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2.
J Virol ; 97(6): e0026223, 2023 06 29.
Article in English | MEDLINE | ID: mdl-37289055

ABSTRACT

Herpes simplex virus 1 (HSV-1) must overcome epidermal barriers to reach its receptors on keratinocytes and initiate infection in human skin. The cell-adhesion molecule nectin-1, which is expressed in human epidermis, acts as an efficient receptor for HSV-1 but is not within reach of the virus upon exposure of human skin under nonpathological conditions. Atopic dermatitis skin, however, can provide an entry portal for HSV-1 emphasizing the role of impaired barrier functions. Here, we explored how epidermal barriers impact HSV-1 invasion in human epidermis and influence the accessibility of nectin-1 for the virus. Using human epidermal equivalents, we observed a correlation of the number of infected cells with tight-junction formation, suggesting that mature tight junctions prior to formation of the stratum corneum prevent viral access to nectin-1. Consequently, impaired epidermal barriers driven by Th2-inflammatory cytokines interleukin 4 (IL-4) and IL-13 as well as the genetic predisposition of nonlesional atopic dermatitis keratinocytes correlated with enhanced infection supporting the impact of functional tight junctions for preventing infection in human epidermis. Comparable to E-cadherin, nectin-1 was distributed throughout the epidermal layers and localized just underneath the tight-junctions. While nectin-1 was evenly distributed on primary human keratinocytes in culture, the receptor was enriched at lateral surfaces of basal and suprabasal cells during differentiation. Nectin-1 showed no major redistribution in the thickened atopic dermatitis and IL-4/IL-13-treated human epidermis in which HSV-1 can invade. However, nectin-1 localization toward tight junction components changed, suggesting that defective tight-junction barriers make nectin-1 accessible for HSV-1 which enables facilitated viral penetration. IMPORTANCE Herpes simplex virus 1 (HSV-1) is a widely distributed human pathogen which productively infects epithelia. The open question is which barriers of the highly protected epithelia must the virus overcome to reach its receptor nectin-1. Here, we used human epidermal equivalents to understand how physical barrier formation and nectin-1 distribution contribute to successful viral invasion. Inflammation-induced barrier defects led to facilitated viral penetration strengthening the role of functional tight-junctions in hindering viral access to nectin-1 that is localized just underneath tight junctions and distributed throughout all layers. We also found nectin-1 ubiquitously localized in the epidermis of atopic dermatitis and IL-4/IL-13-treated human skin implying that impaired tight-junctions in combination with a defective cornified layer allow the accessibility of nectin-1 to HSV-1. Our results support that successful invasion of HSV-1 in human skin relies on defective epidermal barriers, which not only include a dysfunctional cornified layer but also depend on impaired tight junctions.


Subject(s)
Dermatitis, Atopic , Herpes Simplex , Herpesvirus 1, Human , Nectins , Tight Junctions , Humans , Dermatitis, Atopic/virology , Epidermis/virology , Herpesvirus 1, Human/physiology , Interleukin-13 , Interleukin-4
3.
Genes (Basel) ; 13(12)2022 12 15.
Article in English | MEDLINE | ID: mdl-36553635

ABSTRACT

Already used for the treatment of some allergic and inflammatory diseases, such as asthma or atopic dermatitis, dupilumab has also been approved as add-on therapy for patients with CRSwNP, and it could represent the keystone to reducing the remission time as well as to improve healing and quality of life. On the other hand, the role of miRNAs as potential biomarkers of immune modulation is emerging. We analyzed the effects of a short-time treatment with dupilumab in patients with CRSwNP, analyzing the immune response modification as well as miRNAs modulations. First, in this early observation stage, all patients experienced remarkable improvement and were clinically stable. Indeed, we observed a significant decrease in CD4+ T cells and a significant reduction in total IgE (p < 0.05) and serum IL-8 levels (p < 0.01), indicating a reduction in the general inflammatory condition. In addition, we analyzed a panel of about 200 circulating miRNAs. After treatment, we noted a significant downregulation of hsa-mir-25-3p (p-value = 0.02415) and hsa-mir-185-5p (p-value = 0.04547), two miRNAs involved in the proliferation, inflammation, and dug-resistance, in accordance with the clinical status of patients. All these preliminary data aimed to identify new biomarkers of prognosis, identifiable with non-invasive procedures for patients. Further, these patients are still under observation, and others with different levels of responsiveness to treatment need to be enrolled to increase the statistical data.


Subject(s)
MicroRNAs , Receptors, Interleukin-13 , Receptors, Interleukin-4 , Rhinitis , Sinusitis , Humans , Biomarkers , Inflammation , MicroRNAs/genetics , Quality of Life , Receptors, Interleukin-4/antagonists & inhibitors , Receptors, Interleukin-13/antagonists & inhibitors , Sinusitis/drug therapy , Rhinitis/drug therapy
4.
Eur J Immunol ; 52(12): 1925-1933, 2022 12.
Article in English | MEDLINE | ID: mdl-36116042

ABSTRACT

Infection of mice with Nippostrongylus brasiliensis (Nb) serves as a model for human hookworm infection affecting about 600 million people world-wide. Expulsion of Nb from the intestine requires IL-13-mediated mucus secretion from goblet cells and activation of smooth muscles cells. Type 2 innate lymphoid cells (ILC2s) are a major cellular source of IL-13 but it remains unclear whether IL-13 secretion from ILC2s is required for Nb expulsion. Here, we compared the immune response to Nb infection in mixed bone marrow chimeras with wild-type or IL-4/IL-13-deficient ILC2s. ILC2-derived IL-4/IL-13 was required for recruitment of eosinophils to the lung but had no influence of systemic eosinophil levels. In the small intestine, goblet cell hyperplasia and tuft cell accumulation was largely dependent on IL-4/IL-13 secretion from ILC2s. This further translated to higher eggs counts and impaired worm expulsion in mice with IL-4/IL-13-deficient ILC2s. Overall, we demonstrate that ILC2s constitute a non-redundant source of IL-4/IL-13 required for protective immunity against primary Nb infection.


Subject(s)
Immunity, Innate , Lymphocytes , Strongylida Infections , Animals , Mice , Interleukin-13 , Interleukin-4 , Nippostrongylus , Strongylida Infections/immunology
5.
J Virol ; 96(17): e0086422, 2022 09 14.
Article in English | MEDLINE | ID: mdl-35969080

ABSTRACT

To infect its human host, herpes simplex virus 1 (HSV-1) must overcome the protective barriers of skin and mucosa. Here, we addressed whether pathological skin conditions can facilitate viral entry via the skin surface and used ex vivo infection studies to explore viral invasion in atopic dermatitis (AD) skin characterized by disturbed barrier functions. Our focus was on the visualization of the onset of infection in single cells to determine the primary entry portals in the epidermis. After ex vivo infection of lesional AD skin, we observed infected cells in suprabasal layers indicating successful invasion in the epidermis via the skin surface which was never detected in control skin where only sample edges allowed viral access. The redistribution of filaggrin, loricrin, and tight-junction components in the lesional skin samples suggested multiple defective mechanical barriers. To dissect the parameters that contribute to HSV-1 invasion, we induced an AD-like phenotype by adding the Th2 cytokines interleukin 4 (IL-4) and IL-13 to healthy human skin samples. Strikingly, we detected infected cells in the epidermis, implying that the IL-4/IL-13-driven inflammation is sufficient to induce modifications allowing HSV-1 to penetrate the skin surface. In summary, not only did lesional AD skin facilitate HSV-1 penetration but IL-4/IL-13 responses alone allowed virus invasion. Our results suggest that the defective epidermal barriers of AD skin and the inflammation-induced altered barriers in healthy skin can make receptors accessible for HSV-1. IMPORTANCE Herpes simplex virus 1 (HSV-1) can target skin to establish primary infection in the epithelium. While the human skin provides effective barriers against viral invasion under healthy conditions, a prominent example of successful invasion is the disseminated HSV-1 infection in the skin of atopic dermatitis (AD) patients. AD is characterized by impaired epidermal barrier functions, chronic inflammation, and dysbiosis of skin microbiota. We addressed the initial invasion process of HSV-1 in atopic dermatitis skin to understand whether the physical barrier functions are sufficiently disturbed to allow the virus to invade skin and reach its receptors on skin cells. Our results demonstrate that HSV-1 can indeed penetrate and initiate infection in atopic dermatitis skin. Since treatment of skin with IL-4 and IL-13 already resulted in successful invasion, we assume that inflammation-induced barrier defects play an important role for the facilitated access of HSV-1 to its target cells.


Subject(s)
Dermatitis, Atopic , Epidermis , Herpes Simplex , Herpesvirus 1, Human , Skin Diseases , Epidermis/pathology , Epidermis/virology , Herpes Simplex/pathology , Herpesvirus 1, Human/physiology , Humans , Inflammation , Interleukin-13 , Interleukin-4 , Skin/pathology , Skin/virology , Skin Diseases/virology , Tissue Culture Techniques
6.
Methods Mol Biol ; 2465: 137-153, 2022.
Article in English | MEDLINE | ID: mdl-35118620

ABSTRACT

Recently, we have shown that fate of a vaccine is determined by the cytokine milieu in the innate immune compartment at the early stage of vaccination. Specifically, 24 h post-delivery, level of innate lymphoid cell type 2 (ILC2)-derived IL-13/IL-13Rα2 are the master regulators of DC and also different ILC subsets responsible for modulating the downstream immune outcomes. Here, we provide step-by-step details how to assess different ILC and DC subsets in lung and muscle following intranasal and intramuscular viral vector vaccination, respectively, using multi-color flow cytometry and confocal microscopy.


Subject(s)
Immunity, Innate , Viral Vaccines , Dendritic Cells , Lymphocytes , Vaccination
7.
J Asthma ; 59(5): 1021-1029, 2022 05.
Article in English | MEDLINE | ID: mdl-33760700

ABSTRACT

OBJECTIVE: The 2019 GINA guidance incorporates the presence of T2 inflammation in severe asthma patients to determine eligibility for add-on biologic therapy, though little data exists to characterize this population. The objective of this manuscript is to conduct a descriptive analysis to characterize patients with severe asthma in emerging countries based on disease severity, patient exacerbation history, and T2 phenotype. METHODS: A cross-sectional survey of physicians treating asthma patients ages 12 years and older was conducted in eight countries. Physicians characterized their severe asthma patients and reported data from their patients' medical charts. Medical chart data was selected from the physicians' six most recent asthma patients taking prescription medication. RESULTS: A total of 550 physicians completed the survey and filled out 3,300 patient record forms. A total of 876 patients have been characterized with uncontrolled severe asthma. Of the 420 patients with available EOS lab data, 40% are indicated with T2 inflammation (EOS ≥150/µL). Ninety-one percent of all patients with available IgE lab data (n = 498) had IgE 30 - 1500 IU/mL indicating allergy-driven asthma. Finally, chronic OCS use (as reported by physicians) was reported in 11% of patients. CONCLUSION: This research revealed that 65% of patients had at least one of three T2 inflammation comorbidities assessed: allergic rhinitis, chronic rhinosinusitis with nasal polyps, and atopic dermatitis. Discrepancies were observed between patients' treatment regimens and GINA step reported, suggesting there may be room to improve understanding of asthma severity as defined per GINA guidelines as well as asthma control assessment in clinical practice.


Subject(s)
Asthma , Physicians , Rhinitis, Allergic , Asthma/drug therapy , Asthma/epidemiology , Cross-Sectional Studies , Humans , Immunoglobulin E , Inflammation/epidemiology , Latin America/epidemiology
8.
Front Immunol ; 13: 1084879, 2022.
Article in English | MEDLINE | ID: mdl-36591252

ABSTRACT

Kimura disease (KD) is a rare and benign chronic inflammatory disease of unknown cause. It is characterized by subcutaneous granuloma of soft tissues in the head and neck region, increased eosinophil count, and elevated serum IgE. Currently, no definitive treatments are recommended. A 57-year-old Chinese man was diagnosed with KD after 7 years of slow subcutaneous masses growth. The patient underwent treatment of oral glucocorticoids for 1 year, but the masses recurred as the dosage was tapered down. Subsequent anti-IgE therapy of omalizumab administered subcutaneously at 450 mg/day at a 4-week interval did not show improvement. The size of masses and serum IgE and circulating eosinophils did not decrease significantly after 19 cycles of continuous treatment. Ultimately, switched strategy of dupilumab was applied at an initial dose of 600 mg, followed by 300 mg every 2 weeks for 4 months. This treatment demonstrated dramatical effects with reduced masses in each area and fast dropdown of eosinophil counts, while the high level of serum IgE remained without changes. Recently, different biologics including anti-IgE, anti-IL-5, and anti-IL-4/IL-13 have been applied to treat KD with satisfied results and help to explore the pathogenesis of this rare disease. To our knowledge, this is the first report that demonstrates the effects of two different biologics in the same patient and reveals the impressive clinical efficacy of dupilumab to treat KD independent of IgE. Therefore, further investigation of the underlying mechanism and the development of diagnosis and treatment of KD is valuable.


Subject(s)
Biological Products , Kimura Disease , Male , Humans , Middle Aged , Kimura Disease/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Omalizumab/therapeutic use , Immunosuppressive Agents , Biological Products/therapeutic use
9.
Front Immunol ; 12: 738907, 2021.
Article in English | MEDLINE | ID: mdl-34721404

ABSTRACT

Background: Bullous pemphigoid (BP) is an autoimmune blistering disorder that predominantly affects the elderly. As the main treatment for BP, systemic corticosteroids are often limited by their side effects. Safer treatment modalities are therefore needed. Dupilumab is a biologic agent used to treat BP in recent years. Methods: Medical records of patients with moderate-to-severe BP were retrospectively reviewed. Twenty-four patients were included (follow-up period: 32 weeks), eight of whom received dupilumab in combination with methylprednisolone and azathioprine (dupilumab group) while the other 16 patients received methylprednisolone and azathioprine (conventional group). Response to dupilumab was evaluated by comparison of several parameters (time to stop new blister formation, time to reduce the systemic glucocorticoids to minimal dose, and total amount of methylprednisolone). Results: The median age of patients in the dupilumab and conventional groups were 64.50 years (range: 22-90 years) and 64.50 years (range: 17-86 years), respectively. The median duration of disease before admission in the dupilumab group was 2 months (range: 1-240 months) and 2.5 months (range: 1-60 months) in the conventional group. The median time to stop new blister formation was 8 days (range: 1-13 days) and 12 days (range: 5-21 days) in patients of the dupilumab and conventional groups, respectively (p = 0.028 by Kaplan-Meier analysis). In addition, the median time to reduce the systemic glucocorticoids to minimal dose (methylprednisolone 0.08 mg/kg/day) was 121.5 and 148.5 days for the dupilumab and conventional therapy groups, respectively (p = 0.0053 by Kaplan-Meier analysis). The median total amount of methylprednisolone (at the time of reaching the minimal dose) used in the dupilumab group was 1,898 mg (range: 1,624-2,932 mg) while the cumulative dose of conventional group was 2,344 mg (range: 1,708-4,744 mg) (p = 0.036 by Mann-Whitney U test). The median total amount of azathioprine (at the time of reaching the minimal dose) used in dupilumab group was 8,300 mg (range: 7,100-10,400 mg) while the total dose of conventional group was 10,300 mg (range: 8,900-14,400 mg) (p = 0.0048 by Mann-Whitney U test). No adverse event related to dupilumab was recorded. Conclusions: Dupilumab in addition to methylprednisolone and azathioprine seems superior to methylprednisolone/azathioprine alone in controlling disease progression and accelerating the tapering of glucocorticoids.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Immunosuppressive Agents/therapeutic use , Pemphigoid, Bullous/drug therapy , Skin/drug effects , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal, Humanized/adverse effects , Azathioprine/therapeutic use , Drug Tapering , Drug Therapy, Combination , Female , Humans , Immunosuppressive Agents/adverse effects , Male , Methylprednisolone/therapeutic use , Middle Aged , Pemphigoid, Bullous/diagnosis , Pemphigoid, Bullous/immunology , Remission Induction , Retrospective Studies , Severity of Illness Index , Skin/immunology , Skin/pathology , Time Factors , Treatment Outcome , Young Adult
10.
J Trace Elem Med Biol ; 68: 126826, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34371327

ABSTRACT

BACKGROUND: We investigated the concentrations of metals in fine particulate matter PM2.5 in the outdoor air around the home sites of 123 male children from Ahvaz, average age 7.56, along with their blood samples to measure pro-inflammatory responses (Immunoglobulin E and cytokines: IgE, IL-4 and IL-13). METHODS: We measured 6 metals (As, Cd, Cr, Hg, Ni and Pb) in three Ahvaz's regions including industrial (Padad), vehicle traffic (Golestan) and control (Kianpars). RESULTS: The higher concentrations of metals in the Padad as the industrial ambient air i.e., arsenic, cadmium, chromium, mercury and nickel coincided with the higher concentrations of those metals in exposed children (P < 0.05) versus the controls. Children in Golestan, the high traffic air pollution area had the highest lead concentrations (p < 0.05). Also a significant association was shown in Padad between blood arsenic and IgE (ß = 26.59, P < 0.001), IL-4 (ß = 172.1, P < 0.001) and IL-13 (ß = 14.84, P < 0.001), blood chromium and IgE (ß = 10.38, P < 0.001), IL-4 (ß = 75.27, P < 0.001) and IL-13 (ß = 5.27, P < 0.001) and blood mercury and IgE (ß = 13.11, P < 0.001), IL-4 (ß = 108.09, P < 0.001) and IL-13 (ß = 7.96, P < 0.001) and blood lead and IgE(ß = 0.92, P = 0.025), IL-4(ß = 7.16, P < 0.001) and IL-13(ß = 0.58, P = 0.003). However, no significant relation was found for Cadmium, Nickel in blood with IgE, IL-4 and IL-13 levels. Moreover, children from industrial areas showed significantly higher concentrations of IgE (mean = 146.44 pg/200landa, P < 0.001), IL-4 (mean = 548.23 pg/200landa, P < 0.001) and IL-13 (mean = 52.93 pg/200landa, P < 0.001) versus Golestan and Kianpars. CONCLUSION: Children residing in an industrial area with high concentrations of metals in PM2.5 had high metals in blood and high production of IgE, IL-4 and IL-13, reflecting an immune dysregulation and brisk inflammatory responses.


Subject(s)
Air Pollutants/toxicity , Arsenic , Asthma , Environmental Monitoring , Hypersensitivity , Mercury , Metals, Heavy , Particulate Matter/toxicity , Arsenic/analysis , Biomarkers , Cadmium/analysis , Child , Chromium , Humans , Immunoglobulin E , Interleukin-13 , Interleukin-4 , Lead , Male , Metals, Heavy/analysis , Metals, Heavy/toxicity , Nickel , Particulate Matter/analysis
11.
Proc Natl Acad Sci U S A ; 118(30)2021 07 27.
Article in English | MEDLINE | ID: mdl-34290141

ABSTRACT

"Taste-like" tuft cells in the intestine trigger type 2 immunity in response to worm infection. The secretion of interleukin-13 (IL-13) from type 2 innate lymphoid cells (ILC2) represents a key step in the tuft cell-ILC2 cell-intestinal epithelial cell circuit that drives the clearance of worms from the gut via type 2 immune responses. Hallmark features of type 2 responses include tissue remodeling, such as tuft and goblet cell expansion, and villus atrophy, yet it remains unclear if additional molecular changes in the gut epithelium facilitate the clearance of worms from the gut. Using gut organoids, we demonstrated that IL-4 and IL-13, two type 2 cytokines with similar functions, not only induced the classical type 2 responses (e.g., tuft cell expansion) but also drastically up-regulated the expression of gasdermin C genes (Gsdmcs). Using an in vivo worm-induced type 2 immunity model, we confirmed the up-regulation of Gsdmcs in Nippostrongylus brasiliensis-infected wild-type C57BL/6 mice. Consistent with gasdermin family members being principal effectors of pyroptosis, overexpression of Gsdmc2 in human embryonic kidney 293 (HEK293) cells triggered pyroptosis and lytic cell death. Moreover, in intestinal organoids treated with IL-4 or IL-13, or in wild-type mice infected with N. brasiliensis, lytic cell death increased, which may account for villus atrophy observed in worm-infected mice. Thus, we propose that the up-regulated Gsdmc family may be major effectors for type 2 responses in the gut and that Gsdmc-mediated pyroptosis may provide a conduit for the release of antiparasitic factors from enterocytes to facilitate the clearance of worms.


Subject(s)
Cell Death , DNA-Binding Proteins/metabolism , Enterocytes/pathology , Immunity, Innate/immunology , Intestine, Small/pathology , Strongylida Infections/complications , Th2 Cells/immunology , Animals , Cell Proliferation , DNA-Binding Proteins/genetics , Enterocytes/immunology , Enterocytes/metabolism , Enterocytes/parasitology , Female , Interleukin-13/metabolism , Interleukin-4/metabolism , Intestine, Small/immunology , Intestine, Small/metabolism , Intestine, Small/parasitology , Male , Mice , Mice, Inbred C57BL , Nippostrongylus/physiology , Signal Transduction , Strongylida Infections/immunology , Strongylida Infections/metabolism , Strongylida Infections/parasitology
12.
Vaccines (Basel) ; 9(5)2021 May 01.
Article in English | MEDLINE | ID: mdl-34062727

ABSTRACT

We have shown that manipulation of IL-13 and STAT6 signaling at the vaccination site can lead to different innate lymphoid cell (ILC)/dendritic cell (DC) recruitment, resulting in high avidity/poly-functional T cells and effective antibody differentiation. Here we show that permanent versus transient blockage of IL-13 and STAT6 at the vaccination site can lead to unique ILC-derived IL-13 and IFN-γ profiles, and differential IL-13Rα2, type I and II IL-4 receptor regulation on ILC. Specifically, STAT6-/- BALB/c mice given fowl pox virus (FPV) expressing HIV antigens induced elevated ST2/IL-33R+ ILC2-derived IL-13 and reduced NKp46+/- ILC1/ILC3-derived IFN-γ expression, whilst the opposite (reduced IL-13 and elevated IFN-γ expression) was observed during transient inhibition of STAT6 signaling in wild type BALB/c mice given FPV-HIV-IL-4R antagonist vaccination. Interestingly, disruption/inhibition of STAT6 signaling considerably impacted IL-13Rα2 expression by ST2/IL-33R+ ILC2 and NKp46- ILC1/ILC3, unlike direct IL-13 inhibition. Consistently with our previous findings, this further indicated that inhibition of STAT6 most likely promoted IL-13 regulation via IL-13Rα2. Moreover, the elevated ST2/IL-33R+ IL-13Rα2+ lung ILC2, 24 h post FPV-HIV-IL-4R antagonist vaccination was also suggestive of an autocrine regulation of ILC2-derived IL-13 and IL-13Rα2, under certain conditions. Knowing that IL-13 can modulate IFN-γ expression, the elevated expression of IFN-γR on lung ST2/IL-33R+ ILC2 provoked the notion that there could also be inter-regulation of lung ILC2-derived IL-13 and NKp46- ILC1/ILC3-derived IFN-γ via their respective receptors (IFN-γR and IL-13Rα2) at the lung mucosae early stages of vaccination. Intriguingly, under different IL-13 conditions differential regulation of IL-13/IL-13Rα2 on lung DC was also observed. Collectively these findings further substantiated that IL-13 is the master regulator of, not only DC, but also different ILC subsets at early stages of viral vector vaccination, and responsible for shaping the downstream adaptive immune outcomes. Thus, thoughtful selection of vaccine strategies/adjuvants that can manipulate IL-13Rα2, and STAT6 signaling at the ILC/DC level may prove useful in designing more efficacious vaccines against different/chronic pathogens.

13.
Auris Nasus Larynx ; 48(3): 353-360, 2021 Jun.
Article in English | MEDLINE | ID: mdl-32943257

ABSTRACT

OBJECTIVES: Eosinophilic otitis media (EOM) is an intractable otitis media mostly associated with bronchial asthma. Dupilumab, an anti-interleukin (IL)-4 receptor (R)α, is effective and has been approved for use in patients with moderate to severe bronchial asthma, atopic dermatitis and chronic rhinosinusitis with nasal polyposis, whose diseases are not controlled by previous treatments including other molecular targeted drugs. We aimed to assess efficacy of dupilumab in three EOM patients with associated bronchial asthma, who were poor responders to previous topical and systemic corticosteroid therapy and molecular targeted therapies. PATIENTS AND METHODS: Three patients with severe, refractory EOM (two with a granulation type) associated with bronchial asthma received dupilumab as add-on therapy for at least 6 months. The efficacy of dupilumab therapy was evaluated using severity scores, symptom scores, hearing acuities, temporal bone computed tomography (CT) scores, and surrogate markers before and after therapy. RESULTS: Severity scores in all patients were dramatically reduced to 2 points or less (full score: 16 points) after initiation of therapy. Air conduction hearing levels were improved in all patients. Temporal bone CT scores in two patients were reduced, and serum IgE levels in all three patients also decreased following therapy. CONCLUSION: We provide the first report that add-on dupilumab therapy was effective in patients with severe, refractory EOM who did not respond to the treatments including other molecular targeted therapy. Patients with severe middle ear mucosal change may benefit particularly from dupilumab therapy.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Asthma/drug therapy , Eosinophilia/complications , Otitis Media/drug therapy , Aged , Aged, 80 and over , Anti-Asthmatic Agents/therapeutic use , Asthma/complications , Bone Conduction , Drug Therapy, Combination , Female , Humans , Immunoglobulin E/blood , Male , Middle Aged , Otitis Media/complications , Retrospective Studies , Severity of Illness Index , Temporal Bone/diagnostic imaging , Tomography, X-Ray Computed
16.
Eur J Immunol ; 50(7): 1044-1056, 2020 07.
Article in English | MEDLINE | ID: mdl-32108934

ABSTRACT

Repeated inhalation of airborne conidia derived from the fungus Aspergillus fumigatus (Af) can lead to a severe eosinophil-dominated inflammatory condition of the lung termed allergic bronchopulmonary aspergillosis (ABPA). ABPA affects about 5 million individuals worldwide and the mechanisms regulating lung pathology in ABPA are poorly understood. Here, we used a mouse model of ABPA to investigate the role of eosinophils and T cell-derived IL-4/IL-13 for induction of allergic lung inflammation. Selective deletion of IL-4/IL-13 in T cells blunted the Af-induced lung eosinophilia and further resulted in lower expression of STAT6-regulated chemokines and effector proteins such as Arginase 1, Relm-α, Relm-ß, and Muc5a/c. Eosinophil-deficient ΔdblGata mice showed lower IL-4 expression in the lung and the number of Th2 cells in the lung parenchyma was reduced. However, expression of the goblet cell markers Clca1 and Muc5a/c, abundance of mucin-positive cells, as well as weight gain of lungs were comparable between Af-challenged ΔdblGata and WT mice. Based on these results, we conclude that T cell-derived IL-4/IL-13 is essential for Af-induced lung eosinophilia and inflammation while eosinophils may play a more subtle immunomodulatory role and should not simply be regarded as pro-inflammatory effector cells in ABPA.


Subject(s)
Aspergillosis, Allergic Bronchopulmonary/immunology , Aspergillus fumigatus/immunology , Eosinophils/immunology , Lung/immunology , Th2 Cells/immunology , Animals , Aspergillosis, Allergic Bronchopulmonary/genetics , Aspergillosis, Allergic Bronchopulmonary/pathology , Disease Models, Animal , Eosinophils/pathology , Interleukin-13/genetics , Interleukin-13/immunology , Interleukin-4/immunology , Lung/pathology , Mice , Mice, Knockout , Mucin 5AC/genetics , Mucin 5AC/immunology , STAT6 Transcription Factor/genetics , STAT6 Transcription Factor/immunology , Th2 Cells/pathology
17.
Adv Exp Med Biol ; 1132: 7-20, 2019.
Article in English | MEDLINE | ID: mdl-31037620

ABSTRACT

Although many studies have described the role of periostin in various diseases, the functions of periostin derived from alternative splicing and proteinase cleavage at its C-terminus remain unknown. Further experiments investigating the periostin structures that are relevant to diseases are essential for an in-depth understanding of their functions, which would accelerate their clinical applications by establishing new approaches for curing intractable diseases. Furthermore, this understanding would enhance our knowledge of novel functions of periostin related to stemness and response to mechanical stress .


Subject(s)
Alternative Splicing , Cell Adhesion Molecules/genetics , Humans
18.
J Plast Surg Hand Surg ; 53(5): 288-294, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31066603

ABSTRACT

Excess scar formation can occur after skin injurふy and lead to abnormal scar formation, such as keloids and hypertrophic scars, which are characterised by substantial deposition of extracellular matrix in the dermis. Periostin, an extracellular matrix protein that plays a crucial role in skin development and maintaining homeostasis, is also involved in skin disorders such as systemic/limited scleroderma, wound closure, and abnormal scar formation. However, the mechanism of periostin involvement in abnormal scar formation is not yet fully understood. In this study, we investigated the mechanism by which periostin is involved in abnormal scar formation. Treatment of human dermal fibroblasts (HDFs) with IL-4 and IL-13, which are cytokines of Th2 type immune responses that are up-regulated in abnormal scars, dramatically elevated the levels of periostin mRNA and protein, and also promoted the secretion of periostin by HDFs. Transforming growth factor-ß1 (TGF-ß1) had the same effect on HDFs as IL-4 and IL-13. Stimulation of HDFs with periostin promoted RhoA/ROCK pathway-mediated TGF-ß1 secretion from HDFs. Our results suggest that IL-4 and IL-13 induce periostin expression and secretion, and in turn, secreted periostin induces RhoA/ROCK pathway-mediated TGF-ß1 secretion. Secreted TGF-ß1 then induces further periostin production and secretion, thereby promoting abnormal scar formation.


Subject(s)
Cell Adhesion Molecules/metabolism , Fibroblasts/metabolism , Interleukin-13/pharmacology , Interleukin-4/pharmacology , Transforming Growth Factor beta1/metabolism , Case-Control Studies , Cell Adhesion Molecules/genetics , Cells, Cultured , Cicatrix, Hypertrophic/etiology , Cicatrix, Hypertrophic/pathology , Dermis/cytology , Humans , Keloid/etiology , Keloid/pathology , RNA, Messenger/metabolism , Real-Time Polymerase Chain Reaction , Up-Regulation , rho-Associated Kinases/metabolism , rhoA GTP-Binding Protein/metabolism
19.
Curr Clin Pharmacol ; 14(2): 157-164, 2019.
Article in English | MEDLINE | ID: mdl-30556505

ABSTRACT

BACKGROUND: In this study, we aimed to detect the changes in the level of interleukin (IL)-4 and IL-13 cytokines and their downstream genes including interleukin-13 receptor subunit alpha-2 (IL13Ra2), interleukin-4 receptor subunit alpha-1 (IL4Ra1), dual oxidase 1 (DUOX1) and dual oxidase 2 (DUOX2). The protective effects of Selenium-L-methionine on radiation-induced histopathological damages and changes in the level of these cytokines and genes were detected. METHODS: Four groups of 20 rats (5 rats in each) namely, control; Selenium-L-methionine, radiation and radiation plus Selenium-L-methionine were used in this study. 4 mg/kg of Selenium-Lmethionine was administered 1 day before irradiation and five consecutive days after irradiation. Irradiation was done using a dose of 15 Gy 60Co gamma rays at 109 cGy/min. All rats were sacrificed 10 weeks after irradiation for detecting changes in IL-4 and IL-13 cytokines, the expressions of IL13Ra2, IL4Ra1, Duox1 and Duox2 and histopathological changes. RESULTS: The level of IL-4 but not IL-13 increased after irradiation. This was associated with increased expression of IL4Ra1, Duox1 and Duox2, in addition to changes in morphological properties. Selenium-L-methionine could attenuate all injury markers following lung irradiation. CONCLUSION: Selenium-L-methionine can protect lung tissues against toxic effects of ionizing radiation. It is possible that the modulation of immune responses and redox interactions are involved in the radioprotective effect of this agent.


Subject(s)
Methionine/therapeutic use , Pneumonia/prevention & control , Pulmonary Fibrosis/prevention & control , Radiation Injuries, Experimental/prevention & control , Radiation-Protective Agents/therapeutic use , Selenium/therapeutic use , Animals , Dual Oxidases/metabolism , Interleukin-13/metabolism , Interleukin-13 Receptor alpha2 Subunit/metabolism , Interleukin-4/metabolism , Interleukin-4 Receptor alpha Subunit/metabolism , Male , Pneumonia/etiology , Pneumonia/pathology , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/pathology , Radiation Injuries, Experimental/complications , Radiation Injuries, Experimental/pathology , Rats , Rats, Wistar
20.
Int Immunopharmacol ; 65: 392-401, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30380514

ABSTRACT

The IL-4/IL-13/Stat6 pathway is the key driver of asthma pathophysiology. Therefore the development of inhibitors that specifically modulate IL-13/IL-4 or the downstream signaling molecules like Stat6 may be useful as a therapeutic strategy for the treatment of asthma and multiple allergic diseases. We have previously identified the fungal 2,6-cyclofarnesane cyclonerodiol as an inhibitor of IL-4 induced Stat6-dependent signaling in the alveolar epithelial cell line A549 using a transcriptional reporter. In this study we investigated the underlying mode of action of cyclonerodiol on the IL-4/IL-13/Stat6 pathway. Cyclonerodiol failed to interfere with activation, nuclear transport or binding of Stat6 to the corresponding consensus sequence on the DNA. Our results showed that cyclonerodiol blocked serine phosphorylation of Stat6 by affecting its association with p38 and Erk1/2. Cyclonerodiol also prevented the recruitment of the transcriptional coactivator p300 and Stat6 acetylation. These findings suggest that cyclonerodiol affects IL-4/IL-13 induced expression of asthma related marker genes by blocking transcriptional activation.


Subject(s)
Asthma/drug therapy , Respiratory Mucosa/drug effects , STAT6 Transcription Factor/metabolism , Sesquiterpenes/pharmacology , Trans-Activators/pharmacology , A549 Cells , Acetylation , Humans , Interleukin-13/metabolism , Interleukin-4/metabolism , MAP Kinase Signaling System , Respiratory Mucosa/physiology , Transcriptional Activation/drug effects , p300-CBP Transcription Factors/metabolism , p38 Mitogen-Activated Protein Kinases/metabolism
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