Mechanisms of antihistamines and mast cell stabilizers in ocular allergic inflammation.

Mast cells play a central role in allergic reactions and inflammation. Successful anti-allergic therapies have typically targeted mast cell mediators, particularly histamine. Antihistaminic compounds interact with the various histamine receptors found on many cells, whereas other compounds such as disodium cromoglycate, are referred to as mast cell stabilizers, as they inhibit degranulation. Some of the most successful compounds developed recently are dual-action, in that they have both anti-histaminic and mast cell stabilizing activities. Recent trends in pharmaceutical intervention, however, have been focused on the secondary effects of mast cell mediators on epithelial cell adhesion molecule expression and mediator release in the process of allergic inflammation. Since, the ocular mucosa is highly exposed to environmental allergens it is commonly involved in allergic reactions and, as such, has been a useful and accessible model in which to test new therapies in vivo. These ocular allergen provocation studies permit analysis of ocular surface cells and evaluation of tear film mediators. Furthermore, techniques to purify conjunctival mast cells have facilitated the study of the effects of mast cell stabilizing compounds on other mast cell mediators, such as cytokines, and the direct effects of mast cell mediators on epithelial cells in vitro. This review will discuss current understanding of how anti-histamines and mast cell stabilizers work, particularly in the context of molecular mechanisms of ocular allergic inflammation.

Olopatadine inhibits anti-immunoglobulin E-stimulated conjunctival mast cell upregulation of ICAM-1 expression on conjunctival epithelial cells.

BACKGROUND: Olopatadine is a clinically effective dual-action (antihistamine/mast cell stabilizer) ophthalmic antiallergic agent. We have previously demonstrated that olopatadine inhibits tumor necrosis factor alpha (TNF-alpha) release from purified human conjunctival mast cells and that supernates from stimulated mast cells upregulate intercellular adhesion molecule 1 (ICAM-1) expression on epithelial cells via TNF-alpha. OBJECTIVE: To investigate the effect of olopatadine on the TNF-alpha-mediated mast cell upregulation of ICAM-1 expression on conjunctival epithelial cells. METHODS: Human conjunctival mast cells and epithelial cells were purified (>95%) from cadaveric tissue. Conjunctival mast cells were preincubated with three doses (30, 300, or 3,000 microM) of olopatadine or buffer alone for 30 minutes followed by 90-minute challenge with anti-immunoglobulin E (10 microg/mL). The resulting supernates were incubated with conjunctival epithelial cell monolayers for 24 hours along with the following treatments: rTNF-alpha, mast cell supernate + anti-TNF-alpha, recombinant (r)TNF-alpha + anti-TNF-alpha, the three doses of olopatadine, olopatadine supernates, olopatadine supernates + rTNF-alpha. ICAM-1 expression was measured using flow cytometry. RESULTS: Anti-IgE-stimulated human conjunctival mast cell supernates upregulated human conjunctival epithelial cell ICAM-1 expression to the same extent as rTNF-alpha. ICAM-1 upregulation could be completely blocked with anti-TNF-alpha. Preincubation of conjunctival mast cells with olopatadine significantly blocked the ability of supernates to upregulate ICAM-1 on conjunctival epithelial cells. ICAM-1 expression could be restored by adding rTNF-alpha to the olopatadine-preincubated mast cell supernates. CONCLUSIONS: Olopatadine is able to significantly decrease the anti-immunoglobulin E mast cell supernate-mediated upregulation of ICAM-1 on human conjunctival epithelial cells in vitro. This seems to be mediated through an effect on a TNF-alpha-specific mechanism.

Conjunctival mast cells in ocular allergic disease.

Allergic eye disease is a common clinical problem adversely affecting the quality of life for millions of sufferers. This ocular process is associated with IgE-mediated conjunctival inflammation leading to signs of immediate hypersensitivity including redness, itching, and tearing. Pathologic studies have shown that the conjunctiva contains mast cells that when sensitized with IgE antibody and exposed to environmental allergens can release mediators of allergic inflammation. The type, release kinetics, and concentration of these mediators in the conjunctiva have not been completely characterized. The ability to isolate and purify mast cells and epithelial cells from human conjunctival tissue has permitted the study of mediator release and cell-to-cell signaling in this tissue. Our laboratory has developed in vitro and in vivo models to better understand how inflammatory cells are recruited to and infiltrate conjunctival tissues. These models demonstrate that mast cell activation may supply sufficient cytokine signaling to initiate and direct the well-orchestrated trafficking of eosinophils to the ocular surface, facilitate their adhesion, and cause release of potent mediators of ocular inflammation.

Simultaneous measurement of six cytokines in a single sample of human tears using microparticle-based flow cytometry: allergics vs. non-allergics.

Tears play an essential role in maintaining corneal and conjunctival integrity by providing a tightly regulated, optimal extracellular environment critical to its numerous functions, which include anti-microbial defense, wound healing and inflammatory responses such as allergies. Elevated levels of inflammatory cytokines have been reported in tears from various ocular disease states. Characterization of tear cytokines has been limited by the small volume (microliter amounts) attainable. This limitation was addressed with the newly developed Becton Dickinson Cytometric Bead Array (CBA), which combines the principles of the "sandwich" immunoassay with the capability of flow cytometry for simultaneous measurement of the characteristics of multiple particles. This technique allows determination of six human cytokine (IFNgamma, TNFalpha, IL-2, IL-4, IL-5, IL-10) concentrations simultaneously in a single tear sample. Tears were collected from the inferior fornix of non-allergic (n=7) and allergic (n=9) donors. Each tear sample or cytokine standard was incubated with a mixture of capture Ab-bead reagent and detector Ab-phycoerythrin (PE) reagent, and analyzed using flow cytometry. All six cytokines were detectable in both non-allergic and allergic tears. Tears from allergic donors contained significantly less IL-10 (p=0.035), and had significant increases in the ratios of TNFalpha/IFNgamma, IL-5/IFNgamma and IL-5/IL-10 (p=0.0008, 0.0124 and 0.011, respectively). The small volume required (5-10 microl/test) by the Cytometric Bead Array allows measurement of all six cytokines from a single collection of tears. This decreases collection time, minimizing the confounding effect of stimulation on cytokine concentration in tears, as well as allowing calculation of cytokine ratios.

Effect of L-tryptophan supplementation on eosinophils and eotaxin in guinea pigs.

Eosinophilia Myalgia Syndrome is a hypereosinophilic disorder that appears to result from the ingestion of the dietary supplement L-tryptophan by susceptible individuals. It is unclear if this disease results from tryptophan, contaminants found in tryptophan, individual predisposition (such as immune status and allergies), or some combination of effects. To evaluate effects of L-tryptophan on eosinophil migration, guinea pigs were compared with or without supplemental tryptophan (0.4 g/kg/day), with or without immune sensitization, and with or without immune challenge. Eosinophil counts were obtained from bone marrow, blood, lung, and bronchial alveolar lavage fluid (BAL). Lung cells were obtained to measure eotaxin concentrations in supernates and lysates with or without antigen and calcium ionophore challenge using direct ELISA. Skin biopsies were taken from both non-injected and antigen injection sites. The tryptophan supplemented, antigen-sensitized/antigen-challenged guinea pigs showed a significant decrease in blood eosinophils, compared to control (cellulose) supplemented antigen-sensitized/antigen-challenged guinea pigs [(0.086 +/- 0.023) x 10(6) vs (0.147 +/- 0.021) x 10(6) eosinophils/ml recovered, respectively] with a significant increase in BAL eosinophils [(0.052 +/- 0.008) x 10(6) vs (0.033 +/- 0.005) x 10(6) eosinophils/ml recovered, respectively]. Unchallenged lung cell lysates from tryptophan-supplemented guinea pigs contained significantly less eotaxin compared to cellulose-supplemented guinea pigs regardless of whether they were sensitized (0.006 +/- 0.002 vs 0.027 +/- 0.008 ng/10(6) cells, respectively). No differences were observed in skin biopsies between cellulose and tryptophan groups. These results suggest that L-tryptophan-supplemented guinea pigs have altered eotaxin regulation, a potential mechanism by which human overconsumption of tryptophan dietary supplements could lead to hypereosinophilic disorders in susceptible individuals.

CLA reduces antigen-induced histamine and PGE(2) release from sensitized guinea pig tracheae.

Conjugated linoleic acid (CLA) has been shown to enhance immune reactions such as lymphocyte blastogenesis and delayed-type hypersensitivity. We investigated the role of CLA in type I (immediate) hypersensitivity, using a guinea pig tracheal superfusion model for measuring antigen-induced airway smooth muscle contraction and inflammatory mediator release. Female Hartley guinea pigs were fed a diet supplemented with 0.25 g corn oil or linoleic acid/100 g of diet (control) or 0.25 g CLA/100 g of diet for at least 1 wk before and during active sensitization to ovalbumin antigen. Tracheae from sensitized guinea pigs were suspended in air-filled water-jacketed (37 degrees C) tissue chambers in a superfusion apparatus. Tracheae were superfused with buffer containing antigen, and tissue contraction was recorded. Superfusate was collected at 90-s intervals for evaluation of histamine and PGE(2) release. CLA did not affect antigen-induced tracheal contractions when expressed as gram contraction per gram tissue. CLA significantly reduced antigen-induced histamine and PGE(2) release. CLA appears to decrease release of some inflammatory mediators during type I hypersensitivity reactions.

G(1) Phase growth arrest and induction of p21(Waf1/Cip1/Sdi1) in IB3-1 cells treated with 4-sodium phenylbutyrate.

4-Sodium phenylbutyrate (4-PBA) has been used for many years in the treatment of urea cycle defects and has recently been studied as a chemotherapeutic agent for certain malignancies. 4-PBA has been shown to cause growth arrest, cellular differentiation, and apoptosis in certain malignant cells. Recently, it was shown that IB3-1 cells (a cystic fibrosis cell line, Delta508/W128X) treated with 4-PBA demonstrated a partial correction of the cystic fibrosis chloride channel defect. We were interested in evaluating the effect of 4-PBA on cell growth and cell cycle regulation in IB3-1 cells treated with 2 to 10 mM concentrations. We found that cells treated with 2 mM concentrations of 4-PBA for 96 h underwent a significant decrease in cell growth (P <.007). Using flow cytometry, we were able to demonstrate that growth arrest occurred at the G(1) phase of the cell cycle. This was detected as early as 24 h in IB3-1 cells treated with 5 mM 4-PBA (P <.03). Furthermore, the percentage of IB3-1 cells with less than a 2N DNA content increased with higher concentrations of 4-PBA, although this was not associated with an increase in apoptosis. Finally, p21(Waf1/Cip1/Sdi1) protein levels were induced in IB3-1 cells receiving 2 and 5 mM concentrations of 4-PBA as early as 24 h of exposure, suggesting that G(1) phase growth arrest in IB3-1 cells treated with 4-PBA is regulated through the p21(Waf1/Cip1/Sdi1) pathway.

Antihistamines and epithelial cells.

Antihistamines have long been utilized in the symptomatic management (antihistaminic effects) of allergic rhinitis and conjunctivitis. Investigation into the nonsedating second-generation antihistamines suggests that they also possess antiinflammatory activity, and may be useful in the management of inflammation associated with allergic airway disease. In vitro studies have shown that these antihistamines decrease the migration and activation of eosinophils and diminish the release of pro-inflammatory mediators from mast cells and basophils after induction by immunological and nonimmunological stimuli. In vivo studies have also demonstrated that these antihistamines decrease inflammatory cell infiltration in allergic airway disease, and mediator release from mast cells and basophils. Epithelial cells, due to their spatial arrangement and predominance in the airways, play a pivotal role in the etiology of airway disease. There is evidence that antihistamines may modulate airway inflammation by influencing the activity of these airway epithelial cells. Studies have shown that expression of adhesion molecules on epithelial cells is decreased by second-generation antihistamines. Collectively, these studies suggest that second-generation H1-histamine receptor antagonists have potential use either as safe antiinflammatory alternatives to corticosteroids or as rescue medication in combination with corticosteroids for the management of severe airway disease.

Olopatadine inhibits TNFalpha release from human conjunctival mast cells.

BACKGROUND: Tumor necrosis factor-alpha (TNFalpha) release likely plays a crucial role in allergic ocular inflammation via increasing ICAM-1 on epithelial cells and triggering other proinflammatory events. The immediate and prolonged release of TNFalpha from human conjunctival mast cells in response to allergen challenge is potentially an important target for therapeutic intervention, yet the effect of ocular anti-allergic agents on this process has not been examined. Olopatadine (Patanol) is a clinically effective dual-action ophthalmic anti-allergic agent that has been shown to inhibit mast cell histamine, tryptase, and PGD2 release in vitro and promote decreased H1 receptor binding activity in vitro and functional H1 receptor antagonism in vivo. OBJECTIVE: To investigate the effect of olopatadine on TNFalpha release from anti-IgE antibody challenged purified human conjunctival mast cells. METHODS: Human conjunctival mast cells were purified (>95%) from cadaveric tissues using a procedure combining enzymatic digestion and Percoll gradient centrifugation. These cells were incubated with olopatadine for 30 minutes then challenged with anti-IgE antibody for 90 minutes. Supernatants were analyzed for TNFalpha. RESULTS: Purified human conjunctival mast cells responded to anti-IgE antibody challenge with TNFalpha release in a concentration dependent manner (optimum concentration was 10 microg/mL). Olopatadine pre-incubation resulted in a dose-dependent decrease in anti-IgE antibody mediated TNFalpha release (IC50 = 13.1 microM). At a concentration of 3 mM olopatadine reduced TNFalpha release to the level of unchallenged controls. CONCLUSION: Olopatadine inhibited anti-IgE antibody-mediated release of TNFalpha from human conjunctival mast cells. This effect could contribute to the long duration of anti-allergic activity reported for the drug.

Cytokines, chemokines, RANTES, and eotaxin.

Over the past several years, a number of cytokines with chemoattractive properties (chemokines) have been identified. These low molecular weight molecules have been shown to be important leukocyte chemical attractants to sites of inflammation and infection. Chemokines act on leukocytes through selective receptors and are now known to function also in leukocyte maturation, trafficking, and homing of these cells. RANTES and eotaxin (among other chemokines) are important chemoattractants for eosinophils. Since eosinophils seem to play a critical role in the production of allergic inflammation, an understanding of the mechanism of action of these chemokines may lead to new therapies for asthma and other allergic processes.

Human conjunctival mast cells: expression of Fc epsilonRI, c-kit, ICAM-1, and IgE.

OBJECTIVE: To characterize the expression and regulation of conjunctival mast cell surface receptors important in allergic inflammation. METHODS: Mast cells were isolated from human conjunctival tissues of cadavers. Mast cell surface markers were identified using flow cytometry with antibodies to IgE, Fc epsilonRI, c-kit, and intercellular adhesion molecule-1 (ICAM-1). We evaluated the effect of 24-hour tumor necrosis factor alpha (TNF-alpha) or interleukin 4 (IL-4) incubation on the expression of mast cell c-kit, ICAM-1, and surface-bound IgE. RESULTS: Staining of mast cells (c-kit and/or tryptase positive) yielded positive results for all of the variables measured. The intensity of mast cell c-kit staining increased with TNF-alpha incubation, but decreased below that of unstimulated mast cells when incubated with IL-4. Anti-ICAM-1 and anti-IgE staining were increased over that of unstimulated cells when incubated with TNF-alpha or IL-4. CONCLUSIONS: In this model, TNF-alpha up-regulates mast cell surface receptors and cell-bound IgE. Interleukin 4 up-regulates mast cell ICAM-1 and cell-bound IgE, but down-regulates c-kit. CLINICAL RELEVANCE: Conjunctival mast cells play a critical role in the pathogenesis of atopic ocular disease. Characterization of the expression and regulation of mast cell surface receptors is important to the development of potential novel treatments for ocular inflammation.

Epithelial cells are a major cellular source of the chemokine eotaxin in the guinea pig lung.

Eotaxin is the major eosinophil chemoattractant found in bronchoalveolar lavage (BAL) fluid from sensitized guinea pigs after antigen challenge. In this study we have performed immunostaining for eotaxin in airways obtained from challenged animals and examined purified guinea pig lung cells (epithelial cells > 98% purity, mast cells > 90% purity) for eotaxin mRNA and protein. In the airways of antigen (ovalbumin) challenged animals, significant amounts of epithelial cell eotaxin immunostaining were observed. Northern analysis of total RNA obtained from unchallenged, freshly isolated airway epithelial cells contained high levels of eotaxin mRNA. Semi-pure and high purity lung mast cell preparations (challenged or unchallenged) did not express eotaxin mRNA. Western analysis of supernatant fluids obtained from incubated airway epithelial cells demonstrated detectable amounts of eotaxin protein, with the majority of the protein being cell-associated. Thus, airway epithelial cells are identified as a major cellular source of eotaxin in the guinea pig pulmonary system.

Isolation of human conjunctival mast cells and epithelial cells: tumor necrosis factor-alpha from mast cells affects intercellular adhesion molecule 1 expression on epithelial cells.

PURPOSE: To isolate and purify mast cells and epithelial cells from human cadaveric donor conjunctival tissue and to characterize interactions between these cell types in vitro. METHODS: Monodispersed cell suspensions obtained by enzymatic digestion of conjunctival tissue were applied to a single-density Percoll gradient. Epithelial cells obtained from the top layer of the gradient were cultured to confluence. Mast cells obtained from the pellet were equilibrated in culture medium and further purified using a two-step Percoll gradient. Using reverse transcription-polymerase chain reaction (RT-PCR), RNA from the purified mast cell preparation was probed for tumor necrosis factor-alpha (TNF alpha) message. Fluorescence activated cell sorting (FACS) analysis of intracellular immunostained mast cells was used to detect the TNF alpha protein. An examination for intercellular adhesion molecule 1 (ICAM-1) on epithelial cells was performed after 24-hour incubations with either recombinant TNF alpha supernatants from calcium ionophore A23187 (CaI)-stimulated mast cells or appropriate controls using FACS analysis. RESULTS: Highly purified human conjunctival mast cells and epithelial cells (each > 95%) were obtained from human cadaveric donor tissue. RT-PCR analysis of purified mast cell RNA revealed the expression of TNF alpha mRNA. An evaluation of mast cells for intracellular protein demonstrated positive staining for tryptase and TNF alpha. ICAM-1 was found on purified epithelial cells, and incubation of epithelial cell monolayers with supernatants from Cal-stimulated mast cells resulted in upregulation of this receptor. This upregulation was blocked by incubation with TNF alpha-neutralizing antibody. CONCLUSIONS: This work provides the methods for isolating and purifying mast cells and epithelial cells from human donor tissue and the opportunity for studying mechanisms of conjunctival inflammation by evaluating the interactions between these cells.

Breeding-hen and progeny performance when hens are fed excessive dietary zinc.

Short-term (12 wk) and long-term (44 wk) studies were conducted to observe the effects of excessive Zn supplementation on the performance of breeding hens and their progeny. Zinc sulfate was added to a corn-soybean meal diet containing 28 mg of Zn/kg in order to provide Zn supplementation at 0, 20, 200, and 2,000 mg/kg. Each dietary treatment was fed to two groups of 20, Single Comb White Leghorn hens and one New Hampshire rooster. The hens were 56-wk old at the start of the short-term study and 24-wk old when the long-term study began. Determinations were made for: fertility, hatchability, progeny growth to 3 wk of age, Zn-related feather-fraying among the progeny as well as Zn, Cu, and Fe in the liver, pancreas, and right tibiotarsus. The Zn treatments had no effect on hen performance or on reproductive performance. Even though Zn was considerably elevated and Cu was reduced in the eggs collected from hens fed the highest level of Zn, chick performance and the tissue content of Zn, Cu, and Fe were not influenced by the maternal Zn nutritional status.

Zinc, copper and iron utilisation by chicks fed various concentrations of zinc.

1. Zinc, iron and copper interactions were examined in chicks (New Hampshire X Single Comb White Leghorn) grown individually in stainless steel cages and fed on purified diets with three concentrations of zinc: control (37 mg Zn/kg), moderate (100 mg Zn/kg) and excess (2000 mg Zn/kg) in three studies. 2. Chicks given either moderate or excess zinc excreted more than twice as much 65Zn from a test diet as those fed on the control diet. Thus chicks given the moderate amount of zinc had concentrations of zinc in tissues similar to those of controls but chicks given excess zinc accumulated zinc in their tissues. 3. The specific activity of 65Zn in the tissues, especially in the bursa of Fabricius, of chicks given excess zinc was not reduced as much as would be predicted. Thus, ingestion of excess zinc appeared to reduce tissue turnover of 65Zn, especially in the bursa. However, humoral immune responses, as measured by antibody titres to sheep red blood cells, were not affected. 4. Chicks given excess zinc or pair-fed on the control diet retained less 59Fe from a test diet than chicks given control or moderate concentrations of zinc ad libitum. The iron concentrations in tibiae of chicks given excess zinc were depressed.

Zinc supplementation: its effect on egg production, feed conversion, fertility, and hatchability.

Studies were conducted over four layer years using Single Comb White Leghorn hens, 24 to 68 weeks of age, to observe the effects of zinc supplementation of a corn-soybean meal layer ration on egg production, feed conversion, fertility, and hatchability. Pullets were housed in floor pens; 20 birds per pen. New Hampshire cockerels were used as sires. Treatments were the basal corn-soy-based diet (28 or 34 ppm zinc by analysis) with the following supplemental zinc levels (as the carbonate): 0, 10, 20, or 40 ppm. Feed, water, and crushed oyster shell were supplied ad libitum in all trials. No consistent production effects due to zinc supplementation were observed. Egg production, feed intake, and feed conversion were not improved by zinc supplementation. Fertility and hatchability, likewise, were not improved by zinc supplementation. The chicks produced showed no significant differences in 3-week body weights. However, the chicks produced from hens on the 28 ppm zinc (control) diet showed an increased incidence of zinc-related feather fraying. There was a significant (P less than .05) increase the first two laying trials and a numerical increase the last two trials. Thus it appears that 28 ppm of zinc, naturally supplied, is adequate for egg production, fertility, hatchability, and growth of progeny.

Zinc deficiency in pheasant chicks fed practical diets.

A disease syndrome characterized by abnormal feathering and varus deviation of the tarsometatarsus spontaneously occurred in pheasant chicks fed a practical commercially prepared diet. The addition of supplemental Zn to the commercial diet was effective in alleviating the clinical signs, even though the commercial mix had Zn levels that met the published pheasant chick requirement. Supplemental arginine was ineffective in reducing the severity of the clinical signs. Also, when the diet was mixed in a laboratory setting, pheasant chicks did not develop abnormal feathering and leg bones. Clinical signs caused by feeding the commercial mix were not reproduced by altering dietary calcium and phosphorus levels in the laboratory mix. Neither adding a pellet binder nor removing supplemental Zn from the lab mix produced as severe leg and feather deformities as the commercial mix. Thus, unidentified dietary factors are capable of causing a Zn-deficiency syndrome in pheasant chicks fed practical diets with analyzed Zn levels meeting the required levels.

Water consumption the first week by egg strain chicks.

Water consumption was measured on 12 groups of 75 straight run day-old Leghorn-type chicks. For 2 years the consumption was measured on a per day basis for the first week. Control waterers were set up in the floor pens to measure evaporation. Feed consumption averaged 6.9 kg per pen for the week. Average water consumption in liters/1000 chicks/day for the first 7 days was as follows, respectively: 8.5, 8.6, 11.4, 11.9, 13.1, 15.5, 16.4. These values are slightly less than the National Research Council (1977) values and considerably less than other reported values.