[en] Background
Endotoxins are pro-inflammatory substances present in the environment. In man, inhalation of its purified derivative lipopolysaccharide (LPS) induces inflammation related to macrophages and neutrophils. Corticosteroids and phosphodiesterase (PDE)-4 inhibitors have inhibiting effects on macrophages and neutrophils, respectively. This study investigated the effect of prednisolone and of the PDE-4 inhibitor cilomilast on the LPS-induced acute inflammation.
Methods
The study was a placebo-controlled, double-blind crossover design. On three occasions, at 2 weeks interval, 16 healthy subjects inhaled 50 μg LPS after a 6-day treatment with cilomilast (15 mg bd), prednisolone (10 mg bd) or placebo. For the assessment of the inflammatory response, induced sputum was obtained before inclusion and 6 h post-LPS while blood samples were collected before, 6 and 24 h post-LPS.
Results
Inhaled LPS induced an increase in sputum neutrophils (p<0.0001), logMMP-9 (p<0.05), logMMP-9/TIMP-1 (p<0.01) and logTNF-α (p<0.02). At the blood level there were significant rise in neutrophilia (p<0.001), E-selectin (p<0.02), C-reactive protein (CRP) (p<0.001) and LPS-binding protein (p<0.001). There was both a slight, but not significant, increase in body temperature and decrease in forced expiratory volume in 1 s (FEV1). Neither prednisolone nor cilomilast had protective effect on the LPS-induced airways’ inflammation. The LPS-induced CRP acute-phase protein of inflammation (0.58±0.13 and 3.52±0.41 mg/dL, before and after LPS, respectively) was significantly inhibited by a pre-treatment with prednisolone (1.39±0.32 mg/dL, p<0.01) and attenuated (2.65±0.30 mg/dL, p=0.09) with cilomilast.
Conclusion
In healthy subjects, while the LPS-induced airways’ inflammation was not modified either by oral prednisolone or by PDE-4 inhibitor cilomilast (at actual dosage), the LPS-induced acute phase of blood inflammation was reduced by prednisolone.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Michel, Olivier
Dentener, Mieke
Cataldo, Didier ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie et physiologie générales, humaines et path.
Cantinieaux, Brigitte
Vertongen, Françoise
Delvaux, Catherine
Murdoch, Robert D
Language :
English
Title :
Evaluation of oral corticosteroids and phosphodiesterase-4 inhibitor on the acute inflammation induced by inhaled lipopolysaccharide in human.
Rylander R, editor. Endotoxins in the environment: a criteria document. Int J Occup Environ Health 1997; 3 (Suppl. 1): S1-48.
Hasday J.D., Bascom R., Costa J.J., Fitzgerald T., and Dubin W. Bacterial endotoxin is an active component of cigarette smoke. Chest 115 (1999) 829-835
Park J.-H., Gold D.R., Spiegelma D.L., Burge H.A., and Milton D.K. House dust endotoxin and wheeze in the first year of life. Am J Respir Crit Care Med 163 (2001) 322-328
Michel O., Kips J., Duchateau J., Vertongen F., Robert L., Collet H., et al. Severity of asthma is related to endotoxin in house dust. Am J Respir Crit Care Med 154 (1996) 1641-1646
Thorne P.S., Kulhankova K., Yin M., Cohn R., Arbes S.J., and Zeldin D.C. Endotoxin exposure is a risk factor for asthma. Am J Respir Crit Care Med 172 (2005) 1371-1377
Michel O., Nagy A.M., Schroeven M., Duchateau J., Neve J., Fondu P., et al. Dose-response relationship to inhaled endotoxin in normal subjects. Am J Respir Crit Care Med 156 (1997) 1157-1164
Thorn J., and Rylander R. Inflammatory response after inhalation of bacterial endotoxin assessed by the induced sputum technique. Thorax 53 (1998) 1047-1052
Nightingale J.A., Rogers D.F., Hart L.A., Kharitonov S.A., Chung K.F., and Barnes P.J. Effect of inhaled endotoxin on induced sputum in normal, atopic, and atopic asthmatic subjects. Thorax 53 (1998) 563-571
Michel O., Dentener M., Corazza F., Buurman W., and Rylander R. Normal subjects express differences in clinical responses to inhaled lipopolysaccharide wich are related with inflammation and with atopy. J Allergy Clin Immunol 107 (2001) 797-804
Vecchiarelli A., Siracusa A., Cenci E., Puliti M., and Abbritti G. Effect of corticosteroid treatment on interleukin-1 and tumor necrosis factor secretion by monocytes from subjects with asthma. Clin Exp Allergy 22 (1992) 365-370
Martinet N., Vaillant P., Charles T., Lambert J., and Martinet Y. Dexamethasone modulation of tumor necrosis factor-α (cachectin) release by activated normal human alveolar macrophages. Eur Respir J 5 (1992) 67-72
Torphy T.J. Phosphodiesterase isozymes: molecular targets for novel antiasthma agents. Am J Respir Crit Care Med 157 (1998) 351-370
Barnette M.S., Christensen S.B., Essayan D.M., Grous M., Prabhakar U., Rush J.A., et al. SB 207499 (Ariflo), a potent and selective second-generation phosphodiesterase 4 inhibitor: in vitro anti-inflammatory actions. J Pharmacol Exp Ther 284 (1998) 420-426
Underwood D.C., Osborn R.R., Bochnowicz S., Rieman D.J., Romanic A.M., Hay D.W.P., et al. Ariflo (SB 207499) inhibits airway neutrophilia, inflammatory cytokine production and matrix metalloproteinase-9 activity in the guinea pig (abstract). Am J Respir Crit Care Med 161 (2000) A492
Pavord I.D., Pizzichini M.M.M., Pizzichini E., and Hargraeve F.E. The use of induced sputum to investigate airway inflammation. Thorax 52 (1997) 498-501
Cataldo D., Munaut C., Noel A., Frankenne F., Bartsch P., Foidart J., et al. MMP-2 and MMP-9 linked gelatinolytic activity in the sputum from patients with asthma and chronic obstructive pulmonary disease. Int Arch Allergy Immunol 123 (2000) 259-267
Bishop C.R., Athens J.W., Boggs D.R., Warner H.R., Cartwright G.E., and Wintrobe M.M. Leukokinetic studies: a non-steady-state kinetic evaluation of the mechanism of cortisone-induced granulocytosis. J Clin Invest 47 2 (1968) 249-260
Max J., Bochner B.S., Schleimer R.P., and Beck L.A. The effect of systemic glucocorticoids on cutaneous IL-1β production, endothelial E-selectin expression and PMN infiltration after bacterial endotoxin injection in human subjects (abstract). J Allergy Clin Immunol 99 (1997) S337
Culpitt S.V., Maziak W., Loukidis S., Nightingale J.A., Matthews J.L., and Barnes P.J. Effect of high dose inhaled steroids on cells, cytokines, and proteases in induced sputum in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 160 (1999) 1635-1639
Keatings V.M., Jatakanon A., Worsdell Y.M., and Barnes P.J. Effetcs of inhaled and oral glucocorticoids on inflammatory indices in asthma and COPD. Am J Respir Crit Care Med 155 (1997) 542-548
Hasett C. Granulocyte apoptosis and its role in the resolution and control of lung inflammation. Am J Respir Crit Care Med 160 (1999) S5-S11
Sadikot R.T., Jansen E.D., Blackwell T.R., Zoia O., Yull F., Christman J.W., et al. High-dose dexamethasone accentuates nuclear factor-κB activation in endotoxin-treated mice. Am J Respir Crit Care Med 164 (2001) 873-878
Mercer P.F., Shute J.K., Bhowmik A., Donaldson G.C., Wedzicha J.A., and Warner J.A. MMP-9, TIMP-1 and inflammatory cells in sputum from COPD patients during exacerbation. Respir Res 6 (2005) 151-159
Lefort J., Motreff L., and Vargaftig B. Airway administration of Escherichia coli endotoxin to mice induces glucocoticosteroid-resistant bronchoconstriction and vasopermeation. Am J Respir Cell Mol Biol 24 (2001) 34-351
Woolley S.T., Weyman-Jones C., and Young A. A comparison of the effect of PDE4 inhibitor on neutrophilia and cytokine expression in a murine model of LPS-induced lung inflammation (abstract). Eur Respir J 16 Suppl. 31 (2000) 539s
O'Leary E.C., Marder P., and Zuckerman S.H. Glucocorticoid effects in an endotoxin-induced rat pulmonary inflammation model: differential effects on neutrophil influx, integrin expression, and inflammatory mediators. Am J Respir Cell Mol Biol 15 (1996) 97-106
Scheilmer R.P., Spahn J.D., Covar R., and Szefler S. Glucocorticoids. In: Adkinson N.F., Yunginger J.W., Busse W.W., et al. (Eds). Middleton's allergy principles and practice (2003), Mosby, Philadelphia 870-913
Barber A.E., Coyle S.M., Marano M.A., Fischer E., Calvano S.E., Fong Y., et al. Glucocorticoid therapy alters hormonal and cytokine responses to endotoxin in man. J Immunol 150 (1993) 1999-2006
Alvarez J., Surs W., Leung D.Y.M., Ikle D., Gelfand E.W., and Szefler S. Steroid-resitant asthma: immunologic and pharmacologic features. J Allergy Clin Immunol 89 (1992) 714-721
Pipkorn U., Proud D., Lichtenstein L.M., Schleimer R.P., Peters S.P., Adkinson Jr. N.F., et al. Effect of short-term systemic glucocorticoid treatment on human nasal mediator release after antigen challenge. J Clin Invest 80 (1987) 957-961
Webb J.R. Dose response of patients to oral corticosteroid treatment during exacerbations of asthma. Br Med J Clin Res Ed 292 (1986) 1045-1049
Rylander R., Bake B., Fischer J.J., and Helander I.M. Pulmonary function and symptoms after inhalation of endotoxin. Am Rev Respir Dis 140 (1989) 981-986
Michel O., LeVan T.D., Stern D., Dentener M., Thorn J., Gnat D., et al. Systemic responsiveness to lipopolyssacharide and polymorphisms in the Toll-like receptor 4 gene in humans. J Allergy Clin Immunol 112 (2003) 928-934
Gabay C., and Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340 (1999) 448-454
Michel O., Olbrecht J., Moulard D., and Sergysels R. Effect of anti-asthmatic drugs on the response to inhaled endotoxin. Ann Allergy Asthma Immunol 85 (2000) 305-310
Compton C.H., Gubb J., Nieman R., Edelson J., Amit O., Bakst A., et al. Cilomilast, a selective phosphodiesterase-4 inhibitor for treatment of patients with chronic obstructive pulmonary disease: a randomised, dose-ranging study. Lancet 358 (2001) 256-257
Gamble E., Grootendorst D.C., Brightling E., Troy S., Qiu Y., Zhu J., et al. Antiinflammatory effects of the phosphodiesterase-4 inhibitor cilomilast (Ariflo) in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 168 (2003) 976-982
Prabhakar U., Lipshutz D., Bartus J.O., Slivjak M.J., Smith III E.F., Lee J.C., et al. Characterization of cAMP-dependent inhibition of LPS-induced TNFα production by rolipram, a specific phosphodiesterase IV (PDE IV) inhibitor. Int J Pharmacol 16 (1994) 805-816
Griswold D.E., Webb E.F., Badger A.M., Gorycki P.D., Levandoski P.A., Barnette M.A., et al. SB 207499 (Ariflo), a second generation phosphodiesterase 4 inhibitor, reduces tumor necrosis factor æ and interleukin-4 production in vivo. J Pharmacol Exp Ther 287 (1998) 705-711
Spond J., Chapman R., Fine J., Jones H., Kreutner W., Kung T.T., et al. Comparison of PDE4 inhibitors, rolipram and SB 207499 (ariflo), in a rat model of pulmonary neutrophilia. Pulm Pharmacol Ther 14 (2001) 157-164