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Aberrant phenotypes of airway smooth muscle cells are central to the pathophysiology of asthma. The hypercontractile nature of these cells and hypertrophy are the key reasons for the excessive narrowing of the airways observed in allergic asthma. Although previous studies have indicated a role of enhanced content of smMLCK in modulating the contractile reactivity, as well as an indication of hypertrophy of HASM cells in asthmatic conditions, the effect of IgE on the expression of smMLCK in HASM cells is not fully understood. In this study, we demonstrate that IgE augments the expression of smMLCK at the mRNA and protein level. Inhibition of IgE binding with anti-FcεRI blocking antibody, Syk silencing, pharmacological inhibitors to MAPK (ERK1/2, p38, and JNK) and PI3K significantly diminished the IgE-mediated smMLCK expression in HASM cells. Finally, we found that IgE, similar to metacholine induces the contraction of HASM cells grown on collagen gel matrix. Our data suggest that IgE stimulates the phosphorylation of ERK, P38, STAT3 and induces the dephosphorylation of smMLCK to phosphorylate myosin regulatory light chain in HASM cells. Taken together, our data suggest a modulatory role of IgE in regulating the contractile machinery and hypertrophic phenotype of HASM cells.

Aberrant phenotypes of airway smooth muscle cells are central to the pathophysiology of asthma. The hypercontractile nature of these cells and hypertrophy are the key reasons for the excessive narrowing of the airways observed in allergic asthma. Although previous studies have indicated a role of enhanced content of smMLCK in modulating the contractile reactivity, as well as an indication of hypertrophy of HASM cells in asthmatic conditions, the effect of IgE on the expression of smMLCK in HASM cells is not fully understood. In this study, we demonstrate that IgE augments the expression of smMLCK at the mRNA and protein level. Inhibition of IgE binding with anti-FcεRI blocking antibody, Syk silencing, pharmacological inhibitors to MAPK (ERK1/2, p38, and JNK) and PI3K significantly diminished the IgE-mediated smMLCK expression in HASM cells. Finally, we found that IgE, similar to metacholine induces the contraction of HASM cells grown on collagen gel matrix. Our data suggest that IgE stimulates the phosphorylation of ERK, P38, STAT3 and induces the dephosphorylation of smMLCK to phosphorylate myosin regulatory light chain in HASM cells. Taken together, our data suggest a modulatory role of IgE in regulating the contractile machinery and hypertrophic phenotype of HASM cells.

<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.

Immunopathological disorders are no longer defined by dysregulated T-helper (Th) type 1/ Th2 responses but account for modulatory cell types such as regulatory and Th17 cells. The newly defined Th17 subset is an effector memory subtype which regulates mucosal host defense responses. A distinctive feature of interleukin (IL)-17 is its ability to invoke neutrophilic responses and to synergize cytokine responses in proximal structural cells. This effect is most evident for proinflammatory cytokines and neutrophil-mobilizing chemokines which are under the regulatory control of the canonical, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. The uniqueness of the IL-17A receptor (IL-17RA) signal transduction pathway however has been a limiting factor in uncovering IL-17-mediated effector functions since the receptor bears little homology to other known receptors and contains a unique cytoplasmic consensus binding motif. Hence, the composition, dynamics and subunit interactions of the IL-17R complex have become an emerging area of research where novel recruitment motifs and adaptor proteins are actively being explored. Our study sought to uncover the signal transduction and molecular mechanisms mediating the initiation and amplification responses induced by IL-17. We hypothesize that (i) IL-17 represents a key cytokine which initiates inflammatory responses by acting on proximal structural cells to rapidly release neutrophil-mobilizing chemokines and myeloid growth factors and that (ii) IL-17 directly promotes survival responses of immune effector cells. Genomic analysis of stimulated human airway smooth muscle cells support the proinflammatory nature of IL-17 as NF-κB associated genes and chemokines were most significantly upregulated within 2 hours. However, IL-17 induced a modest fold increase in gene expression levels whereby only 4 genes achieved greater than 2 fold increases. This, along with the observation that IL-17 enhanced IL-1β-mediated CXCL8 expression via transcriptional promoter activation levels and post-transcriptional mRNA stabilization mechanisms suggests that IL-17 cooperatively functions with secondary cytokines to mediate inflammatory responses. Despite activating the p38-mitogen-activated protein kinase (MAPK) signaling pathway in peripheral blood neutrophils, IL-17 did not directly affect the apoptotic capacity of these cells but unexpectedly antagonized the survival response mediated by the granulocyte-macrophage colony stimulating factor (GM-CSF). Collectively, our results suggest that IL-17 is a potent synergistic cytokine which signals via the MAPK-NF-κB pathway to indirectly recruit neutrophils via CXC-chemokines produced by non-hematopoietic cells and that IL-17 may potentially dampen inflammatory responses by directly antagonizing inflammatory effector cells.

Chitosan is a biocompatible and biodegradable mucoadhesive polymer with unique advantages, such as the distinct trait of opening the junctions to allow paracellular transport of antigen and good tolerability. However, the poor solubility of chitosan in neutral or alkalinized media has restricted its applications in the pharmaceutical field. Chitosan can be easily carboxymethylated to improve its solubility in aqueous media, while its biodegradability and biocompatibility are preserved. Apart from this, carboxymethyl chitosan (CMCS) can be easily processed into nanoparticles which highlight its suitability and extensive usage for preparing different drug delivery formulations. The present study deals with the development and characterization of a delivery system based on CMCS nanoparticles using ovalbumin as model protein. We demonstrated that ovalbumin loaded nanoparticles were successfully synthetized using calcium chloride as a cross-linker by ionic gelation. The nanoparticles exhibited an average size of approximately 169 nm and presented a pseudo-spherical shape. The nanoparticles size increased according to the addition of CaCl2 due to the strong electrostatic attraction. During storage the nanoparticles size increased was attributed to swelling and aggregation. The loading efficiency of ovalbumin was found to be 17%. Confocal microscopy clearly showed the association between ovalbumin and CMCS chains into nanoparticles. Therefore, we suggest these nanoparticles can be considered as an attractive and promising carrier candidate for proteins and antigens. The major challenge that limits the use of such carriers is their instability in an aqueous medium. Thus, the next step of this work was to determine the robustness of several formulations using distinct freeze-drying protocols. This study demonstrated that mannitol in concentration of 10% (w/v) is well suited to preserve ovalbumin loaded CMCS nanocapsules from aggregation during lyophilization and subsequent reconstitution. Importantly, the results showed that an annealing step has a huge impact on porosity of freeze-dried cake by nearly complete crystallization of mannitol, once the crystalline matrix prevents the partial collapse and the formation of larger pores observed without annealing. Therefore, the usual observation that annealing increases the pore size due to growth of ice crystal size does not always apply, at least when crystallization of solute is involved. Since all characterizations and stability studies had been performed, the main purpose of this study was to develop a stable antigen delivery system for oral immunization using CMCS and inactivated rabies virus (RV) as the antigen. RV loaded nanoparticles was found to enhance both systemic (IgG) and local (IgA) immune responses against RV after oral delivery in mice. The effective doses 50% were 50-times higher than the negative controls, indicating that the immune response started only after the third boosting dose. Furthermore, enough neutralizing antibodies was produced to be protected against the harmful effects of the rabies virus. It is therefore concluded, that the CMCS nanoparticles formulated in this study, are suitable for oral vaccine delivery, and can be suggested as a promising delivery system for a diverse range of antigens as well as a gene/protein delivery system, especially for those positively charged. Since several approaches show that effective intervention in airway allergic inflammation can be achieved with allergen-activated interleukin-10-secreting cells, the final part of this work was dedicated to assessing whether IL-10 loaded chitosan nanoparticles (IL10-CSNPs) could be used as a possible inhalable therapeutic tool for preventing exacerbations in asthmatic patients. As positive controls, we also assess whether interleukin 17A and interleukin 9 have the ability to stimulate human airway smooth muscle (HASM) cell contractility using magnetic twisting cytometry (MTC). Significant decreased baseline cell stiffness was observed in HASM cells pre-treated with IL-10, but not with IL10-CSNPs, whereas treatment with IL-17A significantly enhanced baseline cell stiffening. Our findings reveal a previously unknown mechanism underlying immunotherapy for prevention and treatment of asthma. / A quitosana é um polímero mucoadesivo biocompatível e biodegradável, com vantagens únicas, tais como a característica distinta de abrir as junções que permitim o transporte paracelular de antígenos e boa tolerabilidade. No entanto, sua baixa solubilidade em meios neutros ou alcalinizados tem restringido suas aplicações no campo farmacêutico. A quitosana pode ser facilmente carboximetilada para melhorar de sua solubilidade em meios aquosos, enquanto sua biodegradabilidade e biocompatibilidade são preservadas. Além disso, a carboximetilquitosana (CMCS) pode ser facilmente processada na forma de nanopartículas, o que destaca sua adequabilidade para uso extensivo no preparo de sistemas de delivery de medicamentos. O presente estudo trata do desenvolvimento e caracterização de um sistema de delivery baseado em nanopartículas de CMCS utilizando ovalbumina como proteína modelo. Nós demonstramos que as nanopartículas carregadas com ovalbumina foram sintetizadas com sucesso utilizando cloreto de cálcio como agente de reticulação por gelificação iônica. As nanopartículas exibiram um tamanho médio de aproximadamente 169 nm e apresentaram uma forma pseudo-esférica. O tamanho das nanopartículas aumentou de acordo com a adição de CaCl2 devido à forte atração eletrostática. Durante o armazenamento, o tamanho aumentado das nanopartículas foi atribuído a incorporação de água e agregação. A eficiência de encapsulamento da ovalbumina foi de aproximadamente 17%. A microscopia confocal mostrou claramente a associação entre ovalbumina e a cadeias de CMCS nas nanopartículas. Sugerimos, portanto, que tal sistema pode ser considerado como candidato atraente e promissor para o carreamento de proteínas e antígenos. O principal desafio que limita o uso desses carreadores consiste na instabilidade em meio aquoso. Assim, o próximo passo deste trabalho foi determinar a robustez de várias formulações utilizandose diferentes protocolos de liofilização. Este estudo demonstrou que o manitol em uma concentração de 10% (p/v) é adequado para preservar da agregação as nanocápsulas de CMCS carregadas com ovalbumina durante a liofilização e subsequente reconstituição. Mais importante, os resultados mostraram que uma etapa de annealing tem um enorme impacto sobre a porosidade da amostra liofilizada devido a quase completa cristalização do manitol, uma vez que a matriz cristalina evita o colapso parcial e a formação de poros maiores observados na ausência do annealing. Portanto, a observação comum de que o annealing aumenta o tamanho doporos devido ao crescimento dos cristais de gelo nem sempre se aplica, pelo menos quando a cristalização de um soluto está envolvida. Uma vez que todas as caracterizações e estudos de estabilidade foram realizados, o principal objetivo deste estudo foi desenvolver um sistema estável de delivery de antígeno para imunização oral utilizando CMCS e vírus rábico inativado (RV) como antígeno. Verificou-se que as nanopartículas carregadas com RV aumentam as respostas imune sistêmica (IgG) e local (IgA) contra o RV após administração oral em camundongos. As doses efetivas 50% foram 50 vezes maiores que os controles negativos, indicando que a resposta imune foi iniciada apenas após a terceira dose da vacina. Além disso, foram produzidos anticorpos neutralizantes suficientes para proteção contra os efeitos nocivos do vírus rábico. Conclui-se, portanto, que as nanopartículas de CMCS formuladas neste estudo, são adequadas para o delivery oral de vacinas, e podem ser sugeridas como um sistema promissor de delivery para uma gama diversa de antígenos, bem como para o delivery de genes/proteínas, especialmente para aqueles carregados positivamente. Uma vez que diversas abordagens mostram que uma intervenção efetiva em casos de inflamação alérgica de vias aéreas pode ser conseguida por meio de células secretoras de interleucina 10 (IL-10) mediante ativação por alergenos, a parte final deste trabalho esteve dedicada a avaliação de nanopartículas de quitosana carregadas com IL-10 (IL10-CSNPs) como possível ferramenta terapêutica inalável para prevenção de exacerbações em pacientes asmáticos. Como controles positivos, avaliou-se adicionalmente se as interleucinas 17A (IL-17A) e 9 (IL-9) possuem a capacidade de estimular a contratilidade de células humanas de músculo liso de vias aéreas humanas (HASM) por meio de citometria de torção magnética (MTC). Uma diminuição significativa da rigidez celular basal foi observada em células HASM pré-tratadas com IL-10, mas não com IL10-CSNPs, enquanto que o tratamento com IL-17A aumentou significativamente a magnitude rigidez celular basal. Nossos resultados revelam um mecanismo previamente desconhecido subjacente à imunoterapia para prevenção e tratamento da asma.

Typ 2-cytokiner, IL-4 och IL-13 är kända för att spela en viktig roll i airway hyperresponsiveness (AHR) eller luftvägshyperreaktivitet, där de glatta muskelcellerna (ASM) drar ihop sig för lätt och för mycket som svar på direkta eller indirekta stimuli. Detta gör AHR till en avgörande egenskap hos astmatiker. Det har gjorts studier som har visat involvering av typ 2-cytokiner i AHR, men deras specifika inflammatoriska mekanismer är ännu outforskade. Denna experimentella studie på glatta muskelceller från luftvägarna (ASM) syftade till att undersöka involveringen av typ 2-cytokin inducerad kontraktilitet genom att fokusera på receptoraktivering, receptoruttryck samt ge insikter om frisättning av proteiner relaterade till luftvägsfibros, så kallad remodelling. Dessutom studerar den också effekten av IL- 4/IL-13 receptor antagonisten Dupilumab (anti-IL4Ra) på cytokinbehandlade HASM. Efter stimulering av HASM med IL-13 under 24 timmar visade resultaten att IL-13 orsakar en ospecifik, icke-receptormedierad ökning av intracellulärt kalciumflöde som svar på kalciumjonoforen A23187. Detta skulle potentiellt kunna öka kontraktiliteten hos glatta muskelceller som svar på flera olika kontraktila stimuli. Denna forskning ger också preliminära resultat som tyder på att IL-13 och IL-4 också ökar kalciumflödet som svar på aktivering av receptorer för specifika kontraktila mediatorer (Histamin, Carbachol, Leukotriene D4 och Substance P), och att effekten förmedlas via IL-4/IL-13-receptorn vilket blockeras med dupilumab som verkade minska effekten. Närvaron av fler receptorer för kontraktila mediatorer kan också öka kontraktiliteten hos glatta muskelceller som svar på IL-4 och IL-13. Återigen sågs ökat uttryck av receptorer för kontraktila stimuli efter behandling med cytokinerna som inhiberades av dupilumab. Dessutom undersökte vi effekten av IL-13 och IL-4 på frisättning av prokollagen 1 (en prekursor för mogna kollagena former) från mänskliga glatta muskelceller i luftvägarna. Våra resultat visade inte några signifikanta effekter på frisättningen av just detta kollagenprotein. Sammantaget visar vi att typ 2 cytokiner kan på flera olika sätt öka kontraktiliteten av glatta muskelceller vilket ökar vår kunskap om mekanismerna som orsakar luftvägshyperreaktivitet hos astmatiker. / Type 2 cytokines, IL-4 and IL-13 are known to play an essential role in airway hyperresponsiveness (AHR) - in response to direct or indirect stimulus the smooth muscle cells (ASM) contract too easily and too heavily. This makes AHR a defining feature of asthma. There have been studies that have demonstrated involvement of type 2 cytokines in AHR. However, the specific mechanisms involved remain undefined. This experimental study in airway smooth muscle (ASM) was aimed to investigate the involvement of type 2 cytokine on AHR by focusing on the expression and activation of receptors for contractile mediators as well as provide insights on the release of proteins related to airway remodelling. Experiments were performed where human airway smooth muscle cells were treated with IL-4 and/or IL-13, with or without Dupilumab, an antagonist of the joint IL-4/IL-13 receptor (anti-IL4Ra). After stimulating HASMs with IL-13 for 24 hours, results showed that IL-13 caused a non-specific, non-receptor-mediated increase in intracellular calcium flux in response to the calcium ionophore A23187. This could potentially increase the contractility of smooth muscle cells in response to any contractile stimulus. This study also suggests that IL-13 and IL-4 increased calcium flux in response to activation of receptors for specific contractile mediators (Histamine, Carbachol, Leukotriene D4 and Substance P). The mechanism involved likely involves the common IL-4/IL-13 receptor as blocking this with dupilumab seemed to reduce the effect. The presence of more receptors for contractile mediators could also increase contractility of smooth muscle cells in response to IL-4 and IL-13. Preliminary results show that mRNA expression of receptors for Histamine (H1) and LTD4 (CYSLT1) were upregulated by type 2 cytokines and again, this upregulation appeared to be inhibited by dupilumab. Moreover, we examined the effect of IL-13 and IL-4 on release of procollagen 1 (a precursor of mature collagen forms) from human airway smooth muscle cells. Our results did not show any significant effects on the release of this particular collagen protein. Taken together these findings increase our understanding of the mechanisms whereby type 2 cytokines may increase the contractility of airway smooth muscle and provide a basis for follow-up investigations. Improved knowledge of the mechanisms underlying AHR could ultimately lead to improved treatment of asthma.