Peripheral erythrocytes decrease upon specific respiratory challenge with grass pollen allergen in sensitized mice and in human subjects.

BACKGROUND AND AIMS: Specific hyper-responsiveness towards an allergen and non-specific airway hyperreactivity both impair quality of life in patients with respiratory allergic diseases. We aimed to investigate cellular responses following specific and non-specific airway challenges locally and systemically in i) sensitized BALB/c mice challenged with grass pollen allergen Phl p 5, and in ii) grass pollen sensitized allergic rhinitis subjects undergoing specific airway challenge in the Vienna Challenge Chamber (VCC). METHODS AND RESULTS: BALB/c mice (n = 20) were intraperitoneally immunized with grass pollen allergen Phl p 5 and afterwards aerosol challenged with either the specific allergen Phl p 5 (n = 10) or the non-specific antigen ovalbumin (OVA) (n = 10). A protocol for inducing allergic asthma as well as allergic rhinitis, according to the united airway concept, was used. Both groups of exposed mice showed significantly reduced physical activity after airway challenge. Specific airway challenge further resulted in goblet cell hyperplasia, enhanced mucous secretion, intrapulmonary leukocyte infiltration and lymphoid follicle formation, associated with significant expression of IL-4, IL-5 and IL-13 in splenocytes and also partially in lung tissue. Concerning circulating blood cell dynamics, we observed a significant drop of erythrocyte counts, hemoglobin and hematocrit levels in both mouse groups, challenged with allergen or OVA. A significant decrease in circulating erythrocytes and hematocrit levels after airway challenges with grass pollen allergen was also found in grass pollen sensitized human rhinitis subjects (n = 42) at the VCC. The effects on peripheral leukocyte counts in mice and humans however were opposed, possibly due to the different primary inflammation sites. CONCLUSION: Our data revealed that, besides significant leukocyte dynamics, particularly erythrocytes are involved in acute hypersensitivity reactions to respiratory allergens. A rapid recruitment of erythrocytes to the lungs to compensate for hypoxia is a possible explanation for these findings.

Colonic vitamin D metabolism: implications for the pathogenesis of inflammatory bowel disease and colorectal cancer.

In epidemiological studies serum levels below 30 nM of 25-OHD(3), the precursor of the active vitamin D metabolite 1,25-(OH)(2)D(3), were consistently associated with incidence of colorectal cancer. The active vitamin D metabolite possesses antimitotic, prodifferentiating and proapoptotic capacity in vivo and in vitro. The intestinal autocrine/paracrine vitamin D system, which is the main source of local 1,25-(OH)(2)D(3) plays a critical role in maintaining both mucosal immunity and normal growth of epithelial cells. It has been hypothesized that the VDR-mediated signaling antagonizing TNF-α and IL-6 receptor-activated pro-inflammatory and proliferative intracellular pathways, may prevent development of IBD and colitis-associated colorectal cancer. Conversely, any situation that impairs the efficiency of the 1,25-(OH)(2)D(3)/VDR signaling system at the level of the gut mucosa, e.g. vitamin D insufficiency, may increase risk for the development of IBD and colorectal cancer. Therefore, not only adequate serum levels of the precursor 25-OHD(3) are essential, but also optimal expression of the 1α-hydroxylating enzyme CYP27B1. The 1,25-(OH)(2)D(3) catabolizing hydroxylase CYP24A1 is increasingly expressed during colon cancer progression, indicating that colonocytes are released from normal growth control by the steroid hormone. Securing adequate levels of calcitriol by inhibition of catabolism and support of 1α-hydroxylation by calcium, phytoestrogens and folate could be a valid approach to control, at least in part, IBD and CRC pathogenesis.

The candidate oncogene CYP24A1: A potential biomarker for colorectal tumorigenesis.

The main autocrine/paracrine role of the active metabolite of vitamin D(3), 1alpha,25-dihydroxyvitamin D(3) (1,25-D(3)), is inhibition of cell growth and induction of cell differentiation and/or apoptosis. Synthesis and degradation of the secosteroid occurs not only in the kidney but also in normal tissue or malignant extrarenal tissues such as the colon. Because 25-hydroxyvitamin D(3) 24-hydroxylase (CYP24A1) is considered to be the main enzyme determining the biological half-life of 1,25-D(3), we have examined expression of the CYP24A1 mRNA (by real-time RT-PCR) and protein (by immunohistochemistry) in normal human colon mucosa, colorectal adenomas, and adenocarcinomas in 111 patients. Although 76% of the normal and benign colonic tissue was either completely devoid of or expressed very low levels of CYP24A1, in the majority of the adenocarcinomas (69%), the enzyme was present at high concentrations. A parallel increased expression of the proliferation marker Ki-67 in the same samples suggests that overexpression of CYP24A1 reduced local 1,25-D(3) availability, decreasing its antiproliferative effect.

Modulation of vitamin D synthesis and catabolism in colorectal mucosa: a new target for cancer prevention.

Sporadic colorectal cancer is a disease of advancing age and the percentage of the population which reaches an advanced age is strongly increasing. Multiple factors are responsible for the etiology of this cancer since the colorectal mucosa is directly influenced by nutrients reaching the colonic lumen and impacting on mucosal cells. The vitamin D system appears to be central to several preventative molecular pathways. Insufficiency of the serum precursor 25-hydroxyvitamin D3 has been linked by epidemiology to enhanced colon tumor incidence, most likely because it is a major determinant of 1,25-dihydroxyvitamin D3 synthesis in colonic mucosal cells. Bound to its receptor, vitamin D regulates colonic proliferation, differentiation and apoptosis in an autocrine/paracrine manner. During early malignancy, vitamin D synthesis is enhanced to counteract hyperproliferation, whereas in high-grade tumors catabolism by far surpasses synthesis. The colonic vitamin D system is regulated by several known natural factors. One of the most important ones is nutritional calcium that, if supply is low, will result in enhanced catabolism of colonic 1,25-dihydroxyvitamin D3. Estrogenic compounds can increase expression and activity of the synthesizing 25-hydroxyvitamin D-1alpha-hydroxylase. Due to enhanced synthesis of the active metabolite, this can lead to protection against colorectal tumors in women. During tumor progression, expression of 25-hydroxyvitamin D-1alpha-hydroxylase as well as of the catabolizing 25-hydroxyvitamin D-24-hydroxylase appears to be under epigenetic control as demonstrated by studies with phytoestrogens and folate. It is commonly accepted that sporadic colorectal cancer pathogenesis is multifactorial and these are just a few examples of the regulatory capacity of natural (nutrient) substances for improving the colonic vitamin D system. However, protection by vitamin D might have central importance, with nutrients increasing the efficiency of the vitamin D system in a targeted manner. This could result in prevention of hyperproliferation or retardation of progression to clinically manifest primary colonic tumors.

Parallel elevation of colonic 1,25-dihydroxyvitamin D3 levels and apoptosis in female mice on a calcium-deficient diet.

BACKGROUND: Epidemiology suggests that nutritional calcium and vitamin D together prevent colorectal tumor progression. 1,25(OH)2D3 is synthesized and degraded in colonocytes and, when bound to its receptor, has antiproliferative activity. MATERIALS AND METHODS: 1,25(OH)2D3 levels have been successfully measured in cell culture, but this is technically difficult in tissues. Double extraction coupled to an enzyme immunoassay was used to determine 1,25(OH)2D3 concentration in colon mucosa. RESULTS: In a mouse model fed low (0.04%) nutritional calcium, expression of the vitamin D catabolizing CYP24A1, of the synthesizing CYP27B1 hydroxylase and of the vitamin D receptor was induced in the right colon only. While CYP24A1 mRNA was raised in both genders, raised CYP27B1 and VDR was found in females only. Levels of 1,25(OH)2D3 were significantly higher in the right colon of females fed 0.04% calcium compared with the control group on 0.9% calcium, and with males fed either diet. Parallel to increased 1,25(OH)2D3, the intrinsic apoptotic pathway was enhanced in the right colon of females only. CONCLUSION: This demonstrates the significance of high nutritional calcium for colonic accumulation of 1,25(OH)2D3 and suggests that female sex hormones may protect against mitotic action of low nutritional calcium by inducing 1,25(OH)2D3 synthesis.

Nutritional calcium modulates colonic expression of vitamin D receptor and pregnane X receptor target genes.

Low nutritional calcium contributes to disruption of the intestinal epithelial barrier function, to hyperproliferation of colonocytes and increased occurrence of aggressive secondary bile acids in the gut lumen. These mechanisms are also known to be involved in the etiology of colonic inflammation and cancer. We studied in mice and human adenocarcinoma-derived Caco-2 cells the impact of low calcium on markers of inflammation (cyclooxygenase-2; COX-2), of detoxification (pregnane and xenobiotic receptor (PXR)/steroid and xenobiotic receptor (SXR), cytochrome P450 steroid-inducible 3a11 (CYP3A11)), and on expression of the vitamin D system as a protection against tumorigenesis. Caco-2 cells express high COX-2 and low SXR mRNA levels when subconfluent. During differentiation this is reversed, while low calcium enhanced COX-2 protein expression. In vivo low dietary calcium significantly increased the expression of the PXR target gene CYP3A11 in the proximal colon, suggesting compensatory defense mechanisms. In comparison with males, low nutritional calcium elicits a better protective response in females: both the vitamin D synthesizing 25-hydroxyvitamin D(3 )1alpha hydroxylase (CYP27B1) mRNA and the detoxifying CYP3A11 mRNA are augmented more. While it is recognized that colonic vitamin D synthesis may prevent tumor progression, low dietary calcium also elevates the 1,25-(OH)(2)-D(3) catabolic 25-hydroxyvitamin D(3) 24 hydroxylase (CYP24) expression primarily in the proximal colon. Our data suggest the proximal colon as the primary site of response to insufficient calcium intake.