The Role of Omalizumab in NSAID-Exacerbated Respiratory Disease: A Narrative Review.

Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is a condition characterized by the triad of chronic rhinosinusitis with nasal polyps, bronchial asthma, and hypersensitivity to nonsteroidal anti-inflammatory drugs. This article explores the current knowledge on the various pathological mechanism(s) of N-ERD-such as arachidonic acid metabolism, cysteinyl leukotrienes, prostaglandins, platelets, IgE, mast cells, eosinophils, basophils, and innate immune system-and the role of omalizumab in its management. The authors dive deep into the role of IgE in N-ERD and its potential as a therapeutic target. IgE plays a significant role in mediating allergic reactions, is intricately linked with mast cells, interacts with multiple immunopathological pathways involved in N-ERD, and tends to be elevated in patients with N-ERD. Multiple real-world studies, observational studies, and case series, as well as 2 phase III trials, have demonstrated the effectiveness of omalizumab in the management of N-ERD. For a disease with such a well-documented history, the pathophysiology of N-ERD and the most effective ways to manage it remain a mystery. With this background, the authors ask-is IgE a missing piece of the N-ERD puzzle, thus explaining the efficacy of omalizumab in the treatment of the disease?

The microRNA processing subunit DGCR8 is required for a T cell-dependent germinal center response.

We have previously shown that the microRNA (miRNA) processor complex consisting of the RNAse Drosha and the DiGeorge Critical Region (DGCR) 8 protein is essential for B cell maturation. To determine whether miRNA processing is required to initiate T cell-mediated antibody responses, we deleted DGCR8 in maturing B2 cells by crossing a mouse with loxP-flanked DGCR8 alleles with a CD23-Cre mouse. As expected, non-immunized mice showed reduced numbers of mature B2 cells and IgG-secreting cells and diminished serum IgG titers. In accordance, germinal centers and antigen-specific IgG-secreting cells were absent in mice immunized with T-dependent antigens. Therefore, DGCR8 is required to mount an efficient T-dependent antibody response. However, DGCR8 deletion in B1 cells was incomplete, resulting in unaltered B1 cell numbers and normal IgM and IgA titers in DGCR8-knock-out mice. Therefore, this mouse model could be used to analyze B1 responses in the absence of functional B2 cells.

Mechanistic aspects of carotenoid health benefits - where are we now?

Dietary intake and tissue levels of carotenoids have been associated with a reduced risk of several chronic diseases, including cardiovascular diseases, type 2 diabetes, obesity, brain-related diseases and some types of cancer. However, intervention trials with isolated carotenoid supplements have mostly failed to confirm the postulated health benefits. It has thereby been speculated that dosing, matrix and synergistic effects, as well as underlying health and the individual nutritional status plus genetic background do play a role. It appears that our knowledge on carotenoid-mediated health benefits may still be incomplete, as the underlying mechanisms of action are poorly understood in relation to human relevance. Antioxidant mechanisms - direct or via transcription factors such as NRF2 and NF-κB - and activation of nuclear hormone receptor pathways such as of RAR, RXR or also PPARs, via carotenoid metabolites, are the basic principles which we try to connect with carotenoid-transmitted health benefits as exemplified with described common diseases including obesity/diabetes and cancer. Depending on the targeted diseases, single or multiple mechanisms of actions may play a role. In this review and position paper, we try to highlight our present knowledge on carotenoid metabolism and mechanisms translatable into health benefits related to several chronic diseases.

Handling wine pomace: The importance of drying to preserve phenolic profile and antioxidant capacity for product valorization.

Four different wine grape pomaces (GP) (Vitis vinifera) varieties, Auxerrois, Pinot Blanc, Gamay and Pinot Noir, and obtained from white, rosé or red wine vinification, were considered for possible valorization in food supplement industry. Stabilization of GP by drying is paramount prior to further processing in the valorization chain, as GP might suffer spoilage over time. The objectives of this work were therefore to: evaluate the effect of microbiological spoilage and drying on the polyphenol profile and antioxidant capacity of GP; define a drying procedure by comparing kinetics of freeze-drying (FD) and vacuum oven (VO) (at 60 °C and 40 °C). Microbiological spoilage led to significant losses (P < 0.01) of antioxidant capacity (40% to 87%) and total phenolic content (70% to 90%), while drying had no significant effect. FD and VO at 60 °C drying kinetics exhibited similar drying curves, and a dry weight (DW) plateau was reached by 48 hr. In contrast VO at 40 °C required 170 hr to reach similar DW values, pointing out the importance of temperature when opting for VO technology. Antioxidant capacity of GP extracts did not differ between drying methods. Interestingly, GPs from white and rosé wines (AUX, PB, and GAM) had up to 3.5 times higher content (P < 0.001) of total polyphenols compared to PN, obtained from red wine. These results reinforce the importance of drying of GP as a pretreatment, which otherwise could result in significant product degradation. Additionally, we propose white and rosé GP as more interesting sources for valorization, with higher phenolic content, compared to red wine GP.

From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations.

There is uncertainty regarding carotenoid intake recommendations, because positive and negative health effects have been found or are correlated with carotenoid intake and tissue levels (including blood, adipose tissue, and the macula), depending on the type of study (epidemiological vs intervention), the dose (physiological vs supraphysiological) and the matrix (foods vs supplements, isolated or used in combination). All these factors, combined with interindividual response variations (eg, depending on age, sex, disease state, genetic makeup), make the relationship between carotenoid intake and their blood/tissue concentrations often unclear and highly variable. Although blood total carotenoid concentrations <1000 nmol/L have been related to increased chronic disease risk, no dietary reference intakes (DRIs) exist. Although high total plasma/serum carotenoid concentrations of up to 7500 nmol/L are achievable after supplementation, a plateauing effect for higher doses and prolonged intake is apparent. In this review and position paper, the current knowledge on carotenoids in serum/plasma and tissues and their relationship to dietary intake and health status is summarized with the aim of proposing suggestions for a "normal," safe, and desirable range of concentrations that presumably are beneficial for health. Existing recommendations are likewise evaluated and practical dietary suggestions are included.

miR-148a controls metabolic programming and survival of mature CD19-negative plasma cells in mice.

Long-lived antibody-secreting plasma cells are essential to establish humoral memory against pathogens. While a regulatory transcription factor network has been established in plasma cell differentiation, the regulatory role of miRNAs remains enigmatic. We have recently identified miR-148a as the most abundant miRNA in primary mouse and human plasma cells. To determine whether this plasma cell signature miRNA controls the in vivo development of B cells into long-lived plasma cells, we established mice with genomic, conditional, and inducible deletions of miR-148a. The analysis of miR-148a-deficient mice revealed reduced serum Ig, decreased numbers of newly formed plasmablasts and reduced CD19-negative, CD93-positive long-lived plasma cells. Transcriptome and metabolic analysis revealed an impaired glucose uptake, a reduced oxidative phosphorylation-based energy metabolism, and an altered abundance of homing receptors CXCR3 (increase) and CXCR4 (reduction) in miR-148a-deficient plasma cells. These findings support the role of miR-148a as a positive regulator of the maintenance of long-lived plasma cells.

Interaction of divalent minerals with liposoluble nutrients and phytochemicals during digestion and influences on their bioavailability - a review.

Several divalent minerals, including the macroelements calcium and magnesium, are essential nutrients for humans. However, their intake, especially via high-dose supplements, has been suspected to reduce the availability of lipophilic dietary constituents, including lipids, liposoluble vitamins, and several phytochemicals such as carotenoids. These constituents require emulsification in order to be bioavailable, and high divalent mineral concentrations may perturb this process, due to precipitations of free fatty acids or bile salt complexation, both pivotal for mixed micelle formation. Though in part based on in vitro or indirect evidence, it appears likely that high-dose supplements of divalent minerals around or even below their recommended dietary allowance perturb the availability of certain liposoluble miroconstituents, in addition to reducing absorption of dietary lipids/cholesterol. In this review, we investigate possible negative influences of divalent minerals, including trace elements (iron, zinc), on the digestion and intestinal uptake of lipophilic dietary constituents, with a focus on carotenoids.

Magnesium affects spinach carotenoid bioaccessibility in vitro depending on intestinal bile and pancreatic enzyme concentrations.

Magnesium may reduce carotenoid bioavailability by forming insoluble complexes with bile salts/fatty acids, inhibiting micelle formation. Here, we investigated whether altering bile/pancreatin concentration influenced potential negative effects of magnesium on carotenoid bioaccessibility. Spinach (4g) was digested in vitro with added magnesium (0, 200, 400mg/L) and canola oil/coffee creamer, at varying bile extract (1 or 8mM) and pancreatin (100 or 990mg/L) concentrations. Bioaccessibility was determined for ß-carotene, lutein, and total carotenoids via HPLC. Additionally, lipolysis, particle size, and zeta potential of the micellar fractions were investigated. Increasing magnesium concentrations negatively affected carotenoid bioaccessibility (p<0.001), lipolysis, particle size and zeta potential. The impact of magnesium on carotenoid bioaccessibility was modulated mainly by bile concentration, with samples digested with 1mM of bile being more susceptible to inhibitory effects of magnesium than those digested with 8mM (p<0.001). Thus, magnesium was found to potentially interfere with carotenoid bioaccessibility at various physiologically plausible conditions.

A new staining protocol for detection of murine antibody-secreting plasma cell subsets by flow cytometry.

We provide a robust four-color fluorescence-based flow cytometry protocol that distinguishes viable dividing plasmablasts from nondividing plasma cells and, based on CD19 surface abundance, identifies two mature plasma cell populations in the spleen and the bone marrow of mice.

No influence of supplemental dietary calcium intake on the bioavailability of spinach carotenoids in humans.

Dietary carotenoid intake, especially from fruits and vegetables, has been associated with a reduced incidence of several chronic diseases. However, its bioavailability can vary, depending on the food matrix and host factors. Recently, it has been suggested that divalent minerals negatively impinge on carotenoid bioavailability by reducing bile-salt and non-esterified fatty-acid levels in the gut, which normally aid in emulsifying carotenoids. The aim of the present study was to investigate whether supplemental Ca would negatively influence carotenoid absorption in humans. A total of twenty-five healthy, non-obese men (age: 20-46 years, BMI<30 kg/m2) were recruited for this postprandial, randomised, crossover, double-blinded trial. Following a randomised block design, each participant received (after 2-week washout periods), on three occasions separated by 1 week, 270 g of spinach-based meals (8·61 (sd 1·08) mg carotenoids/100 g fresh weight), supplemented with 0, 500 or 1000 mg of Ca (as calcium carbonate), with each participant acting as his or her own control. Blood samples were collected at regular postprandial intervals for up to 10 h following test meal intake, and standardised lunches were served. TAG-rich lipoprotein fractions were separated and carotenoid concentrations determined. AUC for meals without supplemented Ca were 22·72 (sem 2·78) nmol×h/l (lutein), 0·19 (sem 3·90) nmol×h/l (ß-carotene) and 2·80 (sem 1·75) nmol×h/l (ß-cryptoxanthin). No significant influence of supplementation with either 500 or 1000 mg of supplemental Ca was found. In conclusion, Ca - the most abundant divalent mineral in the diet - given at high but physiological concentrations, does not appear to have repercussions on the bioavailability of carotenoids from a spinach-based meal.

Bioaccessibility of phytoene and phytofluene is superior to other carotenoids from selected fruit and vegetable juices.

Phytoene and phytofluene are major abundant dietary carotenoids largely ignored in the context of agro-food and health. The bioaccessibility of phytoene and phytofluene in tomato, carrot, blood orange (sanguinello cultivar), and apricot juices was analysed following simulated gastro-intestinal digestion with coffee cream as a lipid source, and compared with that of other main carotenoids from these matrices. The bioaccessibility of phytoene and phytofluene, and also total carotenoid bioaccessibility, followed the order: sanguinello>apricot>tomato>carrot. Phytoene was consistently the carotenoid with the highest bioaccessibility, up to 97%, generally followed by phytofluene. The higher bioaccessibility of these carotenoids could mainly be due to their marked difference in chemical structure and matrix distribution. For most juices, cis-isomers presented a higher bioaccessibility than their all-trans counterparts (P<0.05). The dietary source that provided highest amounts of potentially absorbable phytoene/phytofluene was by far tomato juice (5mg/250mL juice).

Negative effects of divalent mineral cations on the bioaccessibility of carotenoids from plant food matrices and related physical properties of gastro-intestinal fluids.

Carotenoid intake and tissue levels have been frequently associated with reduced risk of chronic diseases. However, their bioavailability is low and influenced by many dietary related parameters. Divalent mineral cations have been suggested to interfere with carotenoid digestion and to hamper micellarization, a prerequisite for their uptake, via complexation of bile salts and precipitation of fatty acids. In the present investigation, we have evaluated the effects of increasing concentrations of magnesium (0-300 mg L-1), calcium (0-1500 mg L-1), zinc (0-200 mg L-1), and sodium (0-1500 mg L-1; control monovalent cation), on carotenoid bioaccessibility from frequently consumed food items rich in carotenoids (tomato juice, carrot juice, apricot nectar, spinach and field salad), following simulated gastro-intestinal digestion. In addition, physicochemical parameters of digesta (macroviscosity, surface tension), micelle size, and zeta-potential were evaluated. All divalent minerals (DM) reduced bioaccessibility of total carotenoids (P < 0.01), as well as of individual carotenoids. Calcium and magnesium led to reductions of up to 100% at the 2 highest concentrations. Curiously, sodium increased (P < 0.01) carotenoid bioaccessiblity of most investigated matrices. The absolute value of the zeta-potential decreased with increasing concentrations of DM, suggesting a decreased stability of the colloidal digesta dispersion. Viscosity decreased, except for apricot nectar samples, while surface tension increased with DM concentration (P < 0.05). Thus, at physiological ranges, calcium and magnesium could negatively impact carotenoid bioavailability, while for zinc, negative effects were only seen at supplemental concentrations. The potential negative effects of DM on carotenoid bioavailability should be further studied in vivo.

Effect of divalent minerals on the bioaccessibility of pure carotenoids and on physical properties of gastro-intestinal fluids.

During digestion, high concentrations of divalent minerals (DMs) can lead to insoluble lipid-soap complex formation, hampering carotenoid bioaccessibility. The effect of varying concentrations (0-1000 mg/L) of calcium, magnesium, zinc and sodium (control) on the bioaccessibility of lutein, neoxanthin, lycopene and ß-carotene, following in vitro gastro-intestinal digestion (GI), was investigated systematically and coupled with physical measurements of the digesta. Addition of DMs significantly decreased (p<0.001) carotenoid bioaccessibility, up to 100% in the case of calcium. Mean half maximal inhibitory concentrations (EC50) for calcium, magnesium and zinc were 270±18, 253±75 and 420±322 mg/L respectively. Increased DM concentrations correlated with decreased viscosity (r>0.9) and decreased carotenoid bioaccessibility. Surface tension of digesta correlated inversely (p<0.05) with the bioaccessibility of carotenoids. This correlation was mineral and carotenoid dependent. Although based on in vitro findings, it is plausible that similar interactions occur in vivo, with DMs affecting the bioaccessibility and bioavailability of carotenoids and other lipophilic micronutrients and phytochemicals.

Chlorophylls and carotenoids of kiwifruit puree are affected similarly or less by microwave than by conventional heat processing and storage.

The impact of microwave (1000 W - 340 s) and conventional heat (97 °C - 30s) pasteurisation and storage (4, 10, 22 °C for up to 63 d) on total and individual carotenoids and chlorophylls in kiwifruit puree was evaluated. Bioaccessibility of carotenoids, before and after pasteurisation and storage, was also studied. Microwaves and conventional heating led to marked changes in the chlorophyll (42-100% losses) and carotenoid (62-91% losses) content. First- and second-order kinetics appropriately explained the degradation of total carotenoids and chlorophylls over time, respectively. Pasteurised samples showed significantly (p < 0.05) enhanced stability of these pigments, with microwaves (k = 0.007-0.031100 g mg(-1) day(-1) at 4-22 °C) promoting chlorophyll stability to a greater extent than conventional heating (k = 0.0015-0.034100 g mg(-1) day(-1) at 4-22 °C). Bioaccessibility of carotenoids remained (p < 0.05) unaffected by processing and storage. These results highlighted that the pigment composition of microwaved kiwifruit was more similar to that of the fresh fruit and better preserved during storage.

miR-148a promotes plasma cell differentiation and targets the germinal center transcription factors Mitf and Bach2.

B cells undergo affinity maturation and class switch recombination of their immunoglobulin receptors during a germinal center (GC) reaction, before they differentiate into long-lived antibody-secreting plasma cells (PCs). Transcription factors such as Bach2 and Mitf are essential during this process, as they delay premature differentiation of GC B cells by repressing Blimp-1 and IRF4, two transcription factors required for terminal PC differentiation. Therefore, Bach2 and Mitf expression must be attenuated in activated B cells to allow terminal PC differentiation, but the precise mechanism remains enigmatic. Here, we provide evidence that miR-148a, a small noncoding microRNA, fosters PC differentiation and survival. Next-generation sequencing revealed that miR-148a is the most abundant microRNA in primary human and murine PCs, and its expression is upregulated in activated murine B cells and coincides with Blimp-1 synthesis. miR-148a targets Bach2, Mitf and proapoptotic factors such as PTEN and Bim. When prematurely expressed, miR-148a promotes the differentiation and survival of plasmablasts and reduces frequencies of IgG1(+) cells in primary B-cell cultures. In summary, we propose that miR-148a is a new player in the regulatory network controlling terminal PC differentiation and could, therefore, be a therapeutic target for interfering with PC differentiation and survival.

Selective factors governing in vitro ß-carotene bioaccessibility: negative influence of low filtration cutoffs and alterations by emulsifiers and food matrices.

Because of their putative health benefits, the biological fate of carotenoids after digestion has been met with much interest, and ex vivo methods using carotenoid standards to study their digestion and further metabolism have been developed. In the absence of a complex food matrix, that is, when studying isolated carotenoids, protocol conditions of gastrointestinal digestion models have to be adjusted. In this investigation, we hypothesized that certain selected factors would significantly influence the bioaccessibility of ß-carotene in vitro. The factors considered included (i) type of lipid matrix employed (milk, cream, or oil), (ii) presence/absence of emulsifiers (e.g. lecithin and taurocholate), (iii) addition of a gastric lipase, and (iv) final filtration (20 or 200 nm) of the digesta. Adding an emulsifier mixture (10 mg lecithin + 50 mg monoolein + 5 mg oleic acid) enhanced ß-carotene bioaccessibility 3 times (P < 0.001), whereas additional taurocholate and the presence/absence of gastric lipase added before intestinal digestion had no significant effect. ß-Carotene bioaccessibility was superior with oil than with milk (18.8% ± 0.7% and 6.1% ± 0.7%, respectively; P = 0.03), especially after filtration, thus suggesting incomplete micelle formation after addition of milk. Filtration through 20 nm filters reduced carotenoid concentration in the aqueous fraction (from 7.1% ± 0.2% to 5.5% ± 0.2% in samples digested with canola oil, P < 0.001), indicating that not all formed micelles compared in size with those normally formed in vivo. When studying carotenoid standards during in vitro digestion, care should be taken to separate mixed micelles by filtration, and the choice of emulsifier and matrix should be considered.

Autoimmunity triggers in the NOD mouse: a role for natural auto-antibody reactivities in type 1 diabetes.

The nonobese diabetic mouse (NOD) is widely used as a model to study human type 1 diabetes (T1D). In the NOD mouse T1D is a T cell-mediated autoimmune disease of complex etiology in which B cells play an essential role. One of the major unresolved issues in T1D is the genetic and/or environmental factors that trigger the autoimmune reaction. In the NOD mouse, as in humans, auto-antibodies to pancreatic islets are present at early ages and are highly correlated to diabetes progression, but their etiological role has long been disputed. NOD auto-antibodies have the characteristics of a natural repertoire, and B1 cells, the main natural antibody producers, exhibit functional differences in this strain that could have consequences for disease determination. Using a genetic approach, we propose to test if the NOD natural auto-antibody repertoire includes innate reactivities that participate in diabetes pathogenesis by promoting insulitis initiation.