Introduction: Bronchiectasis is a common chronic debilitating respiratory condition. Patients suffer daily cough, excess sputum production and recurrent chest infections because of inflamed and permanently damaged airways. The pathogenesis of bronchiectasis is poorly understood. Pulmonary pathology shows excess neutrophilic airways inflammation, but despite this over two thirds of patients are chronically infected with potential pathogenic microorganisms. The acute inflammatory response is a protective mechanism that is evolved to eliminate invading organisms and should ideally be self-limiting and lead to complete resolution. The driver for persistent neutrophilic airway inflammation in bronchiectasis is unknown, but infection is considered to play a major role. AIMS The main aims of this thesis were to: (i) Characterize neutrophils in the serum and airways in bronchiectasis in the stable state and during exacerbations; (ii) Cohort study to establish if LXA4 deficiency correlates with disease severity (iii) Characterize lipids in bronchiectasis airways and peripheral blood to establish the correlation of LXA4 to disease severity; (iv) To investigate a potential mechanism for low levels of LXA4 in bronchiectasis, lipoxin biosynthetic genes expression will be measured; (v) Assess the anti-inflammatory and pro resolution effect of LXA4 on neutrophils and monocyte derived macrophages from healthy volunteers; (vi) Assess the anti-inflammatory and pro resolution effect of LXA4 on neutrophils during exacerbations in bronchiectasis and community acquired pneumonia. Methods (I) To establish the serum neutrophil subtype in stable state and following antibiotic treatment in patients with bronchiectasis, the following studies were done. Inclusion criteria: Patients aged 18-80 were recruited. All had an established radiological diagnosis of bronchiectasis (CT of the chest). Patients had clinically significant bronchiectasis, aetiology being either idiopathic or post infection. Exclusion Criteria: current smokers or ex-smokers of less than 1 year; >20 pack year history; cystic fibrosis; active allergic bronchopulmonary aspergillosis; active tuberculosis; poorly controlled asthma; severe COPD requiring nebulised bronchodilators or long term oxygen therapy; patients on aspirin or leukotriene inhibitors, pregnancy or breast feeding, active malignancy. A. 6 patients with mild bronchiectasis, 6 patients with severe bronchiectasis and 6 healthy volunteers were recruited. Serum and airways neutrophils were subsequently isolated. Neutrophil apoptosis, CD11b and CD62L expression, myeloperoxidase release, superoxide generation, phagocytosis and killing of GFP labeled bacteria were assessed. B. To compare serum with airways neutrophils function, bacterial phagocytosis and killing of GFP labeled bacteria was done, with both serum and airways neutrophils. Samples were obtained from the above group of patients. C. To establish neutrophil function following antibiotic treatment, 6 bronchiectasis patients at the beginning (day1) and the end (day14) of intravenous antibiotic therapy for an exacerbation were studied. As a control group, 6 community acquired pneumonia patients at the beginning (day1) and the end (day 5) of intravenous antibiotic therapy for infection were studied. Induced sputum and peripheral blood was taken at day1 and 5, where able. Phagocytosis and killing of GFP labeled bacteria was assessed and the two groups compared. (II) To address if lipoxin A4 deficiency correlates with disease severity, a cohort study was done in bronchiectasis patients. 169 patients were recruited and followed up for 1 year. Assessments done were Bronchiectasis severity index, systemic inflammatory markers (white cell count, ESR and c-reactive protein), Forced Expired Volume in 1sec, Forced Vital Capacity and its ratio, antibiotic courses in 1 year, hospital admissions in 1 year, sputum microbiology, quality of life assessments by Leicester Cough Questionnaire and St. Georges Respiratory Questionnaire, interleukin 8, myeloperoxidase, neutrophil elastase and leukotriene B4 (from sputum). (III) To assess effect of lipoxin on disease severity, 6 healthy volunteers, 10 patients with mild disease, 15 with moderate and 9 with severe disease were recruited. Disease severity was calculated as per the bronchiectasis severity index. All participants had 60mls of blood taken and underwent a bronchoscopy. Two segments of the lungs were washed out from bronchiectasis patients, an area affected by bronchiectasis and an area unaffected by bronchiectasis. This led to patients acting as their own internal control. Serum and airways neutrophils (from both segments) were subsequently isolated. Assessments done were systemic inflammatory markers (white cell count, ESR and c-reactive protein), serum lipoxin A4 and the cathelicidin LL-37, Forced Expired Volume in 1sec, Forced Vital Capacity and its ratio, transfer factor for carbon monoxide, antibiotic courses in 1 year, hospital admissions in 1 year and sputum microbiology. Phagocytosis and bacterial killing were assessed by both serum and airways neutrophils. From bronchoalveolar lavage fluid (BALF), I measured myeloperoxidase and neutrophil elastase. For both serum and BALF, lipidomics were obtained. (IV) To address the impact of anatomic compartment, gene expression was measured in from endobronchial brushings from the same cohort of bronchiectasis patients and controls as above, where samples were available. qPCR was performed for the following eicosanoid biosynthetic genes- 5 Lipoxygenase (LOX), 15 LO-A, 15LO-B and leukotriene (LT) A4 hydrolase. (V) To assess the anti inflammatory and pro resolution effect of LXA4 on neutrophils and monocyte derived macrophages from healthy volunteers, freshly isolated PMN will be treated with LXA4 or vehicle control. Spontaneous apoptosis was measured. fMLF and cytochalasin B was added and the inflammatory response assessed measuring myeloperoxidase (MPO), free neutrophil elastase (NE), CD11b, CD18 and CD62L. Human monocytes and PMNs were isolated from bronchiectasis patients. Following differentiation, LXA4 treated or control adherent, washed MDMs will be incubated with apoptotic stained PMNs. Efferocytosis was analyzed by flow cytometry. (VI) To establish the effect of Lipoxin A4 on neutrophil function following antibiotic treatment, the same study group used to evaluate aim 1 was taken. As a control group, 6 community acquired pneumonia patients at the beginning (day1) and the end (day 5) of oral or intravenous antibiotic therapy for infection were studied. Induced sputum and peripheral blood was taken at day1 and 5, where able. Phagocytosis and killing of GFP labeled bacteria and the effect of Lipoxin A4 was assessed and the two groups compared. Serum and sputum lipidomics were obtained in bronchiectasis exacerbations on day 1 and day 14. Serum lipidomics was obtained in pneumonia on day 1 and day 5. RESULTS (I) Neutrophil sub type study (Studied on healthy volunteers/ mild/ severe bronchiectasis) Peripheral blood neutrophils from bronchiectasis patients showed that there was significantly more viable neutrophils in mild and severe bronchiectasis compared to healthy volunteers, p=0.002 and p=0.005 respectively. In addition, there was significantly less apoptotic neutrophils in mild and severe bronchiectasis compared to healthy volunteers, p=0.0003 and p < 0.0001 respectively. There was a significantly higher level of CD11b in the mild (p=0.01) and severe bronchiectasis (p=0.01) compared to healthy volunteers. There was more CD62L shedding (p=0.02) and myeloperoxidase release (p=0.04) in bronchiectasis compared to healthy volunteers. There was lesser phagocytosis in mild (p=0.04) and severe (p=0.03) bronchiectasis compared to healthy volunteers. This led to lesser bacterial killing in mild (p=0.04) and severe (p=0.0004) bronchiectasis compared to healthy volunteers.

No description available.

Yes / Aspirin and eicosapentaenoic acid (EPA) have colorectal polyp prevention activity, alone and in combination. This study measured levels of plasma and rectal mucosal oxylipins in participants of the seAFOod 2 × 2 factorial, randomised, placebo-controlled trial, who received aspirin 300 mg daily and EPA 2000 mg free fatty acid, alone and in combination, for 12 months. Resolvin (Rv) E1, 15-epi-lipoxin (LX) A4 and respective precursors 18-HEPE and 15-HETE (with chiral separation) were measured by ultra-high performance liquid chromatography-tandem mass spectrometry in plasma taken at baseline, 6 months and 12 months, as well as rectal mucosa obtained at trial exit colonoscopy at 12 months, in 401 trial participants. Despite detection of S- and R- enantiomers of 18-HEPE and 15-HETE in ng/ml concentrations, RvE1 or 15‑epi-LXA4 were not detected above a limit of detection of 20 pg/ml in plasma or rectal mucosa, even in individuals randomised to both aspirin and EPA. We have confirmed in a large clinical trial cohort that prolonged (12 months) treatment with EPA is associated with increased plasma 18-HEPE concentrations (median [inter-quartile range] total 18-HEPE 0.51 [0.21-1.95] ng/ml at baseline versus 0.95 [0.46-4.06] ng/ml at 6 months [P

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Lipoxinas (LXs) são metabólitos do ácido araquidônico com reconhecidas atividades antiinflamatórias e pró-resolução. Apesar do grande número de trabalhos publicados descrevendo o papel das LXs e seus análogos em leucócitos e outros tipos celulares envolvidos em doenças inflamatórias, pouco é sabido a respeito dos mecanismos de ação que desencadeiam estas respostas. Neste trabalho investigamos o papel do 15-epi-16-(para-flúor)-fenoxi-lipoxina A4 (ATL-1), um análogo sintético da 15-epi-lipoxina A4, sobre diversos processos de ativação de monócitos. Caracterizamos, pela primeira vez, o receptor da lipoxina A4 (ALX) na linhagem monocítica U937, através da avaliação de sua expressão gênica e protéica e de sua funcionalidade analisando a ativação de ERK-2, o que torna esta célula uma ferramenta apta para estudo dos mecanismos de ação das LXs e seus análogos sobre os monócitos. Além disso, demonstramos que o ATL-1 aumenta a expressão da enzima heme oxigenase (HO) -1 em células U937 via ativação da p38 MAP quinase (MAPK) e diminui a secreção da Monocyte chemoattractant protein-1 (MCP-1), uma quimiocina envolvida com o recrutamento de monócitos para o foco inflamatório, em células U937 estimuladas com LPS. A inibição da secreção de MCP-1 foi revertida pela utilização do SB203580, sugerindo que este efeito é dependente da ativação da via p38 MAPK. O presente estudo elucida alguns dos mecanismos envolvidos na ativação de monócitos pelas lipoxinas que podem levar a novas abordagens para o controle de diversas doenças nas quais o componente inflamatório é importante / Lipoxins (LXs) are arachidonic acid metabolites with well recognized anti-inflammatory and pro-resolution activities. Despite the large number of studies describing the role of LXs and their analogs in leukocytes and other cell types involved in inflammatory diseases, little is known about the mechanisms of action that trigger these responses. This work investigated the role of 15-epi-16-(para-fluoro)-phenoxy-lipoxin A4 (ATL-1), a synthetic analog of 15-epi-lipoxin A4 on various processes of monocyte activation. We characterized, for the first time, the lipoxin A4 receptor (ALX) in the monocytic lineage U937, through the assessment of its gene expression and protein and its functionality through the activation of ERK-2, which makes this cell line a suitable tool to study the mechanisms of action of LXs and their analogs on the monocytes. Furthermore, we demonstrated that ATL-1 increases the expression of the enzyme heme oxygenase (HO)-1 in the U937 cells via activation of p38 MAP kinase (MAPK) and decreases the secretion of Monocyte chemoattractant protein-1 (MCP-1), a chemokine involved in the recruitment of monocytes to the inflammatory focus in LPS-stimulated U937 cells. MCP-1 secretion inhibition by ATL-1 was reverted by SB203580 indicating that this effect is dependent on the activation of p38 MAPK pathway. This study clarifies some of the mechanisms involved in the activation of monocytes by lipoxins which may lead to new approaches for the control of different pathologies where the inflammatory component is relevant

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Lipoxinas (LXs) são metabólitos do ácido araquidônico com reconhecidas atividades antiinflamatórias e pró-resolução. Apesar do grande número de trabalhos publicados descrevendo o papel das LXs e seus análogos em leucócitos e outros tipos celulares envolvidos em doenças inflamatórias, pouco é sabido a respeito dos mecanismos de ação que desencadeiam estas respostas. Neste trabalho investigamos o papel do 15-epi-16-(para-flúor)-fenoxi-lipoxina A4 (ATL-1), um análogo sintético da 15-epi-lipoxina A4, sobre diversos processos de ativação de monócitos. Caracterizamos, pela primeira vez, o receptor da lipoxina A4 (ALX) na linhagem monocítica U937, através da avaliação de sua expressão gênica e protéica e de sua funcionalidade analisando a ativação de ERK-2, o que torna esta célula uma ferramenta apta para estudo dos mecanismos de ação das LXs e seus análogos sobre os monócitos. Além disso, demonstramos que o ATL-1 aumenta a expressão da enzima heme oxigenase (HO) -1 em células U937 via ativação da p38 MAP quinase (MAPK) e diminui a secreção da Monocyte chemoattractant protein-1 (MCP-1), uma quimiocina envolvida com o recrutamento de monócitos para o foco inflamatório, em células U937 estimuladas com LPS. A inibição da secreção de MCP-1 foi revertida pela utilização do SB203580, sugerindo que este efeito é dependente da ativação da via p38 MAPK. O presente estudo elucida alguns dos mecanismos envolvidos na ativação de monócitos pelas lipoxinas que podem levar a novas abordagens para o controle de diversas doenças nas quais o componente inflamatório é importante / Lipoxins (LXs) are arachidonic acid metabolites with well recognized anti-inflammatory and pro-resolution activities. Despite the large number of studies describing the role of LXs and their analogs in leukocytes and other cell types involved in inflammatory diseases, little is known about the mechanisms of action that trigger these responses. This work investigated the role of 15-epi-16-(para-fluoro)-phenoxy-lipoxin A4 (ATL-1), a synthetic analog of 15-epi-lipoxin A4 on various processes of monocyte activation. We characterized, for the first time, the lipoxin A4 receptor (ALX) in the monocytic lineage U937, through the assessment of its gene expression and protein and its functionality through the activation of ERK-2, which makes this cell line a suitable tool to study the mechanisms of action of LXs and their analogs on the monocytes. Furthermore, we demonstrated that ATL-1 increases the expression of the enzyme heme oxygenase (HO)-1 in the U937 cells via activation of p38 MAP kinase (MAPK) and decreases the secretion of Monocyte chemoattractant protein-1 (MCP-1), a chemokine involved in the recruitment of monocytes to the inflammatory focus in LPS-stimulated U937 cells. MCP-1 secretion inhibition by ATL-1 was reverted by SB203580 indicating that this effect is dependent on the activation of p38 MAPK pathway. This study clarifies some of the mechanisms involved in the activation of monocytes by lipoxins which may lead to new approaches for the control of different pathologies where the inflammatory component is relevant

BACKGROUND: Obesity is a global health problem that is associated with wide range of diseases, including atherosclerosis and Nonalcoholic fatty liver (NAFL) disease. Hepatic inflammation can cause cirrhosis, hepatic decompensation (liver failure) and cancer. Recent research now looks at the chronic systemic effects and inter-organ communication between atherosclerosis potentially promoting the development of NAFL. The resolution of inflammation is regulated naturally in the body by specialized pro-resolving mediators (SPMs). Immunoresolvents like ⍹6-derived Lipoxin A4 are suggested as a therapeutic strategy to overcome chronic inflammation and disease. In this study we investigated the therapeutic potential of Lipoxin A4 (LXA4) in cholesterol fed rabbit model of hypercholesterolemia, with atherosclerotic plaques and confined vascular endothelial injury and its effect on the progression of NAFL. OBJECTIVE: This is a continuation of studies pioneered in the Hamilton lab and an extension of the recent study by Taylor et. al in 201811 linking aortic plaque and liver disease. We will now investigate the therapeutic potential of Lipoxin A4 on lipid-rich atherosclerotic plaques in cholesterol fed rabbits and its effect on the progression of NAFL to NASH. METHODS: In vivo magnetic resonance imaging (MRI) measured aortic atherosclerotic inflammation (with plaque Gd-enhancement), plaque size (vessel wall area), and composition, within rabbits fed normal chow or a 1% cholesterol-enriched diet. Biomarkers in the blood were monitored in the rabbits, with follow-up by histology, which included Masson’s trichrome staining. Light Microscopy was used for liver imaging. Ex vivo MRI, T1W imaging was used to quantify VWA (vessel wall area), with Image J programming. RESULTS: Cholesterol-fed rabbits with and without aortic injury developed hypercholesterolemia, NAFL, and atherosclerotic plaques in the aorta. Elevated plasma gamma-glutamyl transferase (GGT; p =0.014) and the ratio of liver enzymes aspartate and alanine aminotransferases (AST/ALT; p = 0.033) confirmed the progression of steatosis to non-alcoholic steatohepatitis (NASH). Histological images showed less fibrosis in those rabbits fed 1% CHOL diet with injury treated with LipoxinA4, when compared to 1% CHOL diet and injury alone. The plasma biomarkers showed a decrease in cholesterol (79%) and triglycerides (49.9%) in those rabbits given LXA4 therapy. The LXA4 treated 1% CHOL diet with injury group showed a marked decrease in the aorta vessel wall area when compared to the 1% CHOL diet with injury, without treatment; as seen in ex vivo, MRI T1W imaging. CONCLUSION: Lipoxin implementation in cholesterol fed rabbits that have localized regions of highly inflamed aortic atherosclerotic plaques, may contribute to the attenuation on the progression of NAFL to NASH as seen in histology and plasma biomarkers including; cholesterol and triglycerides. Lipoxin as a therapeutic has an effect on treating atherosclerotic plaques and attenuating atherosclerosis progression.

Inhibition of cyclooxygenase (COX)-2 increases cardiovascular deaths. Identifying a biomarker of COX-2 is desirable but difficult, since COX-1 and COX-2 ordinarily catalyze formation of an identical product, prostaglandin H2. When acetylated by aspirin, however, COX-2 (but not COX-1) can form 15(R)-HETE, which is metabolized to aspirin-triggered lipoxin (ATL), 15-epi-lipoxin A4. Here we have used COX-1- and COX-2-knockout mice to establish whether plasma ATL could be used as a biomarker of vascular COX-2 in vivo. Vascular COX-2 was low but increased by LPS (10 mg/kg; i.p). Aspirin (10 mg/kg; i.v.) inhibited COX-1, measured as blood thromboxane and COX-2, measured as lung PGE2. Aspirin also increased the levels of ATL in the lungs of LPS-treated wild-type C57Bl6 mice (vehicle: 25.5±9.3 ng/ml; 100 mg/kg: 112.0±7.4 ng/ml; P<0.05). Despite this, ATL was unchanged in plasma after LPS and aspirin. This was true in wild-type as well as COX-1−/− and COX-2−/− mice. Thus, in mice in which COX-2 has been induced by LPS treatment, aspirin triggers detectable 15-epi-lipoxin A4 in lung tissue, but not in plasma. This important study is the first to demonstrate that while ATL can be measured in tissue, plasma ATL is not a biomarker of vascular COX-2 expression.—Kirkby, N. S., Chan, M. V., Lundberg, M. H., Massey, K. A., Edmands, W. M. B., MacKenzie, L. S., Holmes, E., Nicolaou, A., Warner, T. D., Mitchell, J. A. Aspirin-triggered 15-epi-lipoxin A4 predicts cyclooxygenase-2 in the lungs of LPS-treated mice but not in the circulation: implications for a clinical test.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23760号 / 医博第4806号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 平井 豊博, 教授 湊谷 謙司, 教授 森信 暁雄 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM