The main goal of this research was the in vitro investigation of the stiffness response of contracted airway smooth muscles under different external oscillations. Living animal airway smooth muscle tissues were dissected from pig tracheas and stimulated by a chemical stimulus (acetylcholine). These tissues were then systematically excited with different external vibrations. The force change was recorded to reflect the muscle stiffness change under vibration. The static and dynamic stiffness of contracted airway smooth muscles in isometric contraction were determined before, during and after vibrations. A continuum cross-bridge dynamic model (the fading memory model) was modified to accommodate smooth muscle behaviour and dynamically describes the cross-bridge kinetics. A two-dimensional finite element model (FEM) was developed to simulate longitudinal and transverse vibrations of the tissue. An empirical equation, derived from the experiments, is incorporated into the FEM. The results indicate that the stiffness of active smooth muscles can be physically reduced using external vibrations. This reduction is caused by a certain physical position change between actin and myosin. The dynamic stiffness has the tendency of decreasing as the frequency and/or amplitude of external vibration increases. However, the static stiffness decreases with an increase in the frequency and amplitude of excitation until it reaches a critical value of frequency where no variation in stiffness is observed. It is postulated that the tissue elasticity and mass inertia are the main contributors to the dynamic stiffness while the actin-myosin cross-bridge cycling is the main contributor to the static stiffness.

Asthma is a chronic inflammatory lung disease characterized by recurrent wheezing, coughing and difficulties in breathing. Asthma affects 25.7 million people in the USA including 8 million children. Asthma is often associated with early-life exposure to environmental insults. However, mechanisms that link early-life insults to persistent airway dysfunction are unknown. Our previous studies in mice showed that early-life allergen exposure increases the levels of neurotrophin 4 (NT4) causing airway smooth muscle (ASM) hyper innervation and persistent airway hyper reactivity (AHR). I show that early-life allergen exposure selectively increases cholinergic innervation. Notably, cholinergic nerves release acetylcholine, a potent airway constrictor that signals through the M3 receptor in ASM. Building upon these findings, my thesis encompasses two components. Firstly, how is NT4 expression aberrantly up regulated following early-life allergen exposure? Secondly, what is the effect of enhanced cholinergic innervation on the neonatal ASM? I find that NT4 is selectively expressed by ASM and mast cells in mice, nonhuman primates and humans. We show in mice that while NT4 expression in ASM remains unchanged upon allergen exposure, mast cells expand in number and degranulate to release NT4 thereby increasing NT4 levels in the lung. Adoptive transfer of wild-type mast cells, but not NT4-/- mast cells restores ASM innervation and AHR in KitW-sh/W-sh mice following early-life insults. In an infant primate model of asthma, the increased ASM innervation is also associated with the expansion and degranulation of mast cells. Therefore, pulmonary mast cells are a key source of aberrant NT4 expression following early-life insults in both mice and possibly primates. Next, I speculated that an increased cholinergic output in the neonatal lung might lead to persistent AHR. Using recurrent methacholine exposure and M3 receptor blocker, 4-DAMP, I show that enhanced cholinergic signaling in neonatal mice leads to persistent AHR without inflammation. In contrast, methacholine exposure in adult mice has no prolonged effects on airway reactivity. Together, my findings support a model in which deregulated neural activities following early-life insults cause persistent ASM hyper contractility. Thus, early-life interventions to block mast cell degranulation and the cholinergic pathway may benefit children with recurrent wheezing. / 2016-12-15T00:00:00Z

Airway hyperresponsiveness (AHR) is a hallmark of asthma where constriction of airway smooth muscle (ASM) causes excessive airway narrowing. Asthmatics, unlike healthy subjects, cannot prevent or reverse this narrowing by stretching their airways with a deep inspiration (DI). Since stretching of isolated ASM causes dramatic reductions in force generation and asthmatics tend to have stiffer airways, researchers hypothesize that reduced ASM stretching during breathing and DIs results in hyperreactive airways. However, counterintuitively, excised measurement on intact airways show narrowing is minimally reversed by pressure oscillations simulating breathing and DIs. We hypothesized that AHR does not result from reduced capacity to stretch the airways; furthermore, each constituent of the airway wall experiences different strain magnitude during breathing and DIs. To test this, we used an intact airway system which controls transmural pressure (Ptm) to simulate breathing while measuring luminal diameter in response to ASM agonists. An ultrasound system and automated segmentation algorithm were implemented to quantify and compare the ability of Ptm fluctuations to reverse and prevent narrowing in larger (diameter=5.72±0.52mm) relative to smaller airways (diameter=2.92±0.29mm). We found the ability of Ptm oscillations to reverse airway narrowing was proportional to strain imposed on the airway wall. Further, tidal-like breathing Ptm oscillations (5-15cmH2O) after constriction imposed 196% more strain in smaller compared to larger airways (14.6% vs. 5.58%), resulting in 76% greater reversal of narrowing (41.2% vs. 23.4%). However, Ptm oscillations applied before and during constriction resulted in the same steady-state diameter as when Ptm oscillations were applied only after constriction. To better understand these results, we optimized an ultrasound elastography technique utilizing finite element-based image registration to estimate spatial distributions of displacements, strains, and material properties throughout an airway wall during breathing and bronchoconstriction. This required we formulate and solve an inverse elasticity problem to reconstruct the distribution of nonlinear material properties. Strains and material properties were radially and longitudinally heterogeneous, and patterns and magnitudes changed significantly after induced narrowing. Taken together, these data show AHR likely does not emerge due to reduced straining of airways prior to challenge, but remodeling that stiffens airway walls might serve to sustain constriction during an asthmatic-like attack.

No description available.

<p>Bronchial thermoplasty has recently been FDA approved as a novel therapy for use on adults suffering from severe asthma. The procedure uses radiofrequency energy to heat the airways to 65°C for 10 s. This has been shown in dogs to lead to a reduction of airway smooth muscle mass and in humans to improve quality of life and asthma control. Early cellular reactions to this treatment are unclear; as well, there is limited information regarding thermal sensitivity of airway smooth muscle when exposed to extreme temperatures (50-65°C). We examined the cellular impact of bronchial thermoplasty by investigating the response of airway smooth muscle to heat by immersing bovine tracheal strips and bronchial segments in heated Krebs. We confirmed dramatically decreased functionality over the temperature range 50-60°C at 1 h and 24 h in all tissues. TUNEL analysis noted significant cell death in all tissues heated to 65°C and limited cell death in bronchial tissues treated with <55°C. Immunohistochemical analysis showed an effect of temperature on caspase 3 activation in bronchi; tracheal strips demonstrated co-localization of caspase 3 and TUNEL at 55°C but not 65°C. These data suggests that cell death of airway smooth muscle contributes to the cellular effects observed following heating to 65°C; at lower temperatures, cell death may be limited. We conclude that bronchial thermoplasty (heat treatment to 65°C for ~30 seconds) leads to a number of structural and functional changes in the airway smooth muscle, which culminate in marked loss of function and cell death.</p> / Master of Health Sciences (MSc)

<p>Allergic atopic asthma is a respiratory condition that involves immune responses to specific allergens resulting in coughing, wheezing, shortness of breath and tightness in the chest. During an atopic asthmatic attack, the immune system initiates cellular infiltration of lymphocytes and eosinophils, airway hyper-responsiveness and ECM remodeling, which manifests in lung dysfunction in chronic disease. ASMC have recently been shown to play a role in the inflammatory processes of asthma through the production of inflammatory mediators. Various cytokines and chemokines serve as stimulants for these pathways and therefore require further attention to examine inflammatory signaling. OSM, a member of the gp130 family of cytokines, is secreted by inflammatory cells and has been detected in the sputum of asthmatics. Previous findings have established the potential of OSM in induction of lung inflammation, its role in increasing ECM, and its potential role in asthma. Viral or bacterial infections cause asthma exacerbations which result in increased severity of symptoms. The innate immune system relies on pattern recognition receptors including the TLRs to recognize invading pathogens and activate cells such as macrophages and natural killer cells. Although there are a number of these TLRs, this project will focus on the role of TLR3 and TLR4 in ASMC. I generally hypothesized that OSM markedly increases lung cell airway smooth muscle cell responses to external stimulae, such as products of bacteria or viruses that activate toll-like receptors. This exacerbates inflammation and extracellular matrix remodeling which contributes to pathology in asthmatic patients. Findings in this thesis have demonstrated that OSM stimulation increases the production of various cytokines and chemokines and growth factors seen in asthma. Co-stimulations with OSM and TLR-ligands augmented the production of a variety of these inflammatory mediators in comparison to ligands alone. TLR responses were shown to be associated with TLR expression, at both the mRNA and protein level, as well through the activation of the JAK-STAT and NFκB pathways. These findings implicate ASMC in immunomodulatory roles in response to TLR-ligands and OSM, and could play a role in the increased severity of asthma seen during exacerbations.</p> / Master of Science (MSc)

Die Ergebnisse der Arbeit weisen mehrfach auf eine defizitäre IL-10 Produktion in Alveolarmakrophagen von Asthmatikern hin. Die reduzierte IL-10 Expression auf Protein- und Genebene korrelierte mit einer erhöhten Produktion proinflammatorischer Zytokine (TNF-?, MIP1-?, GM-CSF). Diese Beobachtung impliziert einen Defekt in der IL-10 Synthese, der in einer verstärkten und prolongierten pulmonalen Entzündungsantwort resultiert. Daraus läßt sich schlußfolgern, dass beim Asthma bronchiale eine Dysbalance zwischen pro- und antiinflammatorischen Zytokinen pathogenetisch von Bedeutung ist. Die verringerte Sensitivität von Alveolarmakrophagen auf die inhibitorischen Effekte von exogenem IL-10 im Vergleich zu Blutmonozyten ist durch Unterschiede in den Mechanismen der Signaltransduktion bedingt (37, 54). Der Nachweis der Expression von proinflammatorischen Zytokinen in Bronchialmyozyten (RANTES, IL-8) führte zu einer Neubewertung dieser Zellen als Immuneffektorzellen in der Pathogenese des Asthma bronchiale. Neben der Kontraktilität sind Myozyten auch aktiv an der Aufrechterhaltung der Atemwegsentzündung beteiligt. Die inhibitorischen Effekte von IL-10 und IL-13 auf die Synthese proinflammatorischer Chemokine (RANTES, IL-8, MIP-1() in migrierten Entzündungszellen und residenten Bronchialmyozyten konnten in verschiedenen Arbeiten gut dokumentiert werden. Die Vielzahl antiinflammatorischer Effekte von IL-10, die sich auf unterschiedliche Zellsysteme wie Monozyten, Makrophagen und Bronchialmyozyten erstrecken, unterstreicht die pathogenetische Bedeutung dieses Zytokins. Der molekulare Mechanismus, welcher die IL-10 Wirkung vermittelt, ist derzeit noch nicht vollständig aufgeklärt. Angenommen wird eine rezeptorvermittelte Inhibition von Transkriptionsfaktoren des Stat Systems und NF-(B (76). Zukünftige molekularbiologische und klinische Studien sind jedoch notwendig, um den Kenntnisstand der Effekte antiinflammatorischer Zytokine zu vertiefen, und die Gabe von rekombinantem IL-10 als möglichen Ansatz zur Therapie chronisch entzündlicher Lungenerkrankungen zu evaluieren (81). / The results of this present thesis show a deficiency of IL-10 production in alveolar macrophages in asthma. The reduced IL-10 expression on protein and m-RNA level correlated with an increased production of pro-inflammatory cytokines such as TNF-(, MIP1- ( and GM-CSF. These observations implicate an impaired IL-10 synthesis in asthma with a subsequent prolongation of the inflammatory response. This leads to the conclusion that a dysbalance between pro- and anti-inflammatory cytokines is present in asthma and may be therefore of pathogenetic importance. The reduced sensitivity of alveolar macrophages to the inhibitory effects of exogenous IL-10 compared to peripheral blood monocytes may be caused by different signal transduction mechanisms. The expression of the proinflammatory cytokines RANTES and IL-8 in cultured human airway smooth muscle cells led to the conclusion that airway smooth muscle cells may act beside their contractile function as immunomodulatory cells in the pathogenesis of asthma. The inhibitory effects of IL-10 and IL-13 on the synthesis of proinflammatory cytokines (RANTES, IL-8, MIP1-() in immigrated inflammatory cells and resident cells such as airway smooth muscle cells have been shown in several publications that are part of the present thesis. The numerous antiinflammatory effects of IL-10 on different inflammatory cell systems such as monocytes/macrophages and smooth muscle cells underline the pathogenetic importance of this cytokine. The molecular mechanisms that mediate the IL-10 effects involve the transcription factors NF-(B and the Stat-System. Future studies are needed to determine the molecular mechanisms of the anti-inflammatory effects of IL-10 and IL-13 more deeply and to evaluate their application for the therapy of chronic inflammatory pulmonary diseases.

Le souffle chez les chevaux et l’asthme chez l’humain sont des maladies respiratoires qui partagent plusieurs caractéristiques, notamment des épisodes de bronchospasme et de détresse respiratoire dus à une inflammation pulmonaire inappropriée en réponse à une inhalation de substances antigéniques. Les manifestations cliniques incluent des efforts respiratoires augmentés, des sifflements et de la toux. Au niveau des voies respiratoires, on observe une augmentation du muscle lisse péribronchique, une fibrose sous épithéliale, une métaplasie/hyperplasie épithéliale et du mucus en quantité augmentée. L’augmentation du muscle lisse est particulièrement importante car elle n’affecte pas seulement le calibre basal des voies respiratoires, mais elle accentue l’obstruction respiratoire lors de bronchoconstriction. Ces changements sont regroupés sous le terme de « remodelage » et sont associés à un déclin accéléré de la fonction respiratoire chez les patients asthmatiques. Alors que les traitements actuels contrôlent efficacement le bronchospasme et relativement bien l’inflammation, leurs effets sur le remodelage sont mal connus. Dans le cadre de thèse, la réversibilité du remodelage musculaire péribronchique a été investiguée chez des chevaux atteints du souffle dans deux études longitudinales. Ces études, faites principalement sur du tissu pulmonaire prélevé par thoracoscopie, sont difficilement réalisables chez l’humain pour des raisons éthiques, ou chez d’autres animaux, car ceux-ci présentent rarement une inflammation de type asthmatique de façon spontanée. Les résultats démontrent que les chevaux atteints du souffle ont approximativement deux fois plus de muscle péribronchique que les chevaux sains d’âge similaire gardés dans les mêmes conditions, et que la prolifération des myocytes contribue à cette augmentation. Ils démontrent aussi qu’une stimulation antigénique relativement brève chez des chevaux atteints du souffle depuis plusieurs années n’accentue pas le remodelage, ce qui suggère que l’augmentation du muscle lisse atteint un plateau. Nous avons également montré que le remodelage du muscle lisse chez des chevaux adultes est partiellement réversible et que cette réversibilité peut être accélérée par l’administration de corticostéroïdes par inhalation. Il semble toutefois qu’une portion du remodelage chronique est irréversible puisque les corticostéroïdes ont accéléré la diminution du muscle mais sans toutefois mener à une amélioration plus marquée au terme de l’étude qu’avec une modification environnementale stricte. La diminution de trente pourcent observée sur un an paraît modeste mais elle démontre clairement, et pour une première fois, que le remodelage du muscle lisse présent chez des chevaux adultes malades depuis plusieurs années est au moins partiellement réversible. / Equine heaves and asthma in people are two respiratory diseases that share many characteristics, including episodes of bronchospasm and respiratory distress due to an inappropriate airway inflammation in response to inhaled antigens. In both diseases, the main clinical manifestations are increased breathing efforts, wheezing and coughing. Changes in the airway wall include increased airway smooth muscle, subepithelial fibrosis, epithelial changes, and increased mucus. The increase in smooth muscle is of particular importance as it not only affects baseline airway caliber, but also accentuates the effect of bronchoconstriction on airflow limitation. These structural changes are grouped under the term “remodeling” and are associated with the accelerated decline of respiratory function in asthmatics. While current treatments offer adequate control of bronchospasm and inflammation, their effects on remodeling are unknown. In this thesis, airway smooth muscle remodeling reversibility was investigated in heaves-affected horses. The longitudinal studies conducted here, mostly made on peripheral pulmonary tissue harvested under thoracoscopic guidance, can not be easily done in people for ethical reasons, or in other animal species, few of them having spontaneous asthma-like disease like horses. Results have shown that heaves-affected horses have twice as much airway smooth muscle than age-matched controls kept in the same environment, and that myocyte proliferation contributes to this increase. It was also shown that a relatively brief antigenic exposure in chronically affected horses does not further increase smooth muscle mass, which suggests that it may reach a plateau over time. It was also shown that airway smooth muscle is partially reversible and that this reversibility can be accelerated with inhaled corticosteroids. On the other hand, corticosteroids only accelerated the decrease in mass compared to strict environmental control, without affecting the total improvement observed at the end of the study, which suggests that some of this chronic remodeling is irreversible. The thirty percent decrease seems relatively modest but it is nevertheless the first demonstration that airway smooth muscle remodeling of adult horses affected by heaves for years is at least in part reversible.

L’hyperplasie et l’hypertrophie contribuent à l'augmentation de la masse de muscle lisse bronchique observée dans le souffle. Les cellules musculaires lisses (CML) présentent deux phénotypes; prolifératif ou contractile. Le serum response factor (SRF), un facteur de transcription impliqué dans l’activation de nombreux gènes, contribuerait à cette modulation phénotypique. Notamment, lorsqu'associé au cofacteur Elk-1, un phénotype prolifératif serait observé, alors qu'en présence de la myocardine (MYOCD) il y aurait induction d'un profil contractile. Récemment, il a été démontré que SRF est surexprimé dans les voies périphériques chez les chevaux atteints du souffle suite à une exposition antigénique. Cette étude vise à caractériser l'expression protéique et génique de SRF, Elk-1 et MYOCD dans les CML des voies respiratoires centrales et périphériques chez des chevaux atteints du souffle et des chevaux contrôles. L'évaluation de l’expression protéique de SRF, Elk-1 et MYOCD s’est effectuée par immunodétection sur des tissus provenant de biopsies thoracoscopiques ou endobronchiques, et ce, avant, à 1 et 30 jours du défi antigénique. L'expression génique a été étudiée par qPCR sur du muscle lisse disséqué de la trachée, et des bronches, ainsi que sur des voies respiratoires intermédiaires et périphériques. Les expressions génique et protéique de MYOCD sont augmentées uniquement dans les voies périphériques. L’expression génique de SRF et Elk-1 varient dans les voies centrales alors que le taux de protéines demeure stable. En conclusion, SRF et MYOCD pourraient être impliquées dans l’hypertrophie des voies respiratoires périphériques dans le souffle alors que l’hyperplasie ne semble pas être activée par Elk-1. / Airway smooth muscle (ASM) cells hyperplasia and hypertrophy contribute to the increased airway smooth muscle mass present in heaves. ASM cells express either a synthetic proliferative or a contractile phenotype. Serum response factor (SRF) is a transcription factor that has been shown to regulate myocyte differentiation in vitro in vascular and intestinal smooth muscles. When SRF is associated with Elk-1, it promotes ASM proliferation while myocardin (MYOCD) promotes the expression of contractile elements. Recently, SRF was shown to be overexpressed in the peripheral airways of heaves affected horses following an antigenic challenge. The objective of this study was to characterize the protein and gene expression of SRF, Elk-1 and MYOCD in ASM cells from central and peripheral airways of heaves affected horses and controls. Protein expression of Elk-1 and MYOCD was evaluated using immunohistochemistry while immunofluorescence was used for SRF detection in pulmonary peripheral and endobronchial biopsies before and at 1 and 30 days of antigenic exposure. Gene expression was investigated in ASM cells dissected from trachea and bronchi as well as from intermediate and peripheral airways using qPCR. MYOCD gene and protein expressions are increased only in peripheral airways. SRF and Elk-1 gene expression varied in the central airways while the positive cell percentage remains stable. In conclusion, the pulmonary peripheral airways hypertrophy observed in heaves seems to implicate SRF and MYOCD while the hyperplasia doesn’t seem to be activated by Elk-1.

In this study, the origin and development of the intrinsic innervation in the foetal mouse lung is described and experimental evidence is provided to support the involvement of glial cell line-derived neurotrophic factor (GDNF) in the guidance of nerves and neuronal precursors in the developing lung. Antibodies were used to stain for neuronal precursors, neurones, nerve fibres, primordial epithelium and smooth muscle. These structures were revealed in whole mounts of foetal mouse lungs by immunofluorescence and confocal microscopy, and their spatial and temporal distribution was mapped from the onset of lung development and through the pseudoglandular period. The results showed that neuronal precursors, positive for neural crest cell markers, were present in the vagal tract of the foregut at embryonic day 10 (E10), the time of the evagination of the lung buds. These neural crest-derived cells (NCC) migrated into the lung at E11, along nerve processes directed from the vagus to the smooth musclecovered trachea and emerging lobar bronchi. During E11-E14, a network of nerves and ganglia became established along the dorsal trachea, and large ganglia formed a plexus at the ventral hilum. Nerve trunks issued from these ganglia, travelled along the smooth muscle-covered bronchi, providing a pathway for migrating NCC. To investigate the role of GDNF in the innervation of the lung, an in vitro model of left lung lobes was established. Lung growth and tubule branching was comparable to that in vivo, and neural tissue and smooth muscle continued to grow and thrive. A significant increase in nerve growth occurred when explants were cultured with GDNF compared to controls. Nerves extended, and NCC migrated towards GDNF-impregnated beads suggesting that GDNF may be the molecule guiding nerve fibres and NCC in the lung. The migrating NCC were negative for GDNF-family receptor α1 (GFRα1) during their migration into the lung while the nerves were positive. Since GDNF needs to be associated with its binding receptor, GFRα1, for cellular signalling, GDNF may induce the migration of the NCC if they migrate along the GFRα1-positive nerve fibres. It is concluded that neural tissue and smooth muscle become integral components of the lung shortly after the onset of lung development. The results show that the migration of neural crest-derived cells into the lung and the establishment of the innervation requires coordinated cross-talk between NCC, nerves and smooth muscle throughout development.