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1.
PLoS One ; 9(5): e97448, 2014.
Article in English | MEDLINE | ID: mdl-24848372

ABSTRACT

G1-phase cell cycle defects, such as alterations in cyclin D1 or cyclin-dependent kinase (cdk) levels, are seen in most tumors. For example, increased cyclin D1 and decreased cdk6 levels are seen in many human breast tumors. Overexpression of cdk6 in breast tumor cells in culture has been shown to suppress proliferation, unlike the growth stimulating effects of its close homolog, cdk4. In addition to directly affecting proliferation, alterations in cdk6 or cdk4 levels in breast tumor cells also differentially influence levels of numerous steroid metabolic enzymes (SMEs), including those involved in estrogen metabolism. Overexpression of cdk6 in tumor cell lines having low cdk6 resulted in decreased levels of mRNAs encoding aldo-keto reductase (AKR)1C1, AKR1C2 and AKR1C3, which are hydroxysteroid dehydrogenases (HSDs) involved in steroid hormone metabolism. In contrast, increasing cdk4 dramatically increased these transcript levels, especially those encoding AKR1C3, an enzyme that converts estrone to 17ß-estradiol, a change that could result in a pro-estrogenic state favoring tumor growth. Effects on other estrogen metabolizing enzymes, including cytochrome P450 (CYP) 19 aromatase, 17ß-HSD2, and CYP1B1 transcripts, were also observed. Interactions of cdk6 and cdk4, but not cyclin D1, with the promoter region of a cdk-regulated gene, 17ß-HSD2, were detected. The results uncover a previously unsuspected link between the cell cycle and hormone metabolism and differential roles for cdk6 and cdk4 in a novel mechanism for pre-receptor control of steroid hormone action, with important implications for the origin and treatment of steroid hormone-dependent cancers.


Subject(s)
Cyclin-Dependent Kinase 4/genetics , Cyclin-Dependent Kinase 6/genetics , G1 Phase/genetics , Gene Expression Regulation, Neoplastic , Mammary Glands, Human/metabolism , 20-Hydroxysteroid Dehydrogenases/genetics , 20-Hydroxysteroid Dehydrogenases/metabolism , 3-Hydroxysteroid Dehydrogenases/genetics , 3-Hydroxysteroid Dehydrogenases/metabolism , Aldo-Keto Reductase Family 1 Member C3 , Aromatase/genetics , Aromatase/metabolism , Cell Line, Tumor , Cell Proliferation , Cyclin D1/genetics , Cyclin D1/metabolism , Cyclin-Dependent Kinase 4/metabolism , Cyclin-Dependent Kinase 6/metabolism , Cytochrome P-450 CYP1B1/genetics , Cytochrome P-450 CYP1B1/metabolism , Estradiol/metabolism , Estradiol Dehydrogenases/genetics , Estradiol Dehydrogenases/metabolism , Estrogens/metabolism , Estrone/metabolism , Female , Humans , Hydroxyprostaglandin Dehydrogenases/genetics , Hydroxyprostaglandin Dehydrogenases/metabolism , Hydroxysteroid Dehydrogenases/genetics , Hydroxysteroid Dehydrogenases/metabolism , Mammary Glands, Human/pathology , Signal Transduction
2.
J Allergy Clin Immunol ; 123(1): 249-57, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19130938

ABSTRACT

BACKGROUND: Ligation of the leukotriene B(4) (LTB(4)) receptor 1 on effector memory CD8(+) T cells by LTB(4) is important for the recruitment of CD8(+) T cells into the airways, which appears central to the induction of airway hyperresponsiveness (AHR) and allergic inflammation. Phosphorylation of extracellular signal-regulated kinase (ERK) is important in activation and cytokine production from many cell types. OBJECTIVE: The roles of ERKs in effector CD8(+) T-cell function and on CD8(+) T cell-mediated AHR were determined. METHODS: Effector CD8(+) T cells were generated from OVA(257-264) (SIINFEKL) peptide-primed mononuclear cells from OT-1 mice. The effects of U0126, an ERK inhibitor, on effector CD8(+) T-cell function and on CD8(+) T cell-mediated AHR and allergic inflammation were examined. RESULTS: Pretreatment of effector CD8(+) T cells with U0126 suppressed anti-CD3/anti-CD28-induced ERK1/2 phosphorylation and cytokine production, but did not affect LTB(4)-induced Ca(2+) mobilization or chemotaxis. Adoptive transfer of U0126-treated CD8(+) T cells into sensitized mice before secondary allergen challenge resulted in significant decreases in AHR, eosinophilic inflammation, goblet cell metaplasia, and IL-5 and IL-13 levels in bronchoalveolar lavage fluid of recipient mice. The number of transferred CD8(+) T cells accumulating in bronchoalveolar lavage fluid or lungs was unaffected by treatment. CONCLUSION: ERK1/2-dependent pathways are essential for the effector functions of CD8(+) T cells, including T(H)2 cytokine production, allergic inflammation, and development of AHR. Inhibition of ERK1/2 signaling has potential therapeutic benefit in preventing CD8(+) T cell-mediated AHR.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , Chemotaxis/immunology , MAP Kinase Signaling System/immunology , Mitogen-Activated Protein Kinase 1/immunology , Mitogen-Activated Protein Kinase 3/immunology , Respiratory Hypersensitivity/immunology , Adoptive Transfer , Allergens/immunology , Allergens/pharmacology , Animals , Bronchoalveolar Lavage Fluid/immunology , Butadienes/pharmacology , CD8-Positive T-Lymphocytes/enzymology , CD8-Positive T-Lymphocytes/pathology , Calcium/immunology , Calcium/metabolism , Chemotaxis/drug effects , Enzyme Inhibitors/pharmacology , Eosinophils/enzymology , Eosinophils/immunology , Eosinophils/pathology , Goblet Cells/enzymology , Goblet Cells/immunology , Goblet Cells/pathology , Immunologic Memory/drug effects , Immunologic Memory/immunology , Inflammation/enzymology , Inflammation/immunology , Inflammation/pathology , Leukotriene B4/immunology , Leukotriene B4/metabolism , Leukotriene B4/pharmacology , Lung/enzymology , Lung/immunology , Lung/pathology , MAP Kinase Signaling System/drug effects , Metaplasia/enzymology , Metaplasia/immunology , Metaplasia/pathology , Mice , Mice, Transgenic , Mitogen-Activated Protein Kinase 1/antagonists & inhibitors , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinase 3/antagonists & inhibitors , Mitogen-Activated Protein Kinase 3/metabolism , Nitriles/pharmacology , Receptors, Leukotriene B4/immunology , Receptors, Leukotriene B4/metabolism , Respiratory Hypersensitivity/enzymology , Respiratory Hypersensitivity/pathology , Th2 Cells/enzymology , Th2 Cells/immunology , Th2 Cells/pathology
3.
J Exp Med ; 205(5): 1087-97, 2008 May 12.
Article in English | MEDLINE | ID: mdl-18426985

ABSTRACT

Adoptive transfer of in vivo-primed CD8(+) T cells or in vitro-generated effector memory CD8(+) T (T(EFF)) cells restores airway hyperresponsiveness (AHR) and airway inflammation in CD8-deficient (CD8(-/-)) mice. Examining transcription levels, there was a strong induction of Notch1 in T(EFF) cells compared with central memory CD8(+) T cells. Treatment of T(EFF) cells with a gamma-secretase inhibitor (GSI) strongly inhibited Notch signaling in these cells, and after adoptive transfer, GSI-treated T(EFF) cells failed to restore AHR and airway inflammation in sensitized and challenged recipient CD8(-/-) mice, or to enhance these responses in recipient wild-type (WT) mice. These effects of GSI were also associated with increased expression of the Notch ligand Delta1 in T(EFF) cells. Treatment of sensitized and challenged WT mice with Delta1-Fc resulted in decreased AHR and airway inflammation accompanied by higher levels of interferon gamma in bronchoalveolar lavage fluid. These results demonstrate a role for Notch in skewing the T cell response from a T helper (Th)2 to a Th1 phenotype as a consequence of the inhibition of Notch receptor activation and the up-regulation of the Notch ligand Delta1. These data are the first to show a functional role for Notch in the challenge phase of CD8(+) T cell-mediated development of AHR and airway inflammation, and identify Delta1 as an important regulator of allergic airway inflammation.


Subject(s)
Bronchial Hyperreactivity/physiopathology , CD8-Positive T-Lymphocytes/immunology , Cytokines/physiology , Immunologic Memory , Inflammation/physiopathology , Receptors, Notch/physiology , Adoptive Transfer , Animals , Bronchial Hyperreactivity/immunology , Cytokines/immunology , Inflammation/immunology , Mice , Mice, Inbred C57BL , Mice, Transgenic , Oligonucleotide Array Sequence Analysis , Ovalbumin/immunology , RNA/genetics , Receptors, Antigen, T-Cell/genetics , Receptors, Antigen, T-Cell/immunology
4.
Am J Respir Cell Mol Biol ; 38(5): 501-8, 2008 May.
Article in English | MEDLINE | ID: mdl-18063836

ABSTRACT

The female hormone estrogen is an important factor in the regulation of airway function and inflammation, and sex differences in the prevalence of asthma are well described. Using an animal model, we determined how sex differences may underlie the development of altered airway function in response to allergen exposure. We compared sex differences in the development of airway hyperresponsiveness (AHR) after allergen exposure exclusively via the airways. Ovalbumin (OVA) was administered by nebulization on 10 consecutive days in BALB/c mice. After methacholine challenge, significant AHR developed in male mice but not in female mice. Ovariectomized female mice showed significant AHR after 10-day OVA inhalation. ICI182,780, an estrogen antagonist, similarly enhanced airway responsiveness even when administered 1 hour before assay. In contrast, 17beta-estradiol dose-dependently suppressed AHR in male mice. In all cases, airway responsiveness was inhibited by the administration of a neurokinin 1 receptor antagonist. These results demonstrate that sex differences in 10-day OVA-induced AHR are due to endogenous estrogen, which negatively regulates airway responsiveness in female mice. Cumulatively, the results suggest that endogenous estrogen may regulate the neurokinin 1-dependent prejunctional activation of airway smooth muscle in allergen-exposed mice.


Subject(s)
Allergens/administration & dosage , Bronchial Hyperreactivity/immunology , Bronchial Hyperreactivity/physiopathology , Estrogens/physiology , Ovalbumin/administration & dosage , Sex Characteristics , Allergens/immunology , Animals , Bronchial Hyperreactivity/metabolism , Disease Models, Animal , Estradiol/administration & dosage , Estradiol/analogs & derivatives , Estrogen Receptor Modulators/administration & dosage , Female , Fulvestrant , Male , Methacholine Chloride/administration & dosage , Mice , Mice, Inbred BALB C , Neurokinin A/antagonists & inhibitors , Neurokinin A/physiology , Neurokinin-1 Receptor Antagonists , Ovalbumin/immunology
5.
J Immunol ; 179(5): 2787-96, 2007 Sep 01.
Article in English | MEDLINE | ID: mdl-17709492

ABSTRACT

CD4+ T cells, particularly Th2 cells, play a pivotal role in allergic airway inflammation. However, the requirements for interactions between CD4+ and CD8+ T cells in airway allergic inflammation have not been delineated. Sensitized and challenged OT-1 mice in which CD8+ T cells expressing the transgene for the OVA(257-264) peptide (SIINFEKL) failed to develop airway hyperresponsiveness (AHR), airway eosinophilia, Th2 cytokine elevation, or goblet cell metaplasia. OT-1 mice that received naive CD4+IL-4+ T cells but not CD4+IL-4- T cells before sensitization developed all of these responses to the same degree as wild-type mice. Moreover, recipients of CD4+IL-4+ T cells developed significant increases in the number of CD8+IL-13+ T cells in the lung, whereas sensitized OT-1 mice that received primed CD4+ T cells just before challenge failed to develop these responses. Sensitized CD8-deficient mice that received CD8+ T cells from OT-1 mice that received naive CD4+ T cells before sensitization increased AHR and eosinophil numbers in bronchoalveolar lavage fluid when challenged with allergen. In contrast, sensitized CD8-deficient mice receiving CD8+ T cells from OT-1 mice without CD4+ T cells developed reduced AHR and eosinophil numbers in bronchoalveolar lavage fluid when challenged. These data suggest that interactions between CD4+ and CD8+ T cells, in part through IL-4 during the sensitization phase, are essential to the development of CD8+IL-13+ T cell-dependent AHR and airway allergic inflammation.


Subject(s)
Asthma/immunology , Bronchial Hyperreactivity/immunology , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Interleukin-4/metabolism , Adoptive Transfer , Animals , Asthma/prevention & control , Bronchial Hyperreactivity/prevention & control , CD4 Antigens/analysis , Egg Proteins/genetics , Egg Proteins/metabolism , Inflammation/immunology , Inflammation/prevention & control , Interleukin-4/administration & dosage , Interleukin-4/genetics , Mice , Mice, Transgenic , Ovalbumin/genetics , Ovalbumin/metabolism , Peptide Fragments , Transgenes
6.
Am J Respir Cell Mol Biol ; 36(3): 324-32, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17038663

ABSTRACT

IL-18 is known to induce IFN-gamma production, which is enhanced when combined with IL-2. In the present study, we investigated whether the combination of exogenous IL-2 and IL-18 alters airway hyperresponsiveness (AHR) and airway inflammation. Sensitized mice exposed to ovalbumin (OVA) challenge developed AHR, inflammatory cells in the bronchoalveolar lavage (BAL) fluid, and increases in levels of Th2 cytokines and goblet cell numbers. The combination of IL-2 and IL-18, but neither alone, prevented these changes while increasing levels of IL-12 and IFN-gamma. The combination of IL-2 and IL-18 was ineffective in IFN-gamma-deficient and signal transducer and activator of transcription (STAT)4-deficient mice. Flow cytometry analysis showed significant increases in numbers of IFN-gamma-positive natural killer (NK) cells in the lung after treatment with the combination therapy, and transfer of lung NK cells isolated from sensitized and challenged mice treated with the combination significantly suppressed AHR and BAL eosinophilia. These data demonstrate that the combination of IL-2 and IL-18 prevents AHR and airway inflammation, likely through IL-12-mediated induction of IFN-gamma production in NK cells.


Subject(s)
Interferon-gamma/metabolism , Interleukin-18/pharmacology , Interleukin-2/pharmacology , Killer Cells, Natural/immunology , Respiratory Hypersensitivity/therapy , STAT4 Transcription Factor/metabolism , Adoptive Transfer , Animals , Cell Count , Drug Synergism , Female , Goblet Cells/drug effects , Goblet Cells/pathology , Humans , Inflammation , Injections, Intraperitoneal , Interferon-gamma/deficiency , Interleukin-18/administration & dosage , Interleukin-2/administration & dosage , Killer Cells, Natural/transplantation , Lung/drug effects , Lung/pathology , Male , Metaplasia , Mice , Mice, Inbred C57BL , Ovalbumin , STAT4 Transcription Factor/deficiency
7.
Am J Respir Cell Mol Biol ; 34(4): 426-33, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16339999

ABSTRACT

We evaluated the role of Syk, using an inhibitor, on allergen-induced airway hyperresponsiveness (AHR) and airway inflammation in a system shown to be B cell- and mast cell-independent. Sensitization of BALB/c mice with ovalbumin (OVA) and alum after three consecutive OVA challenges resulted in AHR to inhaled methacholine and airway inflammation. The Syk inhibitor R406 (30 mg/kg, administered orally, twice daily) prevented the development of AHR, increases in eosinophils and lymphocytes and IL-13 levels in bronchoalveolar lavage (BAL) fluid, and goblet cell metaplasia when administered after sensitization and before challenge with OVA. Levels of IL-4, IL-5, and IFN-gamma in BAL fluid and allergen-specific antibody levels in serum were not affected by treatment. Because many of these responses may be influenced by dendritic cell function, we investigated the effect of R406 on bone marrow-derived dendritic cell (BMDC) function. Co-culture of BMDC with immune complexes of OVA and IgG anti-OVA together with OVA-sensitized spleen mononuclear cells resulted in increases in IL-13 production. IL-13 production was inhibited if the BMDCs were pretreated with the Syk inhibitor. Intratracheal transfer of immune complex-pulsed BMDCs (but not nonpulsed BMDCs) to naive mice before airway allergen challenge induced the development of AHR and increases in BAL eosinophils and lymphocytes. All of these responses were inhibited if the transferred BMDCs were pretreated with R406. These results demonstrate that Syk inhibition prevents allergen-induced AHR and airway inflammation after systemic sensitization and challenge, at least in part through alteration of DC function.


Subject(s)
Bronchial Hyperreactivity/physiopathology , Dendritic Cells/enzymology , Inflammation/enzymology , Intracellular Signaling Peptides and Proteins/metabolism , Protein-Tyrosine Kinases/metabolism , Respiratory System/physiopathology , Allergens , Animals , B-Lymphocytes/physiology , Bone Marrow Cells/drug effects , Bone Marrow Cells/metabolism , Bronchial Hyperreactivity/immunology , Bronchial Hyperreactivity/pathology , Cells, Cultured , Coculture Techniques , Cytokines/biosynthesis , Dendritic Cells/physiology , Enzyme Activation , Female , Goblet Cells/pathology , Inflammation/immunology , Inflammation/pathology , Interleukin-13/biosynthesis , Intracellular Signaling Peptides and Proteins/antagonists & inhibitors , Mast Cells/physiology , Metaplasia , Methacholine Chloride , Mice , Mice, Inbred BALB C , Ovalbumin/immunology , Oxazines/pharmacology , Protein-Tyrosine Kinases/antagonists & inhibitors , Pyridines/pharmacology , Respiratory System/drug effects , Respiratory System/immunology , Syk Kinase
8.
Am J Respir Crit Care Med ; 170(9): 952-9, 2004 Nov 01.
Article in English | MEDLINE | ID: mdl-15306536

ABSTRACT

Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis during infancy and is associated with subsequent wheezing and asthma, but the nature of this association is not fully understood. We investigated the role of RSV-specific IgE antibodies in the pathophysiology of virus-induced airway dysfunction in a mouse model. Lung infection with RSV resulted in significant increases in mRNA expression for IgE and both of its high- and low-affinity receptors. In serum, virus-specific IgE antibodies reached peak levels by Day 21 after infection. Data from in vitro experiments show that RSV can induce mast cell degranulation, but only if these cells are sensitized with specific IgE. When passively sensitized in vivo with virus-specific IgE, mice developed exaggerated airway responsiveness to methacholine on airway infection, an effect that required the high-affinity receptor of IgE. These data suggest that RSV-specific IgE may contribute to the pathophysiology of airway dysfunction in children who develop this class of specific antibody.


Subject(s)
Antibodies, Viral/analysis , Asthma/physiopathology , Bronchial Hyperreactivity/immunology , Immunoglobulin E/immunology , Respiratory Syncytial Virus Infections/immunology , Animals , Asthma/immunology , Base Sequence , Bronchial Hyperreactivity/virology , Bronchoalveolar Lavage Fluid/immunology , Disease Models, Animal , Female , Male , Mice , Mice, Inbred BALB C , Molecular Sequence Data , Polymerase Chain Reaction , Probability , RNA, Messenger/analysis , Respiratory Syncytial Virus Infections/physiopathology , Respiratory Syncytial Viruses/immunology , Sensitivity and Specificity
9.
J Immunol ; 172(10): 6398-406, 2004 May 15.
Article in English | MEDLINE | ID: mdl-15128831

ABSTRACT

In certain models of allergic airway disease, mast cells facilitate the development of inflammation and airway hyper-responsiveness (AHR). To define the role of the high affinity IgE receptor (FcepsilonRI) in the development of AHR, mice with a disruption of the alpha subunit of the high affinity IgE receptor (FcepsilonRI(-/-)) were exposed on 10 consecutive days to nebulized OVA. Forty-eight hours after the last nebulization, airway responsiveness was monitored by the contractile response of tracheal smooth muscle to electrical field stimulation (EFS). After the 10-day OVA challenge protocol, wild-type mice demonstrated increased responsiveness to EFS, whereas similarly challenged FcepsilonRI(-/-) mice showed a low response to EFS, similar to nonexposed animals. Further, allergen-challenged FcepsilonRI(-/-) mice showed less airway inflammation, goblet cell hyperplasia, and lower levels of IL-13 in lung homogenates compared with the controls. IL-13-deficient mice failed to develop an increased response to EFS or goblet cell hyperplasia after the 10-day OVA challenge. We transferred bone marrow-derived mast cells from wild-type mice to FcepsilonRI(-/-) mice 1 day before initiating the challenge protocol. After the 10-day OVA challenge, recipient FcepsilonRI(-/-) mice demonstrated EFS-induced responses similar to those of challenged wild-type mice. Transferred mast cells could be detected in tracheal preparations. These results show that FcepsilonRI is important for the development of AHR after an aerosolized allergen sensitization protocol and that this effect is mediated through FcepsilonRI on mast cells and production of IL-13 in the lung.


Subject(s)
Adjuvants, Immunologic , Allergens/administration & dosage , Bronchial Hyperreactivity/immunology , Interleukin-13/physiology , Mast Cells/immunology , Receptors, IgE/physiology , Adoptive Transfer , Aerosols , Allergens/immunology , Animals , Bone Marrow Transplantation/immunology , Bronchial Hyperreactivity/genetics , Electric Stimulation , Female , Goblet Cells/immunology , Goblet Cells/pathology , Hyperplasia , Immunoglobulin E/biosynthesis , Immunoglobulin G/biosynthesis , Inflammation/genetics , Inflammation/pathology , Interleukin-13/deficiency , Interleukin-13/genetics , Interleukin-13/metabolism , Leukopenia/genetics , Leukopenia/immunology , Lung/immunology , Lung/pathology , Mast Cells/pathology , Mast Cells/transplantation , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Mice, Knockout , Mice, Mutant Strains , Mice, Transgenic , Nebulizers and Vaporizers , Ovalbumin/administration & dosage , Ovalbumin/immunology , Receptors, IgE/deficiency , Receptors, IgE/genetics , Trachea/cytology , Trachea/immunology , Trachea/metabolism
10.
Am J Respir Cell Mol Biol ; 30(6): 830-6, 2004 Jun.
Article in English | MEDLINE | ID: mdl-14754758

ABSTRACT

The role of an interleukin (IL)-1 receptor antagonist (IL-1Ra) on the development of airway hyperresponsiveness (AHR) and airway inflammation following acute O(3) exposure in mice was investigated. Exposure of C57/BL6 mice to O(3) at a concentration of 2.0 ppm or filtered air for 3 h resulted in increases in airway responsiveness to inhaled methacholine (MCh) 8 and 16 h after the exposure, and an increase in neutrophils in the bronchoalveolar lavage (BAL) fluid. IL-1beta expression, assessed by gene microarray, was increased 2-fold 4 h after O(3) exposure, and returned to baseline levels by 24 h. Levels of IL-1beta in lung homogenates were also increased 8 h after O(3) exposure. Administration of (human) IL-1Ra before and after O(3) exposure prevented development of AHR and decreased BAL fluid neutrophilia. Increases in chemokine levels in lung homogenates, tumor necrosis factor-alpha, MIP-2, and keratinocyte chemoattractant following O(3) exposure were prevented by IL-1Ra. Inhalation of dexamethasone, an inhibitor of IL-1 production, blocked the development of AHR, BAL fluid neutrophilia, and decreased levels of IL-1 following O(3) exposure. In summary, acute exposure to O(3) induces AHR, neutrophilic inflammation, epithelial damage, and IL-1. An IL-1Ra effectively prevents the development of altered airway function, inflammation, and structural damage.


Subject(s)
Bronchial Hyperreactivity/immunology , Ozone/immunology , Receptors, Interleukin-1/antagonists & inhibitors , Receptors, Interleukin-1/immunology , Animals , Bronchoalveolar Lavage Fluid/chemistry , Bronchoalveolar Lavage Fluid/cytology , Bronchoconstrictor Agents/pharmacology , Cytokines/metabolism , Dexamethasone/pharmacology , Female , Gene Expression Profiling , Gene Expression Regulation , Glucocorticoids/pharmacology , Humans , Interleukin-1/genetics , Interleukin-1/metabolism , Methacholine Chloride/pharmacology , Mice , Mice, Inbred C57BL , Neutrophils/immunology , Neutrophils/metabolism , Oxidants, Photochemical/pharmacology , Ozone/pharmacology , Respiratory Mucosa/cytology , Respiratory Mucosa/drug effects , Respiratory Mucosa/metabolism , Respiratory Mucosa/pathology
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