September 5, 2013

The dopamine D1 receptor is expressed and facilitates relaxation in airway smooth muscle

Open Access
Research


Kentaro MizutaYi ZhangDingbang XuFumiko MizutaFrank D¿OvidioEiji Masaki andCharles W Emala
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Respiratory Research 2013, 14:89 doi:10.1186/1465-9921-14-89
Published: 2 September 2013

Abstract (provisional)

Background

Dopamine signaling is mediated by Gs protein-coupled "D1-like" receptors (D1 and D5) and Gi-coupled "D2-like" receptors (D2-4). In asthmatic patients, inhaled dopamine induces bronchodilation. Although the Gi-coupled dopamine D2 receptor is expressed and sensitizes adenylyl cyclase activity in airway smooth muscle (ASM) cells, the Gs-coupled dopamine D1-like receptor subtypes have never been identified on these cells. Activation of Gs-coupled receptors stimulates cyclic AMP (cAMP) production through the stimulation of adenylyl cyclase, which promotes ASM relaxation. We questioned whether the dopamine D1-like receptor is expressed on ASM, and modulates its function through Gs-coupling.

Methods

The mRNA and protein expression of dopamine D1-like receptor subtypes in both native human and guinea pig ASM tissue and cultured human ASM (HASM) cells was measured. To characterize the stimulation of cAMP through the dopamine D1 receptor, HASM cells were treated with dopamine or the dopamine D1-like receptor agonists (A68930 or SKF38393) before cAMP measurements. To evaluate whether the activation of dopamine D1 receptor induces ASM relaxation, guinea pig tracheal rings suspended under isometric tension in organ baths were treated with cumulatively increasing concentrations of dopamine or A68930, following an acetylcholine-induced contraction with or without the cAMP-dependent protein kinase (PKA) inhibitor Rp-cAMPS, the large-conductance calcium-activated potassium (BKCa) channel blocker iberiotoxin, or the exchange proteins directly activated by cAMP (Epac) antagonist NSC45576.

Results

Messenger RNA encoding the dopamine D1 and D5 receptors were detected in native human ASM tissue and cultured HASM cells. Immunoblots confirmed the protein expression of the dopamine D1 receptor in both native human and guinea pig ASM tissue and cultured HASM cells. The dopamine D1 receptor was also immunohistochemically localized to both human and guinea pig ASM. The dopamine D1-like receptor agonists stimulated cAMP production in HASM cells, which was reversed by the selective dopamine D1-like receptor antagonists SCH23390 or SCH39166. A68930 relaxed acetylcholine-contracted guinea pig tracheal rings, which was attenuated by Rp-cAMPS but not by iberiotoxin or NSC45576.

Conclusions

These results demonstrate that the dopamine D1 receptors are expressed on ASM and regulate smooth muscle force via cAMP activation of PKA, and offer a novel target for therapeutic relaxation of ASM.

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Stan Szefler, MD talks with Michael Wechsler, MD about Dr. Wechsler's new JACI article "Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma"

September 4, 2013

Significant, quantifiable differences exist between IgG subclass standards WHO67/97 and ERM-DA470k and can result in different interpretation of results

Available online 25 July 2013
  • a Binding Site Group Limited, 8 Calthorpe Road, Birmingham B15 1QT, United Kingdom
  • b Clinical Immunology & Allergy, GSTS Pathology, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom
  • c Haifa and Western Galilee Laboratory, Clalit Health Services, 47 Hataasia St, Nesher 20300, PO Box 428, Haifa, Israel
  • d Département de Biologie Clinique, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
  Open Access

Highlights

Samples from four testing sites were measured using commercial IgG subclass assays.
The assays are calibrated to two different reference materials.
Calibrations were similar for IgG1 and IgG2.
For IgG3 and IgG4, the calibrations were significantly different.
The two manufacturers' assays can give differing clinical classifications.

Abstract

Objectives

Accurate measurement of IgG subclass (IgGSc) levels are essential to aid in the diagnosis of disease states such as primary immunodeficiencies. However, there is no single standardisation of nephelometric and turbidimetric assays for these analytes and two reference materials have been utilised. We expand on previous reports and present data from a multi-site analysis that both identifies and quantitatively defines the differences in calibration resulting from the use of different reference materials.

Design and methods

IgGSc antibodies in the serum specimens and reference materials were measured according to the manufacturers' instructions using commercially available IgGSc assays or components.

Results

Data from four independent sites showed that in spite of the different commercial suppliers of IgGSc assays calibrating to different reference materials, ERM-DA470k and WHO67 /97, the resulting calibrations were comparable for IgG1 and IgG2. However, for IgG3 and IgG4 the calibrations were significantly different. The use of assay specific normal ranges should compensate for these calibration differences, however, the two manufacturers' assays can give differing clinical classifications. The agreement between the different manufacturers' IgGSc assays was between 85.1% and 95.8% for all IgGSc assays, the discordance of sample classification for IgG1 and IgG2 assays was approximately 12% and 15% respectively, whilst that for IgG3 and IgG4 was 4% and 13% respectively.

Conclusion

We discuss the similarities and differences between assays that utilise the different reference materials.

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  • Increased Numbers of NK Cells, NKT-Like Cells, and NK Inhibitory Receptors in Peripheral Blood of Patients with COPD

    Clinical and Developmental Immunology
    Volume 2013 (2013), Article ID 721782, 8 pages
    http://dx.doi.org/10.1155/2013/721782
    Clinical Study

    Increased Numbers of NK Cells, NKT-Like Cells, and NK Inhibitory Receptors in Peripheral Blood of Patients with Chronic Obstructive Pulmonary Disease

    1Department of Respiratory Medicine, The First Hospital, Jilin University, Changchun 130021, China
    2Department of the Central Laboratory, The Second Part of the First Hospital, Jilin University, Changchun 130021, China
    Received 11 January 2013; Revised 24 June 2013; Accepted 26 June 2013
    Academic Editor: G. Opdenakker
    Copyright © 2013 Ying Tang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    T cells and B cells participate in the pathogenesis of COPD. Currently, NK cells and NKT cells have gained increasing attention. In the present study, 19 COPD patients and 12 healthy nonsmokers (HNS) were recruited, and their pulmonary function was assessed. The frequencies of CD3+ T, CD4+ T, CD8+T, B, NK, and NKT-like cells were determined using flow cytometry. The frequencies of spontaneous and inducible IFN-γ+ or CD107a+ NK and NKT-like cells as well as activating or inhibitory receptors were also detected. The potential association of lymphocyte subsets with disease severity was further analyzed. Significantly decreased numbers of CD3+ and CD4+ T cells, and the CD4+/CD8+ ratio, but increased numbers of CD3CD56+ NK and CD3+CD56+ NKT-like cells were observed in COPD patients compared to HNS. The frequencies of inducible IFN-γ-secreting NK and NKT-like cells were less in COPD patients. The frequencies of CD158a and CD158b on NK cells and CD158b on NKT-like cells were greater. The frequency of CD158b+ NK cells was negatively correlated with FEV1% prediction and FEV1/FVC. Our data indicate that COPD patients have immune dysfunction, and higher frequencies of inhibitory NK cells and NKT-like cells may participate in the pathogenesis of COPD.

    Influence of subcutaneous specific immunotherapy on drug costs in children suffering from allergic asthma

    Open Access
    Research


    Thomas ReinholdJulia OstermannSusanne Thum-Oltmer and Bernd Brüggenjürgen
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    Clinical and Translational Allergy 2013, 3:30 doi:10.1186/2045-7022-3-30
    Published: 3 September 2013

    Abstract (provisional)

    Background

    Subcutaneous specific immunotherapy (SCIT) is an effective treatment attenuating the progression of allergic asthma. To date, there is a lack of studies investigating the economic consequences of SCIT on health care expenditures.

    Methods

    A health-economic piggy-back analysis of SCIT was conducted based on a RCT that enrolled 65 children and adolescents with allergic asthma. Patients were allocated into two groups: A group receiving SCIT with a high-dose hypoallergenic house dust mite preparation plus asthma medication and a control group receiving only asthma medication. For both groups asthma control was achieved before the start of the SCIT treatment and was maintained during the study. Both, costs and cost-effectiveness of SCIT with the high-dose hypoallergenic house dust mite preparation were investigated based on total medication costs, incremental medication costs and treatment effects (measured as lung function), respectively. A bootstrap analysis was performed to validate the results.

    Results

    A steady decline in medication costs could be observed in the SCIT group one year after treatment start compared to the control group. This cost trend became statistically significant 3 years after SCIT started. The calculated potential savings in the SCIT group correlated with an improved lung function. The distribution of the bootstrap results revealed that the probability of SCIT having a superior effectiveness compared to the control group is around 90%.

    Conclusion

    SCIT with a high-dose hypoallergenic preparation received by children and adolescents suffering from mite induced allergic asthma reduces the allergic medication intake and has cost-saving effects. Additional costs associated with SCIT may be completely compensated by drug cost savings 4 years after end of SCIT. Additionally, SCIT is superior compared to routine care as measured by the lung function that improved in SCIT-treated patients. Trial registration: (EudraCT no. 2004 - 003892 - 35).

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


    September 3, 2013

    Single venom-based immunotherapy effectively protects patients with double positive tests to honey bee and Vespula venom

    Open Access
    Research


    Johanna StoevesandtBernd HofmannJohannes HainAndreas Kerstan and Axel Trautmann
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    Allergy, Asthma & Clinical Immunology 2013, 9:33 doi:10.1186/1710-1492-9-33
    Published: 2 September 2013

    Abstract (provisional)

    Background

    Referring to individuals with reactivity to honey bee and Vespula venom in diagnostic tests, the umbrella terms "double sensitization" or "double positivity" cover patients with true clinical double allergy and those allergic to a single venom with asymptomatic sensitization to the other. There is no international consensus on whether immunotherapy regimens should generally include both venoms in double sensitized patients.

    Objective

    We investigated the long-term outcome of single venom-based immunotherapy with regard to potential risk factors for treatment failure and specifically compared the risk of relapse in mono sensitized and double sensitized patients.

    Methods

    Re-sting data were obtained from 635 patients who had completed at least 3 years of immunotherapy between 1988 and 2008. The adequate venom for immunotherapy was selected using an algorithm based on clinical details and the results of diagnostic tests.

    Results

    Of 635 patients, 351 (55.3%) were double sensitized to both venoms. The overall re-exposure rate to Hymenoptera stings during and after immunotherapy was 62.4%; the relapse rate was 7.1% (6.0% in mono sensitized, 7.8% in double sensitized patients). Recurring anaphylaxis was statistically less severe than the index sting reaction (P = 0.004). Double sensitization was not significantly related to relapsing anaphylaxis (P = 0.56), but there was a tendency towards an increased risk of relapse in a subgroup of patients with equal reactivity to both venoms in diagnostic tests (P = 0.15).

    Conclusions

    Single venom-based immunotherapy over 3 to 5 years effectively and long-lastingly protects the vast majority of both mono sensitized and double sensitized Hymenoptera venom allergic patients. Double venom immunotherapy is indicated in clinically double allergic patients reporting systemic reactions to stings of both Hymenoptera and in those with equal reactivity to both venoms in diagnostic tests who have not reliably identified the culprit stinging insect.

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



    Omalizumab may decrease IgE synthesis by targeting membrane IgE+ human B cells

    Open Access
    Research


    Marcia A ChanNicole M GigliottiAbby L Dotson and Lanny J Rosenwasser
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    Clinical and Translational Allergy 2013, 3:29 doi:10.1186/2045-7022-3-29
    Published: 2 September 2013

    Abstract (provisional)

    Background

    Omalizumab, is a humanized anti-IgE monoclonal antibody used to treat allergic asthma. Decreased serum IgE levels, lower eosinophil and B cell counts have been noted as a result of treatment. In vitro studies and animal models support the hypothesis that omalizumab inhibits IgE synthesis by B cells and causes elimination of IgE-expressing cells either by induction of apoptosis or induction of anergy or tolerance.

    Methods

    We examined the influence of omalizumab on human tonsillar B cell survival and on the genes involved in IgE synthesis. Tonsillar B cells were stimulated with IL-4 plus anti-CD40 antibody to induce class switch recombination to IgE production in the presence or absence of omalizumab. Cell viability was assessed and RNA extracted to examine specific genes involved in IgE synthesis.

    Conclusions

    We found that omalizumab reduced viable cell numbers but this was not through induction of apoptosis. IL-4R and germline Cepsilon mRNA levels were decreased as well as the number of membrane IgE+ cells in B cells treated with omalizumab. These data suggest that omalizumab may decrease IgE synthesis by human B cells by specifically targeting membrane IgE-bearing B cells and inducing a state of anergy.

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