Abstract
BackgroundVirus-induced exacerbations of Chronic Obstructive Pulmonary Disease (COPD) are a significant health burden and occur even in those receiving the best current therapies. Rhinovirus (RV) infections are responsible for half of all COPD exacerbations. The mechanism by which exacerbations occur remains undefined, however it is likely to be due to virus-induced inflammation. Given that phophodiesterase 4 (PDE4) inhibitors have an anti-inflammatory effect in patients with COPD they present a potential therapy prior to, and during, these exacerbations.MethodsIn the present study we investigated whether the PDE4 inhibitor piclamilast (10-6 M) could alter RV or viral mimetic (5 μg/mL of imiquimod or poly I:C) induced inflammation and RV replication in primary human airway smooth muscle cells (ASMC) and bronchial epithelial cells (HBEC). The mediators IL-6, IL-8, prostaglandin E2 and cAMP production were assayed by ELISA and RV replication was assayed by viral titration.ResultsWe found that in ASMCs the TLR3 agonist poly I:C induced IL-8 release was reduced while induced IL-6 release by the TLR7/8 agonist imiquimod was further increased by the presence of piclamilast. However, in RV infected ASMCs, virus replication and induced mediator release were unaltered by piclamilast, as was also found in HBECs. The novel findings of this study reveal that although PDE inhibitors may not influence RV-induced cytokine production in ASMCs and replication in either ASMCs or HBECs, they have the capacity to be anti-inflammatory during TLR activation by modulating the induction of these chemotactic cytokines.ConclusionBy extrapolating our in vitro findings to exacerbations of COPD in vivo this suggests that PDE4 inhibitors may have beneficial anti-inflammatory properties when patients are infected with bacteria or viruses other than RV.
Highlights
Virus-induced exacerbations of Chronic Obstructive Pulmonary Disease (COPD) are a significant health burden and occur even in those receiving the best current therapies
Since reports have shown that IL-6 can limit the recruitment of neutrophils and oppositely, IL-8 can induce neutrophil chemotaxis [38,39], our results suggest that the increase in IL-6 and reduction of IL-8 cytokine release by phophodiesterase 4 (PDE4) inhibition during inflammatory circumstances may be important in the anti-inflammatory mechanism of action of PDE4 inhibitors
Others have shown that PDE4 inhibitors can reduce basal inflammatory levels of IL-8 in Human bronchial epithelial cells (HBEC) obtained from patients with the severe inflammatory respiratory disorder: bronchiolitis obliterans syndrome [24]
Summary
Virus-induced exacerbations of Chronic Obstructive Pulmonary Disease (COPD) are a significant health burden and occur even in those receiving the best current therapies. Human bronchial epithelial cells (HBEC), fibroblasts and airway smooth muscle cells (ASMC) express TLRs and are involved in the innate immune response to viral infections in the lungs [6]. During viral infections these cells can detect RV as well as other viruses through the presence of double stranded RNA (dsRNA) via TLR3, Retinoic Acid-Inducible Gene 1 (RIG-I) and Melanoma Differentiation-Associated protein 5 (MDA-5); and single stranded RNA (ssRNA) via TLR7/8 [7,8].
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