Niacin Reduces Atherosclerosis Development in APOE*3Leiden.CETP Mice Mainly by Reducing NonHDL-Cholesterol

Objective

Niacin potently lowers triglycerides, mildly decreases LDL-cholesterol, and largely increases HDL-cholesterol. Despite evidence for an atheroprotective effect of niacin from previous small clinical studies, the large outcome trials, AIM-HIGH and HPS2-THRIVE did not reveal additional beneficial effects of niacin (alone or in combination with laropiprant) on top of statin treatment. We aimed to address this apparent discrepancy by investigating the effects of niacin without and with simvastatin on atherosclerosis development and determine the underlying mechanisms, in APOE*3Leiden.CETP mice, a model for familial dysbetalipoproteinemia (FD).

Approach and Results

Mice were fed a western-type diet containing cholesterol without or with niacin (120 mg/kg/day), simvastatin (36 mg/kg/day) or their combination for 18 weeks. Similarly as in FD patients, niacin reduced total cholesterol by -39% and triglycerides by −50%, (both P<0.001). Simvastatin and the combination reduced total cholesterol (−30%; −55%, P<0.001) where the combination revealed a greater reduction compared to simvastatin (−36%, P<0.001). Niacin decreased total cholesterol and triglycerides primarily by increasing VLDL clearance. Niacin increased HDL-cholesterol (+28%, P<0.01) and mildly increased reverse cholesterol transport. All treatments reduced monocyte adhesion to the endothelium (−46%; −47%, P<0.01; −53%, P<0.001), atherosclerotic lesion area (−78%; −49%, P<0.01; −87%, P<0.001) and severity. Compared to simvastatin, the combination increased plaque stability index [(SMC+collagen)/macrophages] (3-fold, P<0.01). Niacin and the combination reduced T cells in the aortic root (−71%, P<0.01; −81%, P<0.001). Lesion area was strongly predicted by nonHDL-cholesterol (R² = 0.69, P<0.001) and to a much lesser extent by HDL-cholesterol (R² = 0.20, P<0.001).

Conclusion

Niacin decreases atherosclerosis development mainly by reducing nonHDL-cholesterol with modest HDL-cholesterol-raising and additional anti-inflammatory effects. The additive effect of niacin on top of simvastatin is mostly dependent on its nonHDL-cholesterol-lowering capacities. These data suggest that clinical beneficial effects of niacin are largely dependent on its ability to lower LDL-cholesterol on top of concomitant lipid-lowering therapy.     

慢性炎症与动脉粥样硬化关系的研究进展

动脉粥样硬化(atherosclerosis,AS)的发病机制非常复杂,对其研究经历了一个半世纪,直到1999年Ross提出"动脉粥样硬化是一种炎症性疾病",各种炎症细胞和炎症因子参与动脉粥样硬化的发生和发展过程。已有众多的基础和临床研究都证实炎症在AS中的重要作用,但仍需要对AS发生发展的深入研究,使我们更准确认识和有效的防治AS。本文就近年来慢性炎症与动脉粥样硬化关系的研究进展作一综述。     

慢性炎症与动脉粥样硬化关系的研究进展

动脉粥样硬化（atherosclerosis,AS）的发病机制非常复杂,对其研究经历了一个半世纪,直到1999年Ross提出”动脉粥样硬化是一种炎症性疾病”,各种炎症细胞和炎症因子参与动脉粥样硬化的发生和发展过程。已有众多的基础和临床研究都证实炎症在AS中的重要作用,但仍需要对AS发生发展的深入研究,使我们更准确认识和有效的防治AS。本文就近年来慢性炎症与动脉粥样硬化关系的研究进展作一综述。     

Overexpression of CCN3 Inhibits Inflammation and Progression of Atherosclerosis in Apolipoprotein E-Deficient Mice

Background

Cysteine-rich 61/connective tissue growth factor/nephroblastoma overexpressed (CCN) 3 has been recently reported to play a role in regulating inflammation of vascular endothelial cells. However, the role of CCN3 in atherosclerosis, which is characterized by vascular inflammation, remains unclear.

Hypothesis and Objectives

Overexpression of CCN3 may relieve the inflammation response in and inhibit the progress of atherosclerosis. We aimed to explore the potential roles of CCN3 in inflammation in atherosclerosis.

Strategy and Main Results

In in vitro studies using cultured human aortic endothelial cells and human umbilical vein endothelial cells, CCN3 mRNA and protein expression significantly decreased in response to tumor necrosis factor-α and interleukin-1β treatments (p<0.05), when analyzed by quantitative real-time polymerase chain reaction and Western blot. Using a mouse model of atherosclerosis, the mRNA and protein levels of CCN3 decreased by 72.2% (p = 0.041) and 86.4% (p = 0.036), respectively, compared with levels in wild-type control mice, respectively. Overexpression of CCN3 by adenovirus-mediated gene overexpression decreased low-density lipoprotein cholesterol by 48.9% (p = 0.017), total cholesterol by 58.9% (p = 0.031), and triglycerides by 56.8% (p = 0.022), and it increased high-density lipoprotein cholesterol level by 2.16-fold (p = 0.039), compared with control groups. Additionally, a reduced plaque area and increased fibrous cap were observed (p<0.05). Furthermore, CCN3 overexpression decreased cell adhesion molecule-1 mRNA expression by 84.7% (p = 0.007) and intercellular adhesion molecule-1 mRNA expression by 61.2% (p = 0.044). Inflammatory factors, including matrix metalloproteinases, cyclooxygenase 2, and tissue factor also significantly (p<0.05) decreased with CCN3 overexpression in the atherosclerotic mouse model. Additionally, CCN1 and CCN2, which have been reported to be highly expressed in aortic atherosclerotic plaques, were significantly downregulated (p<0.05) by CCN3 overexpression.

Conclusion

CCN3 overexpression is associated with control of inflammatory processes and reversion of dyslipidemia in the process of atherosclerosis, which implies that CCN3 may be a promising target in the treatment of atherosclerosis.     

Thioredoxin-1 Protects against Neutrophilic Inflammation and Emphysema Progression in a Mouse Model of Chronic Obstructive Pulmonary Disease Exacerbation

Background

Exacerbations of chronic obstructive pulmonary disease (COPD) are characterized by acute enhancement of airway neutrophilic inflammation under oxidative stress and can be involved in emphysema progression. However, pharmacotherapy against the neutrophilic inflammation and emphysema progression associated with exacerbation has not been established. Thioredoxin-1 has anti-oxidative and anti-inflammatory properties and it can ameliorate neutrophilic inflammation through anti-chemotactic effects and prevent cigarette smoke (CS)-induced emphysema. We aimed to determine whether thioredoxin-1 can suppress neutrophilic inflammation and emphysema progression in a mouse model of COPD exacerbation and if so, to reveal the underlying mechanisms.

Results

Mice were exposed to CS and then challenged with polyinosine-polycytidylic acid [poly(I:C)], an agonist for virus-induced innate immunity. Airway neutrophilic inflammation, oxidative stress and lung apoptosis were enhanced in smoke-sensitive C57Bl/6, but not in smoke-resistant NZW mice. Exposure to CS and poly(I:C) challenge accelerated emphysema progression in C57Bl/6 mice. Thioredoxin-1 suppressed neutrophilic inflammation and emphysema progression. Poly(I:C) caused early neutrophilic inflammation through keratinocyte-derived chemokine and granulocyte-macrophage colony-stimulating factor (GM-CSF) release in the lung exposed to CS. Late neutrophilic inflammation was caused by persistent GM-CSF release, which thioredoxin-1 ameliorated. Thioredoxin-1 enhanced pulmonary mRNA expression of MAP kinase phosphatase 1 (MKP-1), and the suppressive effects of thioredoxin-1 on prolonged GM-CSF release and late neutrophilic inflammation disappeared by inhibiting MKP-1.

Conclusion

Using a mouse model of COPD exacerbation, we demonstrated that thioredoxin-1 ameliorated neutrophilic inflammation by suppressing GM-CSF release, which prevented emphysema progression. Our findings deepen understanding of the mechanisms underlying the regulation of neutrophilic inflammation by thioredoxin-1 and indicate that thioredoxin-1 could have potential as a drug to counteract COPD exacerbation.     

Leukocytosis and Enhanced Susceptibility to Endotoxemia but Not Atherosclerosis in Adrenalectomized APOE Knockout Mice

Hyperlipidemic apolipoprotein E (APOE) knockout mice show an enhanced level of adrenal-derived anti-inflammatory glucocorticoids. Here we determined in APOE knockout mice the impact of total removal of adrenal function through adrenalectomy (ADX) on two inflammation-associated pathologies, endotoxemia and atherosclerosis. ADX mice exhibited 91% decreased corticosterone levels (P<0.001), leukocytosis (WBC count: 10.0 ± 0.4 x 10E9/L vs 6.5 ± 0.5 x 10E9/L; P<0.001) and an increased spleen weight (P<0.01). FACS analysis on blood leukocytes revealed increased B-lymphocyte numbers (55 ± 2% vs 46 ± 1%; P<0.01). T-cell populations in blood appeared to be more immature (CD62L+: 26 ± 2% vs 19 ± 1% for CD4+ T-cells, P<0.001 and 58 ± 7% vs 47 ± 4% for CD8+ T-cells, P<0.05), which coincided with immature CD4/CD8 double positive thymocyte enrichment. Exposure to lipopolysaccharide failed to increase corticosterone levels in ADX mice and was associated with a 3-fold higher (P<0.05) TNF-alpha response. In contrast, the development of initial fatty streak lesions and progression to advanced collagen-containing atherosclerotic lesions was unaffected. Plasma cholesterol levels were decreased by 35% (P<0.001) in ADX mice. This could be attributed to a decrease in pro-atherogenic very-low-density lipoproteins (VLDL) as a result of a diminished hepatic VLDL secretion rate (-24%; P<0.05). In conclusion, our studies show that adrenalectomy induces leukocytosis and enhances the susceptibility for endotoxemia in APOE knockout mice. The adrenalectomy-associated rise in white blood cells, however, does not alter atherosclerotic lesion development probably due to the parallel decrease in plasma levels of pro-atherogenic lipoproteins.     

Automated Measurement of Pulmonary Emphysema and Small Airway Remodeling in Cigarette Smoke-exposed Mice

COPD is projected to be the third most common cause of mortality world-wide by 2020⁽¹⁾. Animal models of COPD are used to identify molecules that contribute to the disease process and to test the efficacy of novel therapies for COPD. Researchers use a number of models of COPD employing different species including rodents, guinea-pigs, rabbits, and dogs⁽²⁾. However, the most widely-used model is that in which mice are exposed to cigarette smoke. Mice are an especially useful species in which to model COPD because their genome can readily be manipulated to generate animals that are either deficient in, or over-express individual proteins. Studies of gene-targeted mice that have been exposed to cigarette smoke have provided valuable information about the contributions of individual molecules to different lung pathologies in COPD^(3-5). Most studies have focused on pathways involved in emphysema development which contributes to the airflow obstruction that is characteristic of COPD. However, small airway fibrosis also contributes significantly to airflow obstruction in human COPD patients⁽⁶⁾, but much less is known about the pathogenesis of this lesion in smoke-exposed animals. To address this knowledge gap, this protocol quantifies both emphysema development and small airway fibrosis in smoke-exposed mice. This protocol exposes mice to CS using a whole-body exposure technique, then measures respiratory mechanics in the mice, inflates the lungs of mice to a standard pressure, and fixes the lungs in formalin. The researcher then stains the lung sections with either Gill’s stain to measure the mean alveolar chord length (as a readout of emphysema severity) or Masson’s trichrome stain to measure deposition of extracellular matrix (ECM) proteins around small airways (as a readout of small airway fibrosis). Studies of the effects of molecular pathways on both of these lung pathologies will lead to a better understanding of the pathogenesis of COPD.     

青藤碱对慢性非细菌性大鼠前列腺炎大鼠炎症反应及P38Mapk信号通路的影响

目的:观察青藤碱对慢性非细菌性大鼠前列腺炎大鼠炎症反应及P38Mapk信号通路的影响。方法:将SD大鼠随机分为对照组、青藤碱高、低剂量组。对照组组给予生理盐水灌胃,青藤碱低、中、高剂量组分别给予青藤碱40、80、160mg/kg灌胃,28天后处死。realtime RT-PCR法和western blot法检测肿瘤组织中TNF-、IL-6 mRNA和TNF-、IL-6、p-P38 MAPK蛋白的表达。结果:青藤碱能明显降低慢性非细菌性大鼠前列腺炎大鼠前列腺组织中TNF-、IL-6 mRNA和TNF-、IL-6、p-P38 MAPK蛋白的表达。结论:青藤碱能抑制慢性非细菌性大鼠前列腺炎大鼠前列腺炎症反应,其机制可能与抑制P38 MAP信号通路有关。     

青藤碱对慢性非细菌性大鼠前列腺炎大鼠炎症反应及P38Mapk信号通路的影响

目的：观察青藤碱对慢性非细菌性大鼠前列腺炎大鼠炎症反应及P38Mapk信号通路的影响。方法：将SD大鼠随机分为对照组、青藤碱高、低剂量组。对照组组给予生理盐水灌胃,青藤碱低、中、高剂量组分别给予青藤碱40,80、160mg／kg灌胃,28天后处死。realtimeRT-PCR法和westernblot法检测肿瘤组织中TNF-、IL-6rnR_NA和TNF-、IL-6、P—P38MAPK蛋白的表达。结果：青藤碱能明显降低慢性非细菌性大鼠前列腺炎大鼠前5,1腺组织中TNF-、IL-6mRNA和TNF-、IL-6、p-P38MAPK蛋白的表达。结论：青藤碱能抑制慢性非细菌性大鼠前列腺炎大鼠前列腺炎症反应,其机制可能与抑制P38MAP信号通路有关。     

Ameliorating the Effect of Pioglitazone on LPS-Induced Inflammation of Human Oligodendrocyte Progenitor Cells

Oligodendrocyte progenitor cells (OPCs) are appropriate model cells for studying the progress of neurodegenerative disorders and evaluation of pharmacological efficacies of small molecules for treatment of these disorders. Here, we focused on the therapeutic role of Pioglitazone, which is a selective agonist of peroxisome proliferator-activated receptor gamma (PPARγ), a respective nuclear receptor in inflammatory responses. Human embryonic stem cell-derived OPCs were pretreated by Pioglitazone at differing concentrations. Pretreated OPCs were further examined after induction of inflammation by LPS. Interestingly, Pioglitazone reversed the inflammatory conditions and enhanced OPC viability. Data showed that Pioglitazone reduced Nitric Oxide (NO) production. Moreover, Pioglitazone enhanced cell viability through distinct mechanisms including reduction of apoptosis and regulation of cell cycle markers. This study demonstrated that NO induces apoptosis through FOXO1 and degradation of β-catenin, while the presence of Pioglitazone inhibited these effects in rescuing human OPCs from apoptosis. Also, Pioglitazone did not show a significant influence on mRNA levels of TLR2, TRL4, and TNFα. Furthermore, simultaneous treatment of Pioglitazone with CHIR, a GSKβ inhibitor, facilitated anti-apoptotic responses of OPCs. Taken together, therapy with Pioglitazone represents a novel potential drug in alleviating the loss of OPCs in neurodegenerative conditions.     

A Combined Pulmonary Function and Emphysema Score Prognostic Index for Staging in Chronic Obstructive Pulmonary Disease

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone.

Aim

To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach.

Material-Methods

Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used.

Results

169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04–1.252) and emphysema score (HR = 1.034, 95% CI = 1.007–1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity <210% predicted). This approach was more discriminatory for survival (HR = 3.123; 95% CI = 1.094–10.412) than either individual component alone.

Conclusion

Although to an extent limited by the small sample size, this preliminary study indicates that the composite Emphysema score-Functional Residual Capacity index might provide a better separation of high and low risk patients with COPD, than other individual predictors alone.     

血必净干预对慢性阻塞性肺疾病大鼠体内炎症因子的影响 *

摘要 目的： 通过观察血必净干预对慢性阻塞性肺疾病 （COPD ） 大鼠体内炎症因子的影响, 探讨血必净治疗 COPD 的机制。方法： 36 只 Wistar 雄性大鼠随机分为对照组、 COPD 型组 （ 简称型组 ） 、 血必净干预组 （简称干预组）, 每组 12 只。 采用香烟烟雾暴露 加气管内滴注脂多糖法建立 COPD 大鼠型。 造模时间共 30 天, 其中干预组在后 15 天给予血必净 4 ml/Kg 体重尾静脉注射。 分 别测定各组肺功能, 肺组织病理学变化, 血清及肺泡灌洗液中肿瘤坏死因子 （ TNF-α ） 、 白介素 -6 （IL-6 ） 、 白介素 -8 （ IL-8 ） 浓度。结 果： 模型组大鼠 FEV0.3/FVC [(57.8 ± 5.6) %]和动态肺顺应性 （Cydn ） [(0.098± 0.006) cmH2 O · mL -1 · s -1 , 1cmH2O=0.098 kPa]均明显 低于对照组[(81.4± 3.1)%和(0.195± 0.012) cmH2 O · mL -1 · s -1 ],而干预组大鼠[(67.2 ± 3.2)%和(0.142± 0.024) cmH2O · mL -1 · s -1 ]则较 模型组有显著提高, 差异均具有统计学意义 （t 值分别为 -13.940、 -15.165、 -5.552、 -6.927, 均 P＜ 0.01 ） ; 型组大鼠平均气道阻力 （RI ） [(0.802± 0.070) mL/cmH2 O]明显高于对照组[(0.224± 0.069) mL/cmH2 O],而干预组[(0.475± 0.050) mL/cmH2 O]则较型组有 明显下降, 差异均具有统计学意义 （t 值分别为 -22.389、 -12.658, 均 P＜ 0.01 ） ; 模型组大鼠血清和肺泡灌洗液中 TNF-α、 IL-6、 IL-8 浓度[(27.8± 7. 4) pg/mL和(340.0± 79. 6) pg/mL、 (209.9± 82.1) pg/mL和(337.3± 96. 4) pg/mL、 (37.7± 11.4) pg/mL和(69.6± 18. 9) pg/mL] 均显著高于对照组, 差异均具有统计学意义 （t 值分别为 -12.466、 -19.648、 -11.749、 -16.364、 12.550、 14.834, 均 P＜ 0.01 ） ,而干预组 大鼠[(9.6± 5.6) pg/mL和(45.6± 22.9) pg/mL、 (36.3± 17.9) pg/mL和(42.9± 20.5) pg/mL、 (10.3± 5.6) pg/mL和(15.7± 8.0) pg/mL]则较 型组有显著降低, 差异均具有统计学意义 （t 值分别为 -9.367、 -17.390、 -10.106、 -14.631、 10.475、 12.772, 均 P＜ 0.01 ）。 结论： COPD 大鼠血清及肺泡灌洗液中炎症因子 TNF-琢、 IL-6、 IL-8 的浓度均显著增高, 血必净干预能显著下调上述关键致炎因子的表达, 并与 其临床症状、 肺功能、 病理学改变相印证。因此, 我们推测： 血必净可能通过下调 COPD 炎症时 TNF-α、 IL-6、 IL-8 等关键致炎因子 的表达, 进一步抑制气道炎症的级联效应来发挥其强大的抗炎作用。     

The Effect of TIP on Pneumovirus-Induced Pulmonary Edema in Mice

Background

Pulmonary edema plays a pivotal role in the pathophysiology of respiratory syncytial virus (RSV)-induced respiratory failure. In this study we determined whether treatment with TIP (AP301), a synthetic cyclic peptide that mimics the lectin-like domain of human TNF, decreases pulmonary edema in a mouse model of severe human RSV infection. TIP is currently undergoing clinical trials as a therapy for pulmonary permeability edema and has been shown to decrease pulmonary edema in different lung injury models.

Methods

C57BL/6 mice were infected with pneumonia virus of mice (PVM) and received TIP or saline (control group) by intratracheal instillation on day five (early administration) or day seven (late administration) after infection. In a separate set of experiments the effect of multiple dose administration of TIP versus saline was tested. Pulmonary edema was determined by the lung wet-to-dry (W/D) weight ratio and was assessed at different time-points after the administration of TIP. Secondary outcomes included clinical scores and lung cellular response.

Results

TIP did not have an effect on pulmonary edema in different dose regimens at different time points during PVM infection. In addition, TIP administration did not affect clinical severity scores or lung cellular response.

Conclusion

In this murine model of severe RSV infection TIP did not affect pulmonary edema nor course of disease.     

Efficacy and Safety of Inhaled Carbon Monoxide during Pulmonary Inflammation in Mice

Background

Pulmonary inflammation is a major contributor to morbidity in a variety of respiratory disorders, but treatment options are limited. Here we investigate the efficacy, safety and mechanism of action of low dose inhaled carbon monoxide (CO) using a mouse model of lipopolysaccharide (LPS)-induced pulmonary inflammation.

Methodology

Mice were exposed to 0–500 ppm inhaled CO for periods of up to 24 hours prior to and following intratracheal instillation of 10 ng LPS. Animals were sacrificed and assessed for intraalveolar neutrophil influx and cytokine levels, flow cytometric determination of neutrophil number and activation in blood, lung and lavage fluid samples, or neutrophil mobilisation from bone marrow.

Principal Findings

When administered for 24 hours both before and after LPS, inhaled CO of 100 ppm or more reduced intraalveolar neutrophil infiltration by 40–50%, although doses above 100 ppm were associated with either high carboxyhemoglobin, weight loss or reduced physical activity. This anti-inflammatory effect of CO did not require pre-exposure before induction of injury. 100 ppm CO exposure attenuated neutrophil sequestration within the pulmonary vasculature as well as LPS-induced neutrophilia at 6 hours after LPS, likely due to abrogation of neutrophil mobilisation from bone marrow. In contrast to such apparently beneficial effects, 100 ppm inhaled CO induced an increase in pulmonary barrier permeability as determined by lavage fluid protein content and translocation of labelled albumin from blood to the alveolar space.

Conclusions

Overall, these data confirm some protective role for inhaled CO during pulmonary inflammation, although this required a dose that produced carboxyhemoglobin values close to potentially toxic levels for humans, and increased lung permeability.     

Effects of Sleep Fragmentation and Chronic Latent Viral Infection on Behavior and Inflammation in Mice

Many chronic diseases are associated with both fatigue and disrupted or nonrestorative sleep. In addition, so-called ‘sickness behaviors’ (for example, anorexia, anhedonia, reduced social interaction, fatigue) are common during infectious and inflammatory disease and have been linked to facets of the immune response. To study these relationships, we used murine gammaherpesvirus (MuGHV), a natural pathogen of wild rodents that provides an experimental model for studying the pathophysiology of an Epstein-Barr (EBV)-like γ-herpesvirus infection in mice. We exposed male and female C57BL/6J mice that were either uninfected or latently infected with MuGHV to either sleep fragmentation (SF) or control conditions and measured the effects on behavior and markers of inflammation. Exposure of infected male mice to SF during the normal somnolent (light) phase significantly reduced locomotor activity during the subsequent active phase, despite an intervening 6-h rest period. Infection was associated with significant increases in lung IFNγ and CXC motif ligand (CXCL) 10 in both male and female mice. In both infected and uninfected male mice, exposure to SF was associated with lower levels of IL1β and C-C motif ligand (CCL) 3 in lung. Exposure of infected female mice to SF led to reductions in lung IL2, CXCL1, and CCL 3. Thus, compared with control conditions, SF was generally associated with lower concentrations of various cytokines in lung. These findings, together with our previous work, indicate that complex interactions among several host factors likely contribute to the behavioral and inflammatory changes associated with viral infection and sleep disruption even in a well-controlled mouse model.Abbreviations: CCL, CC motif ligand; CXCL, CXC motif ligand; CW, consolidated walking; DE, disk environment; EBV, Epstein–Barr virus; HC, home cage; MuGHV, murine gammaherpesvius; SF, sleep fragmentationSo-called ‘sickness behaviors’ (for example, fatigue, anorexia, anhedonia, reduced social interaction) have often been linked to facets of the host response to immune or inflammatory challenge. During chronic infections or other inflammatory conditions, the continually primed host immune response is likely to create a powerful and unrelenting stimulus for these debilitating symptoms in some patients. Epstein–Barr virus (EBV) is a ubiquitous human gammaherpesvirus that causes acute disease, establishes life-long latency, and is associated with the common syndrome of infectious mononucleosis and with other conditions. Infection with or reactivation of EBV in humans is often associated with fatigue and excessive sleepiness.^{1,20,24,46,53} These and related symptoms could be mediated in part by immune activation or dysfunction, neural–endocrine homeostatic imbalance, or both, as produced secondary to the acute and chronic viral infection.^7,36 Studies demonstrating that antibodies to latent EBV proteins are elevated in some patients with chronic fatigue have led to speculation that 1) the synthesis of these viral proteins reflects stress-related reactivation of latent virus,^17,23,31 and 2) although host responses to reactivation may abort complete viral replication, the viral proteins themselves or the resultant host immune response may trigger or exacerbate fatigue.¹⁸Because gammaherpesviruses coevolved with their host species, they are highly species-specific, and infections of animals with EBV have rarely been reported. However, murine gammaherpesvirus (MuGHV) is a natural pathogen of wild rodents that provides an experimental model for studying the pathophysiology of an EBV-like gammaherpesvirus in laboratory mice, which are a permissive host.^15,16,32 After intranasal infection of immunocompetent mice with MuGHV, pulmonary viral titers peak between days 6 to 9, and lytic virus is cleared from the lung in about 10 to 14 d.¹⁴ Like other herpesviruses, MuGHV can maintain lifelong latency in its host. Latent virus is established in lung within days after infection.¹⁴ Spleen, lymph nodes, and bone marrow also harbor latent virus, primarily in B lymphocytes.^13-15,44 The number of latently infected cells peaks at approximately day 14 after infection and then declines rapidly, such that viral load at 4 wk after infection is barely above the limits of detection.⁶ Immunologic features of MuGHV infection resemble the infectious mononucleosis stage of EBV infection.^5,9,15,51 Key common features of EBV and MuGHV infections include splenomegaly and lymphocytosis.Our past work has shown that mice develop significant clinical illness during the acute stage of MuGHV infection and show elevated behavioral sensitivity to challenge with LPS during the chronic–latent stage of infection.³³ In our more recent work,⁴⁹ male C57BL/6J and BALB/cByJ mice that were placed in a novel cage containing its normal inhabitant during the initial 6 h of the light (somnolent) phase were less active during the subsequent dark (active) phase, independent of infection status and despite a 6-h light-phase interval that provided time for recovery sleep after the period of socially induced arousal. In these mice, changes in inflammatory mediators were complex, with both independent and interactive effects of infection status, mouse strain, and exposure to the perturbation.⁴⁹ However, the chemokine CXC motif ligand (CXCL) 10 was consistently elevated in the lung of latently infected mice. Exposure to an unfamiliar mouse for 6 h also was associated with higher pulmonary concentrations of CXCL10, IL1β, granulocyte colony-stimulating factor, and monocyte chemoattractant protein 1 at 12 h after exposure, independent of infection status. These data indicate that exposure of mice to a social challenge is associated with 1) a pulmonary inflammatory response and 2) reduced activity that could represent fatigue, depression, or other facets of sickness behavior; both of these effects are at least in part independent of mouse strain and latent MuGHV infection.To further investigate the effect of common mild stressors on behavior and inflammation in association with latent viral infection, we exposed mice to sleep fragmentation (SF). We selected SF as a perturbation in light of the common incidence of disturbed or shortened sleep in the human population. In our laboratory, we induce SF by placing mice on a rotating disk that requires them to engage in frequent but brief epochs of walking. Therefore, we also evaluated 2 control conditions: consolidated walking (CW) and exposure to the disk environment with minimal rotation (DE).     

Negative Regulation of Pulmonary Th17 Responses by C3a Anaphylatoxin during Allergic Inflammation in Mice

Activation of complement is one of the earliest immune responses to exogenous threats, resulting in various cleavage products including anaphylatoxin C3a. In addition to its contribution to host defense, C3a has been shown to mediate Th2 responses in animal models of asthma. However, the role of C3a on pulmonary Th17 responses during allergic inflammation remains unclear. Here, we show that mice deficient in C3a receptor (C3aR) exhibited (i) higher percentages of endogenous IL-17-producing CD4⁺ T cells in the lungs, (ii) higher amounts of IL-17 in the bronchoalveolar lavage fluid, and (iii) more neutrophils in the lungs than wild-type mice when challenged with intranasal allergens. Moreover, adoptive transfer experiments showed that the frequencies of antigen-specific IL-17-producing CD4⁺ T cells were significantly higher in the lungs and bronchial lymph nodes of C3aR-deficient recipients than those of wild-types recipients. Bone-marrow reconstitution study indicated that C3aR-deficiency on hematopoietic cells was required for the increased Th17 responses. Furthermore, C3aR-deficient mice exhibited increased percentages of Foxp3⁺ regulatory T cells; however, depletion of these cells minimally affected the induction of antigen-specific Th17 cell population in the lungs. Neutralization of IL-17 significantly reduced the number of neutrophils in bronchoalveolar lavage fluid of C3aR-deficient mice. Our findings demonstrate that C3a signals negatively regulate antigen-specific Th17 responses during allergic lung inflammation and the size of Foxp3⁺ regulatory T cell population in the periphery.     

Cigarette Smoke-Induced Emphysema and Pulmonary Hypertension Can Be Prevented by Phosphodiesterase 4 and 5 Inhibition in Mice

Rationale

Chronic obstructive pulmonary disease (COPD) is a widespread disease, with no curative therapies available. Recent findings suggest a key role of NO and sGC-cGMP signaling for the pathogenesis of the disease. Previous data suggest a downregulation/inactivation of the cGMP producing soluble guanylate cyclase, and sGC stimulation prevented cigarette smoke-induced emphysema and pulmonary hypertension (PH) in mice. We thus aimed to investigate if the inhibition of the cGMP degrading phosphodiesterase (PDE)5 has similar effects. Results were compared to the effects of a PDE 4 inhibitor (cAMP elevating) and a combination of both.

Methods

C57BL6/J mice were chronically exposed to cigarette smoke and in parallel either treated with Tadalafil (PDE5 inhibitor), Piclamilast (PDE4 inhibitor) or both. Functional measurements (lung compliance, hemodynamics) and structural investigations (alveolar and vascular morphometry) as well as the heart ratio were determined after 6 months of tobacco smoke exposure. In addition, the number of alveolar macrophages in the respective lungs was counted.

Results

Preventive treatment with Tadalafil, Piclamilast or a combination of both almost completely prevented the development of emphysema, the increase in lung compliance, tidal volume, structural remodeling of the lung vasculature, right ventricular systolic pressure, and right ventricular hypertrophy induced by cigarette smoke exposure. Single, but not combination treatment prevented or reduced smoke-induced increase in alveolar macrophages.

Conclusion

Cigarette smoke-induced emphysema and PH could be prevented by inhibition of the phosphodiesterases 4 and 5 in mice.     

Longitudinal Study of Spatially Heterogeneous Emphysema Progression in Current Smokers with Chronic Obstructive Pulmonary Disease

Background

Cigarette smoke is the main risk factor for emphysema, which is a key pathology in chronic obstructive pulmonary disease (COPD). Low attenuation areas (LAA) in computed tomography (CT) images reflect emphysema, and the cumulative size distribution of LAA clusters follows a power law characterized by the exponent D. This property of LAA clusters can be explained by model simulation, where mechanical force breaks alveolar walls causing local heterogeneous lung tissue destruction. However, a longitudinal CT study has not investigated whether continuous smoking causes the spatially heterogeneous progression of emphysema.

Methods

We measured annual changes in ratios of LAA (LAA%), D and numbers of LAA clusters (LAN) in CT images acquired at intervals of ≥3 years from 22 current and 31 former smokers with COPD to assess emphysema progression. We constructed model simulations using CT images to morphologically interpret changes in current smokers.

Results

D was decreased in current and former smokers, whereas LAA% and LAN were increased only in current smokers. The annual changes in LAA%, D, and LAN were greater in current, than in former smokers (1.03 vs. 0.37%, p = 0.008; −0.045 vs. −0.01, p = 0.004; 13.9 vs. 1.1, p = 0.007, respectively). When LAA% increased in model simulations, the coalescence of neighboring LAA clusters decreased D, but the combination of changes in D and LAN in current smokers could not be explained by the homogeneous emphysema progression model despite cluster coalescence. Conversely, a model in which LAAs heterogeneously increased and LAA clusters merged somewhat in relatively advanced emphysematous regions could reflect actual changes.

Conclusions

Susceptibility to parenchymal destruction induced by continuous smoking is not uniform over the lung, but might be higher in local regions of relatively advanced emphysema. These could result in the spatially heterogeneous progression of emphysema in current smokers.