|
|
||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
,1,2
,2



* Pulmonary and Critical Care Medicine, Department of Internal Medicine and
Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA;
Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan, USA; and
Department of Medicinal Chemistry and
|| Department of Immunology, Berlex Biosciences, Richmond, California, USA
1Correspondence: Pulmonary and Critical Care Medicine, Thorn Bldg., Rm. 826a, Brigham and Womens Hospital, 75 Francis St., Boston, MA 02115, USA. E-mail: blevy{at}partners.org
| ABSTRACT |
|---|
|
|
|---|
Key Words: resolution lipid mediators leukocytes
| INTRODUCTION |
|---|
|
|
|---|
5% of asthmatic patients are poorly controlled with corticosteroids and develop severe asthma that is refractory to treatment (2)
A rapidly expanding number of counter-regulatory mediators were recently uncovered that are endogenously generated to limit acute inflammatory responses and promote resolution (3)
. Lipoxins are the first described endogenous lipid mediators of anti-inflammation and resolution. Lipoxin A4 (LXA4) is a short-acting, naturally occurring eicosanoid with potent anti-inflammatory actions in vitro and in vivo (for a recent review, see ref. 3
). In humans, the lions share of LXA4 is produced locally at sites of inflammation by transcellular biosynthesis, and endogenous LXA4 synthesis can be primed by cytokines. Aspirin, which is known to inhibit prostaglandin and thromboxane biosynthesis, has a unique ability to trigger formation of the 15-epimer of LXA4, both in vitro and in vivo, via a mechanism involving cyclooxygenase-2 inhibition (3)
. Aspirin-triggered lipoxins (ATLs) retain the anti-inflammatory properties of LXA4 and may mediate, in part, aspirins therapeutic effects. LXA4 and the ATL or 15-epi-LXA4 exert anti-inflammatory effects through signals generated by binding to a high-affinity, G-protein-coupled LXA4 receptor, denoted ALX. ALX receptors are conserved in mammalian species and constitutively expressed on neutrophils, Eos, monocytes, and epithelium, thus being ideally localized to play key roles in modulating cell-cell interactions and cell-mediated immune responses in the airway. High-level ALX expression on neutrophils and Eos correlates with the ability of LXA4 to potently stop chemotaxis and transcellular migration of these inflammatory cells. Also of note, both LXA4 and 15-epi-LXA4 can compete with leukotriene D4 (LTD4) for specific binding at cysteinyl leukotriene 1 (CysLT1) receptors to serve in vivo as an antagonist for CysLT signaling (4)
, similar to existing asthma therapeutic agents, such as montelukast (1)
.
Rapid metabolic inactivation of LXA4 and 15-epi-LXA4 occurs via oxidation at C-15 and reduction at C13-C14 (5)
. These LXA4 metabolites have a reduced affinity for ALX and lower potency as anti-inflammatory agents in vitro. Chemical modifications to the C15-C20 region of LXA4 and ATLs prevent metabolic inactivation, providing metabolically stable analogs with superior pharmaceutical characteristics (6)
. These analogs have been used to establish that both LXA4 and ATLs stop neutrophil diapedesis, reduce epithelial cell cytokine release, and decrease vascular permeability of murine skin exposed to inflammatory stimuli (3)
. Eos-driven allergic reactions are also blocked by LXA4 and its stable analogs (7
, 8)
. In the airway, LXA4 and specific LX analogs administered intravenously dampen allergic airway inflammation and hyper-reactivity (8)
, and promote resolution of mild acute lung injury from aspiration of hydrochloric acid (9)
. Hence, LXA4 serves as a selective agonist at ALX receptors for cell type-specific actions and as an antagonist at CysLT1 receptors to block LTD4-mediated airway responses. Of particular interest in asthma, glucocorticoids, the most common anti-inflammatory agent used in its treatment, can induce LX signaling circuits by increasing expression of leukocyte ALX receptors (10)
and the counter-regulatory peptide mediator annexin 1 that signals via ALX (11)
. Taken together, these data indicate involvement of the endogenous LXA4/ALX pathway in promoting attenuation and/or resolution of responses to diverse proinflammatory mediators in airway inflammation.
Here we provide new findings on the actions and mechanisms for LXA4 analogs in altering allergic airway inflammation and hyper-reactivity in two distinct murine models of allergen-driven asthmatic responses and determine a structure activity relationship for LXA4-specific actions in the airway that are distinct from CysLT1 receptor antagonism.
| MATERIALS AND METHODS |
|---|
|
|
|---|
15 min (13)
|
Ovalbumin sensitization and challenge
Five- to 7-wk-old male FVB (Charles River Laboratories, Wilmington, MA, USA) mice were housed under pathogen-free conditions. After Harvard Medical Area IRB approval (protocol #03618), mice were sensitized with i.p. injections of ovalbumin (OVA; Grade III, Sigma-Aldrich Co., St. Louis, MO, USA) (200 µg) plus 1 mg aluminum hydroxide (Sigma-Aldrich) as adjuvant in 0.2 ml sterile saline (0.9%) on days 0 and 7. On days 14–17, mice received test compound (
500 µg/kg) by gavage, including 15-epi-16-parafluorophenoxy LXA4-me (ATLa; 10 µg=22.8 nmol), 3-oxa-trienyne-16-parafluorophenoxy LXA4 (3-oxa-LXA4; 10 µg=23.5 nmol), montelukast (10 µg=16.4 nmol), or vehicle (0.5% ethanol) in 0.2 ml sterile 0.9% saline 60 min before nebulization with 6% OVA (25 min). On day 18, mice were anesthetized and underwent bronchoalveolar lavage (BAL) with two instillations of 1 ml PBS plus 0.6 mM EDTA. After inflation to 25 cm H2O, lung tissues were excised into 10% neutral buffered formalin (Fisher Scientific, Pittsburgh, PA, USA) for histological examination.
Cockroach allergen sensitization and induction of airway responses
Five to seven week old Balb/c mice were immunized by i.p. injection with 10 µg of cockroach allergen (CRA, Bayer Pharmaceuticals, West Haven, CT, USA) emulsified in incomplete Freunds adjuvant on day 0. After 14 days the mice were lightly anesthetized and given an intranasal challenge of 10 µg of CRA in 10 µl diluent to localize the response to the airway. Seven days later animals were given an intratracheal injection of 4 µg of CRA in 40 µl of sterile PBS or with PBS alone (vehicle). A second intratracheal administration of allergen was performed 48 h later. This procedure has demonstrated a strong Th2-mediated, eosinophil-rich response. Animals were treated with an LXA4 analog or vehicle at the time of the final two intratracheal allergen challenges or provided in the drinking water (0, 1, or 10 µg/ml) for 3 days beginning on day 14, 2 h before intranasal allergen challenge. The amount of water the animals consumed in the 3 day period of treatment was measured and averaged on a per mouse basis. To conserve material, animals were analyzed 24 h after the final allergen challenge.
Allergen-initiated respiratory inflammation
BAL fluid was centrifuged (800 g, 10 min, 4°C), and the supernatant was aliquotted and stored at –80°C for later determination of mediator levels, including IL-4, IL-5, IL-10, RANTES (R&D systems, Minneapolis, MN, USA), CysLTs (Cayman Chemical, Ann Arbor, MI, USA), and LXA4 (Neogen, Lexington, KY, USA). The cell pellet was gently resuspended in PBS for total cell counts. To determine differentials, cells were concentrated onto microscope slides by cytocentrifuge (STATspin, Norwood, MA, USA) (265 g) and stained with a Wright-Giemsa stain (Sigma-Aldrich). At least 200 cells were counted per sample.
Lung homogenates
The right upper lobe from each mouse was flash-frozen in liquid nitrogen and kept at –80°C. Just prior to running the ELISA assays, the lungs were homogenized in 1 ml of homogenization buffer containing protease inhibitors (Complete, Roche, Indianapolis, IN, USA) and 0.1% Triton-X 100 in PBS.
Lung cytokine and chemokine ELISAs
Cytokines were quantitated from homogenized lung aqueous extracts using a double ligand ELISA system as in ref. 16
. Briefly, flat-bottomed 96-well microtiter plates were coated with capture antibody (3.2 µg/ml, overnight, 4°C). Nonspecific binding sites were blocked with 2% BSA in PBS (1 h, 37°C). Plates were washed and specimens were added in triplicate, followed by incubation at 37°C and washing. Biotinylated antibody was added for 1 h at 37°C. After washing, bound antibody was conjugated with streptavidin-peroxidase and detected with chromogen substrate. The individual polypeptides were standardized to total protein (ng/µg total protein). The lower limit of detection for these assays was
50 pg/ml. These ELISAs are specific and do not cross-react to other chemokine or cytokines.
Morphometric analysis of peribronchial Eos accumulation
Lungs from mice immunized and challenged with CRA or vehicle were preserved with 4% paraformaldehyde (1 ml) on day 18 postchallenge. The fixed lungs were embedded in paraffin and multiple 50 µm sections were stained with Wright-Giemsa to identify Eos. Individual Eos were counted from 100 high-power fields (HPF, 1000x) per lung using multiple-step sections of lung. The Eos counted were only in the peribronchial region to ensure the enumeration of only those Eos within or immediately adjacent to an airway. The inflammation observed in this model was completely associated with the airway with little or no alveolitis.
Measurement of airway hyper-reactivity
Airway hyper-reactivity was measured using a Buxco mouse plethysmograph specifically designed for low tidal volumes (Buxco, Troy, NY, USA) as described (16)
. Briefly, the mice were anesthetized, intubated, and ventilated with a Harvard pump ventilator (tidal volume=0.4 ml, frequency=120 breaths/min, positive end-expiratory pressure 2.5–3.0 cm H2O). Initial readings were acquired after 5 min of ventilation. Once baseline levels were stabilized and initial readings taken, a methacholine challenge was given via the cannulated tail vein. After determining a dose response curve (0.001 to 0.5 mg), an optimal dose of methacholine (0.1 mg) was chosen and used throughout the rest of the experiments in this study. After methacholine challenge, peak airway resistance was recorded as a measure of airway hyper-reactivity.
Statistical analyses
Numerical results were expressed as mean ± SE. Analysis of variance was used to determine the level of difference between groups. Pairs of groups were compared by unpaired 2-tailed Students t test. Significance was determined with P values of <0.05.
| RESULTS |
|---|
|
|
|---|
500 µg/kg of either ATLa, ZK-994, or montelukast, which were administered by gavage 60 min before aerosol challenge. Twenty-four hours after the last of four daily OVA aerosol challenges, BAL was performed or lung tissues were collected for microscopic analyses (see Materials and Methods). Similar to results with intravenous administration (8)
|
|
Oral ATLa treatment blocks airway responses to CRA
The cell population that has been most closely associated with asthma is the Eos (17)
and, unlike the Eos-rich alveolitis generated by OVA aerosol challenge, direct airway challenge with CRA, a common clinical trigger for human asthma (17)
, leads principally to peribronchial Eos accumulation, which is required for the development of airway hyper-reactivity (18)
. To determine the effect of LXA4 on allergic airway responses in this second experimental model of asthma, ATLa was prepared at two different concentrations, 1 µg/ml H2O or 10 µg/ml H2O, administered in the animals drinking water just before intranasal CRA and continued throughout the entire allergen challenge period (see Materials and Methods). In the 3 days (72 h) of ATLa oral administration, the animals consumed an average of 13 ml/mouse and 14 ml/mouse of the 1 and 10 µg/ml, respectively; 24 h after the final allergen challenge, the animals tested for airway hyper-reactivity or lung tissues were processed for cytokine analysis. In animals challenged with allergen and given ATLa orally in the drinking water, airway hyper-reactivity to methacholine was significantly decreased in a dose-dependent manner (Fig. 4
a). The decreased airway responsiveness with ATLa was also associated with decrements in lung IL-4 and IL-5 levels (Fig. 4b
). Together, these findings indicate that ATLa is orally active and that treatment with ATLa potently regulates allergic airway responses.
|
ZK-994 decreases allergic airway responses to CRA
To determine whether the ZK-994 LX/ATL analog could reduce CRA-driven airway inflammation, the compound (100–1000 µg/kg) or a vehicle control was administered intraperitoneally 2 h before intratracheal CRA challenge. Although the lowest dose of ZK-994 (100 µg/kg) showed no significant effect on the development of airway inflammation or hyper-reactivity (vide infra), administration of ZK-994 at 400 µg/kg and higher led to reductions in airway responses. Lung histology revealed reduced peribronchial inflammatory infilitrates (Fig. 5
a), and tissue morphometry demonstrated significantly reduced peribronchial Eos accumulation in those animals treated with ZK-994 (Fig. 5b
). In murine lung extracts, levels were determined for select cytokines, including IL-4, IL-5, IL-10, IL-12, and IFN
(Fig. 6
a, b), and chemokines, including C10, RANTES, eotaxin, and MCP-1 (Fig. 6c)
. In this experimental model, the only cytokine levels that were significantly altered by ZK-994 were pulmonary IL-5, IFN
, and IL-10 (Fig. 6a, b
). Significant decrements in all the chemokines except MCP-1 were also present with ZK-994 (Fig. 6c
). Decreased IL-5, IL-10, and chemokine levels with increased amounts of IFN
indicate a central regulatory effect of this analog on adaptive immunity that, in addition to LXA4s direct cellular actions, served to reduce leukocyte activation and trafficking. Besides these parameters of inflammation, systemic administration of ZK-994 by i.p. injection gave a concentration-dependent inhibition of airway hyper-reactivity to methacholine (Fig. 7
a). This protection from airway hyper-responsiveness to methacholine was also present when ZK-994 was administered by oral gavage. This reduction in bronchial hyper-reactivity was similar in potency to that observed with equivalent doses of montelukast (Fig. 7b
). Together, these data indicate that ZK-994 carries potent counter-regulatory properties that dampen allergic airway responses; it is orally bioavailable, and either oral administration or a single systemic administration of ZK-994 has protective biological effects that persist for several days.
|
|
|
| DISCUSSION |
|---|
|
|
|---|
Cysteinyl LTs are generated during allergic airway inflammation and serve as potent bronchoconstrictors (19)
. CysLT1 receptor activation has been associated with chronic airway inflammation and airway remodeling (20)
. Because LXA4 and select analogs can interact with both ALX and CysLT1, we directly compared responses of LXA4 stable analogs to montelukast, a pharmacological CysLT1 receptor antagonist, in allergen-induced airway inflammation. Unlike montelukast, LXA4 stable analogs significantly decreased Eos and Lymph trafficking as monitored by lung histology and enumeration of cells in BAL fluids. Both montelukast and LXA4 analogs reduced IL-13 levels, yet only the LX analogs dampened IL-4 and IL-5 levels. Of interest, ATLa also blocked CysLT levels. These findings indicate that LXA4 stable analogs transduce their protective effects via sites of action, such as ALX, that are distinct from CysLT1. It is still possible that decrements in IL-13 levels relate in part to regulation of CysLT1 signaling, but the LXA4 stable analogs were substantially more potent regulators of acute inflammation than montelukast.
In two different experimental models of asthma, systemic administration of LXA4 analogs modulated local immune responses, including Eos accumulation, Th2 type cytokine levels, and airway hyper-reactivity. The approach used to elicit inflammation and airway hyper-reactivity can be a critical determinant of the cells and mediators that are responsible for the allergic responses in murine lung (21)
as well as the lung compartment involved (18)
. Systemic sensitization by i.p. injection of OVA adsorbed to an adjuvant, followed by OVA aerosol challenge, induces airway eosinophilia and hyper-reactivity with increased levels of Th2 cytokines and chemokines; however, mast cells and IgE are not required for these responses. In contrast, direct administration of allergen, such as CRA, without adjuvant to the airway leads to mast cell-dependent responses (21)
and a more focused peribronchial eosinophilia that better reflects the pathobiology of human asthma (18)
. Here, ATLa and ZK-994 provided protection in both models. LXs and LX analogs are potent regulators of adaptive immunity, including dendritic and epithelial cell responses (22
, 23)
, as well as cellular effectors of both innate and adaptive immunity such as neutrophils, macrophages, Eos, and Lymphs (8
, 9
, 23
, 24)
.
Several potential links between LX signaling and cytokines and chemokines in regulating cellular responses have been uncovered (25)
. Activation of ALX in monocytes leads to phosphorylation of the chemokine receptor CCR5 and attenuates cell responses to select chemokines (26)
. In addition, HIV gp120 binds to ALX and alters the expression and function of CCR5 and CxCR4, again suggesting that this activation event, via ligation of ALX receptors, actively alters the chemotactic potential of leukocytes (27)
. In the OVA challenge model, ATLa and ZK-994 both inhibited airway Eos but utilized slightly different mechanisms. ATLa led to decrements in CysLTs and IL-5 whereas ZK-994 reduced RANTES. Specific cytokines, such as IL-5, and chemokines, including C10, eotaxin, and RANTES, play crucial roles in recruiting Eos to the site of allergic reactions (28)
. In the CRA model, ZK-994 significantly decreased all of these peptide mediators. Lipoxins also regulate structural cells in the airway (29)
and inflammatory pain (30)
. Because inflammatory and neuropeptide mediators have also been associated with airway remodeling in asthma (28)
, LXA4 stable analog alteration of the mediator phenotype within the lung has the potential to prevent chronic damage and lessen severity in asthma.
LXA4 is generated during human asthmatic responses (31)
. More severe variants of asthma, including aspirin-exacerbated respiratory disease, are associated with diminished lipoxin biosynthesis compared with more mild asthma (32
, 33)
. The relative conversion of arachidonic acid to LXA4 vs. CysLTs correlates with airflow obstruction (32)
, and administration of LXA4 to asthmatic subjects challenged with LTC4 significantly attenuates airway responsiveness (34)
. In conjunction with results presented here in experimental murine models of asthma, these findings indicate that endogenous LXA4 can counter asthmatic inflammation and airway responses.
In summary, our results demonstrate that LXA4 analogs administered by gavage, i.p. injection, or orally in drinking water regulate allergic airway responses in two different experimental models with a mode of therapeutic immunomodulation that is distinct from the currently clinically used montelukast. Thus, the potent counter-regulatory actions of LXA4 stable analogs display promise as needed therapies for allergic airway diseases and as a new therapeutic strategy in asthma.
| ACKNOWLEDGMENTS |
|---|
| FOOTNOTES |
|---|
3 Current address: Applied Research US, Bayer Healthcare Pharmaceuticals, 2600 Hilltop Drive, Richmond, CA 94804, USA. ![]()
Received for publication April 12, 2007. Accepted for publication May 31, 2007.
| REFERENCES |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
V. Starosta, K. Pazdrak, I. Boldogh, T. Svider, and A. Kurosky Lipoxin A4 Counterregulates GM-CSF Signaling in Eosinophilic Granulocytes J. Immunol., December 15, 2008; 181(12): 8688 - 8699. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Planaguma, S. Kazani, G. Marigowda, O. Haworth, T. J. Mariani, E. Israel, E. R. Bleecker, D. Curran-Everett, S. C. Erzurum, W. J. Calhoun, et al. Airway Lipoxin A4 Generation and Lipoxin A4 Receptor Expression Are Decreased in Severe Asthma Am. J. Respir. Crit. Care Med., September 15, 2008; 178(6): 574 - 582. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |