help button home button
AJRCMB
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pang, L.
Right arrow Articles by Knox, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pang, L.
Right arrow Articles by Knox, A. J.
Am. J. Respir. Cell Mol. Biol., Volume 23, Number 1, July 2000 79-85

Synergistic Inhibition by beta 2-Agonists and Corticosteroids on Tumor Necrosis Factor-alpha -Induced Interleukin-8 Release from Cultured Human Airway Smooth-Muscle Cells

Linhua Pang and Alan J. Knox

Division of Respiratory Medicine, City Hospital, University of Nottingham, Nottingham, United Kingdom


    Abstract
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

We have previously reported that human airway smooth-muscle (ASM) cells produce abundant interleukin (IL)-8, a major neutrophil chemoattractant involved in asthma exacerbations. Here, we tested the effects of the beta 2-agonists salbutamol (Salbu) and salmeterol (Salme) on IL-8 release and tumor necrosis factor (TNF)-alpha -induced IL-8 release from ASM cells. We found that TNF-alpha strongly enhanced IL-8 release in a time- and concentration-dependent manner, whereas Salbu, Salme, the direct adenylyl cyclase activator forskolin (FSK), and the cyclic monophosphate (cAMP) analogue 8-bromoadenosine 3',5'-cAMP (8-Br-cAMP) alone weakly stimulated IL-8 release. TNF-alpha (10 ng/ml)-induced IL-8 release was markedly inhibited by the steroids dexamethasone (Dex) (0.1 to 10 µM) and fluticasone (Flut) (0.01 to 1 µM) but unaffected by Salbu, Salme, FSK, or 8-Br-cAMP. However, a combination of Dex (1 µM) or Flut (0.1 µM) with Salbu (10 µM), Salme (1 µM), FSK (10 µM), or 8-Br-cAMP (10 and 100 µM) significantly enhanced the inhibition by Dex or Flut alone. Experiments with KT5720, a selective inhibitor of cAMP-dependent protein kinase A; rolipram, a selective inhibitor of type IV phosphodiesterase; and ICI-118,551, a beta 2-receptor antagonist, suggested that the synergistic inhibition was mediated by beta 2-receptor in a cAMP-dependent manner. This novel synergistic interaction of beta 2-agonists and steroids may partly explain the benefits that result when these agents are combined to treat asthma.


    Introduction
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Airway inflammation is a central feature of the pathophysiology of asthma, and cytokine networks play a fundamental role in the chronic inflammatory process (1). Anti- inflammatory treatment with inhaled steroids provides the mainstay of asthma management in conjunction with bronchodilator therapy (2). Short-acting beta 2-adrenoceptor (beta 2AR) agonists have been used as bronchodilator treatment in asthma for decades, and although these agents produce useful bronchodilatation through airway smooth-muscle (ASM) relaxation, concerns have been raised that they may have deleterious proinflammatory effects. When given on their own, short-acting beta -agonists can cause a rebound increase in bronchial responsiveness after cessation of therapy (3), and regular salbutamol (Salbu) use can increase the early response to allergen and neutrophilic airway inflammation (4). Recently, however, a number of studies have shown, in contrast, that when beta 2-agonists (particularly long-acting beta 2-agonists) are given in conjunction with inhaled steroids they produce beneficial effects on symptoms, airflow, and asthma exacerbations (5). A possible explanation for this effect is that there is a beneficial interaction between beta 2AR agonists and steroids on part of the inflammatory process.

Although most anti-inflammatory research in asthma has concentrated on eosinophilic inflammation, asthma exacerbations are characterized by neutrophilic airway infiltration (9), and neutrophil influx occurs during allergen challenge (14). Neutrophil influx contributes to bronchial hyperresponsiveness. Neutrophils are recruited into the airways in asthma by a number of mediators and chemokines, the most important of which is interleukin (IL)-8 (15). Recent studies from ourselves and others have shown that human ASM is a rich source of biologically active chemokines and mediators including IL-8, which is released in large quantities in response to bradykinin (20), tumor necrosis factor (TNF)-alpha , or IL-1beta (21). Inasmuch as ASM mass is increased in chronic asthma, it may serve as an important source of chemokines, which may amplify the inflammatory response (22).

We hypothesized that if steroids and beta 2AR have a beneficial interaction in asthma, it would seem likely that this interaction would be maximal in cells such as human ASM cells, which express large numbers of beta 2ARs (23). Because we have previously shown that IL-8 production by human ASM cells is regulated by prostaglandin (PG) E2 (20), which is coupled to adenylyl cyclase and elevations in cyclic monophosphate (cAMP), we postulated that alterations in cAMP in response to beta 2-agonists might also regulate IL-8 release. We therefore studied the effect of beta 2-agonists on IL-8 release by human ASM cells. We also tested for any interaction between beta 2-agonists and the corticosteroids dexamethasone (Dex) and fluticasone (Flut) on IL-8 production by the cytokine TNF-alpha and studied the cAMP dependence of the effect of beta 2-agonists. TNF-alpha is increased during asthma exacerbations (24) and causes neutrophilia and airway hyperresponsiveness (25) and therefore seemed a relevant proinflammatory cytokine to study with respect to IL-8 release.

    Materials and Methods
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Cell Culture

Human tracheas were obtained from four postmortem individuals within 12 h of death. The donors had no history of respiratory diseases and no evidence of airway abnormalities. Primary cultures of human ASM cells were prepared from explants of ASM according to methods previously reported (26, 27). Cells at passage 3-4 were used for all experiments. We have previously shown that the cells grown in this manner depict the immunohistochemical and light-microscopic characteristics of typical ASM cells (26).

Experiment Protocol

The cells were cultured to confluence in 10% fetal calf serum (ICN Pharmaceuticals, Basingstoke, Hampshire, UK)-Dulbecco's modified Eagle's medium (Sigma, Poole, Dorset, UK) in humidified 5% CO2/95% air at 37°C in 24-well culture plates and growth- arrested in serum-deprived medium for 24 h before experiments. Immediately before each experiment, fresh serum-free medium containing TNF-alpha (Sigma) was added. In the time-course experiments the cells were incubated with TNF-alpha (10 ng/ml) for 1 to 24 h, whereas in the concentration-response experiments the cells were incubated for 16 h with 0.1 to 100 ng/ml TNF-alpha . In most experiments thereafter the cells were incubated with 10 ng/ml TNF-alpha for 16 h. At the indicated times, the culture media were harvested and stored at -20°C until the enzyme-linked immunosorbent assay (ELISA) for IL-8. To test the inhibition by various drugs on the effect of TNF-alpha , the beta 2-agonists Salbu and salmeterol (Salme), the beta 2-antagonist ICI-118,551 (ICI), the direct adenylyl cyclase activator forskolin (FSK), the membrane-permeable cAMP analogue 8-bromoadenosine 3',5'-cAMP (8-Br-cAMP), the specific type IV cAMP-dependent phosphodiesterase inhibitor rolipram (Roli), the corticosteroids Dex (all from Sigma) and Flut propionate (kindly provided by Dr. Malcolm Johnson, GlaxoWellcome Research and Development, Uxbridge, Middlesex, UK), and the specific cAMP-dependent protein kinase (PK) A inhibitor KT-5720 (Calbiochem-Novabiochem, Nottingham, Notts, UK) were added 1 or 2 h before the addition of TNF-alpha as specified in figure captions. The time-course and concentration response of IL-8 release by the beta 2-agonists Salbu and Salme and the direct adenylyl cyclase activator FSK were conducted in the same way as TNF-alpha .

IL-8 Assay

The concentration of IL-8 in the culture medium was determined using an ELISA kit (CLB, Amsterdam, the Netherlands) according to the manufacturer's instructions. Briefly, 96-well ELISA plates were coated overnight at room temperature with 200 µL antihuman IL-8 coating antibody diluted in 0.1 M carbonate/bicarbonate buffer (pH 9.6). Plates were then washed five times with phosphate-buffered saline (PBS) (pH 7.2-7.4) and blocked for 1 h at room temperature with 200 µL blocking buffer. Plates were washed again with washing buffer (PBS with 0.05% Tween 20) and 100 µL of recombinant human IL-8 standards (1 to 240 pg/ml) as well as study samples (diluted 1/10-50 with dilution buffer) were added in duplicate to individual wells and incubated at room temperature for 1 h. After five washes, 100 µL of biotinylated IL-8 antibody diluted in dilution buffer was added for 1 h. After another five washes, 100 µL of streptavidin-horseradish peroxidase (HRP) conjugate, diluted 1/10,000 in dilution buffer, was added for 30 min. After the final washes, 100 µL of the substrate buffer containing HRP substrate tetramethylbenzidine dihydrochloride and hydrogen peroxide in 0.05 M phosphate-citrate buffer (pH 5.0) was added for 30 min in the dark and color-developed in proportion to the amount of IL-8 present. The reaction was stopped by adding 100 µL of stop solution (1.8 M sulfuric acid) and the degree of color generated was determined by measuring the optical density at 450 nm in a Dynatech MR5000 microplate reader (Dynatech, Billinghurst, Sussex, UK). The standard curve was linearized and subjected to regression analysis. The IL-8 concentration of unknown samples was extracted by using the standard curve. The results were expressed as picograms per milliliter of culture medium. The sensitivity of the ELISA kit at our hands was at least 5 pg/ml, which was consistent with the manufacturer's specifications. According to the kit insert, the anti-IL-8 antibody does not cross-react with IL-1 through -7 and IL-9 through -11, TNF, interferon-gamma , granulocyte macrophage colony-stimulating factor, and regulated on activation, normal T cells expressed and secreted. All reagents used in the assay were supplied by the ELISA manufacturer except the HRP substrate tetramethylbenzidine dihydrochloride, which was obtained from Sigma.

Cell Viability

The toxicity of all the chemicals used in this study and their vehicles dimethyl sulfoxide (DMSO) and ethanol (Sigma; final concentration =< 0.6% vol/vol) to human ASM cells was determined by thiazolyl blue, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltertrazolium bromide (MTT) assay (26). After 16 or 24 h incubation with the chemicals, 20 µl 5 mg/ml MTT (Sigma) was added to the culture medium in 96-well plates and incubated for 1 h at 37°C. After removing the medium, 200 µl DMSO was added to solubilize the blue-colored tetrazolium, the plates were shaken for 5 min, and the optical density550 values were read in a Dynatech MR5000 microplate reader. Viability was set as 100% in control cells.

Statistical Analysis

Data are expressed as means ± standard error of the mean (SEM) from n determinations (wells). Statistical analysis was performed by using statistical software from SPSS, Inc. (28). One-way analysis of variance and/or unpaired two-tailed t test were used to determine the significant differences between the means. The results were adjusted for multiple testing by using Bonferroni's correction. P values of less than 0.05 were accepted as statistically significant.

    Results
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

Effect of TNF-alpha on IL-8 Production

To investigate the time course of IL-8 production, human ASM cells were cultured in the presence or absence of TNF-alpha (10 ng/ml). Cell-culture supernatants from control cells were collected at 0.5, 2, 8, and 16 h, and those from TNF-alpha -treated cells were collected at 0.5, 1, 2, 4, 8, 16, and 24 h. IL-8 release from control cells was low even though there was a slight increase over the incubation period up to 16 h (5.13 pg/ml at 0.5 h, 8.68 pg/ml at 2 h, 12.06 pg/ml at 8 h, and 21.16 pg/ml at 16 h). There was a marked and time-dependent increase in IL-8 release after stimulation with TNF-alpha , significant difference was observed from after 0.5 h of stimulation as compared with IL-8 production from control cells (P < 0.001), and the highest IL-8 concentration was achieved after 16 h stimulation (P < 0.001) (Figure 1A). When the cells were cultured with TNF-alpha at concentrations of 0.1, 1.0, 10, and 100 ng/ml for 16 h, a concentration-dependent increase in IL-8 production was also observed, which was significant from 0.1 ng/ml (P < 0.001) and peaked at 100 ng/ml (Figure 1B). With regard to the results, an incubation time of 16 h and a concentration of 10 ng/ml were chosen for the following experiments.


View larger version (13K):
[in this window]
[in a new window]
 
Figure 1.   Time course (A) and concentration response (B) of TNF-alpha on IL-8 production. Human ASM cells were incubated with 10 ng/ml TNF-alpha for the times indicated or with increasing concentrations of TNF-alpha for 16 h for the concentration response. IL-8 accumulation in the medium was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments.

Effects of Various cAMP Stimulants on IL-8 Release

The effect of the beta 2-agonists Salbu and Salme and the direct adenylyl cyclase activator FSK on IL-8 production from human ASM cells was assessed. As shown in Figure 2A, Salbu (10 µM), Salme (1 µM), and FSK (10 µM) each caused a time-dependent increase in IL-8 accumulation that was significant after 4 h incubation with Salbu (P < 0.01 compared with control 10.13 pg/ml), 8 h incubation with Salme (P < 0.001 compared with control 12.66 pg/ml), and 2 h incubation with FSK (P < 0.001 compared with control 7.32 pg/ml). In the concentration response, all three cAMP stimulants enhanced IL-8 release in a concentration-dependent manner, with significant increase observed at 0.1 µM for Salbu (P < 0.05 compared with control 9.02 pg/ml), at 0.1 µM for Salme (P < 0.001), and at 1 µM for FSK (P < 0.001) (Figure 2B). Maximum effect was achieved with 10 µM Salbu and FSK and 1 µM Salme (Figure 2B). The magnitude of IL-8 release by these three cAMP stimulants was much smaller than that of TNF-alpha , suggesting that the increase of cAMP is a weak inducer of IL-8 generation from human ASM cells.


View larger version (19K):
[in this window]
[in a new window]
 
Figure 2.   Time course (A) and concentration response (B) of cAMP stimulants on IL-8 production. Human ASM cells were incubated with 10 µM Salbu, 1 µM Salme, or 10 µM FSK for the times indicated or with increasing concentrations of Salbu, Salme, or FSK for 16 h for the concentration response. IL-8 accumulation in the medium was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments.

Effects of Steroids on TNF-alpha -Induced IL-8 Release

Pretreatment of the cells with steroids Dex (0.1 to 10 µM) and Flut (0.01 to 1 µM) before TNF-alpha stimulation resulted in a concentration-dependent inhibition (P < 0.001 for all concentrations) but did not abolish TNF-alpha -induced IL-8 release (Figure 3). The amounts of 1 µM of Dex and 0.1 µM of Flut were chosen for subsequent experiments.


View larger version (17K):
[in this window]
[in a new window]
 
Figure 3.   Effects of Dex (A) and Flut (B) on TNF-alpha -induced IL-8 production. Human ASM cells were pretreated with or without increasing concentrations of Dex (0.1 to 10 µM) or Flut (0.01 to 1 µM) for 1 h before incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments. ***P < 0.001 compared with the effect of TNF-alpha .

Effects of cAMP Stimulants on TNF-alpha -Induced IL-8 Release

To investigate whether the increase of cAMP had an impact on cytokine-induced IL-8 release, we studied the effects of Salbu, Salme, and FSK on TNF-alpha -induced IL-8 production from human ASM cells. As shown in Figure 4, TNF-alpha strongly stimulated IL-8 release, but pretreatment of the cells with the cAMP stimulants (all at 0.1 to 10 µM) had no significant effect on the increase. The results suggest that even though cAMP increase on its own weakly but significantly stimulates IL-8 release, it has no effect on the strong accumulation of IL-8 induced by TNF-alpha .


View larger version (38K):
[in this window]
[in a new window]
 
Figure 4.   Effect of cAMP stimulants on TNF-alpha -induced IL-8 production. Human ASM cells were pretreated with or without increasing concentrations (0.1 to 10 µM) of Salbu, Salme, or FSK for 1 h before incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments.

Effect of the Combination of Steroids and cAMP Stimulants on TNF-alpha -Induced IL-8 Release

We then went on to study whether the combined use of steroids and cAMP stimulants could further affect TNF-alpha - induced IL-8 release. As shown before, pretreatment of the cells with either 1 µM Dex or 0.1 µM Flut strongly inhibited but did not abolish TNF-alpha -induced IL-8 release (Figure 5; P < 0.001). However, when Dex and Flut were used in combination with Salbu (1 and 10 µM), Salme (0.1 and 1 µM), or FSK (1 and 10 µM), a significant further inhibition over the effects of Dex and Flut alone on IL-8 release was observed (Figure 5).


View larger version (21K):
[in this window]
[in a new window]
 
Figure 5.   Effects of the combination of steroid Dex (A) and Flut (B) with cAMP stimulants on TNF-alpha -induced IL-8 release. Human ASM cells were pretreated with or without Dex (1 µM), or with Dex + Salbu, Dex + Salme, Dex + FSK, Flut (0.1 µM), Flut + Salbu, Flut + Salme, or Flut + FSK for 1 h before incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments. ***P < 0.001 compared with the effect of TNF-alpha ; ++P < 0.01 and +++P < 0.001 compared with the effect of Dex or Flut alone.

cAMP Dependence of the Synergistic Inhibition

To clarify the role of cAMP in the synergistic inhibition of IL-8 production described earlier, we examined whether KT5720, a potent and selective inhibitor of the cAMP-dependent PKA, could reverse the synergistic inhibition and whether Roli, the specific inhibitor of the cAMP-dependent phosphodiesterase, could further enhance the synergistic inhibition. As shown in Figure 6A, combined pretreatment with Flut (0.1 µM) + Salme (1 µM) and Flut + FSK (10 µM) resulted in marked further inhibition of TNF-alpha - induced IL-8 release as compared with the effect of Flut alone. KT5720 on its own did not affect TNF-alpha -induced IL-8 release; however, when it was used together with Flut + Salme and Flut + FSK it significantly reduced the synergistic inhibitory effects of Flut + Salme (P < 0.05) and Flut + FSK (P < 0.01). Roli on its own did not have any effect on TNF-alpha -induced IL-8 release; however, when it was used together with Flut + Salme and Flut + FSK, an enhanced inhibition was observed with Flut + Salme (P < 0.05) but not with Flut + FSK, which already appeared to have a much stronger inhibition than Flut + Salme (Figure 6B). The results indicate that the synergistic inhibition of TNF-alpha -induced IL-8 release by the combination of steroids and cAMP stimulants is mediated by cAMP increase.


View larger version (20K):
[in this window]
[in a new window]
 
Figure 6.   Effect of KT-5720 (A) and Roli (B) on the synergistic inhibition of TNF-alpha -induced IL-8 release by Flut and cAMP stimulants. Human ASM cells were pretreated with or without KT-5720 (1 µM) or Roli (10 µM) for 1 h before the addition of Flut (0.1 µM), Flut + Salme (1 µM) or Flut + FSK (10 µM), respectively, for another 1 h before the final incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments. **P < 0.01 and ***P < 0.001 compared with the effect of Flut; +P < 0.05 and ++P < 0.01 compared with the effect of Flut + Salme or Flut + FSK.

We also tested whether the effect of cAMP stimulants could be mimicked by the membrane-permeable cAMP analogue 8-Br-cAMP. The results showed that 8-Br-cAMP, like the cAMP stimulants tested, weakly but significantly stimulated IL-8 release from the cells in a concentration-dependent manner (Figure 7A). Pretreatment with 8-Br-cAMP (1 to 100 µM) did not alter TNF-alpha -induced IL-8 release (Figure 7B); however, when 8-Br-cAMP was used in combination with 0.1 µM Flut, a significant further inhibition over the effect of Flut alone on IL-8 release was achieved in a concentration-dependent manner (Figure 7C).


View larger version (18K):
[in this window]
[in a new window]
 
Figure 7.   Effect of 8-Br-cAMP on IL-8 release (A) and TNF-alpha - induced IL-8 release (B), and effect of the combination of Flut with 8-Br-cAMP on TNF-alpha -induced IL-8 release (C). Human ASM cells were treated with increasing concentrations of 8-Br-cAMP (1 to 10 µM) for 16 h (A), or pretreated with 8-Br-cAMP (B), or Flut (0.1 µM) or Flut + 8-Br-cAMP (C) for 1 h before incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments. *P < 0.05 and ***P < 0.001 compared with control (A); **P < 0.01 compared with the effect of TNF-alpha (C); ++P < 0.01 and +++P < 0.001 compared with the effect of Flut alone (C).

beta 2-Receptor Involvement in the Synergistic Inhibition

Finally, we verified whether the synergistic inhibition by beta 2-receptor agonists and steroids was mediated by beta 2-receptors. We found that when the cells were pretreated with the beta 2-receptor-specific antagonist ICI before Flut + Salme or Flut + Salbu, the synergistic inhibition was significantly reversed (P < 0.01; Figures 8A and 8B, respectively). However, the antagonist had no effect on the synergistic inhibition by Flut + FSK (Figure 8A).


View larger version (21K):
[in this window]
[in a new window]
 
Figure 8.   Effect of ICI on the synergistic inhibition of TNF-alpha -induced IL-8 release by Flut and cAMP stimulants. Human ASM cells were pretreated with or without ICI (10 µM) for 1 h before the addition of Flut (0.1 µM) (A and B), Flut + Salme (1 µM), Flut + FSK (10 µM) (A), or Flut + Salbu (10 µM) (B) for another 1 h before the final incubation with TNF-alpha (10 ng/ml) for 16 h. IL-8 production was measured by ELISA as described in MATERIALS AND METHODS. Each point represents the mean ± SEM of six determinations from two independent experiments. **P < 0.01 and ***P < 0.001 compared with the effect of Flut alone; ++P < 0.01 compared with the effect of Flut + Salme (A) or Flut + Salbu (B).

Cell Viability

Cell viability after 16 h (some 24 h) treatment with the chemicals used in this study was consistently > 95% compared with cells treated with the vehicles.

    Discussion
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

There are several novel findings in our studies. First, we showed that the short- and long-acting beta 2-agonists Salbu and Salme, when given alone, increased release of IL-8. Second, we showed that Salbu or Salme, given on their own, did not alter TNF-alpha -stimulated IL-8 production but when given in the presence of Dex or Flut synergistically increased the inhibitory effects of these corticosteroids on TNF-alpha -stimulated IL-8 release. The effects of Salbu and Salme on steroid-mediated suppression of TNF-alpha -stimulated IL-8 release were mimicked by the direct activator of adenylyl cyclase FSK and the membrane-permeable cAMP analogue 8-Br-cAMP; inhibited by KT5720, a selective inhibitor of cAMP-dependent PKA (29); and potentiated by the type IV phosphodiesterase inhibitor Roli (30); suggesting that the effects of Salbu and Salme are cAMP-mediated. These studies may provide a mechanistic explanation for the paradoxical findings that beta 2-agonists, given on their own, are proinflammatory in asthma, but that combining a long-acting beta 2-agonist and an inhaled corticosteroid produces complementary benefits on symptoms and airflow and potentiates the ability of steroids to reduce asthma exacerbations.

The cell-culture methods and assays used in these studies have been previously validated in our laboratories (20, 26, 27). As we previously showed that PGE2, which is coupled to adenylyl cyclase, elevated IL-8 production by human ASM cells (20), we hypothesize that other agents binding to receptors coupled to adenylyl cyclase might have similar effects. We found that Salbu and Salme caused a time- and concentration-dependent increase in IL-8 release when administered on their own. The fact that their effects were mimicked by FSK and 8-Br-cAMP suggests that the effects are cAMP-mediated. This is the first report of an increase in IL-8 release by human ASM cells in response to Salbu and Salme, although a similar effect of Salbu on IL-8 production by airway epithelial cells has previously been reported (31) and FSK has been shown to increase IL-8 release by colonic epithelial cells (32). The magnitude of IL-8 release by the three cAMP stimulants and 8-Br-cAMP given on their own was fairly small, suggesting that cAMP is a relatively weak inducer of IL-8 release from human ASM cells.

We then studied the effects of beta 2-agonists and other cAMP stimulants, given either on their own or in combination with corticosteroids, on TNF-alpha -stimulated IL-8 release. TNF-alpha has previously been shown to be a potent stimulant of IL-8 release by human ASM cells (21). We decided to use this as the cytokine of choice in our experiments because TNF-alpha levels are increased in bronchoalveolar lavage fluid in asthma (24) and TNF-alpha inhalation increases bronchial hyperresponsiveness associated with an increase in neutrophilia (25), suggesting that it may be an important mediator that contributes to neutrophil accumulation and bronchial hyperresponsiveness during asthma exacerbations. We chose to use TNF-alpha in these studies rather than IL-1beta because we have shown that IL-1beta , but not TNF-alpha , induces cyclooxygenase (COX)-2, the inducible form of COX in human ASM cells causing substantial prostanoid release, and that this can impair adenylyl cyclase function (26, 33). In contrast, TNF-alpha neither induces COX-2 nor impairs adenylyl cyclase function over the time course used in our experiments (26, 33). We found that the effect of TNF-alpha on IL-8 release was much stronger than the weak positive effect of cAMP stimulants and was concentration-dependent but partially inhibited by both Dex and Flut. We also found that the effect of either Dex or Flut was considerably enhanced when cells were cotreated with either Salbu or Salme. In contrast, Salbu or Salme given in the absence of corticosteroids had no effect on TNF-alpha -induced IL-8 release. The subsequent studies to probe the mechanism of this synergistic inhibitory effect using FSK, 8-Br-cAMP, KT-5720, and Roli suggest that the effects are cAMP-mediated. The magnitude of the effects of Salbu, Salme, and FSK is consistent with the relative potency of these agents in increasing cAMP in these cells (data not shown). The fact that the effects of Salbu and Salme could be antagonized by the beta 2-receptor-selective antagonist ICI (34) suggests that it is beta 2-receptor-mediated. As would be expected, ICI had no effect on the synergistic inhibition produced by Flut and FSK because FSK activates adenylyl cyclase directly.

The precise mechanism of the effects of cAMP on steroid-induced inhibition of IL-8 release has not yet been studied. However, because there is no cAMP response element on the IL-8 gene promoter, the effect is likely to be a secondary one on other transcriptional elements. In many cells, TNF-alpha -induced IL-8 release is mediated by the transcription factors nuclear factor-kappa B and activator protein-1 (35, 36). Further studies are required to examine interactions between steroids and beta 2-agonists on the transcriptional regulation of the IL-8 promoter to determine the mechanism of the synergistic effect in human ASM cells. It is of interest that in primary lung fibroblasts and vascular smooth-muscle cells beta 2-agonists have been shown to increase the nuclear translocation of the glucocorticoid receptor, which might provide a mechanistic explanation for the effects seen in our studies (37) and the beneficial interaction between Salme and Dex on allergen-induced blood mononuclear cell activation reported by others (38).

We have considered the implications of our findings with respect to the interactions between beta 2-agonists and corticosteroids in asthma. Some studies have shown that beta 2-agonists, when given on their own, are proinflammatory (3, 4), and our findings with IL-8 production are consistent with a weak proinflammatory effect. The strong synergistic inhibitory interaction between beta 2-agonists and steroids on TNF-stimulated IL-8 production seen in our study is, however, more interesting. A number of recent studies, particularly with long-acting beta 2-agonists, have shown that these agents potentiate the effects of cortico-steroids on airflow and asthma symptoms and cause a reduction in asthma exacerbations (5). Our data may be particularly relevant to reduction in asthma exacerbations that occurred in these studies, inasmuch as asthma exacerbations are associated with significant neutrophilic inflammation of the lungs and the neutrophilia is thought to be IL-8-driven. The effects were seen in our studies only at high concentrations of beta 2-agonists. It is difficult to know how the concentrations of beta -agonists used in our in vitro studies compare with the concentrations of beta -agonists found in vivo. It is also possible that the beta -receptor responsiveness of ASM cells in vitro may be different from that in vivo. Nevertheless, our studies suggest a possible mechanism whereby beta 2-agonists might potentiate the reduction in cytokine-stimulated IL-8 release produced by corticosteroids. The studies that have shown the greatest effect on asthmatic subjects in vivo have used long-acting beta 2-agonists in combination with steroids. In our experiments, we saw effects with both short- and long-acting beta 2-agonists. This discrepancy may be explained by the fact that under the experimental conditions used in vitro, Salbu is likely to behave more as a long-acting beta 2-agonist because it is not being washed out or metabolized, whereas in vivo it is metabolized, cleared, and excreted.

We have previously reported that bradykinin (BK) stimulates IL-8 release from human ASM cells largely via a prostanoid-dependent mechanism (20). Because PGE2 is the major prostanoid from human ASM cells and it also causes cAMP accumulation, the effect of BK on IL-8 release, like that of beta 2-agonists we showed in the present study, is also likely to be cAMP-dependent. It would be interesting to know why under certain circumstances cAMP exerts a stimulatory effect, whereas under others it exerts an inhibitory effect, on IL-8 release from human ASM cells. As we stated earlier, TNF-alpha does not stimulate prostanoid generation from these cells, yet exerts a much stronger stimulatory effect on IL-8 release than both BK and beta 2-agonists, thus providing a good model for studying cAMP manipulation of IL-8 release. It is reasonable to speculate from our data that when cAMP is the major mechanism for IL-8 release, it exerts a stimulatory effect; however, when mechanism(s) other than cAMP is the major mechanism, cAMP exerts an inhibitory effect. In view of this, BK and PGE2 are both likely to have similar effects as beta 2-agonists on TNF-alpha -induced IL-8 release. We have also found that IL-1beta stimulates the release of PGE2 and IL-8 simultaneously, and the COX inhibitor indomethacin, which stops prostanoid generation, enhances IL-8 release (unpublished observation), suggesting that IL-1beta - induced IL-8 release is not prostanoid-dependent and that endogenous prostanoids inhibit simultaneous IL-8 release. The results add weight to this speculation and to the suggestion that prostanoid generation as a result of COX-2 induction may exert a braking effect on inflammatory responses.

In conclusion, we found that beta 2-agonists, given on their own, caused a small increase in IL-8 production from human ASM cells. In contrast, when these agents were given in combination with corticosteroids they potentiated corticosteroid-induced inhibition of TNF-alpha -mediated IL-8 release in a cAMP-dependent manner. Our findings may be relevant to the mechanisms of action of these drugs in asthma.

    Footnotes

Abbreviations: airway smooth muscle, ASM; beta 2-adrenoceptor, beta 2AR; bradykinin, BK; 8-bromoadenosine 3',5'-cAMP, 8-Br-cAMP; cyclic monophosphate, cAMP; cyclooxygenase, COX; dexamethasone, Dex; enzyme-linked immunosorbent assay, ELISA; fluticasone, Flut; forskolin, FSK; horseradish peroxidase, HRP; ICI-118,551, ICI; interleukin, IL; prostaglandin, PG; protein kinase, PK; rolipram, Roli; salbutamol, Salbu; salmeterol, Salme; standard error of the mean, SEM; tumor necrosis factor, TNF.

(Received in original form October 18, 1999 and in revised form February 9, 2000).

Acknowledgments: This study was supported by GlaxoWellcome and Wellcome Trust. The authors thank Colin Clelland for providing specimens of human trachea.
    References
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References

1. Barnes, P. J.. 1992. New aspects of asthma. J. Intern. Med. 231: 453-461 [Medline].

2. Barnes, P. J.. 1995. Inhaled glucocorticoids for asthma. N. Engl. J. Med. 332: 868-875 [Free Full Text].

3. Vathenen, A. S., A. J. Knox, B. G. Higgins, J. R. Britton, and A. E. Tattersfield. 1988. Rebound increase in bronchial responsiveness after treatment with inhaled terbutaline. Lancet 1: 554-558 [Medline].

4. Cockroft, D. W., C. P. McParland, S. A. Britto, V. A. Swystun, and B. C. Rutherford. 1993. Regular inhaled Salbutamol and airways responsiveness to allergen. Lancet 342: 833-837 [Medline].

5. Greening, A. P., P. W. Ind, M. Northfield, and G. Shaw. 1994. Added salmeterol versus higher dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Lancet 344: 219-224 [Medline].

6. Woolcock, A., B. Lundback, N. Ringdal, and L. A. Jacques. 1996. Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. Am. J. Respir. Crit. Care Med. 153: 1481-1488 [Abstract].

7. Pauwels, R. A., C. G. Lofdahl, D. S. Postma, A. E. Tattersfield, P. M. O'Byrne, P. J. Barnes, and A. Ullman. 1997. Effect of inhaled formoterol and budesonide on exacerbations of asthma. N. Engl. J. Med. 337: 1405-1411 [Abstract/Free Full Text].

8. Wilding, P. M., J. T. Clark, S. Coon, S. Lewis, L. Rushton, J. Bennett, J. Obourne, S. Cooper, and A. Tattersfield. 1997. Effect of long term treatment with salmeterol on asthma control: a double blind, randomised crossover study. Br. Med. J. 314: 1441-1446 [Abstract/Free Full Text].

9. Djukanovic, R., W. R. Roche, J. W. Wilson, C. R. W. Beasley, O. P. Twentyman, P. H. Howarth, and S. T. Holgate. 1990. Mucosal inflammation in asthma. Am. Rev. Respir. Dis. 142: 434-457 [Medline].

10. Fahy, J. V., K. W. Kim, J. Liu, and H. Boushey. 1995. Prominent neutrophilic inflammation in sputum from subjects with asthma exacerbations. J. Allergy Clin. Immunol. 95: 843-852 [Medline].

11. Sur, S., T. B. Crotty, G. M. Kephart, B. A. Hyma, T. U. Colby, C. E. Reed, L. W. Hunt, and G. J. Gleich. 1993. Sudden onset fatal asthma: a distinct entity with few eosinophils and relatively more neutrophils in the airway submucosa. Am. Rev. Respir. Dis. 148: 713-719 [Medline].

12. Turner, M. O., P. Husack, M. R. Sean, J. Dolovich, and F. E. Hargreave. 1995. Exacerbations of asthma without sputum eosinophilia. Thorax 50: 1057-1061 [Abstract/Free Full Text].

13. Wenzel, S. E., S. J. Szefter, D. Y. M. Leung, S. I. Sloan, M. D. Rex, and R. J. Martin. 1997. Bronchoscopic evaluation of severe asthma: persistent inflammation associated with high dose corticosteroids. Am. J. Respir. Crit. Care Med. 156: 737-743 [Abstract/Free Full Text].

14. Gavreau, G. M., R. M. Watson, M. Jordana, D. Cockroft, and P. M. O'Byrne. 1995. The effect of regular inhaled salbutamol on allergen-induced airway responses and inflammatory cells in blood and induced sputum. Am. J. Respir. Crit. Care Med. 151: A39 .

15. Anticevitch, S. Z., J. M. Hughes, J. L. Black, and C. L. Armour. 1996. Induction of hyper-responsiveness in human airway tissue by neutrophils, mechanism of action. Clin. Exp. Allergy 26: 549-556 [Medline].

16. Shute, J. K., B. Vrugt, I. S. D. Lindley, S. T. Holgate, A. Bron, R. Aalbers, and R. Djukanovic. 1997. Free and complexed IL-8 in blood and bronchial mucosa in asthma. Am. J. Respir. Crit. Care Med. 155: 1877-1883 [Abstract].

17. Nocker, R. E., D. F. M. Schoonbrood, E. A. Vandegraaf, C. E. Hack, R. Lutter, H. M. Jansen, and T. A. Out. 1996. Interleukin-8 in airway inflammation in patients with asthma and COPD. Int. Arch. Allergy Immunol. 109: 183-191 [Medline].

18. Chanez, P., I. Enander, I. Jones, P. Godard, and J. Bousquet. 1996. Interleukin-8 in bronchoalveolar lavage of asthmatic and chronic bronchitic patients. Int. Arch. Allergy Immunol. 111: 83-88 [Medline].

19. Erger, R. A., and T. B. Casale. 1998. Interleukin-8 plays a significant role in IgE mediated lung inflammation. Eur. Respir. J. 11: 299-305 [Abstract].

20. Pang, L. H., E. Holland, and A. J. Knox. 1998. Bradykinin stimulates interleukin-8 production in cultured human airway smooth muscle cells: role of cyclooxygenase products. J. Immunol. 161: 2509-2515 [Abstract/Free Full Text].

21. John, M., B. T. Au, P. J. Jose, S. Lim, P. J. Barnes, J. A. Mitchell, M. G. Belvisi, and K. F. Chung. 1998. Expression and release of interleukin-8 by HASM cells: inhibition by Th-2 cytokines and corticosteroids. Am. J. Respir. Cell Mol. Biol. 18: 84-90 [Abstract/Free Full Text].

22. Johnson, S., and A. J. Knox. 1997. Synthetic functions of airway smooth muscle in asthma. Trends Pharmacol. Sci. 18: 288-292 [Medline].

23. Spina, D., P. J. Rigby, J. W. Paterson, and R. G. Goldie. 1989. Autoradiographic localisation of beta adrenoceptors in asthmatic human lung. Am. Rev. Respir. Dis. 140: 1410-1415 [Medline].

24. Broide, D. H., M. Lotz, A. Cuomo, D. A. Coburn, E. L. Federman, and S. I. Wasserman. Cytokines in symptomatic asthma airways. J. Allergy Clin. Immunol. 89:958-967.

25. Thomas, P. S., D. H. Yates, and P. J.Barnes. 1995. Tumour necrosis factor alpha  increases airway hyper-responsiveness and sputum neutrophilia in normal subjects. Am. J. Respir. Crit. Care Med. 152:76-80.

26. Pang, L. H., and A. J. Knox. 1997. Effect of interleukin-1beta , tumour necrosis factor-alpha and interferon-gamma on the induction of cyclo-oxygenase-2 in cultured human airway smooth muscle cells. Br. J. Pharmacol. 121: 579-587 [Medline].

27. Pang, L. H., and A. J. Knox. 1997. PGE2 release by bradykinin in human airway smooth muscle cells: involvement of cyclooxygenase-2 induction. Am. J. Physiol. 273 (Lung Cell. Mol. Physiol.):L1132-L1140.

28. SPSS, Inc. 1996. SPSS Base for Windows User's Guide. SPSS, Inc., Chicago. 564.

29. Kase, H., K. Iwahashi, S. Nakanishi, Y. Matsuda, K. Yamada, M. Takahashi, C. Murakata, A. Sato, and M. Kaneko. 1987. K-252 compounds, novel and potent inhibitors of protein kinase-C and cyclic nucleotide-dependent protein kinases. Biochem. Biophys. Res. Commun. 142: 436-440 [Medline].

30. Torphy, T. J., and B. J. Undem. 1991. Phosphodiesterase inhibitors: new opportunities for the treatment of asthma. Thorax 46: 512-523 [Free Full Text].

31. Linden, A.. 1996. Increased interleukin-8 release by beta-adrenoceptor activation in human transformed bronchial epithelial cells. Br. J. Pharmacol. 119: 402-406 [Medline].

32. Yu, Y., and K. Chadee. 1998. Prostaglandin E2 stimulates IL-8 gene expression in human colonic epithelial cells by a post transcriptional mechanism. J. Immunol. 161: 3746-3752 [Abstract/Free Full Text].

33. Pang, L. H., E. Holland, and A. J. Knox. 1998. Role of cyclooxygenase-2 induction in interleukin 1beta induced attenuation of cultured human airway smooth muscle cell cyclic AMP generation in response to isoprenaline. Br. J. Pharmacol. 125: 1320-1328 [Medline].

34. Bilski, A. J., S. E. Halliday, J. D. Fitzgerald, and J. L. Wade. 1983. The pharmacology of a beta-2 selective adrenoceptor antagonist ICI-118,551. J. Cardiovasc. Pharmacol. 5: 430-437 . [Medline]

35. Yasumoto, K., S. Okamoto, N. Mukaida, S. Murakami, M. Mai, and K. Matsushima. 1992. Tumour necrosis factor alpha and interferon gamma synergistically induce interleukin-8 production in a human gastric cancer cell line through acting concurrently on AP-1 and NF-kappa B like binding sites of the interleukin-8 gene. J. Biol. Chem. 267: 22506-22511 [Abstract/Free Full Text].

36. Brasier, A. R., M. Jamaladdin, A. Casola, W. Duan, Q. Shen, and R. P. Garofalo. 1998. A promoter recruitment mechanism for TNFalpha induced IL-8 transcription in type II pulmonary epithelial cells. J. Biol. Chem. 273: 3551-3561 [Abstract/Free Full Text].

37. Eickleberg, O., M. Roth, R. Lorx, V. Bruce, J. Rudiger, M. Johnson, and L. H. Block. 1999. Ligand-independent activation of the glucosteroid receptor by beta 2 adrenergic receptor agonists in primary human lung fibroblasts and vascular smooth muscle cells. J. Biol. Chem. 274: 1005-1010 [Abstract/Free Full Text].

38. Odera, S., M. Vestri, R. Testi, and G. A. Rossi. 1998. Salmeterol enhances the inhibiting activity of dexamethasone on allergen-induced blood mononuclear cell activation. Respiration 65: 199-204 [Medline].





This article has been cited by other articles:


Home page
J. Immunol.Home page
A. E. John, Y. M. Zhu, C. E. Brightling, L. Pang, and A. J. Knox
Human Airway Smooth Muscle Cells from Asthmatic Individuals Have CXCL8 Hypersecretion Due to Increased NF-{kappa}B p65, C/EBP{beta}, and RNA Polymerase II Binding to the CXCL8 Promoter
J. Immunol., October 1, 2009; 183(7): 4682 - 4692.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
C. S. Mullan, M. Riley, D. Clarke, A. Tatler, A. Sutcliffe, A. J. Knox, and L. Pang
{beta}-Tryptase Regulates IL-8 Expression in Airway Smooth Muscle Cells by a PAR-2-Independent Mechanism
Am. J. Respir. Cell Mol. Biol., May 1, 2008; 38(5): 600 - 608.
[Abstract] [Full Text] [PDF]


Home page
Mol. Pharmacol.Home page
M. Kaur, J. E. Chivers, M. A. Giembycz, and R. Newton
Long-Acting 2-Adrenoceptor Agonists Synergistically Enhance Glucocorticoid-Dependent Transcription in Human Airway Epithelial and Smooth Muscle Cells
Mol. Pharmacol., January 1, 2008; 73(1): 203 - 214.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
J. Loven, N. Svitacheva, A. Jerre, A. Miller-Larsson, and S. H. Korn
Anti-inflammatory activity of {beta}2-agonists in primary lung epithelial cells is independent of glucocorticoid receptor
Eur. Respir. J., November 1, 2007; 30(5): 848 - 856.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
M. R. Edwards, J. Haas, R. A. Panettieri Jr., M. Johnson, and S. L. Johnston
Corticosteroids and beta2 Agonists Differentially Regulate Rhinovirus-induced Interleukin-6 via Distinct Cis-acting Elements
J. Biol. Chem., May 25, 2007; 282(21): 15366 - 15375.
[Abstract] [Full Text] [PDF]


Home page
ThoraxHome page
A. J Knox, K. Deacon, and R. Clifford
Blanching the airways: steroid effects in asthma
Thorax, April 1, 2007; 62(4): 283 - 285.
[Full Text] [PDF]


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
A. Berndt, F. J. Derksen, P. J. Venta, S. Ewart, V. Yuzbasiyan-Gurkan, and N. E. Robinson
Elevated amount of Toll-like receptor 4 mRNA in bronchial epithelial cells is associated with airway inflammation in horses with recurrent airway obstruction
Am J Physiol Lung Cell Mol Physiol, April 1, 2007; 292(4): L936 - L943.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
P. J. Barnes
Scientific rationale for using a single inhaler for asthma control
Eur. Respir. J., March 1, 2007; 29(3): 587 - 595.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
D. E. O'Donnell, F. Sciurba, B. Celli, D. A. Mahler, K. A. Webb, C. J. Kalberg, and K. Knobil
Effect of Fluticasone Propionate/Salmeterol on Lung Hyperinflation and Exercise Endurance in COPD.
Chest, September 1, 2006; 130(3): 647 - 656.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
S. Henness, E. van Thoor, Q. Ge, C. L. Armour, J. M. Hughes, and A. J. Ammit
IL-17A acts via p38 MAPK to increase stability of TNF-{alpha}-induced IL-8 mRNA in human ASM
Am J Physiol Lung Cell Mol Physiol, June 1, 2006; 290(6): L1283 - L1290.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
M. R. Edwards, M. W. Johnson, and S. L. Johnston
Combination Therapy: Synergistic Suppression of Virus-Induced Chemokines in Airway Epithelial Cells
Am. J. Respir. Cell Mol. Biol., May 1, 2006; 34(5): 616 - 624.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
L. Todorova, E. Gurcan, A. Miller-Larsson, and G. Westergren-Thorsson
Lung Fibroblast Proteoglycan Production Induced by Serum Is Inhibited by Budesonide and Formoterol
Am. J. Respir. Cell Mol. Biol., January 1, 2006; 34(1): 92 - 100.
[Abstract] [Full Text] [PDF]


Home page
Proc Am Thorac SocHome page
K. F. Chung
The Role of Airway Smooth Muscle in the Pathogenesis of Airway Wall Remodeling in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, November 1, 2005; 2(4): 347 - 354.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
O. S. Usmani, K. Ito, K. Maneechotesuwan, M. Ito, M. Johnson, P. J. Barnes, and I. M. Adcock
Glucocorticoid Receptor Nuclear Translocation in Airway Cells after Inhaled Combination Therapy
Am. J. Respir. Crit. Care Med., September 15, 2005; 172(6): 704 - 712.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
S. E. Overbeek, P. G. Mulder, S. M. Baelemans, H. C. Hoogsteden, and J.-B. Prins
Formoterol Added to Low-Dose Budesonide Has No Additional Antiinflammatory Effect in Asthmatic Patients
Chest, September 1, 2005; 128(3): 1121 - 1127.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
M. Nie, A. J. Knox, and L. Pang
{beta}2-Adrenoceptor Agonists, Like Glucocorticoids, Repress Eotaxin Gene Transcription by Selective Inhibition of Histone H4 Acetylation
J. Immunol., July 1, 2005; 175(1): 478 - 486.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
M. Nie, L. Corbett, A. J. Knox, and L. Pang
Differential Regulation of Chemokine Expression by Peroxisome Proliferator-activated Receptor {gamma} Agonists: INTERACTIONS WITH GLUCOCORTICOIDS AND {beta}2-AGONISTS
J. Biol. Chem., January 28, 2005; 280(4): 2550 - 2561.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
A. Linden, M. Laan, and G. P. Anderson
Neutrophils, interleukin-17A and lung disease
Eur. Respir. J., January 1, 2005; 25(1): 159 - 172.
[Abstract] [Full Text] [PDF]


Home page
Proc Am Thorac SocHome page
M. Johnson
Interactions between Corticosteroids and {beta}2-Agonists in Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, November 1, 2004; 1(3): 200 - 206.
[Abstract] [Full Text] [PDF]


Home page
Proc Am Thorac SocHome page
R. A. Panettieri Jr.
Effects of Corticosteroids on Structural Cells in Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, November 1, 2004; 1(3): 231 - 234.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
M. Roth, P. R.A. Johnson, P. Borger, M. P. Bihl, J. J. Rudiger, G. G. King, Q. Ge, K. Hostettler, J. K. Burgess, J. L. Black, et al.
Dysfunctional Interaction of C/EBP{alpha} and the Glucocorticoid Receptor in Asthmatic Bronchial Smooth-Muscle Cells
N. Engl. J. Med., August 5, 2004; 351(6): 560 - 574.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
M. Miyamoto, M. Tomaki, J. Lotvall, and A. Linden
{beta}-Adrenoceptor stimulation and neutrophil accumulation in mouse airways
Eur. Respir. J., August 1, 2004; 24(2): 231 - 237.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
M. Cazzola and R. Dahl
Inhaled Combination Therapy With Long-Acting {beta}2-Agonists and Corticosteroids in Stable COPD
Chest, July 1, 2004; 126(1): 220 - 237.
[Abstract] [Full Text] [PDF]


Home page
Exp PhysiolHome page
M. A. Pellegrino, G. D'Antona, S. Bortolotto, F. Boschi, O. Pastoris, R. Bottinelli, B. Polla, and C. Reggiani
Clenbuterol antagonizes glucocorticoid-induced atrophy and fibre type transformation in mice
Exp Physiol, January 1, 2004; 89(1): 89 - 100.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
C. Jenkins
Formoterol as relief medication in asthma: the jury is still out
Eur. Respir. J., November 1, 2003; 22(5): 723 - 724.
[Full Text] [PDF]


Home page
Eur Respir JHome page
W.A. Wuyts, B.M. Vanaudenaerde, L.J. Dupont, M.G. Demedts, and G.M. Verleden
Modulation by cAMP of IL-1{beta}-induced eotaxin and MCP-1 expression and release in human airway smooth muscle cells
Eur. Respir. J., August 1, 2003; 22(2): 220 - 226.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
Y. M. Zhu, D. A. Bradbury, L. Pang, and A. J. Knox
Transcriptional Regulation of Interleukin (IL)-8 by Bradykinin in Human Airway Smooth Muscle Cells Involves Prostanoid-dependent Activation of AP-1 and Nuclear Factor (NF)-IL-6 and Prostanoid-independent Activation of NF-{kappa}B
J. Biol. Chem., August 1, 2003; 278(31): 29366 - 29375.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
J. M. Madison
Migration of Airway Smooth Muscle Cells
Am. J. Respir. Cell Mol. Biol., July 1, 2003; 29(1): 8 - 11.
[Full Text] [PDF]


Home page
Eur Respir JHome page
D.W. Reid, C. Ward, N. Wang, L. Zheng, R. Bish, B. Orsida, and E.H. Walters
Possible anti-inflammatory effect of salmeterol against interleukin-8 and neutrophil activation in asthma in vivo
Eur. Respir. J., June 1, 2003; 21(6): 994 - 999.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
M. Miyamoto, O. Prause, M. Sjostrand, M. Laan, J. Lotvall, and A. Linden
Endogenous IL-17 as a Mediator of Neutrophil Recruitment Caused by Endotoxin Exposure in Mouse Airways
J. Immunol., May 1, 2003; 170(9): 4665 - 4672.
[Abstract] [Full Text] [PDF]


Home page
ThoraxHome page
P A Beckett and P H Howarth
Pharmacotherapy and airway remodelling in asthma?
Thorax, February 1, 2003; 58(2): 163 - 174.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Cell Mol. Bio.Home page
A. J. Ammit, A. L. Lazaar, C. Irani, G. M. O'Neill, N. D. Gordon, Y. Amrani, R. B. Penn, and R. A. Panettieri Jr.
Tumor Necrosis Factor-alpha -Induced Secretion of RANTES and Interleukin-6 from Human Airway Smooth Muscle Cells . Modulation by Glucocorticoids and beta -Agonists
Am. J. Respir. Cell Mol. Biol., April 1, 2002; 26(4): 465 - 474.
[Abstract] [Full Text] [PDF]


Home page
ThoraxHome page
F M Spoelstra, D S Postma, H Hovenga, J A Noordhoek, and H F Kauffman
Additive anti-inflammatory effect of formoterol and budesonide on human lung fibroblasts
Thorax, March 1, 2002; 57(3): 237 - 241.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
P.J. Barnes
Scientific rationale for inhaled combination therapy with long-acting {beta}2-agonists and corticosteroids
Eur. Respir. J., January 1, 2002; 19(1): 182 - 191.
[Abstract] [Full Text] [PDF]


Home page
FASEB J.Home page
A. J. KNOX, L. CORBETT, J. STOCKS, E. HOLLAND, Y. M. ZHU, and L. PANG
Human airway smooth muscle cells secrete vascular endothelial growth factor: up-regulation by bradykinin via a protein kinase C and prostanoid-dependent mechanism
FASEB J, November 1, 2001; 15(13): 2480 - 2488.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
J. C. KIPS and R. A. PAUWELS
Long-acting Inhaled beta 2-Agonist Therapy in Asthma
Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 923 - 932.
[Full Text] [PDF]


Home page
Br J OphthalmolHome page
A. Yoshida, S. G Elner, Z.-M. Bian, and V. M Elner
Induction of interleukin-8 in human retinal pigment epithelial cells after denuding injury
Br J Ophthalmol, July 1, 2001; 85(7): 872 - 876.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
A.J. Knox, Y.M. Zhu, and L. Pang
Do long-acting {beta}2-adrenoceptor agonists enhance the anti-inflammatory effect of glucocorticoids in asthma?
Eur. Respir. J., June 1, 2001; 17(6): 1059 - 1061.
[Full Text] [PDF]


Home page
Eur Respir JHome page
S.H. Korn, A. Jerre, and R. Brattsand
Effects of formoterol and budesonide on GM-CSF and IL-8 secretion by triggered human bronchial epithelial cells
Eur. Respir. J., June 1, 2001; 17(6): 1070 - 1077.
[Abstract] [Full Text] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pang, L.
Right arrow Articles by Knox, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pang, L.
Right arrow Articles by Knox, A. J.


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Crit. Care Med.
Copyright © 2000 American Thoracic Society.