Effects of lansoprazole and omeprazole Combined With Antimicrobial Agents on Gastric Juice pH and Inflammatory Factors in Elderly Patients With Hp Positive Gastric Ulcer.

Background: Helicobacter pylori (Hp) is one of the most prevalent pathogenic microorganisms in the world, which is related to gastric ulcer. Objective: To observe the effect of lansoprazole and omeprazole combined with antibiotics on gastric juice pH and inflammatory factors in elderly patients with Hp positive gastric ulcer. Design: This study was a prospective observation study. Setting: This study was performed in Department of Gastroenterology, First Affiliated Hospital of Soochow University. Participants: One hundred and ten elder patients with Hp positive gastric ulcer admitted to our hospital from January 2019 to May 2020. Intervention: The control group was treated with omeprazole combined with antibiotics, and the observation group was treated with lansoprazole combined with antibiotics. Primary outcome measures: The level of gastric juice pH, interleukin-1 (IL-1), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and heat shock protein-70 (HSP-70). Methods: The changes of gastric juice pH value, IL-1, IL-8, TNF-α and HSP-70 levels before and after treatment were detected in the two groups. The total effective rate, Hp eradication rate, mature type of regenerated mucosal tissue surrounding ulcer and adverse reaction rate were statistically analyzed. Results: The total effective rate and Hp eradication rate in the observation group were higher than those in the control group, while the adverse reaction rate in the observation group was lower than that in the control group (P < .05). After treatment, the pH value of gastric juice and HSP-70 in the observation group were higher than those in the control group, while the IL-1, IL-8 and TNF-α were lower than those in the control group (P < .05). The mature type of regenerated mucosal tissue structure around ulcer in the observation group was better than that in the control group (P < .05). Conclusion: The overall effect of lansoprazole combined with antibiotics in the treatment of Hp positive gastric ulcer in the elderly is better than that of omeprazole combined with antibiotics.

Clinical Effect of Bushen Huoxue Method Combined with Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis and Its Effect on IL-1, IL-6, VEGF, and PGE-2.

Objective: To observe the clinical efficacy of the Bushen Huoxue method combined with platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA) and its effect on serum and joint fluid interleukin-1 (IL-1), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and prostaglandin E2 (PGE-2). Methods: A total of 64 cases of KOA diagnosed and treated from January 2020 to January 2021 were randomly divided into research group and control group, with 32 cases in each group. The control group was treated with PRP, and the research group took the prescription of the Bushen Huoxue method on the basis of the control group. The clinical efficacy was assessed according to the criteria in "the diagnosis and Treatment of osteoarthritis," osteoarthritis index score and pain visual analogue score (VAS). Serum and articular fluid VAS, IL-1, IL-6, VEGF, and PGE-2 levels were detected by the enzyme-linked immunosorbent assay (ELISA). Results: The clinical effective rate of the research group was 93.8%, which was significantly higher than that of the control group (90.6%). There was no significant difference in the scores of osteoarthritis index between the two groups before treatment, but the scores of both groups decreased after treatment and was lower in the research group than those in the control group. VAS was significantly decreased in two groups after treatment and it was lower in the research group than that in the control group. After treatment, the levels of IL-1, IL-6, and PGE-2 in serum and articular fluid all indexes were decreased, and the levels in the research group were lower than those in the control group. Conclusions: PRP joint cavity injection combined with oral administration of Bushen Huoxue prescription, and PRP joint cavity injection alone can improve the efficacy of KOA, relieve knee pain, and promote the recovery of knee function. The mechanism may be related to the reduction of IL-1, IL-6, VEGF levels, and PGE-2 levels in the serum and joint fluid. However, the efficacy of combination therapy was superior to PRP alone.

Interleukin-37 Attenuates Lipopolysaccharide (LPS)-Induced Neonatal Acute Respiratory Distress Syndrome in Young Mice via Inhibition of Inflammation and Cell Apoptosis.

BACKGROUND Neonatal acute respiratory distress syndrome (ARDS) is a common clinical syndrome caused by lung immaturity and the abnormal synthesis of pulmonary surfactant in preterm newborns, and it has high morbidity and mortality rates. The present study investigated the roles of interleukin-37 (IL-37) in the pathogenesis of neonatal ARDS and the underlying biochemical mechanism. MATERIAL AND METHODS We used 6-day-old neonatal C57BL/6 mice to establish the ARDS model. Inflammatory cytokines levels were measured with enzyme-linked immunosorbent assay (ELISA) Kits. The pathological morphology of lung tissues was observed by hematoxylin-eosin (HE) staining. The expression levels of proteins were assessed by Western blotting and apoptotic cells were detected via TUNEL assay. Further, the expression of nucleotide-bound oligomerization domain (Nod)-like receptor P3 (NLRP3) was detected with immunohistochemistry and Western blotting. RESULTS IL-37 attenuated lipopolysaccharide (LPS)-induced cell apoptosis and excessive inflammatory cytokines levels, including IL-1ß, IL-8, TNF-alpha, and MCP-1, and ameliorated lung pathological manifestations in an LPS-induced neonatal ARDS model. Moreover, IL-37 suppressed the abnormal expression of proteins related to the CXCR4/SDF-1 chemokine axis and NLRP3 inflammasome pathway. CONCLUSIONS The present results suggest that IL-37 protect against LPS-induced lung injury through inhibition of inflammation and apoptosis in lung tissue in an LPS-induced neonatal ARDS model. Hence, IL-37 may be considered as a potential therapeutic agent for neonatal ARDS.

Autologous Conditioned Serum.

Autologous conditioned serum was developed in the mid 1990s as an expeditious, practical, and relatively inexpensive means of generating the interleukin-1 receptor antagonist, a naturally occurring inhibitor of the cytokine interleukin-1. The latter is thought to be an important mediator of inflammation, pain, and tissue destruction in musculoskeletal conditions. ACS has been widely and successfully used in the local treatment of human and equine osteoarthritis and radicular compression; it has also shown promise in treating tendinopathies, muscle injuries, and tunnel widening after reconstruction of the anterior cruciate ligament. Experience suggests that autologous conditioned serum is safe and effective.

Update on the treatment of juvenile idiopathic arthritis.

Juvenile idiopathic arthritis (JIA) is one of the most common chronic diseases of childhood. Although the pathophysiology behind this disease is poorly understood, there are effective treatments for JIA based on the subtype of disease. Treatment options include non-steroidal anti-inflammatory drugs, intra-articular glucocorticoid injections, and traditional disease modifying anti-rheumatic drugs such as methotrexate. In the past decade, the use of biologic therapy in JIA, including tumor necrosis factor inhibitors, interleukin-1 inhibitors, and interleukin-6 inhibitors, has dramatically increased with promising outcomes.

Autologous conditioned serum for the treatment of osteoarthritis and other possible applications in musculoskeletal disorders.

INTRODUCTION: The therapeutic use of interleukin 1 (IL-1) cytokine receptor antagonists (IL-1RA) has promoted the development of new biological therapies for osteoarthritis (OA). Autologous conditioned serum (ACS) is an alternative, safe and well-tolerated treatment in OA. Sources of data We performed a comprehensive search of PubMed, Medline, Cochrane, CINAHL, Embase, SportDiscus, Pedro and Google scholar databases using keywords such as 'interleukin 1', 'osteoarthritis' and 'autologous conditioned serum'. AREAS OF AGREEMENT: ACS, containing endogenous anti-inflammatory cytokines including IL-1RA and several growth factors, could reduce pain and increase function and mobility in mild to moderate knee OA. AREA OF CONTROVERSY: Given the limited data available on the composition of ACS, the mechanisms through which ACS produces clinical improvement, the duration of its effect and the changes in cytokine levels after repeated injections are still unknown. Growing points Although previous clinical data are encouraging and confirm the safety of this modality, given the limitations of current studies, there should be additional, controlled trials to further confirm efficacy for the use of ACS in OA treatment. AREA TIMELY FOR DEVELOPING RESEARCH: ACS can lead to enhancement of tissue regeneration and to reduction of degenerative mechanisms.

Active immunization with IL-1 displayed on virus-like particles protects from autoimmune arthritis.

IL-1 is an important mediator of inflammation and a major cause of tissue damage in rheumatoid arthritis (RA). Therapeutic administration of recombinant IL-1 receptor antagonist (IL-1Ra) is efficacious in reducing clinical symptoms of disease, but suffers from several drawbacks, including the need for frequent administrations of large amounts. Here, we show that immunization of mice with either IL-1alpha or IL-1beta chemically cross-linked to virus-like particles (VLP) of the bacteriophage Qbeta elicited a rapid and long-lasting autoantibody response. The induced Ab efficiently neutralized the binding of the respective IL-1 molecules to their receptors in vitro and their pro-inflammatory activities in vivo. In the collagen-induced arthritis model, both vaccines strongly protected mice from inflammation and degradation of bone and cartilage. Moreover, immunization with either vaccine showed superior efficacy than daily administrations of high amounts of IL-1Ra. In the T and B cell-independent collagen Ab transfer model, immunization with the IL-1beta vaccine strongly protected from arthritis, whereas immunization with the IL-1alpha vaccine had no effect. Our results suggest that active immunization with IL-1alpha, and especially IL-1beta conjugated to Qbeta VLP, might become an efficacious and cost-effective new treatment option for RA and other systemic IL-1-dependent inflammatory disorders.

Infectious complications of biologic treatments of rheumatoid arthritis.

Agents that block the action of tumor necrosis factor-alpha and recombinant interleukin-1 have been shown to be effective biologic treatment modalities in patients with rheumatoid arthritis. Given the immunosuppressive effects of tumor necrosis factor-alpha and interleukin-1 blockers, infections have emerged as possible complications of using these agents, an observation foreshadowed in prelicensure animal studies. At this time, hundreds of thousands of patients have received these drugs, and a wide variety of infectious complications has been reported, among which reactivation tuberculosis is most notable. Case reports alone, however, do not necessarily reflect a causal association between a therapeutic product and an adverse event. The authors review the infectious complications of the use of these agents as reported in the medical literature from November 2001 through October 2002.

Pulmonary edema fluid from patients with acute lung injury augments in vitro alveolar epithelial repair by an IL-1beta-dependent mechanism.

Efficient alveolar epithelial repair is crucial for the restoration of the injured alveolar epithelial barrier in patients with acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS). We hypothesized that pulmonary edema fluid from patients with ALI /ARDS would inhibit alveolar epithelial repair as measured in an in vitro epithelial wound-repair model using the human alveolar epithelial-like cell line A549. In contrast to our initial hypothesis, pulmonary edema fluid from patients with ALI/ARDS increased alveolar epithelial repair by 33 +/- 3% compared with pooled plasma from healthy donors (p < 0.01). By contrast, the plasma and the pulmonary edema fluid from patients with hydrostatic pulmonary edema, and the plasma from patients with ALI/ARDS had similar effects on epithelial repair as pooled plasma from healthy donors. Inhibition of interleukin-1beta (IL-1beta) activity by IL-1 receptor antagonist reduced alveolar epithelial repair induced by ALI/ARDS edema fluid by 46 +/- 4% (p < 0.001), indicating that IL-1beta contributed significantly to the increased epithelial repair. In summary, pulmonary edema fluid collected early in the course of ALI/ARDS increased alveolar epithelial repair in vitro by an IL-1beta-dependent mechanism. These data demonstrate a novel role for IL-1beta in patients with ALI/ARDS, indicating that IL-1beta may promote repair of the injured alveolar epithelium.

[Cytokines as agents for the early pathogenetic therapy of radiation injuries. Their efficacy and mechanism of action]. / Tsitokiny kak sredstva rannei patogeneticheskoi terapii radiatsionnykh povrezhdenii. Effektivnost' i mekhanizm deistviia.

It has been shown in experiments with three species of laboratory animals that an early administration (during the first hours following irradiation) of human recombinant interleukins 1 alpha and 1 beta separately (to mice, rats) or in combination with antibiotic therapy (dogs) substantially increases survivability, favours a more rapid regeneration of the cellular content of the bone marrow and peripheral blood, intensifies the processes of endogenous colony formation and DNA synthesis in the bone marrow and liver and lowers the expressivity of radiation-induced endotoxemia. The significance of using cytokines in the system of remedial measures in radiation pathology is discussed.

[An interleukin-1 beta efficacy study in the treatment of combined radiation-thermal lesions]. / Issledovanie éffektivnosti interleikina-1 beta pri lechenii kombinirovannykh radiatsionno-termicheskikh porazhenii.

The experiments were carried out on F1 (CBA x C57B16) male-mice. It was shown that, in contrast to a therapeutic effect of IL-1 for the solely irradiated mice, a single subcutaneous injection of 100 micrograms/kg recombinant human IL-1 beta in 4 h after a combined radiation-thermal injury (CRTI) increased significantly the death rate of the animals within the first 2-4 days. Administration of 150 ng IL-1 per mouse in 4, 24, or 48 h after the CRTI decreased an average life-span of mice. A single injection of cytokine in 5 days after the CRTI increased the survival rate by 45%. Repeated injections IL-1 with a dose of 100 pg per mouse in 2, 4, and 6 days after the CRTI did not aid in the haematological indices and did not affect the survival rate of the animals.

[The use of recombinant human interleukin-1 alpha and -1 beta as agents in the early treatment of acute radiation sickness in an experiment]. / Primenenie rekombinantnykh interleikinov-1 al'fa i -1 beta cheloveka v kachestve sredstv rannego lecheniia ostroi luchevoi bolezni v éksperimente.

Human recombinant interleukins 1 alpha and 1 beta (IL-1 alpha and IL-1 beta) have a good dose-dependent therapeutic effect for an acute radiation damage. For mice, the optimum therapy dose of IL-1 is 100.0 micrograms/kg-1 (survival rates: CD70--50%, CD100--17%; p < 0.05). For dogs, the dose is 1.0 microgram/kg-1 (survival rate: CD100 in combination with antibacterial therapy-up to 80%; p < 0.05).

Effects of exogenous cytokines on intravascular clearance of bacteria in normal and splenectomized mice.

BACKGROUND: Pretreatment with interleukin-1 (IL-1), granulocyte colony-stimulating factor (G-CSF), and granulocyte macrophage colony-stimulating factor (GM-CSF) can improve alveolar macrophage bactericidal activity against pneumococci. These effects vary in eusplenic and asplenic mice. Likewise, these cytokines have been shown to improve survival after an aerosol pneumococcal challenge. Mice dying in these studies had positive blood cultures and disseminated infection. The purpose of this study was to determine the effect of cytokine pretreatment on intravascular clearance of bacteria from eusplenic and asplenic mice. METHODS: Two weeks after splenectomy or sham operation, mice were pretreated for various times with IL-1, G-CSF, or GM-CSF or their corresponding vehicles. Mice then received tail-vein injections of bacteria (0.1 mL), and quantitative blood cultures were performed 15 and 30 minutes thereafter. RESULTS: Splenectomized mice had impaired clearance of both pneumococci and Pseudomonas compared with sham-operated mice (p < 0.05). IL-1 enhanced clearance in splenectomized mice (p < 0.001) but not in sham-operated mice (p not significant). G-CSF enhanced bacterial clearance in sham-operated mice (p < 0.01) but not in splenectomized mice (p not significant). GM-CSF enhanced clearance in both groups (p < 0.001). CONCLUSION: The net effects of exogenous cytokine therapy for infections depends on the state of the host defenses at the time of therapy. These agents may be useful as adjuvants for the treatment of infections, but further study is warranted.

Phase II study of dual 131I-labeled monoclonal antibody therapy with interferon in patients with metastatic colorectal cancer.

The combination of COL-1 (anti-CEA) and CC49 (anti-TAG-72) has shown an increase in binding and distribution in colon cancer by immunoperoxidase staining compared to either antibody alone. To overcome tumor heterogeneity and allow delivery of higher radiation dose, 131I-labeled COL-1 and CC49 at a total dose of 75 mCi/m2 (2775 MBq/m2) were simultaneously administered to 14 patients with metastatic colon cancer. alpha-IFN (3 x 10(6) IU) was given s.c. on days -5 to +3 to increase carcinoembryonic antigen and TAG-72 antigen expression. Most patients had mild symptoms during IFN therapy, including mild neutropenia, fever, and malaise, which rapidly subsided after IFN cessation. No acute allergic reactions occurred with radioimmunotherapy; two patients experienced transient, delayed grade 2 arthralgias. Transient neutropenia and/or thrombocytopenia, which was maximal at 4-6 weeks, were consistent side effects without adverse events. All patients had tumor localization, and 13 of 14 patients achieved 4+ (highest grade) localization readings to at least one known site of disease. No objective responses occurred; 4 patients were stable and 10 progressed. Tumor dose estimates varied from 393 to 1327 cGy, including liver and extrahepatic sites. Combining two complementary antibodies and IFN administration appeared to increase localization intensity and radiation doses at tumor sites as compared to historical controls. The amount of radiation delivered to tumor sites was still below that required to cause tumor regressions in metastatic colorectal cancer.

A method for the detection of erythrocyte-bound interleukin-8 in humans during interleukin-1 immunotherapy.

Interleukin-8 (IL-8) has been recently shown to bind to human erythrocytes with high affinity and is therefore potentially difficult to detect in serum or plasma. IL-8 is transiently elevated in the serum of baboons after the administration of interleukin-1 alpha (IL-1 alpha). The objective of this study was to investigate whether IL-8 can be detected in the plasma or in detergent-lysed erythrocytes from cancer patients undergoing treatment with IL-1 alpha. Using a specific radioimmunoassay (RIA), plasma IL-8 was detected within 1-2 h after the first IL-1 alpha infusion. Thereafter, the levels declined rapidly and after 4-8 h were undetectable. Erythrocyte-bound IL-8 was detectable 1-2 h after the increase in plasma levels. The erythrocyte-bound IL-8 levels were higher than those measured in plasma and remained elevated long after the plasma levels had become undetectable. Erythrocyte membranes accounted for all of the erythrocyte-associated IL-8, as IL-8 was undetectable in the cytosol after erythrocyte lysis. The assay used in these studies detects IL-8 in erythrocyte lysates when it cannot be measured in plasma and may therefore be useful in monitoring IL-8 production in vivo.

Cytokine production in whole blood cell cultures of patients undergoing therapy with biological response modifiers or 5-fluorouracil.

We have measured the levels of interferon gamma (IFN gamma), tumor necrosis factor alpha (TNF alpha), interleukin-1 alpha (IL-1 alpha), IL-1 beta, and IL-2 in the whole blood cell culture supernatants of 43 tumor patients undergoing a treatment with biological response modifiers or a conventional therapy with 5-fluorouracil and leucovorin. In the blood cell cultures of the 16 patients who received 5-fluorouracil and leucovorin IFN gamma levels decreased (P < or = 0.01) and TNF alpha levels rose (P < or = 0.05) during each therapy cycle. However, in the blood samples a declining number of total leukocytes and lymphocytes was measured (P < or = 0.05). Progressive disease could be correlated to a tendency towards lower IFN gamma levels in the pretherapeutic cultures of these patients. The second group analyzed consisted of 8 patients receiving a low-dose IL-1 beta therapy. In this group we found either an unchanged or an augmented IFN gamma production of the blood cells during treatment. In the group of 13 patients receiving low-dose recombinant IL-2 (< or = 4.5 x 10(6) IU m-2 day-1) significantly increasing IFN gamma levels were seen in the blood cell cultures during the therapy (P < or = 0.05), although total leukocyte counts decreased. In this group, 4 had stable disease for at least 2 months and 9 patients had tumor progression under therapy. In the cultures of the latter a tendency towards lower IFN gamma values was found. Finally, the cytokine production in the blood cell cultures of 6 patients receiving a combination therapy of IFN alpha and high-dose IL-2 was studied. During this therapy a dramatically reduced production not only of IFN gamma but also of all other measured cytokines was found. In this group all patients had tumor progression under therapy. It is concluded that the measurements of cytokine production in a reproducible whole blood culture system may be useful for monitoring immunological therapies and may help us to find out which doses of biological response modifiers have enhancing or suppressive effects on the functions of the immune cells.

Involvement of superoxide dismutase and glutathione peroxidase in attenuation of radiation-induced hyperthermia by interleukin-1 alpha in rats.

Pretreatment with recombinant human interleukin-1 alpha (rhIL-1 alpha) 20 h before irradiation attenuates radiation-induced hyperthermia. Experiments were conducted to determine the role of antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GSHPx) in rhIL-1 alpha-induced attenuation of radiation-induced hyperthermia. Radiation exposure increased SOD and decreased GSHPx levels in the hypothalamus, while treatment with rhIL-1 alpha increased GSHPx levels and had no effect on SOD levels. However, rhIL-1 alpha and irradiation together increased hypothalamic SOD level but prevented the fall in GSHPx level. Our results suggest that attenuation of radiation-induced hyperthermia by rhIL-1 alpha may involve stimulation of SOD and GSHPx because rhIL-1 alpha treatment and irradiation together increased hypothalamic GSHPx and SOD levels, and intracerebroventricular administration of SOD and GSHPx attenuated the radiation-induced hyperthermia.

Antitumor effect of interleukin 1 alpha in combination with hyperthermia.

The combined effects of interleukin-1 alpha (IL-1 alpha) and hyperthermia on SCK tumors grown in the legs of A/J mice were investigated. When the host mice were given i.p. injections of 25 micrograms/kg IL-1 alpha, the tumor blood perfusion, as measured with the 86Rb uptake method, significantly declined, reaching minimum blood perfusion in 3-5 h. Although the tumor blood perfusion started to rise thereafter, the recovery was still incomplete 1 day later. Hyperthermia at 42.5 degrees C or 43.5 degrees C for 1 h also caused a marked decline in tumor blood perfusion. When the tumors were heated 5 h after an i.p. injection of IL-1 alpha at 25 micrograms/kg, at which time the tumor blood perfusion was low, the tumor blood perfusion decreased further. The heating of tumors at 42.5 degrees C or 43 degrees C for 1 h significantly reduced the clonogenic cell number in the tumors, delayed the tumor growth, and prolonged the survival time of host animals. The antitumor effect of 25 micrograms/kg IL-1 alpha alone, as judged from the clonogenic cell number, tumor growth delay, and host survival, was smaller than that of hyperthermia. When the host mice were treated with IL-1 alpha and the tumors were heated 5 h later, the decline in the clonogenic tumor cell number, tumor growth delay, and prolongation of host survival were significantly greater than those produced by either treatment alone. It was concluded that the prior reduction of blood perfusion by IL-1 alpha potentiated the antitumor effect of subsequent heatings.

Endotoxin or cytokines attenuate ozone-induced DNA synthesis in rat nasal transitional epithelium.

Pretreatment of rats with endotoxin (E), a potent inducer of tumor necrosis factor alpha (TNF), and interleukin 1 beta (IL 1), or a combination of TNF and IL1, has been shown to increase levels of lung antioxidant enzymes and protect against pulmonary toxicity associated with hyperoxia. Inhalation of ozone (O3) induces cell injury, followed by increased DNA synthesis, cell proliferation, and secretory cell metaplasia in rat nasal transitional epithelium (NTE). This study was designed to test the effects of E, TNF, and IL1 pretreatment on acute O3-induced NTE cell injury as measured by changes in NTE cell DNA synthesis. Rats were exposed to either 0.8 ppm O3 or air for 6 hr in whole-body inhalation chambers. Immediately before exposure, rats in each group were injected intraperitoneally (ip) with either saline alone or saline containing E (1 microgram/g body wt), TNF (10 micrograms), IL1 (10 micrograms), or both TNF and IL1 (TNF/IL1; 10 micrograms each). Eighteen hours postexposure, rats were injected ip with bromodeoxyuridine (BrdU; 50 micrograms/g body wt) to label cells undergoing DNA synthesis and were euthanized 2 hr later. NTE was processed for light microscopy and immunochemically stained to identify cells that had incorporated BrdU into nuclear DNA. The number of BrdU-labeled NTE nuclei per millimeter of basal lamina was quantitated. There were no significant differences in the number of BrdU-labeled NTE nuclei in air-exposed rats that were injected with E, TNF, IL1, or TNF/IL1 compared with those in saline-injected, air-exposed controls. Rats that were injected with saline and exposed to O3 had approximately 10 times the number of BrdU-labeled NTE nuclei than saline-injected, air-exposed control rats. O3 exposure also induced a significant increase in labeled nuclei in rats that were pretreated with TNF alone. In contrast, pretreatment with E, IL1, or TNF/IL1 attenuated the O3-induced increase in NTE DNA synthesis. These results indicate that both E and the cytokines TNF and IL1 have physiologic effects that can attenuate O3-induced injury or modify the response to NTE cells to O3 exposure.