Evaluation zellulärer Mechanismen der allergen-spezifischen Immuntherapie in einem chronischen Modell der allergischen Atemwegsentzündung

Klinische Studien haben gezeigt, dass die allergenspezifische Immuntherapie (SIT) eine effektive Therapieoption für allergische Erkrankungen ist. Obwohl dieses Therapieverfahren seit über 100 Jahren existiert, sind die zugrunde liegenden Suppressionsmechanismen jedoch nicht vollständig verstanden. Bisher wird angenommen, dass der Behandlungserfolg der SIT auf einer Blockade durch allergenspezifische Antikörper, einer Verschiebung des Th1-Th2-Gleichgewichtes und/oder auf einer Suppression durch regulatorische T-Zellen (Tregs) basiert. Um die Effekte der SIT in einer chronischen Erkrankung in vivo untersuchen zu können, wurde in dieser Doktorarbeit ein Mausmodell für chronisches Asthma entwickelt, das die Situation im Menschen nach einer SIT nachahmt. rnDurch eine SIT war es möglich, allergeninduzierte Asthmasymptome wie Atemwegshyperreagibilität (AHR), Eosinophilie in der Lunge, IgE-Produktion und Atemwegsentzündung im Modell zu unterdrücken. Bemerkenswert ist, dass durch OVA-spezifische Immuntherapie (OVA-IT) ebenfalls eine Verringerung der strukturellen Veränderungen im Lungengewebe im chronischen Krankheitsverlauf erreicht wurde.rnDes Weiteren wurde in diesem Modell nach den Prozessen gesucht, die für die toleranzinduzierende Wirkung der SIT verantwortlich sein können. Dabei wurde im Vergleich zur Placebo-behandelten Gruppe eine erhöhte Antwort spezifischer IgG1-Antikörper, eine verstärkte Th1-Antwort, sowie eine erhöhte Frequenz von FoxP3+ Tregs und von IL-10-produzierenden T-Zellen (Tr1-Zellen) nach OVA-IT festge-stellt. Zur weiteren Untersuchung der von SIT-induzierten T-Zellantworten wurden Mausmodelle des allergischen Asthmas mit einem akuten Verlauf gewählt.rnDie Bedeutung der Th1-Zellen für die SIT wurde in T-bet-/- Mäusen untersucht, welche aufgrund des Fehlens des Transkriptionsfaktors T-bet keine stabile Th1-Antwort induzieren können. Durch SIT war es möglich, allergeninduzierte Asthmasymptome wie AHR, eosinophile Granulozyten in der Lunge, IgE-Produktion und Atemwegsentzündung in den T-bet-/- Tieren im gleichen Maße wie in den Wildtyptieren zu unterdrücken. Diese Untersuchung zeigte, dass die SIT auch ohne funktionelle Th1-Zellen die allergische Entzündung unterdrücken kann. rnDie Rolle der Tregs für die SIT wurde in DO11.10 Mäusen und DO11.10 RAG-/- Mäusen untersucht. In beiden Stämmen konnte nach SIT eine Induktion OVA-spezifischer Tregs nachgewiesen werden. In DO11.10 RAG-/- Mäusen können durch den Knockout im rag2-Gen keine natürlichen, d.h. im Thymus gereiften, Tregs entstehen. Im Blut von DO11.10 RAG-/- Mäusen war direkt nach Durchführung der OVA-IT eine FoxP3+ Treg-Population detektierbar. Demnach wird durch die OVA-IT eine de-novo-Induktion von FoxP3+ Tregs in Gang gesetzt. In Abwesenheit der natürlichen Tregs zeigte sich weiterhin, dass diese Zellen zur Produktion von IL-10 in T-Zellen und somit zum Erfolg der SIT beitragen.rnDie Rolle der FoxP3+ Tregs bei der SIT wurde in DEREG Mäusen untersucht. Eine Depletion der FoxP3+ Tregs in DEREG Mäusen während der Durchführung der OVA-IT hob die protektiven Effekte der Therapie jedoch nur teilweise auf. rnUm die Rolle des regulatorischen Zytokins IL-10 bei der SIT zu untersuchen, wurde ein blockierender Antikörper gegen den IL-10-Rezeptor (anti-IL-10R) im chronischen Modell des allergischen Asthmas mit SIT angewendet. Anti-IL-10R hob die protektive Wirkung der SIT auf die AHR, die Atemwegsentzündung und die strukturellen Veränderungen im Lungengewebe auf. Somit ist die protektive Wirkung der SIT abhängig vom IL-10-Signalweg.rnZusammenfassend stellt diese Arbeit die Bedeutung der SIT für allergische Erkrankungen heraus. SIT kann durch die positive Beeinflussung der allergiebedingten, strukturellen Veränderungen in der Lunge auch für Asthmapatienten große Vorteile bringen. Die aus Studien bekannten Mechanismen konnten im Modell bestätigt werden und wurden im weiteren Verlauf untersucht. Die Arbeit stellt im Besonderen die Bedeutung der IL-10-produzierenden und FoxP3+ Tregs für die Effektivität der SIT in den Vordergrund. Zudem ist durch die Etablierung eines neuen Mausmodells der SIT für chronisches allergisches Asthma ein Mittel zur weiteren Erforschung der zugrunde liegenden Prozesse dieser erfolgreichen Therapie geschaffen worden. rn

Die Rolle der IFN-gamma Signalübertragung und von MyD88 in der Angiotensin-II-induzierten vaskulären Dysfunkion, Inflammation und arteriellen Hypertonie

Im Rahmen dieser Arbeit wurde die Rolle von myelomonozytären Zellen, IFN-gamma (Interferon gamma), MyD88 (myeloid differentiation factor 88) und zugrundeliegenden Signalwege in der Angiotensin II (ATII)-induzierten vaskulären Inflammation, Dysfunktion und arteriellen Hypertonie untersucht. Wie bereits veröffentlichte Vordaten aus meiner Arbeitsgruppe zeigten, schützt die Depletion von Lysozym M (LysM)+ myelomonozytären Zellen (Diphteriatoxin-vermittelt in Mäusen, die transgen für den humanen Diphtheriatoxin-Rezeptor sind, LysMiDTR Mäuse) vor der ATII-induzierten vaskulären Dysfunktion und arterieller Hypertonie, und kann durch adoptiven Zelltransfer von Wildtyp Monozyten wiederhergestellt werden. In meiner Arbeit konnte ich zeigen, dass die Rekonstitution von Monozyten-depletierten LysMiDTR Mäusen mit Wildtyp Monozyten den Phänotyp der vaskulären Dysfunktion wiederherstellen kann, die Rekonstitution mit gp91phox-/y oder Agtr1-/- Monozyten jedoch nicht. Die Hypertonus-mediierenden Effekte dieser infiltrierenden Monozyten scheinen demnach von der intakten ATII und NADPH Oxidase Signalübertragung in diesen Zellen abhängig zu sein. Vermutlich ebenfalls für die Aktivierung der Monozyten funktionell wichtig sind IFN-gamma, produziert durch NK-Zellen, und der Transkriptionsfaktor T-bet (T-box expressed in T cells), exprimiert von NK-Zellen und Monozyten. IFN-gamma-/- Mäuse waren partiell geschützt vor der ATII-induzierten vaskulären Dysfunktion und charakterisiert durch reduzierte Level an Superoxid im Gefäß im Vergleich zu ATII-infundierten Wildtyp Mäusen. IFN-gamma-/- und T-bet defiziente Tbx21-/- Mäuse zeichneten sich ferner durch eine reduzierte ATII-mediierte Rekrutierung von NK1.1+ NK-Zellen, als ein Hautproduzent von IFN-gamma, sowie CD11b+GR-1low Interleukin-12 (IL-12) kompetenten Monozyten aus. Durch Depletions- und adoptive Transferexperimente konnte ich in dieser Arbeit NK-Zellen als essentielle Mitstreiter in der vaskulären Dysfunktion identifizieren und stellte fest, dass T-bet+LysM+ myelomonozytäre Zellen für die NK-Zellrekrutierung in die Gefäßwand und lokale IFN-gamma Produktion benötigt werden. Damit wurde erstmals NK-Zellen eine essentielle Rolle in der ATII-induzierten vaskulären Dysfunktion zugeschrieben. Außerdem wurde der T-bet-IFN-gamma Signalweg und die gegenseitige Monozyten-NK-Zellaktivierung als ein potentielles therapeutisches Ziel in kardiovaskulären Erkrankungen aufgedeckt. Des Weiteren identifizierte ich in meiner Arbeit MyD88 als ein zentrales Signalmolekül in der ATII-getriebenen Inflammation und vaskulären Gefäßschädigung. MyD88 Defizienz reduzierte den ATII-induzierten Anstieg des systolischen Blutdrucks und die endotheliale und glattmuskuläre vaskuläre Dysfunktion. Zusätzlich waren die vaskuläre Superoxid-Bildung sowie die Expressionslevel der NADPH Oxidase, der wichtigsten Quelle für oxidativem Stress im Gefäß, in ATII-infundierten MyD88-/- Mäusen im Vergleich zum Wildtyp reduziert. Mit Hilfe von durchflusszytometrischen Analysen deckte ich zudem auf, dass die ATII-induzierte Einwanderung von CD45+ Leukozyten, insbesondere CD11b+Ly6G-Ly6Chigh inflammatorischen Monozyten in MyD88-/- Mäusen signifikant abgeschwächt war. Diese Resultate wurden durch immunhistochemische Untersuchung von Aortengewebe auf CD68+, F4/80+ und Nox2+ Makrophagen/Phagozyten sowie Expressionsanalysen von Inflammationsmarkern untermauert. Analysen der mRNA Expression in Aortengewebe zeigten ferner eine in Wildtyp Mäusen nach ATII Infusion tendenziell gesteigerte Expression von inflammatorischen Monozytenmakern sowie eine abnehmende Expression von reparativen Monozytenmarken, während dieser Shift zu einem proinflammatorsichen Phänotyp in MyD88-/- blockiert zu sein schien. Dies zeigt eine Rolle von MyD88 in der terminalen Differenzierung von myelomonozytären Zellen an. Um dies weitergehend zu untersuchen und aufzudecken, ob die MyD88 Effekte abhängig sind von Zellen der hämatopoetischen Linie oder Gewebszellen, wurden Knochenmarktransferexperimente durchgeführt. MyD88 Defizienz in Knochenmark-abstammende Zellen reduzierte die ATII-induzierte vaskuläre Dysfunktion und Infiltration der Gefäßwand mit CD45+ Leukozyten und inflammatorischen myelomonozytären Zellen. Die protektiven Effekte der MyD88 Defizienz in der Angiotensin II-induzierten Inflammation konnten nicht auf Signalwege über die Toll-like Rezeptoren TLR2, -7 oder -9 zurückgeführt werden, wie die Untersuchung der vaskulären Reaktivität entsprechender Knockout Mäuse zeigte. Zusammenfassend konnte ich in meiner Arbeit zeigen, dass die Infiltration der Gefäßwand mit Nox2+AT1R+T-bet+MyD88+ myelomonozytären Zellen und die Wechselwirkung und gegenseitige Aktivierung dieser Zellen mit IFN-gamma produzierenden NK-Zellen eine zentrale Bedeutung in der Pathogenese der Angiotensin II (ATII)-induzierten vaskulären Dysfunktion, Inflammation und arteriellen Hypertonie einnehmen.

Anti-inflammatory and immunosuppressive effects of the enaminone E121

Asthma is a chronic inflammatory disease of the airways. The treatment of asthma is far from optimal and hence the need for novel therapeutic agents exists. The purpose of this study was to assess the anti-asthma effects of an enaminone, E121, and also its effects on human peripheral blood mononuclear cell proliferation and cytokine release. The effects of E121 were assessed in an ovalbumin-induced model of airway inflammation and airway hyperresponsiveness. In addition, the effects of E121 on phytohemagglutinin (PHA), anti-CD3 monoclonal antibody and lipopolysaccharide (LPS)-induced human peripheral blood mononuclear cell proliferation and cytokine release, respectively, were assessed. Treatment of mice with E121 significantly decreased the ovalbumin-induced increase in airway total cell influx and eosinophil infiltration and this was associated with an inhibition of ovalbumin-induced airway hyperresponsiveness. Moreover, E121 reduced PHA and anti-CD3-induced human peripheral blood mononuclear cell proliferation in vitro. E121 also inhibited PHA, anti-CD3 monoclonal antibody and LPS-induced cytokine release from human peripheral blood mononuclear cell cultures. These findings indicate that E121 exhibits anti-inflammatory and immunosuppressive activities.

Alveolar inflammation in cystic fibrosis

In infected lungs of the cystic fibrosis (CF) patients, opportunistic pathogens and mutated cystic fibrosis transmembrane conductance regulator protein (CFTR) contribute to chronic airway inflammation that is characterized by neutrophil/macrophage infiltration, cytokine release and ceramide accumulation. We sought to investigate CF lung inflammation in the alveoli.

Pediatric severe asthma is characterized by eosinophilia and remodeling without T(H)2 cytokines

BACKGROUND: The pathology of pediatric severe therapy-resistant asthma (STRA) is little understood. OBJECTIVES: We hypothesized that STRA in children is characterized by airway eosinophilia and mast cell inflammation and is driven by the T(H)2 cytokines IL-4, IL-5, and IL-13. METHODS: Sixty-nine children (mean age, 11.8 years; interquartile range, 5.6-17.3 years; patients with STRA, n = 53; control subjects, n = 16) underwent fiberoptic bronchoscopy, bronchoalveolar lavage (BAL), and endobronchial biopsy. Airway inflammation, remodeling, and BAL fluid and biopsy specimen T(H)2 cytokines were quantified. Children with STRA also underwent symptom assessment (Asthma Control Test), spirometry, exhaled nitric oxide and induced sputum evaluation. RESULTS: Children with STRA had significantly increased BAL fluid and biopsy specimen eosinophil counts compared with those found in control subjects (BAL fluid, P < .001; biopsy specimen, P < .01); within the STRA group, there was marked between-patient variability in eosinophilia. Submucosal mast cell, neutrophil, and lymphocyte counts were similar in both groups. Reticular basement membrane thickness and airway smooth muscle were increased in patients with STRA compared with those found in control subjects (P < .0001 and P < .001, respectively). There was no increase in BAL fluid IL-4, IL-5, or IL-13 levels in patients with STRA compared with control subjects, and these cytokines were rarely detected in induced sputum. Biopsy IL-5(+) and IL-13(+) cell counts were also not higher in patients with STRA compared with those seen in control subjects. The subgroup (n = 15) of children with STRA with detectable BAL fluid T(H)2 cytokines had significantly lower lung function than those with undetectable BAL fluid T(H)2 cytokines. CONCLUSIONS: STRA in children was characterized by remodeling and variable airway eosinophil counts. However, unlike in adults, there was no neutrophilia, and despite the wide range in eosinophil counts, the T(H)2 mediators that are thought to drive allergic asthma were mostly absent.

High rhinovirus burden in lower airways of children with cystic fibrosis

Rhinovirus (RV)-induced pulmonary exacerbations are common in cystic fibrosis (CF) and have been associated with impaired virus clearance by the CF airway epithelium in vitro. Here, we assess in vivo the association of RV prevalence and load with antiviral defense mechanisms, airway inflammation, and lung function parameters in children with CF compared with a control group and children with other chronic respiratory diseases.

Targeted cell replacement with bone marrow cells for airway epithelial regeneration

It has been suggested that some adult bone marrow cells (BMC) can localize to the lung and develop tissue-specific characteristics including those of pulmonary epithelial cells. Here, we show that the combination of mild airway injury (naphthalene-induced) as a conditioning regimen to direct the site of BMC localization and transtracheal delivery of short-term cultured BMC enhances airway localization and adoption of an epithelial-like phenotype. Confocal analysis of airway and alveolar-localized BMC (fluorescently labeled) with epithelial markers shows expression of the pulmonary epithelial proteins, Clara cell secretory protein, and surfactant protein C. To confirm epithelial gene expression by BMC, we generated transgenic mice expressing green fluorescent protein (GFP) driven by the epithelial-specific cytokeratin-18 promoter and injected BMC from these mice transtracheally into wild-type recipients after naphthalene-induced airway injury. BMC retention in the lung was observed for at least 120 days following cell delivery with increasing GFP transgene expression over time. Some BMC cultured in vitro over time also expressed GFP transgene, suggesting epithelial transdifferentiation of the BMC. The results indicate that targeted delivery of BMC can promote airway regeneration.

Inflammation induces hemorrhage in thrombocytopenia

The role of platelets in hemostasis is to produce a plug to arrest bleeding. During thrombocytopenia, spontaneous bleeding is seen in some patients but not in others; the reason for this is unknown. Here, we subjected thrombocytopenic mice to models of dermatitis, stroke, and lung inflammation. The mice showed massive hemorrhage that was limited to the area of inflammation and was not observed in uninflamed thrombocytopenic mice. Endotoxin-induced lung inflammation during thrombocytopenia triggered substantial intra-alveolar hemorrhage leading to profound anemia and respiratory distress. By imaging the cutaneous Arthus reaction through a skin window, we observed in real time the loss of vascular integrity and the kinetics of skin hemorrhage in thrombocytopenic mice. Bleeding-observed mostly from venules-occurred as early as 20 minutes after challenge, pointing to a continuous need for platelets to maintain vascular integrity in inflamed microcirculation. Inflammatory hemorrhage was not seen in genetically engineered mice lacking major platelet adhesion receptors or their activators (alphaIIbbeta3, glycoprotein Ibalpha [GPIbalpha], GPVI, and calcium and diacylglycerol-regulated guanine nucleotide exchange factor I [CalDAG-GEFI]), thus indicating that firm platelet adhesion was not necessary for their supporting role. While platelets were previously shown to promote endothelial activation and recruitment of inflammatory cells, they also appear indispensable to maintain vascular integrity in inflamed tissue. Based on our observations, we propose that inflammation may cause life-threatening hemorrhage during thrombocytopenia.

In vitro allergy tests compared to intradermal testing in horses with recurrent airway obstruction

Recurrent airway obstruction (RAO) is a common condition in stabled horses characterised by small airway inflammation, airway neutrophilia and obstruction following exposure of susceptible horses to mouldy hay and straw and is thus regarded as a hypersensitivity reaction to mould spores. However, the role of IgE-mediated reactions in RAO remains unclear. The aim of the study was to investigate with a serological IgE ELISA test (Allercept), an in vitro sulfidoleukotriene (sLT) release assay (CAST) and with intradermal testing (IDT) whether serum IgE and IgE-mediated reactions against various mould, mite and pollen extracts are associated with RAO. IDT reactions were evaluated at different times in order to detect IgE-mediated immediate type reactions (type I hypersensitivity reactions, 0.5-1 h), immune complex-mediated late type reactions (type III reactions, 4-10 h) and cell-mediated delayed type reactions (type IV hypersensitivity reactions 24-48 h). In the serological test, overall the control horses displayed more positive reactions than the RAO-affected horses but the difference was not significant. Comparison of the measured IgE levels showed that the RAO-affected horses had slightly higher IgE levels against Aspergillus fumigatus than controls (35 and 16 AU, respectively, p<0.05), but all values were below the cut off (150 AU) of the test. In the sLT release assay, seven positive reactions were observed in the RAO-affected horses and four in the controls but this difference was not significant. A significantly higher proportion of late type IDT reactions was observed in RAO-affected horses compared to controls (25 of 238 possible reactions versus 12 of 238 possible reactions, respectively, p<0.05). Interestingly, four RAO-affected but none of the control horses reacted with the recombinant mould allergen A. fumigatus 8 (rAsp f 8, p<0.05), but only late phase and delayed type reactions were observed. In all three tests the majority of the positive reactions was observed with the mite extracts (64%, 74% and 88% of all positive reactions, respectively) but none of the tests showed a significant difference between RAO-affected and control animals. Our findings do not support that IgE-mediated reactions are important in the pathogenesis of RAO. Further studies are needed to investigate whether sensitisation to mite allergens is of clinical relevance in the horse and to understand the role of immune reactions against rAsp f 8.

Interferon-α antagonizes IL-3-mediated immunoregulatory functions of human basophils

Human basophils are major inflammatory cells in maintaining chronic allergic asthma. It has been published that interferon-α (IFN-α) improves clinical symptoms of asthma patients. In contrast, IL-3 exacerbates airway inflammation by inducing IL-4, IL-8 and IL-13 secretion from human basophils thus regulating their immunoregulatory functions. Furthermore, IL-3 exceptionally promotes survival of basophils. Here, we assessed cellular response of human basophils treated with IFN-α alone or in combination with IL-3. Our data show that IFN-α enhances apoptosis in purified human blood basophils compared to spontaneous apoptosis of controls or IFN-γ treated cells. Furthermore, we demonstrate that both IFN-α and FasL enhance apoptosis in human basophils with similar efficiency in a rather additive than synergistic way. IFN-α inhibits IL-3-induced survival to a minor degree. Particularly however, it suppresses IL-3-induced de-novo production of IL-8 and IL-13 up to 80%. In contrast, the production of IL-4 is not affected. Analyses of signaling pathways reveal that IFN-α promotes prolonged phosphorylation of STAT1/STAT2. By using a pan-JAK inhibitor the phosphorylation of STAT1/STAT2 is inhibited and most importantly the pro-apoptotic effect of IFN-α is abolished. Although the phosphorylation of p38-MAPK in IFN-α-treated cells is comparable to non-treated cells, inhibition of p-p38 activity abrogates IFN-α-enhanced apoptosis as well. We conclude that IFN-α-enhanced apoptosis is tightly regulated by the cooperation of JAK/STAT and p38-MAPK pathways. Our study identifies IFN-α as a novel inhibitor of IL-3-induced IL-8 and IL-13 production of human basophils. Taken together our study may explain the improved clinical symptoms of asthma patients treated with IFN-α.

Effects of ex vivo γ-tocopherol on airway macrophage function in healthy and mild allergic asthmatics

Elevated inflammation and altered immune responses are features found in atopic asthmatic airways. Recent studies indicate γ-tocopherol (GT) supplementation can suppress airway inflammation in allergic asthma. We studied the effects of in vitro GT supplementation on receptor-mediated phagocytosis and expression of cell surface molecules associated with innate and adaptive immunity on sputum-derived macrophages. Cells from nonsmoking healthy (n = 6) and mild house dust mite-sensitive allergic asthmatics (n = 6) were treated ex vivo with GT (300 µM) or saline (control). Phagocytosis of opsonized zymosan A bioparticles (Saccharomyces cerevisiae) and expression of surface molecules associated with innate and adaptive immunity were assessed using flow cytometry. GT caused significantly decreased (p < 0.05) internalization of attached zymosan bioparticles and decreased (p < 0.05) macrophage expression of CD206, CD36 and CD86 in allergic asthmatics but not in controls. Overall, GT caused downregulation of both innate and adaptive immune response elements, and atopic status appears to be an important factor.

Owner-reported coughing and nasal discharge are associated with clinical findings, arterial oxygen tension, mucus score and bronchoprovocation in horses with recurrent airway obstruction in a field setting.

REASONS FOR PERFORMING STUDY In clinical practice, veterinarians often depend on owner-reported signs to assess the clinical course of horses with recurrent airway obstruction (RAO). OBJECTIVES To test whether owner-reported information on frequency of coughing and observation of nasal discharge are associated with clinical, cytological and bronchoprovocation findings in RAO-affected horses in nonstandardised field conditions. STUDY DESIGN Cross-sectional study comparing healthy and RAO-affected horses. METHODS Twenty-eight healthy and 34 RAO-affected Swiss Warmblood horses were grouped according to owner-reported 'coughing frequency' and 'nasal discharge'. Differences between these groups were examined using clinical examination, blood gas analyses, endoscopic mucus scores, cytology of tracheobronchial secretion and bronchoalveolar lavage fluid, and airway hyperresponsiveness determined by plethysmography with histamine bronchoprovocation. RESULTS Frequently coughing horses differed most markedly from healthy control animals. Histamine bronchoprovocation-derived parameters were significantly different between the healthy control group and all RAO groups. Mucus grades and tracheobronchial secretion and bronchoalveolar lavage fluid neutrophil percentages had particularly high variability, with overlap of findings between groups. Owner satisfaction with the clinical status of the horse was high, even in severely affected horses. CONCLUSIONS Owner-reported coughing and nasal discharge are associated with specific clinical and diagnostic findings in RAO-affected horses in field settings. While airway hyperresponsiveness differentiates best between healthy horses and asymptomatic RAO-affected horses, the absence of coughing and nasal discharge does not rule out significant neutrophilic airway inflammation. Owner satisfaction with the clinical status of the horse was uninformative.

What's in a name? Inflammatory airway disease in racehorses in training

The term 'inflammatory airway disease' (IAD) is often used to describe the syndrome of lower airway inflammation that frequently affects young racehorses in training around the world. In practice, this inflammation is generally diagnosed using a combination of endoscopic tracheal examination, including grading of amounts of mucus present and tracheal wash sampling. However, a recent consensus statement from the American College of Veterinary Internal Medicine concluded that bronchoalveolar lavage (BAL) sampling, rather than tracheal wash (TW) sampling, is required for cytological diagnosis of IAD and that tracheal mucus is not an essential criterion. However, as BAL is a relatively invasive procedure that is not commonly used on racing yards, this definition can only be applied routinely to a biased referral population. In contrast, many practitioners continue to diagnose IAD using endoscopic tracheal examination and sampling. We argue that, rather than restricting the use of the term IAD to phenotypes diagnosed by BAL, it is important to distinguish in the literature between airway inflammation diagnosed by BAL and that identified in the field using TW sampling. We suggest the use of the term brIAD for the former and trIAD for the latter. It is essential that we continue to endeavour to improve our understanding of the aetiology, pathogenesis and clinical relevance of airway inflammation identified in racehorses in training using tracheal examination and sampling. Future studies should focus on investigations of the component signs of airway inflammation.

Microbiota Promotes Chronic Pulmonary Inflammation by Enhancing IL-17A and Autoantibodies

RATIONALE Changes in the pulmonary microbiota are associated with progressive respiratory diseases including chronic obstructive pulmonary disease. Whether there is a causal relationship between these changes and disease progression remains unknown. OBJECTIVE To investigate the link between an altered microbiota and disease, we utilized a model of chronic lung inflammation in specific pathogen free (SPF) mice and mice depleted of microbiota by antibiotic treatment or devoid of a microbiota (axenic). METHODS Mice were challenged with LPS/elastase intranasally over 4 weeks, resulting in a chronically inflamed and damaged lung. The ensuing cellular infiltration, histological damage and decline in lung function were quantified. MEASUREMENTS AND MAIN RESULTS Similar to human disease, the composition of the pulmonary microbiota was altered in disease animals. We found that the microbiota richness and diversity were decreased in LPS/Elastase-treated mice, with an increased representation of the genera Pseudomonas, Lactobacillus and a reduction in Prevotella. Moreover, the microbiota was implicated in disease development as mice depleted of microbiota exhibited an improvement in lung function, reduction in airway inflammation, decrease in lymphoid neogenesis and auto-reactive antibody responses. The absence of microbial cues also markedly decreased the production of IL-17A, whilst intranasal transfer of fluid enriched with the pulmonary microbiota isolated from diseased mice enhanced IL-17A production in the lungs of antibiotic treated or axenic recipients. Finally, in mice harboring a microbiota, neutralizing IL-17A dampened inflammation and restored lung function. CONCLUSIONS Collectively, our data indicate that host-microbial cross-talk promotes inflammation and could underlie the chronicity of inflammatory lung diseases.

Cytochrome P450 4F isoforms in different species: Identification, gene regulation and putative roles in inflammation

The cytochrome P450 4F subfamily comprises a group of enzymes that metabolize derivatives of arachidonic acid such as prostaglandins, lipoxins leukotrienes and hydroxyeicosatetraenoic acids, which are important mediators involved in the inflammatory response. Therefore, we speculate that CYP4Fs might be able to modulate the extent of the inflammation by controlling of the tissue levels of these inflammatory mediators, especially, leukotriene B4. One way to provide support for this hypothesis is to test whether the expression of CYP4Fs changes under inflammatory conditions, since these changes are required to adjust the levels of inflammatory mediators. ^ A lipopolysacchride (LPS) induced rat inflammation model was used to analyze the expressions of rat CYP4F4 and CYP4F5 in liver and kidney. LPS administration did not change the constitutive expression level of CYP4F4 and CYP4F5. In liver, the expressions of CYP4F4 and CYP4F5 decreased to 50–60% of the untreated level. The same effect of LPS on CYP4F4 and CYP4F5 expression can be mimicked in hepatocyte primary cultures treated with LPS, indicating a direct of effect of LPS on hepatocytes. LPS treatment also decreased the activity of liver microsomes towards chlorpromazine, however, antibody inhibition study revealed that liver CYP4Fs are not the only players in metabolizing chlorpromazine. To study further the underlying mechanism, CYP4F5 gene was isolated, characterized, and the promoter region was defined. ^ Accumulating evidence showed that peroxisome proliferator-activated receptors (PPARs) play an active role in inflammation. To investigate the possible role of PPARα in regulating CYP4F expression by inflammation or by clofibrate treatment, the expressions of two new mouse 4F isoforms were analyzed in PPARα knockout mice upon LPS or clofibrate challenge. A novel induction of CYP4F15 by LPS and clofibrate was observed in kidney, and this effect is totally dependent on the presence of PPARα. Renal CYP4F16 expression was not affected by LPS or clofibrate in both (+/+) and (−/−) mice. In contrast, hepatic expressions of CYP4F15 and CYP4F16 were reduced significantly in (+/+) mice, but much less in (−/−) mice, suggesting that PPARα is partially responsible for this down-regulation. Clofibrate treatment reduced the expression of CYP4F16 in liver, but has no effect on CYP4F15 and PPARα does not have a role in hepatic CYP4F expression regulated by clofibrate. In general, CYP4Fs are regulated in an isoform-, tissue- and species-specific manner. ^ A human CYP4F isoform, CYP4F11, was isolated. The genomic structure was also solved by using database mining and bioinformatics tools. Localization of CYP4F11 to chromosome 19, 16 kb upstream of CYP4F2, suggests that human CYP4F genes may form a cluster on chromosome 19. This novel human 4F is highly expressed in liver, as well as in kidney, heart and skeletal muscle. Further study of the activity and gene regulation on CYP4F11 will provide us more insights into the physiological functions of CYP4F subfamily. ^