Role of chemokines in severe asthma.

The severe asthma phenotype is exhibited by a subset of asthma patients whose asthma symptom is poorly controlled by current therapies. Severe asthma represents a high unmet medical need and warrants research into the mechanisms driving the underlying pathophysiology. It is hypothesized that the underlying pathology associated with severe asthma is driving the symptoms experienced by these patients, which may share common features with mild to moderate asthma or may represent a unique pathological phenotype. For the purpose of this review, the pathophysiology associated with asthma in general are described and extended to incorporate severe asthma. Chemokines may contribute towards multiple features of asthma pathophysiology and this current review focuses on the biology of chemokines pertaining to asthma pathophysiology. Chemokines are important recruiters and activators of inflammatory cells and these infiltrating cells interact with resident cells, such as fibroblasts and it is through these pathways that chemokines appear to exert multiple biological actions. Clinical trials are underway with therapeutics targeting chemokine pathways for other inflammatory diseases. It is hoped that the information generated from these studies will contribute towards furthering our understanding of chemokine biology and be applied towards targeting severe asthma.

Stimulation of hemolysin plaque-forming cells by idoxuridine.

5-Iodo-2'-deoxyuridine markedly stimulates the production of hemolysin plaque-forming cells (HPFC) to sheep red blood cells in C3HeB/FeJ and A/J male and female mice. The degree of stimulation is dose dependent over a range of 50 to 200 mg/kg. Stimulation is observed when drug is given on the day of antigen administration, or up to 3 days thereafter, but not when given before antigen administration or 4 days thereafter. The stimulatory effect of IUdR given on day 2 after antigen is still noted on Day 15, but the time of HPFC production is not prolonged beyond that in controls. Both 19S and 7S HPFC are increased, although the effect on the latter is less pronounced. In addition to stimulating production of HPFC in immunized animals, 5-iodo-2'-deoxyuridine increases background HPFC production in nonimmunized mice by 250% when assayed on the day after treatment.

Correction of a murine mammary tumor virus-associated immunological depression by selective immunosuppression with cytosine arabinoside.

Mammary tumor virus (MTV) infection has been shown to be associated with a diminished hypersensitive reaction to methylated bovine serum albumin. Since methylated bovine serum albumin-induced hypersensitivity appears to be a mixed [humoral versus cell-mediated immunity (CMI)] reaction, the deficit in reactivity could be caused by, among other things, a direct depression of CMI or an increase in a humoral, blocking component. Assay of oxazolone-induced contact sensitivity and phytohemagglutinin-induced lymphocyte stimulation revealed normal or greater than normal CMI in MTV-positive animals. Treatment of MTV-positive and -negative animals with a regimen of cytosine arabinoside designed to inhibit only humoral immunity and leave CMI intact, corrected the deficit in methylated bovine serum albumin reactivity in MTV-positive mice. Thus, it is suggested that MTV infection may facilitate the production of interfering or blocking humoral immunity.

A high performance liquid chromatography assay for the rapid analysis of the subunit content of concanavalin A.

A high performance liquid chromatography system is described which provides a rapid and convenient assay for the relative amounts of intact (26000 dalton) and fragmented (14000 and 12000 dalton) subunits present in preparations of concanavalin A. Analyses were performed on an HPLC size exclusion column using either 8M urea or 6M guanidine hydrochloride as denaturing eluents. The efficiency and resolving power of this technique were confirmed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. This HPLC assay facilitated the monitoring of the purification of concanavalin A to prepare a homogeneous preparation necessary for its biological evaluation.

Monoclonal antibodies as a strategy for pulmonary diseases.

Monoclonal antibodies have been used successfully to elucidate the roles of putative mediators of pulmonary disease. In particular, clinical trials with monoclonal antibodies directed against interleukin-5, IgE or CD4 yielded results that were critical in dissecting the pathophysiology of asthma; but, more importantly, fundamental changes in the discovery, manufacture and safety of monoclonal antibodies have reinforced the enormous potential of these agents in treating pulmonary diseases. An unprecedented number of monoclonal antibodies are in development for a variety of acute and chronic conditions. Moreover, whereas only two monoclonal antibodies had received regulatory approval from the United States Food and Drug Administration between 1986 and 1997, seven more have received approval since then. Indeed, monoclonal antibody therapy has come of age.

Induction of suppressor cells, interleukin-2 production and mitogenesis with monomeric concanavalin A: different actions of tetrameric and monomeric concanavalin A.

The ability of a photoalkylated monomeric concanavalin A (Con A) derivative to induce mitogenesis, interleukin-2 (IL-2) production and suppressor cells in murine spleen cell cultures has been compared with the activity of native, tetrameric Con A. The monomeric derivative was prepared by photochemically induced alkylation of tryptophan residues of tetravalent Con A in the presence of chloroacetamide followed by sizing chromatography [Tanaka et al. (1981) J. Biochem. 89, 1643-1646]. The monomeric derivative appeared to display less mitogenic activity than the tetramer and was also less effective in inducing IL-2 production. No difference was detected between the monomeric and tetrameric forms of Con A in inducing suppressor cells. The data suggest that cross-linking and bridging via sugar-binding sites, while potentiating mitogenesis and IL-2 production, had little effect on suppressor cell induction.

Interleukin-8 production is regulated by protein kinase C in human keratinocytes.

Interleukin-8 (IL-8) is a potent pro-inflammatory molecule present in high amounts in psoriatic skin. Here it may play an important role in the keratinocyte hyperproliferation and the neutrophil and T-lymphocyte infiltration associated with the disease. In this study the effect of protein kinase C inhibitors on IL-8 production by human keratinocytes in vitro was investigated. The anti-inflammatory and immunomodulatory compound auranofin ([1-thio-beta-D-glucopyranose-2,3,4,6-tetraacetato-S] [triethylphosphine] gold) is known to inhibit protein kinase C. In addition, auranofin has been shown to inhibit skin inflammation. As such, auranofin was also studied for its effect on IL-8 production. Auranofin and staurosporine, inhibitors of protein kinase C, inhibited phorbol-myristate-acetate-stimulated IL-8 production. Northern analysis of IL-8 mRNA revealed that the inhibition of IL-8 production was associated with an inhibition of IL-8 mRNA expression. In contrast, these compounds potentiated the minimal IL-8 protein and mRNA seen in response to interleukin-1 beta or tumor necrosis factor-alpha. These findings suggest that IL-8 synthesis may be either positively or negatively regulated by protein kinase C depending on the stimulus.

Intralesional cytokines in chronic oxazolone-induced contact sensitivity suggest roles for tumor necrosis factor alpha and interleukin-4.

An analysis was conducted of the cytokine profile and inflammatory response in oxazolone sensitized mouse skin. Following exposure to oxazolone, the intralesional production of inflammatory cytokines was demonstrable at the levels of both mRNA and protein. An initial challenge led to a transient increase in tumor necrosis factor-alpha production followed predominately by the T helper (Th)1 cytokine, interferon-gamma. There was a minimal production of interleukin-4, a Th2 cytokine. Continued exposure to oxazolone led to a downregulation of interferon-gamma and an upregulation of interleukin-4 production. A strong relationship was found between interleukin-4 and the inflammatory response, as measured by ear thickness. Similar experiments conducted in mast cell-deficient mice revealed reduced neutrophil influx but only minor changes in cytokine profile. An irritant response induced by chronic exposure of mouse skin to phorbol ester did not reveal any significant interferon-gamma or interleukin-4 response but was characterized by a tumor necrosis factor-alpha response that correlated with the inflammatory response. These observations suggest that the major source of interferon-gamma and interleukin-4 in the oxazolone response may be the infiltrating lymphocytes; whereas the tumor necrosis factor-alpha may result from the local irritation seen with both oxazolone and phorbol ester. At the end of 4 wk of chronic exposure to oxazolone, it was found that serum IgE levels had significantly increased. Histologic analysis of the skin lesion revealed that a mixed infiltrate including eosinophils developed upon repeat exposure to oxazolone. These findings are consistent with an early predominate Th1 response that is reduced and largely replaced with a Th2 response upon chronic T cell activation.

Activation of the IL-1 gene in UV-irradiated mouse skin: association with inflammatory sequelae and pharmacologic intervention.

The relationship between ultraviolet irradiation, interleukin-1 production, and inflammatory sequelae and the pharmacologic inhibition of these events was investigated in Balb/c mice exposed to ultraviolet irradiation from a bank of six Westinghouse FS40 sunlamps. The resulting edema (66% increase), inflammatory cell infiltration, and rise in the acute-phase reactant (fourfold) serum amyloid P component was preceded by the activation of the interleukin-1 beta gene and enhanced product formation. Administration of dexamethasone, which is known to inhibit interleukin-1 production, inhibited the inflammatory response to ultraviolet irradiation. Thus, production of interleukin-1 may be one of the initial events leading to the consequences of ultraviolet irradiation exposure.

Quantitative Western blot assay for measurement of the murine acute phase reactant, serum amyloid P component.

Quantitation of the murine acute-phase reactant, serum amyloid P component (SAP), by Western blot is described. The assay is sensitive, reliable and inexpensive. Electrophoresis in standard SDS-polyacrylamide gels (SDS-PAGE) effectively separates SAP from other serum proteins. Electrophoretic blotting of SAP from the SDS-PAGE onto nitrocellulose (NC) paper is followed by a bovine serum albumin 'blocking' wash and exposure to anti-SAP antibody. Subsequent incubation with radioiodinated protein A was followed by autoradiography, and SAP bands were cut from the NC paper and counted in a gamma counter. The utility of this method for quantitation of SAP in biological fluids was verified using sera from normal mice and mice undergoing an acute inflammatory response. The results confirm the elevation of SAP associated with acute inflammation. The sensitivity of this technique coupled with the minute volumes of biological sample required renders it of potential utility for SAP quantitation in a variety of inflammatory disease states.

Identification of live cells for flow cytometric analysis of lymphoid subset proliferation in low viability populations.

Combined analysis of single cell DNA content and immunofluorescence by flow cytometry is complementary to tritiated thymidine analysis of cellular proliferation, allowing detailed dissection of particular cell types in a mixed population which respond proliferatively to selective stimuli. However, in vitro culture of primary immune cells (e.g., mouse spleen or lymph node) for periods of 24-72 h frequently results in a considerable fraction of non-viable cells which bind antibodies non-specifically, resulting in altered immunofluorescence distributions, inaccurate distinctions between positive and negative cells, and sometimes in misleading DNA distributions. Forward angle light scatter cannot readily be used to distinguish live from dead cells in this case because of the heterogeneous size distributions characteristic of cultured populations. We describe a method which uses treatment with DNAase prior to immunofluorescence staining to allow more accurate distinction between live and dead cells. This treatment markedly reduces the intensity of DNA staining for non-viable cells, providing complete live/dead discrimination and improved ability to analyze the proliferative status of specific cell subtypes in low viability cultures.

Evaluation of human cytokine production and effects of pharmacological agents in a heterologous system in vivo.

The ability of human monocytes adoptively transferred into the peritoneal cavity of BALB/c mice to produce tumor necrosis factor-alpha (TNF) and interleukin 1 beta (IL-1) was studied. Human monocytes were isolated from fresh, heparinized blood obtained by venipuncture. BALB/c mice were administered 2-10 x 10(6) cells and challenged with lipopolysaccharide intraperitoneally. 2 h later, they were killed and a peritoneal washout was obtained. The washouts were assayed for TNF and, in some cases, IL-1 content using a species specific enzyme-linked immunosorbant assay (ELISA). This model allowed for the simultaneous evaluation of the production of mouse and human inflammatory cytokines. Significant levels of both human and mouse TNF were seen as early as 60 min after challenge. Peak levels for both were seen at 120 min post administration of LPS. Both human and mouse TNF concentrations declined at the 2 h time point. The phosphodiesterase type 4 inhibitor, R-rolipram was found to inhibit both human and mouse TNF production while SB CSAID, novel kinase inhibitor SB 203580 inhibited human IL-1 and TNF as well as mouse TNF. This model was reliable, reproducible and allowed evaluation of pharmacological agents for their effect on human cytokine production in a heterologous setting in vivo.

Human granulocyte CD11b expression as a pharmacodynamic biomarker of inflammation.

A method has been developed for the direct quantification of the CD11b integrin on granulocytes by flow cytometric analysis of whole blood specimens following either LTB(4) or lipopolysaccharide (LPS) stimulation. This method has utility in evaluating the pharmacodynamic action of either LTB(4) receptor antagonists or immune cell modulators in effecting CD11b integrin expression and granulocyte activation in human subjects administered such drugs. Previous studies using CD11b as a biomarker of granulocyte activation have faltered because of the difficulty in controlling the activation state of the granulocyte following removal of blood from subjects. The present study has made use of a newly validated method using either LTB(4) or LPS to stimulate CD11b expression on granulocytes and has been used, as one measure, in the evaluation of LPS activity when administered to normal human volunteers.

Biologic actions and pharmacokinetic studies of auranofin.

The preclinical profiles of auranofin (Ridaura), an oral chrysotherapeutic agent, parenteral gold sodium thiomalate, gold thioglucose, and their respective ligands were compared. Auranofin was more effective than gold sodium thiomalate in suppressing inflammation and stimulating cell-mediated immunity. In contrast to gold sodium thiomalate and gold thioglucose, auranofin inhibited cellular release of lysosomal enzymes, antibody-dependent cellular cytotoxicity, production of antibodies in adjuvant arthritic rats, and antibodies involved in cytotoxicity reactions. The respective ligands were without significant biologic activity. In rats, a higher fraction of gold was associated with blood cells after auranofin administration than after gold sodium thiomalate. The absorption, distribution, metabolism, and excretion of auranofin are uniquely different from other gold compounds.

Antiinflammatory activity of 5,6-diaryl-2,3-dihydroimidazo[2,1-b]thiazoles. Isomeric 4-pyridyl and 4-substituted phenyl derivatives.

Isomeric 5(6)-(4-pyridyl)- and 6(5)-(4-substituted-phenyl)-2,3-dihydroimidazo[2,1-b]thiazoles were prepared by a mixed benzoin-imidazothione route, and their structures were assigned by spectral comparison to compounds of established substitution pattern. The structural assignment was confirmed by X-ray analysis. Examination of the compounds for antiinflammatory activity by an adjuvant arthritic rat assay revealed strikingly higher potencies for one analogous series than for their isomers. This selectivity was paralleled in the ability to stimulate cell-mediated immunity, as reflected in an oxazolone-induced contact sensitivity model. A drug-receptor complex is proposed that requires at least three sites of interactions.

(E)-3-[[[[6-(2-carboxyethenyl)-5-[[8-(4- methoxyphenyl)octyl]oxy]-2-pyridinyl]-methyl]thio]methyl]benzoic acid and related compounds: high affinity leukotriene B4 receptor antagonists.

(E)-3-[[[[6-(2-Carboxyethenyl)-5-[[8-(4- methoxyphenyl)octyl]oxy]-2-pyridinyl]methyl]thio]methyl]benzoic acid (11, SB 201993) is a novel, potent LTB4 receptor antagonist. Compound 11 arose from a structure-activity study of a series of trisubstituted pyridines that demonstrated LTB4 receptor antagonist activity. The placement of an additional methylene unit in the sulfur containing chain linking the pyridine and benzoic acid moieties of lead compound 8 (K(i) = 80 nM) resulted in a greater than 10-fold increase in receptor affinity. Additionally, in this new series of compounds, the oxidation state of the sulfur was found to be critical to the activity, i.e., the sulfoxide and sulfone showed substantially lower affinity for the LTB4 receptor. Compound 11 competitively inhibits the binding of [3H]LTB4 to LTB4 receptors on human polymorphonuclear leukocytes with a Ki of 7.1 nM and blocks both the LTB4-induced calcium mobilization and the LTB4-induced degranulation responses in these cells with IC50 values of 131 and 271 nM, respectively. Compound 11 demonstrated oral LTB4 antagonist activity as well as topical antiinflammatory activity in the mouse.

(E)-3-[6-[[(2,6-dichlorophenyl)thio]methyl]-3-(2-phenylethoxy)-2- pyridinyl]-2-propenoic acid: a high-affinity leukotriene B4 receptor antagonist with oral antiinflammatory activity.

An extensive structure-activity study based around the high-affinity leukotriene B4 (LTB4) receptor antagonist SB 201146 (1) led to the identification of (E)-3-[6-[[(2,6-dichlorophenyl)-thio]methyl]-3-(2-phenylethoxy)-2- pyridinyl]-2-propenoic acid (3). This compound displays high affinity for the human neutrophil LTB4 receptor (Ki = 0.78 nM), blocks LTB4-induced Ca2+ mobilization with an IC50 of 6.6 +/- 1.5 nM, and demonstrates potent oral and topical antiinflammatory activity in a murine model of dermal inflammation.

5,6-Diaryl-2,3-dihydroimidazo[2,1-b]thiazoles: a new class of immunoregulatory antiinflammatory agents.

A series of substituted 5,6-diaryl-2,3-dihydroimidazo[2,1-b]thiazoles were synthesized and evaluated in the rat adjuvant-induced arthritis and mouse oxazolone-induced contact sensitivity assays to determine the potential of these compounds for use as immunoregulatory antiinflammatory agents. This class of compounds was derived by combining salient structural features of the antiinflammatory agent flumizole and the immunoregulatory drug levamisole. Unlike the latter two, a number of compounds in the target series were found to possess the desired combination of activities. Exploration of structure-activity relationships in the adjuvant-induced arthritic rat assay revealed that optimal potency was exhibited by symmetrically substituted 5,6-diaryl compounds having one of the following alkyl heteroatom or halogen functions at the para position: methoxy, ethoxy, methylthio, N-ethyl-N-methylamino, fluoro, or chloro. Scrambling of these two substituent classes to yield the asymmetrically substituted 5,6-diaryl compounds resulted in potent activity only with the 5-alkyl heteroatom, 6-halo-substituted regioisomers. However in the oxazolone-induced contact sensitivity assay, no consistent relationship of variation in activity with structural change was apparent. The initial target compound 5,6-bis(4-methoxyphenyl)-2,3-dihydroimidazo[2,1-b]thiazole (1) was compared with its progenitors in additional models of inflammation and immunoregulation.

1-substituted 4-aryl-5-pyridinylimidazoles: a new class of cytokine suppressive drugs with low 5-lipoxygenase and cyclooxygenase inhibitory potency.

A series of 1-alkyl- or -aryl-4-aryl-5-pyridinylimidazoles (A) were prepared and tested for their ability to bind to a recently discovered protein kinase termed CSBP and to inhibit lipopolysaccharide (LPS)-stimulated TNF production in mice. The kinase, CSBP, appears to be involved in a signaling cascade initiated by a number of inflammatory stimuli and leading to the biosynthesis of the inflammatory cytokines IL-1 and TNF. Two related imidazole classes (B and C) had previously been reported to bind to CSBP and to inhibit LPS-stimulated human monocyte IL-1 and TNF production. The members of the earlier series exhibited varying degrees of potency as inhibitors of the enzymes of arachidonic acid metabolism, PGHS-1 and 5-LO. Several of the more potent CSBP ligands and TNF biosynthesis inhibitors among the present series of N-1-alkylated imidazoles (A) were tested as inhibitors of PGHS-1 and 5-LO and were found to be weak to inactive as inhibitors of these enzymes. One of the compounds, 9 (SB 210313) which lacked measureable activity as an inhibitor of the enzymes of arachidonate metabolism, and had good potency in the binding and in vivo TNF inhibition assays, was tested for antiarthritic activity in the AA rat model of arthritis. Compound 9 significantly reduced edema and increased bone mineral density in this model.

Bicyclic N-hydroxyurea inhibitors of 5-lipoxygenase: pharmacodynamic, pharmacokinetic, and in vitro metabolic studies characterizing N-hydroxy-N-(2,3-dihydro-6-(phenylmethoxy)-3-benzofuranyl)urea.

A series of N-hydroxyurea derivatives have been prepared and examined as inhibitors of 5-lipoxygenase. Oral activity was established by examining the inhibition of LTB4 biosynthesis in an ex vivo assay in the mouse. The pharmacodynamic performance in the mouse of selected compounds was assessed using an ex vivo LTB4 assay and an adoptive peritoneal anaphylaxis assay at extended pretreat times. Compounds with an extended duration of action were re-examined as the individual enantiomers in the ex vivo assay, and the (S) enantiomer of N-hydroxy-N-[2,3-dihydro-6-(phenylmethoxy)-3-benzofuranyl]urea, (+)-1a (SB 202235), was selected as the compound with the best overall profile. Higher plasma concentrations and longer plasma half-lives were found for (+)-1a relative to its enantiomer in the mouse, monkey, and dog. In vitro metabolic studies in mouse liver microsomes established enantiospecific glucuronidation as a likely mechanism for the observed differences between the enantiomers of 1a. Enantioselective glucuronidation favoring (-)-1a was also found in human liver microsomes.