Lian Wu

Transforming growth factor-β1 genotype and susceptibility to chronic obstructive pulmonary disease

Background: Only a few long term smokers develop symptomatic chronic obstructive pulmonary disease (COPD) and this may be due, at least in part, to genetic susceptibility to the disease. Transforming growth factor β1 (TGF-β1) has a number of actions that make it a candidate for a role in the pathogenesis of COPD. We have investigated a single nucleotide polymorphism at exon 1 nucleotide position 29 (T→C) of the TGF-β1 gene that produces a substitution at codon 10 (Leu→Pro). Methods: The frequency of this polymorphism was determined in 165 subjects with COPD, 140 healthy blood donors, and 76 smokers with normal lung function (resistant smokers) using the polymerase chain reaction and restriction enzyme fragment length polymorphism. Results: The distribution of genotypes was Leu-Leu (41.8%), Leu-Pro (50.3%), and Pro-Pro (7.9%) for subjects with COPD, which was significantly different from the control subjects (blood donors: Leu-Leu (29.3%), Leu-Pro (52.1%) and Pro-Pro (18.6%), p = 0.006; resistant smokers: Leu-Leu (28.9%), Leu-Pro (51.3%) and Pro-Pro (19.7%), p = 0.02). The Pro10 allele was less common in subjects with COPD (33%) than in blood donors (45%; OR = 0.62, 95% CI 0.45 to 0.86, p = 0.005) and resistant smokers (45%; OR = 0.59, 95% CI 0.40 to 0.88, p = 0.01). Conclusions: The proline allele at codon 10 of the TGF-β1 gene occurs more commonly in control subjects than in individuals with COPD. This allele is associated with increased production of TGF-β1 which raises the possibility that TGF-β1 has a protective role in COPD.

Functional variants of antioxidant genes in smokers with COPD and in those with normal lung function

Background: Chronic obstructive pulmonary disease (COPD) is predominantly the consequence of chronic smoking exposure, but its development may be influenced by genetic variants that affect lung remodelling, inflammation, and defence from oxidant stress. A study was undertaken to determine whether genetic variants within genes encoding the antioxidant enzymes superoxide dismutase (SOD) and catalase may be associated with the development of impaired lung function. Methods: In a case-control study, the allele and genotype frequencies of functional polymorphisms from SOD1 (CuZnSOD), SOD2 (MnSOD), SOD3 (extracellular SOD), and catalase (CAT) were compared in chronic smokers with normal lung function (resistant smokers) and in those with COPD. Results: Significantly higher frequencies of the G allele and CG/GG genotype of the 213 SOD3 polymorphism were found in resistant smokers (odds ratios (ORs) 4.3 (95% CI 1.5 to 13.3) and 4.2, 95% CI 1.4 to 13.3), Bonferroni corrected p = 0.02 and p = 0.02, respectively) than in those with COPD. There were no differences between the COPD and resistant smokers for the SOD1, SOD2, or CAT polymorphisms tested. Conclusions: The 213Gly variant of the SOD3 gene may, through antioxidant or anti-inflammatory effects, confer a degree of resistance in some smokers to the development of COPD.

Advanced glycation end products and its receptor (RAGE) are increased in patients with COPD.

UNLABELLED Advanced Glycation End products (AGEs) are the products of nonenzymatic glycation and oxidation of proteins and lipids. Formation of AGEs is increased in response to hyperglycaemia, reactive oxygen species and ageing. AGEs are proinflammatory and can modify the extracellular matrix. RAGE (Receptor for Advanced Glycation End Products) mediates some of the effects of AGEs. METHODS Formalin-fixed lung tissue from patients who had lobectomy for bronchial carcinoma was used to investigate the presence of AGEs and RAGE. Subjects were divided into those with COPD and controls. Immunostaining for AGEs and RAGE was performed and the intensity of staining measured. RESULTS Subjects with COPD and controls were similar in age and smoking history but FEV(1)% predicted was lower for COPD than controls. Intensity of staining for AGEs was greater in the airways (p = 0.025) and alveolar walls (p = 0.004) in COPD. Intensity of staining for RAGE was also significantly increased in alveolar walls (p = 0.03) but not the airways. FEV(1)% predicted was correlated with the intensity of staining for AGEs in the airways and alveoli. CONCLUSIONS The increased staining for both AGEs and RAGE in COPD lung raises the possibility that the RAGE-AGEs interaction may have a role in the pathogenesis of COPD.

Influence of Mediterranean Diet on Asthma Symptoms, Lung Function, and Systemic Inflammation: A Randomized Controlled Trial

Objective. The rapidly increasing prevalence of asthma in developed countries suggests an environmental cause. The benefits of Mediterranean diet (MD) in cardiovascular disease have been tentatively attributed to its anti-inflammatory properties. Asthma is an inflammatory disease and MD is associated with reduced asthma risk in epidemiological studies, but there are no reported interventional studies of MD in asthma. Methods. In this 12-week open-label randomized trial, 38 adults with symptomatic asthma were allocated to high-intervention (HI), low-intervention (LI), and control groups. The first two groups were encouraged to adopt an MD and received multiple consultation sessions with a nutritionist, written advice, and vouchers for the purchase of appropriate foods. Food frequency questionnaires, asthma control questionnaires, asthma-related quality of life questionnaires (AQLQs), and spirometry were completed at the beginning and at the end of the study. Results: The MDt score increased in the HI group (p < .001), indicating successful alteration of dietary behavior. Statistically, nonsignificant improvements were seen in spirometry and several AQLQ subdomains in the two intervention groups. No changes were seen in the asthma control or in inflammatory markers. Conclusions: The trial intervention has successfully altered the dietary behavior among adults with asthma. Small but consistent improvements were seen in quality of life and spirometry among the intervention group. The use of the MD to treat asthma is feasible and warrants evaluation in a larger study, powered to examine clinical endpoints.

Pro-inflammatory Phenotype of COPD Fibroblasts not Compatible with Repair in COPD Lung

Chronic obstructive pulmonary disease (COPD) is characterized by loss of elastic fibres from small airways and alveolar walls, with the decrease in elastin increasing with disease severity. It is unclear why there is a lack of repair of elastic fibres. We have examined fibroblasts cultured from lung tissue from subjects with or without COPD to determine if the secretory profile explains lack of tissue repair. In this study, fibroblasts were cultured from lung parenchyma of patients with mild COPD [Global initiative for chronic Obstructive Lung Disease (GOLD) 1, n= 5], moderate to severe COPD (GOLD 2–3, n= 12) and controls (non‐COPD, n= 5). Measurements were made of proliferation, senescence‐associated β‐galactosidase‐1, mRNA expression of IL‐6, IL‐8, MMP‐1, tropoelastin and versican, and protein levels for IL‐6, IL‐8, PGE2, tropoelastin, insoluble elastin, and versican. GOLD 2–3 fibroblasts proliferated more slowly (P < 0.01), had higher levels of senescence‐associated β‐galactosidase‐1 (P < 0.001) than controls and showed significant increases in mRNA and/or protein for IL‐6 (P < 0.05), IL‐8 (P < 0.01), MMP‐1 (P < 0.05), PGE2 (P < 0.05), versican (P < 0.05) and tropoelastin (P < 0.05). mRNA expression and/or protein levels of tropoelastin (P < 0.01), versican (P < 0.05), IL‐6 (P < 0.05) and IL‐8 (P < 0.05) were negatively correlated with FEV1% of predicted. Insoluble elastin was not increased. In summary, fibroblasts from moderate to severe COPD subjects display a secretory phenotype with up‐regulation of inflammatory molecules including the matrix proteoglycan versican, and increased soluble, but not insoluble, elastin. Versican inhibits assembly of tropoelastin into insoluble elastin and we conclude that the pro‐inflammatory phenotype of COPD fibroblasts is not compatible with repair of elastic fibres.

Intrapleural delivery of MSCs attenuates acute lung injury by paracrine/endocrine mechanism

Two different repair mechanisms of mesenchymal stem cells (MSCs) are suggested to participate in the repair of acute lung injury (ALI): (i) Cell engraftment mechanism, (ii) Paracrine/endocrine mechanism. However, the exact roles they play in the repair remain unclear. The aim of the study was to evaluate the role of paracrine/endocrine mechanism using a novel intrapleural delivery method of MSCs. Either 1 × 106 MSCs in 300 μl of PBS or 300 μl PBS alone were intrapleurally injected into rats with endotoxin‐induced ALI. On days 1, 3 or 7 after injections, samples of lung tissues and bronchoalveolar lavage fluid (BALF) were collected from each rat for assessment of lung injury, biochemical analysis and histology. The distribution of MSCs was also traced by labelling the cells with 4′,6‐diamidino‐2‐phenylindole dihydrochloride (DAPI). MSCs intrapleural injection significantly improved LPS‐induced lung histopathology compared with PBS‐treated group at day 3. There was also a significant decrease in total cell counts and protein concentration in BALF at day 7 in the MSCs ‐treated rats compared to PBS control group. Tracking the DAPI‐marked MSCs showed that there were no exotic MSCs in the lung parenchyma. MSCs administration resulted in a down‐regulation of pro‐inflammatory response to endotoxin by reducing TNF‐α both in the BALF and in the lung, while up‐regulating the anti‐inflammatory cytokine IL‐10 in the lung. In conclusion, treatment with intrapleural MSCs administration markedly attenuates the severity of endotoxin‐induced ALI. This role is mediated by paracrine/endocrine repair mechanism of MSCs rather than by the cell engraftment mechanism.

Inhibited proliferation of human lung fibroblasts by LPS is through IL-6 and IL-8 release.

Through the consideration of decreased proliferation of lung fibroblasts from subjects with chronic obstructive pulmonary disease (COPD) and the proinflammatory role of lipopolysaccharide (LPS) in the COPD development, we hypothesized that LPS might inhibit proliferation in lung fibroblasts and the possible mechanism was investigated. Primary human lung fibroblasts were cultured from peripheral lung tissue and then treated with or without LPS. Proliferation was measured by AlamarBlue® assay. Levels of TNF-α, IL-6, IL-8, IL-12p70, IL-1β and IL-10 in the supernatants were measured by ELISA. The mRNA of histone deacetylases 2 (HDAC2) was analyzed using real-time PCR. LPS appeared to have a dose-dependent inhibitory effect on fibroblasts proliferation. The concentrations of IL-6 and IL-8 in the treatment culture media were significantly increased, accompanied by a reduced mRNA expression of HDAC2. IL-6 or IL-8 itself led to the reduction of fibroblasts proliferation. Treatment with 1 ng/ml TNF-α in fibroblasts also caused a significant decrease in proliferation and an increase in the production of IL-8 and IL-6. Our data suggest that LPS can inhibit the proliferation of in vitro human lung fibroblasts at least through a production of IL-6 and IL-8. The cytokine response is related to the decreased HDAC2 transcription.

Chronic Obstructive Pulmonary Disease in Non-smokers: A Case-Comparison Study

Abstract Background: COPD is often regarded as a smokers disease. In fact, up to 50% of COPD could be attributable to other causes. Relatively little is known about COPD among nonsmokers, and this group is usually excluded from studies of COPD. Methods: In this cross-sectional case-comparison study, smokers and nonsmokers aged over 45 with COPD (post-bronchodilator FEV1 ≤ 70% predicted, FEV1/FVC ratio < 0.7) were recruited from specialist outpatient clinics and from primary care. Subjects completed a questionnaire and interview, and underwent spirometry, venesection, exhaled nitric oxide (ENO) measurement, allergen skinprick testing, formal lung function testing and high resolution CT. Results: 48 nonsmokers and 45 smokers participated. Asthma was nearly universal among nonsmokers and was the commonest identifiable cause of COPD in that group. Nonsmokers also exhibited a high prevalence of objective eosinophilic inflammation (raised ENO and eosinophil counts, positive skinprick tests). Smokers had more severe airflow obstruction, but respiratory symptom prevalences were similar between groups. Nonsmokers reported greater lifetime burdens of respiratory disease. Nonsmokers’ HRCT results showed functional small airways disease, with no significant emphysema in any subject. Previously undiagnosed bronchiectasis was common in both groups (31% and 42%). Conclusions: Asthma is a very common cause of COPD among nonsmokers. Radiological bronchiectasis is common in COPD; the clinical significance of this finding is unclear.

The cyclooxygenase-2-765C promoter polymorphism protects against the development of chronic obstructive pulmonary disease

BACKGROUND Susceptibility to Chronic Obstructive Pulmonary Disease (COPD) has a genetic component. We undertook a study to determine if a genetic variant of the gene encoding the cyclooxygenase-2 gene influences the likelihood of developing COPD. METHODS In a case control study the frequency of a single nucleotide polymorphism in the promoter region of the cyclooxygenase-2 gene (-765 G → C) was determined in 205 subjects with COPD, 171 chronic smokers with normal lung function (resistant smokers) and 95 healthy blood donors using the polymerase chain reaction and restriction enzyme fragment length polymorphism. RESULTS The frequency of the C allele of the -765 cyclooxygenase-2 polymorphism was higher in resistant smokers (24.6%) compared with subjects with COPD (14.4%, OR = 1.98, 95% CI = 1.28-3.06, p = 0.003) and blood donors (14.7%, OR = 1.97, 95% CI = 1.14-3.41, p = 0.03). CONCLUSIONS The -765C allele, which has been shown to be associated with decreased promoter activity of the cyclooxygenase-2 gene, is more common in resistant smokers. This raises the possibility that decreased activity of cyclooxygenase-2 may protect smokers against the development of COPD.

Pulmonary fibroblasts from COPD patients show an impaired response of elastin synthesis to TGF-β1

Insufficiency of tissue repair by pulmonary fibroblasts may contribute to the decrease in elastic fibres in chronic obstructive pulmonary disease (COPD). In this study, the repair function of COPD fibroblasts was assessed by examining the response to transforming growth factor (TGF)-β1. Primary pulmonary fibroblasts were cultured from lung tissue of COPD patients and smoking control subjects. Cellular proliferation was measured with Alamar Blue reduction method. Levels of tropoelastin mRNA and soluble elastin was measured using real-time RT-PCR and Fastin elastin assay respectively. The percentage of increase in proliferation and elastin production after TGF-β1 (1 ng/ml) treatment was calculated for fibroblasts from each subject. COPD fibroblasts showed slower proliferation than control fibroblasts, and a reduced response to TGF-β1 stimulation. The promotive effect of TGF-β1 on elastin synthesis in control fibroblasts was significantly diminished in fibroblasts from COPD patients. Our findings indicate that COPD lung fibroblasts have a significantly decreased response to TGF-β1 in terms of proliferation and elastin production.