A pharmacogenetic study of ADRB2 polymorphisms and indacaterol response in COPD patients.

Genetic variation in the ADRB2 gene has been hypothesized to have a role in differential response to beta-agonist (BA) therapy in asthma. However, study results have been inconsistent and the issue remains controversial. Furthermore, the impact of ADRB2 genetic variation on BA response in chronic obstructive pulmonary disease (COPD) patients has not been thoroughly studied. We carried out a large pharmacogenetic analysis testing for an association between common ADRB2 polymorphisms and indacaterol response in COPD patients. A total of 648 indacaterol-treated patients enrolled in two large randomized phase III studies were genotyped for the most commonly studied polymorphisms in the ADRB2 gene: Gly16Arg, Gln27Glu, Thr164Ile, and a variant in the 5' untranslated region (rs1042711). Our analysis showed little evidence for the association between these ADRB2 variants and indacaterol response, suggesting that ADRB2 genetic variation is unlikely to have a major role in differential response to indacaterol treatment in COPD patients.

Gamma-glutamyl transferase: a novel cardiovascular risk biomarker.

Gamma-glutamyl transferase (GGT) is a second-generation enzymatic liver function test available for several decades, initially used as a sensitive indicator of alcohol ingestion, hepatic inflammation, fatty liver disease, and hepatitis. Longitudinal and cross-sectional investigational studies since 1990 have associated GGT with an increase in all-cause mortality, as well as chronic heart disease events such as congestive heart failure and components of the metabolic syndrome (abnormal body mass index and levels of high-density lipoprotein cholesterol, glucose, triglycerides, and systolic and diastolic blood pressure). In the upper reference range, GGT was found to be an independent biomarker of the metabolic syndrome, with a 20% per GGT quartile trend rise. Additionally, GGT was positively correlated with an 18% per quartile risk of cardiovascular events and a 26% per quartile increased risk of all-cause mortality. Furthermore, it may be considered a biomarker for "oxidative stress" associated with glutathione metabolism and possibly a "proatherogenic" marker because of its indirect relationship in the biochemical steps to low-density lipoprotein cholesterol oxidation. GGT is becoming an important addition to the multimarker approach to cardiovascular risk evaluation. It should be considered a valuable adjunct in stratifying patient risk and in assessing the aggressiveness of appropriate treatment, with hopes of preventing unnecessary cardiac events and deaths in future years.

Optical determination of Cr(VI) using regenerable, functionalized sol-gel monoliths.

Transparent, pyridine-functionalized sol-gel monoliths have been formed and their use in Cr(VI) sensing applications is demonstrated. The monoliths were immersed in acidic Cr(VI)-containing solutions, and the Cr(VI) uptake was monitored using UV-vis and atomic absorption spectroscopies. At concentrations at the ppm level, the monoliths exhibit a yellow color change characteristic of Cr(VI) uptake, and this can be measured by monitoring the absorption change at about 350 nm using UV-vis spectroscopy. Concentrations at the ppb level are below the limit of detection using this wavelength of 350 nm for measurement. However, by adding a diphenylcarbazide solution to monoliths that have been previously immersed in ppb-level Cr(VI) solutions, a distinct color change takes place within the gels that can be measured at about 540 nm using UV-vis spectroscopy. Concentrations as low as 10 ppb Cr(VI) can be measured using this method. The monoliths can then be regenerated for subsequent sensing cycles by thorough washing with 6.0M HCl. The factors affecting monolith uptake of Cr(VI) have been explored. In addition, the gels have been characterized using X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and Brunauer-Emmett-Teller (BET) measurements.

Palladium and the electrochemical quartz crystal microbalance: a new method for the in situ analysis of the precious metal in aqueous solutions.

A new method for the quantitative determination of palladium(II) by the electrochemical quartz crystal microbalance (EQCM) technique has been developed. Using a bare carbon-coated quartz crystal, Pd(II) ions are directly deposited from aqueous solution as palladium metal onto the crystal surface, and the Pd(II) concentration is determined with a detection limit of 0.0156 mM, or 1.66 ppm. No complexing agent or preconcentration of palladium is required for the analysis. The palladium is stripped from the crystal through its electrochemical oxidation, regenerating the crystal for subsequent multi-cycle palladium analyses. A conventional gold-coated quartz crystal was incapable of carrying out the same measurements. The EQCM technique presented is simple, sensitive, and reproducible for the detection of this widely used precious metal.

Conversion of Chromium(III) Propionate to Chromate/dichromate(VI) by the Advanced Oxidation Process. Pretreatment of a Biomimetic Complex for Metal Analysis.

The use of H(2)O(2) and UV irradiation to remove organic ligands in a chromium(III) complex for the subsequent chromium analysis is reported. The Advanced Oxidation Process (AOP) using a 5.5-W UV lamp, H(2)O(2) and Fe(2+)/Fe(3+) as catalyst (photo Fenton process) was found to give complete and quantitative Cr(III) → Cr(VI) conversion and removal of ligands in chromium(III) propionate [Cr(3)O(O(2)CCH(2)CH(3))(6)(H(2)O)(3)]NO(3), a biomimetic chromium species, as subsequent chromium analyses by the 1,5-diphenylcarbazide method and atomic absorption revealed. The current process eliminates the need for mineralization and/or dissolution of the matrix in order to remove the organic ligand, the traditional pretreatments of a sample for metal analysis. Studies to optimize the conditions for the oxidation processes, including the use of Fe(2+)/Fe(3+) catalyst, length of UV irradiation, H(2)O(2) concentration, pH, power of UV lamp, and reactor size, are reported.

Studies of the oxidation of palladium complexes by the advanced oxidation process Pretreatment of model catalysts for precious metal analysis.

The advanced oxidation process (AOP) for the pretreatment of model palladium catalysts has been studied. Most standard metal analysis techniques are for metal ions free of organic ligands. Spent palladium catalysts contain organic ligands that need to be removed prior to analysis. AOP uses a combination of hydrogen peroxide and UV light to generate radicals that decompose such ligands, freeing up metals for further analysis. Palladium acetate Pd(OAc)(2), palladium acetylacetonate Pd(acac)(2), and tris(dibenzylideneacetone)dipalladium (Pd(2)(dba)(3)) were chosen as model precious metal catalysts for investigation. AOP was found to decompose ligands in Pd(OAc)(2), Pd(acac)(2) and give accurate Pd(II) quantification, while ligand decomposition and oxidation of Pd(0) to Pd(II) were demonstrated in treatments involving Pd(2)(dba)(3). The effects of solubility of the palladium complexes, continuous addition of H(2)O(2) during AOP treatments, sample pH, concentration of H(2)O(2), and length of UV irradiation are reported.

Conversion of chromium(III) propionate to chromium(VI) by the Advanced Oxidation Process Pretreatment of a biomimetic complex for metal analysis.

The use of H(2)O(2) and UV irradiation to remove organic ligands in a chromium(III) complex for the subsequent chromium analysis is reported. The Advanced Oxidation Process (AOP) using a 5.5-W UV lamp, H(2)O(2) and Fe(2+)/Fe(3+) as catalyst (photo Fenton process) was found to give complete and quantitative Cr(III)-->Cr(VI) conversion and removal of ligands in chromium(III) propionate [Cr(3)O(O(2)CCH(2)CH(3))(6)(H(2)O)(3)]NO(3), a biomimetic chromium species, as subsequent chromium analyses by the 1,5-diphenylcarbazide method and atomic absorption revealed. The current process eliminates the need for mineralization and/or dissolution of the matrix in order to remove the organic ligand, the traditional pretreatments of a sample for metal analysis. Studies to optimize the conditions for the oxidation processes, including the use of Fe(2+)/Fe(3+) catalyst, length of UV irradiation, H(2)O(2) concentration, pH, power of UV lamp, and reactor size, are reported.

Optical metal ion sensor based on diffusion followed by an immobilizing reaction. Quantitative analysis by a mesoporous monolith containing functional groups.

A new optical metal ion sensor based on diffusion followed by an immobilizing reaction has been developed. The current sensor is based on a model that unifies two fundamental processes which a metal analyte undergoes when it is exposed to a porous, ligand-grafted monolith: (a) diffusion of metal ions to the binding sites and (b) metal-ligand (ML(n)) complexation. A slow diffusion of the metal ions is followed by their fast immobilizing reaction with the ligands in the monolith to give a complex. Inside the region where the ligands have been saturated, the diffusion of the metal ions reaches a steady state with a constant external metal ion concentration (C(0)). If the complex ML(n) could be observed spectroscopically, the absorbance of the product A(p) follows: A(p) = Kt(1/2), K = 2epsilon(p)(L(0)C(0)D)(1/2). D = diffusion constant of the metal ions inside the porous solid; L(0) = concentration of the ligands grafted in the monolith; and t = time. This equation is straightforward to use, and the K vs C(0)(1/2) plot provides the correlations with the concentrations (C(0)) of the metal ions. This is a rare optical sensor for quantitative metal ion analysis. The use of the model in a mesoporous sol-gel monolith containing grafted amine ligands for quantitative Cu(2+) sensing is demonstrated. This model may also be used in other chemical sensors that depend on diffusion of analytes followed by immobilizing reactions in porous sensors containing grafted/encapsulated functional groups/molecules.

Polycarboxylic acid nanoparticles for ophthalmic drug delivery: an ex vivo evaluation with human cornea.

In ophthalmic drug delivery, a major problem is retaining an adequate concentration of a therapeutic agent in the pre-corneal area. Polycarboxylic acid carriers such as polyacrylic acid and polyitaconic acid in sub-colloidal, nanoparticulate hydrogel form have a strong potential for sustained release of a drug in ocular delivery. Formulations have been prepared of brimonidine loaded in polycarboxylic (polyacrylic and polyitaconic) acid nanoparticles for potential ophthalmic delivery. These particles were prepared by a reverse micro-emulsion polymerization technique with sizes in the range of 50 nm. The loading efficiencies of the drug brimonidine in the particles were shown to be between 80-85% for polyacrylic acid nanoparticles and between 65-70% for polyitaconic nanoparticles. The loading efficiency was also found to be pH dependent. In a preliminary biocompatibility test, human corneal epithelial cells incubated with polyacrylic acid nanoparticles were found to retain their viability, whereas polyitaconic acid nanoparticles were found to be toxic. Two-photon laser scanning microscopic studies of the fluorescently labelled polyacrylic acid nanoparticles and human cornea shows that they are adhesive on the corneal surface. The polyacrylic acid nanoparticles demonstrated a controlled release of the opthalmological drug (Brimonidine) through the human cornea as compared to that of the commercial formulation, Alphagan.

Brimonidine formulation in polyacrylic acid nanoparticles for ophthalmic delivery.

In ocular drug delivery, a major problem is providing an adequate concentration of a therapeutic agent in the precorneal area. Mucoadhesive carriers such as polyacrylic acid in sub-colloidal, nanoparticulate form, have a strong potential for ophthalmic drug delivery. A formulation of brimonidine loaded in polyacrylic acid nanoparticles has been prepared for potential delivery in ophthalmic therapy. The particles were prepared by a reverse microemulsion polymerization technique and their sizes were in the range of 50 nm. In a preliminary biocompatibility test, Caco-2 cells (human primary colonic tumour adenocarcinoma) and human corneal epithelial cells incubated with polyacrylic acid nanoparticles were found to retain their viability over varying times. The loading efficiency of the drug brimonidine in the particles was shown to be between 80-85% and pH dependent. The bioadhesive polyacrylic hydrogel nanoparticles, used in the present study, exhibited superior loading properties for brimonidine, and the formulation was stable for more than 5 weeks. When the drug-loaded nanoparticles were dispersed in a phosphate buffer saline (pH = 7.4), the drug was slowly released over several hours. Two-photon laser scanning microscopic studies of dye-conjugated polyacrylic acid nanoparticles demonstrated the accumulation of the particles on the surface and intercellular spaces of Caco-2 cells.

Role of endothelin-1 in lung disease.

Endothelin-1 (ET-1) is a 21 amino acid peptide with diverse biological activity that has been implicated in numerous diseases. ET-1 is a potent mitogen regulator of smooth muscle tone, and inflammatory mediator that may play a key role in diseases of the airways, pulmonary circulation, and inflammatory lung diseases, both acute and chronic. This review will focus on the biology of ET-1 and its role in lung disease.

Upregulation of nitric oxide synthase in mice with severe hypoxia-induced pulmonary hypertension.

BACKGROUND: The importance of nitric oxide (NO) in hypoxic pulmonary hypertension has been demonstrated using nitric oxide synthase (NOS) knockout mice. In that model NO from endothelial NOS (eNOS) plays a central role in modulating pulmonary vascular tone and attenuating hypoxic pulmonary hypertension. However, the normal regulation of NOS expression in mice following hypoxia is uncertain. Because genetically engineered mice are often utilized in studies of NO, we conducted the present study to determine how hypoxia alters NOS expression in wild-type mice. METHOD: Mice were exposed to sea level, ambient conditions (5280 feet) or severe altitude (17,000 feet) for 6 weeks from birth, and hemodynamics and lung NOS expression were assessed. RESULTS: Hypoxic mice developed severe pulmonary hypertension (right ventricular systolic pressure [RVsP] 60 mmHg) as compared with normoxic mice (27 mmHg). Using quantitative reverse-transcription PCR, it was found that expressions of eNOS and inducible NOS (iNOS) increased 1.5-fold and 3.5-fold, respectively, in the lung. In addition, the level of lung eNOS protein was increased, neuronal NOS (nNOS) protein was unchanged, and iNOS was below the limit of detection. Immunohistochemistry demonstrated no change in lung iNOS or nNOS staining in either central or peripheral areas, but suggested increased eNOS in the periphery following hypoxia. CONCLUSION: In mice, hypoxia is associated with increases in lung eNOS, possibly in iNOS, but not in nNOS; this suggests that the pattern of lung NOS expression following hypoxia must be considered in studies using genetically engineered mice.

p27(Kip1) is important in modulating pulmonary artery smooth muscle cell proliferation.

Vascular remodeling due to pulmonary arterial smooth muscle cell (PASMC) proliferation is central to the development of pulmonary hypertension. Cell proliferation requires the coordinated interaction of cyclins and cyclin-dependent kinases (cdk) to drive cells through the cell cycle. Cdk inhibitors can bind cyclin-cdk complexes and cause G(1) arrest. To determine the importance of the cdk inhibitor p27(Kip1) in PASMC proliferation we studied [(3)H]thymidine incorporation, changes in cell cycle, cell proliferation, and protein expression of p27(Kip1) following serum stimulation in early passage rat PASMC. p27(Kip1) expression decreased to 40% of baseline after serum stimulation, which was associated with an increase in both [(3)H]thymidine incorporation and the percent of cells in S phase. p27(Kip1) binding to cyclin E decreased at 24 h, and this correlated with an increase in phosphorylation of retinoblastoma both in vivo and in vitro. Overexpression of p27(Kip1) decreased [(3)H]thymidine incorporation and reduced cell counts at 5 d compared with controls. PASMC obtained from p27(Kip1-/-) mice showed a 2-fold increase in [(3)H]thymidine incorporation (at 24 h) and cell proliferation compared with p27(Kip1+/+) PASMC when cultured in 10% fetal bovine serum (FBS). These results suggest an important role for p27(Kip1) in regulating PASMC mitogenesis and proliferation.

Safety of aerosolized INS 365 in patients with mild to moderate cystic fibrosis: results of a phase I multi-center study.

Cystic fibrosis (CF) is characterized by defective cystic fibrosis transmembrane regulator (CFTR) expression and function, associated with abnormal ion transport and mucociliary clearance, and clinical lung disease. Triphosphate nucleotides such as uridine-5'-triphosphate (UTP) and INS 365, may be useful for CF through actions, mediated via P2Y(2) extracellular receptors, on chloride and liquid secretion, and ciliary beat frequency. INS 365 may offer chemical stability advantages over UTP. In a randomized, double-blind, multicenter phase I study, we studied the safety and maximally tolerated dose of escalating, single doses of aerosolized INS 365, in adult and pediatric patients with mild to moderate CF lung disease (FEV(1) > or = 45% predicted). In four successive dose cohorts of adult patients (n = 12 per cohort, age > or = 18 years) and four successive pediatric dose cohorts (n = 12 per cohort, age 5-12 years), patients were randomized 3:1 active/placebo (0.9% saline) to evaluate doses of 20, 40, 80, and 100 mg INS 365 delivered by nebulizer (Pari Star ). Sputum was collected pre- and post-dosing to obtain preliminary results on clinical efficacy. After each dose cohort, a Data Safety Monitoring Committee (DSMC) reviewed the data. Forty-eight adult and 36 pediatric patients completed the protocol (up to 100 mg for adults, 80 mg for pediatric patients). The predominant adverse events were cough, wheezing, chest tightness, and a decrease in FEV(1) (occurring in 8/48 adults, and 5/36 pediatric patients), which occurred predominantly in the 80-mg and 100-mg dose cohorts. Though a few adult patients had a tendency to increase sputum production, there was little consistent effect noted on sputum production in this acute, single-dose study. The data suggest that aerosolized INS 365 is safe when delivered at single doses of up to 40 mg in adults and children with CF, but that higher doses are unlikely to be tolerated.

Tuberous sclerosis gene products in proliferation control.

Two genes, TSC1 and TSC2, have been shown to be responsible for tuberous sclerosis (TSC). The detection of loss of heterozygosity of TSC1 or TSC2 in hamartomas, the growths characteristically occurring in TSC patients, suggested a tumor suppressor function for their gene products hamartin and tuberin. Studies analyzing ectopically modulated expression of TSC2 in human and rodent cells together with the finding that a homolog of TSC2 regulates the Drosophila cell cycle suggest that TSC is a disease of proliferation/cell cycle control. We discuss this question including very recent data obtained from analyzing mice expressing a modulated TSC2 transgene, and from studying the effects of deregulated TSC1 expression. Elucidation of the cellular functions of these proteins will form the basis of a better understanding of how mutations in these genes cause the disease and for the development of new therapeutic strategies.

Gene therapy for pulmonary diseases.

Gene therapy for pulmonary disease has attracted a great deal of attention since the first report of successful gene delivery 10 years ago. Potential indications for gene therapy include chronic illnesses such as cystic fibrosis and alpha(1)-antitrypsin deficiency, and acute illnesses such as acute transplant rejection and chemotherapy-induced lung injury. The key technological impediment to successful gene therapy is vector optimization. Viral vectors, including adenovirus and adeno-associated virus, have relatively low efficiency in vivo. In addition, adenovirus has been associated with a brisk inflammatory response and limited duration of expression in the lung. Nonviral vectors, particularly liposomes, have also been tried, with limited expression efficiency and some toxicity. Although work is ongoing to improve adenoviral and adeno-associated viral vectors and test other viral and nonviral vectors, an ideal vector has not yet been identified. Several important barriers to successful gene therapy, including the host inflammatory response, promotor down-regulation, tissue-specific targeting, and physical barriers to gene delivery in the airway, will need to be overcome. Despite these daunting problems, several human gene therapy trials have been completed, using adenovirus, adeno-associated virus, and liposomes. In general, these trials have been focused on safety, and have shown that there is dose-dependent inflammation in response to adenovirus. Adeno-associated virus appears to cause little inflammation. Demonstration of successful gene delivery and transcription has been quite variable in human trials. In general, the level of expression of transgene appears to be quite low. In summary, although there is great promise for gene therapy in the lung, significant challenges remain in translating this technology to successful human therapy.

Sustained endothelial nitric-oxide synthase activation requires capacitative Ca2+ entry.

Endothelial nitric-oxide synthase (eNOS), a Ca(2+)/calmodulin-dependent enzyme, is critical for vascular homeostasis. While eNOS is membrane-associated through its N-myristoylation, the significance of membrane association in locating eNOS near sources of Ca(2+) entry is uncertain. To assess the Ca(2+) source required for eNOS activation, chimera containing the full-length eNOS cDNA and HA-tagged aequorin sequence (EHA), and MHA (myristoylation-deficient EHA) were generated and transfected into COS-7 cells. The EHA chimera was primarily targeted to the plasma membrane while MHA was located intracellularly. Both constructs retained enzymatic eNOS activity and aequorin-mediated Ca(2+) sensitivity. The plasma membrane-associated EHA and intracellular MHA were compared in their ability to sense changes in local Ca(2+) concentration, demonstrating preferential sensitivity to Ca(2+) originating from intracellular pools (MHA) or from capacitative Ca(2+) entry (EHA). Measurements of eNOS activation in intact cells revealed that the eNOS enzymatic activity of EHA was more sensitive to Ca(2+) influx via capacitative Ca(2+) entry than intracellular release, whereas MHA eNOS activity was more responsive to intracellular Ca(2+) release. When eNOS activation by CCE was compared with that generated by an equal rise in [Ca(2+)](i) due to the Ca(2+) ionophore ionomycin, a 10-fold greater increase in NO production was found in the former condition. These results demonstrate that EHA and MHA chimera are properly targeted and retain full functions of eNOS and aequorin, and that capacitative Ca(2+) influx is the principle stimulus for sustained activation of eNOS on the plasma membrane in intact cells.

Pulmonary fibrosis and chronic lung inflammation in ET-1 transgenic mice.

The pulmonary endothelin (ET) system has been implicated in the pathogenesis of chronic lung diseases such as pulmonary hypertension, asthma, chronic obstructive lung disease, idiopathic pulmonary fibrosis, and bronchiolitis obliterans. However, the etiologic role of ET-1 in these diseases has not yet been established. We recently demonstrated that ET-1 transgenic mice, generated using the human prepro-ET-1 expression cassette including the cis-acting transcriptional regulatory elements, had predominant transgene expression in lung, brain, and kidney. We used these mice in the present study to analyze the pathophysiologic consequences of long-term pulmonary overexpression of ET-1. We found that ET-1 overexpression in the lungs did not result in significant pulmonary hypertension, but did result in development of a progressive pulmonary fibrosis and recruitment of inflammatory cells (predominantly CD4-positive cells). Our study provides evidence that a long-term activated pulmonary ET system, without any other stimuli, produces chronic lymphocytic inflammation and lung fibrosis. This suggests that overexpression of ET-1 may be a central event in the pathogenesis of lung diseases associated with fibrosis and chronic inflammation, such as pulmonary fibrosis and bronchiolitis.