tolerance. Unlike conventional DCs, pDCs are poor antigen-presenting cells to CD4+ T cells mainly due to their less-efficient antigen-processing machinery and low expression of co-stimulatory molecules [1, 11, 17]. However, there is evidence suggesting that pDCs can efficiently present antigens to CD8+ T cells [18]. pDCs contribute to the induction of tolerance through enhancing the generation of regulatory T (Treg) cells [19-26]. It has been shown that a subset of thymic stromal lymphopoietin protein receptor-expressing human pDCs potentiates the generation of naturally occurring T cells in the thymus [27]. There is also evidence indicating that pDCs contribute to the induction of Treg cells required for immune tolerance in allergic and autoimmune diseases, cancer, transplant and fetal tolerance [19-26].

Effects of urotensin II receptor antagonist, GSK1440115, in asthma


Front. Pharmacol., 29 April 2013 |doi:10.3389/fphar.2013.00054

Effects of urotensin II receptor antagonist, GSK1440115, in asthma

Alison Portnoy1Sanjay Kumar1*, David J. Behm2, Kelly M. Mahar3, Robert B. Noble4John P. Throup1 and Steven F. Russ1,5
  • 1Virtual Proof of Concept Discovery Performance Unit, GlaxoSmithKline, King of Prussia, PA, USA
  • 2Heart Failure Discovery Performance Unit, GlaxoSmithKline, King of Prussia, PA, USA
  • 3Clinical Pharmacology Modeling and Simulation, GlaxoSmithKline, King of Prussia, PA, USA
  • 4Quantitative Sciences, GlaxoSmithKline, Collegeville, PA, USA
  • 5Virtual Proof of Concept Discovery Performance Unit, GlaxoSmithKline, Research Triangle Park, NC, USA
Background: Urotensin II (U-II) is highly expressed in the human lung and has been implicated in regulating respiratory physiology in preclinical studies. Our objective was to test antagonism of the urotensin (UT) receptor by GSK1440115, a novel, competitive, and selective inhibitor of the UT receptor, as a therapeutic strategy for the treatment of asthma.
Methods: Safety, tolerability, and pharmacokinetics (PK) of single doses of GSK1440115 (1–750 mg) were assessed in a Phase I, placebo controlled study in 70 healthy subjects. In a Phase Ib study, 12 asthmatic patients were randomized into a two-period, single-blind crossover study and treated with single doses of 750 mg GSK1440115 or placebo and given a methacholine challenge.
Results: Administration of GSK1440115 was safe and well-tolerated in healthy subjects and asthmatic patients. In both studies, there was a high degree of variability in the observed PK following oral dosing with GSK1440115 at all doses. There was a marked food effect in healthy subjects at the 50 mg dose. In the presence of food at the 750 mg dose, the time to maximal concentration was between 2 and 6 h and the terminal half-life was short at approximately 2 h. All asthmatic patients maintained greater than the predicted concentration levels necessary to achieve predicted 96% receptor occupancy for ≥3 h (between 4 and 7 h post-dose). There were no apparent trends or relationships between the systemic plasma exposure of GSK1440115 and pharmacodynamic endpoints, PC20after methacholine challenge and FEV1, in asthmatics.
Conclusion: While GSK1440115 was safe and well-tolerated, it did not induce bronchodilation in asthmatics, or protect against methacholine-induced bronchospasm, suggesting that acute UT antagonism is not likely to provide benefit as an acute bronchodilator in this patient population.


Keywords: urotensin II, asthma, receptor antagonist
Citation: Portnoy A, Kumar S, Behm DJ, Mahar KM, Noble RB, Throup JP and Russ SF (2013) Effects of urotensin II receptor antagonist, GSK1440115, in asthma. Front. Pharmacol.4:54. doi: 10.3389/fphar.2013.00054
Received: 05 February 2013; Accepted: 10 April 2013;
Published online: 29 April 2013.
Edited by:
Pascal Chanez, Universite de la Mediterranée, France
Reviewed by:
Isabelle Vachier, Med Bio Med, France
Didier Cataldo, University of Liege, Belgium
Copyright: © 2013 Portnoy, Kumar, Behm, Mahar, Noble, Throup and Russ. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.
*Correspondence: Sanjay Kumar, Virtual Proof of Concept Discovery Performance Unit, GlaxoSmithKline, 709 Swedeland Road, UW2230, King of Prussia, PA 19406-0939, USA. e-mail: sanjay.2.kumar@gsk.com

Outpatient Management of Asthma in Children


Logo of cmped
Clin Med Insights Pediatr. 2013; 7: 13–24.
Published online 2013 April 14. doi:  10.4137/CMPed.S7867
PMCID: PMC3629928

Outpatient Management of Asthma in Children

Abstract

The principal aims of asthma management in childhood are to obtain symptom control that allows individuals to engage in unrestricted physical activities and to normalize lung function. These aims should be achieved using the fewest possible medications. Ensuring a correct diagnosis is the first priority. The mainstay of asthma management remains pharmacotherapy. Various treatment options are discussed. Asthma monitoring includes the regular assessment of asthma severity and asthma control, which then informs decisions regarding the stepping up or stepping down of therapy. Delivery systems and devices for inhaled therapy are discussed, as are the factors influencing adherence to prescribed treatment. The role of the pediatric health care provider is to establish a functional partnership with the child and their family in order to minimize the impact of asthma symptoms and exacerbations during childhood.
Keywords: asthma, children, wheeze, management

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Baicalein Reduces Airway Injury in Allergen and IL-13 Induced Airway Inflammation



RESEARCH ARTICLE

Baicalein Reduces Airway Injury in Allergen and IL-13 Induced Airway Inflammation

  • Ulaganathan Mabalirajan mail,
  •  
  • Tanveer Ahmad,
  •  
  • Rakhshinda Rehman,
  •  
  • Geeta Devi Leishangthem,
  •  
  • Amit Kumar Dinda,
  •  
  • Anurag Agrawal,
  •  
  • Balaram Ghosh,
  • Surendra Kumar Sharma

Abstract

Background

Baicalein, a bioflavone present in the dry roots of Scutellaria baicalensis Georgi, is known to reduce eotaxin production in human fibroblasts. However, there are no reports of its anti-asthma activity or its effect on airway injury.

Methodology/Principal Findings

In a standard experimental asthma model, male Balb/c mice that were sensitized with ovalbumin (OVA), treated with baicalein (10 mg/kg, ip) or a vehicle control, either during (preventive use) or after OVA challenge (therapeutic use). In an alternate model, baicalein was administered to male Balb/c mice which were given either IL-4 or IL-13 intranasally. Features of asthma were determined by estimating airway hyperresponsiveness (AHR), histopathological changes and biochemical assays of key inflammatory molecules. Airway injury was determined with apoptotic assays, transmission electron microscopy and assessing key mitochondrial functions. Baicalein treatment reduced AHR and inflammation in both experimental models. TGF-β1, sub-epithelial fibrosis and goblet cell metaplasia, were also reduced. Furthermore, baicalein treatment significantly reduced 12/15-LOX activity, features of mitochondrial dysfunctions, and apoptosis of bronchial epithelia.

Conclusion/Significance

Our findings demonstrate that baicalein can attenuate important features of asthma, possibly through the reduction of airway injury and restoration of mitochondrial function.

Conducting retrospective impact analysis to inform a medical research charity's funding strategies: the case of Asthma UK


Open Access


Research

Conducting retrospective impact analysis to inform a medical research charity's funding strategies: the case of Asthma UK

Stephen R HanneyAmanda WattTeresa H Jones and Leanne Metcalf
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Allergy, Asthma & Clinical Immunology 2013, 9:17 doi:10.1186/1710-1492-9-17
Published: 7 May 2013

Abstract (provisional)

Background

Debate is intensifying about how to assess the full range of impacts from medical research. Complexity increases when assessing the diverse funding streams of funders such as Asthma UK, a charitable patient organisation supporting medical research to benefit people with asthma. This paper aims to describe the various impacts identified from a range of Asthma UK research, and explore how Asthma UK utilised the characteristics of successful funding approaches to inform future research strategies.

Methods

We adapted the Payback Framework, using it both in a survey and to help structure interviews, documentary analysis, and case studies. We sent surveys to 153 lead researchers of projects, plus 10 past research fellows, and also conducted 14 detailed case studies. These covered nine projects and two fellowships, in addition to the innovative case studies on the professorial chairs (funded since 1988) and the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma (the 'Centre') which together facilitated a comprehensive analysis of the whole funding portfolio. We organised each case study to capture whatever academic and wider societal impacts (or payback) might have arisen given the diverse timescales, size of funding involved, and extent to which Asthma UK funding contributed to the impacts.

Results

Projects recorded an average of four peer-reviewed journal articles. Together the chairs reported over 500 papers. All streams of funding attracted follow-on funding. Each of the various categories of societal impacts arose from only a minority of individual projects and fellowships. Some of the research portfolio is influencing asthma-related clinical guidelines, and some contributing to product development. The latter includes potentially major breakthroughs in asthma therapies (in immunotherapy, and new inhaled drugs) trialled by university spin-out companies. Such research-informed guidelines and medicines can, in turn, contribute to health improvements. The role of the chairs and the pioneering collaborative Centre is shown as being particularly important.

Conclusions

We systematically demonstrate that all types of Asthma UK's research funding assessed are making impacts at different levels, but the main societal impacts from projects and fellowships come from a minority of those funded. Asthma UK used the study's findings, especially in relation to the Centre, to inform research funding strategies to promote the achievement of impact.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Evaluation of Banana Hypersensitivity Among a Group of Atopic Egyptian Children: Relation to Parental/Self Reports


Logo of aair
Allergy Asthma Immunol Res. 2013 May; 5(3): 150–154.
Published online 2013 February 4. doi:  10.4168/aair.2013.5.3.150
PMCID: PMC3636449

Evaluation of Banana Hypersensitivity Among a Group of Atopic Egyptian Children: Relation to Parental/Self Reports

Abstract

Purpose

To evaluate the frequency of banana sensitization and allergy among a group of atopic Egyptian children in relation to parental/self reports.

Methods

This is a case-control study included 2 groups of allergic children with and without history of banana allergy, each included 40 patients. They were subjected to skin prick test (SPT) using commercial banana allergen extract and prick-prick test (PPT) using raw banana, in addition to measuring the serum banana-specific IgE. Oral banana challenge was performed in suspected cases.

Results

Banana allergy was diagnosed in 3 (7.5%) patients based on positive history of allergy on exposure to banana, positive SPT/PPT and elevated banana-specific IgE. The 3 patients had bronchial asthma with exacerbation upon banana exposure. The PPT results conform with those of SPT both in diagnosis of banana allergy and in the skin reactivity to banana. Serum banana-specific IgE was detectable in the whole studied sample with higher serum level among those without history of banana allergy (P=0.005). Oral banana challenge was negative for 20 patients with history of banana allergy and positive serum banana-specific IgE but negative SPT and PPT.

Conclusions

Self/parental reports of banana allergy is high while the actual banana allergy is uncommon. The PPT seems as reliable as SPT in diagnosis of banana allergy unlike specific IgE which reflects sensitization rather than allergy. Oral food challenge remains the most helpful tool for diagnosis of food allergy in suspected cases.
Keywords: Banana hypersensitivity, allergic children, skin prick test

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