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1 We have demonstrated recently that exogenous prostaglandin E2 (PGE2) inhibits electrical field stimulation (EFS)-induced acetylcholine (ACh) release from parasympathetic nerve terminals innervating guinea-pig trachea. In the present study, we have attempted to characterize the pre-junctional prostanoid receptor(s) responsible for the inhibitory action of PGE2 and to assess whether other prostanoids modulate, at a prejunctional level, cholinergic neurotransmission in guinea-pig trachea. To this end, we have investigated the effect of a range of both natural and synthetic prostanoid agonists and antagonists on EFS-evoked [3H]-ACh release. 2 In epithelium-denuded tracheal strips pretreated with indomethacin (10 μM), PGE2 (0.1 nM–1 μM) inhibited EFS-evoked [3H]-ACh release in a concentration-dependent manner with an EC50 and maximal effect of 7.62 nM and 74% inhibition, respectively. Cicaprost, an IP-receptor agonist, PGF2α and the stable thromboxane mimetic, U46619 (each at 1 μM), also inhibited [3H]-ACh release by 48%, 41% and 35%, respectively. PGD2 (1 μM) had no significant effect on [3H]-ACh release. 3 The selective TP-receptor antagonist, ICI 192,605 (0.1 μM), completely reversed the inhibition of cholinergic neurotransmission induced by U-46619, but had no significant effect on similar responses effected by PGE2 and PGF2α. 4 A number of EP-receptor agonists mimicked the ability of PGE2 to inhibit [3H]-ACh release with a rank order of potency: GR63799X (EP3-selective)>PGE2>M&B 28,767 (EP3 selective)>17-phenyl-ω-trinor PGE2 (EP1-selective). The EP2-selective agonist, AH 13205 (1 μM), did not affect EFS-induced [3H]-ACh release. 5 AH6809 (10 μM), at a concentration 10 to 100 times greater than its pA2 at DP-, EP1- and EP2-receptors, failed to reverse the inhibitory effect of PGE2 or 17-phenyl-ω-trinor PGE2 on [3H]-ACh release. 6 These results suggest that PGE2 inhibits [3H]-ACh release from parasympathetic nerves supplying guinea-pig trachea via an interaction with prejunctional prostanoid receptors of the EP3-receptor subtype. Evidence for inhibitory prejunctional TP- and, possibly, IP-receptors was also obtained although these receptors may play only a minor role in suppressing [3H]-ACh release when compared to receptors of the EP3-subtype. However, the relative importance of the different receptors will depend not only on the sensitivity of guinea-pig trachea to prostanoids but on the nature of the endogenous ligands released locally that have activity on parasympathetic nerves. British Journal of Pharmacology (1998) 123, 1246–1252; doi:10.1038/sj.bjp.0701720

We have examined whether 4-tert-butyl-N-[6-(2-hydroxy-ethoxy)-5-(2-methoxy-phenoxy)-2,2′-bipyrimidin-4-yl]-benzenesulfonamide (bosentan; endothelin ETA/B receptor antagonist) and (R)2-[(R)-2-[(S)-2-[[1-(hexahydro-1H-azepinyl)]carbonyl] amino-4-methylpentanoil]amino-3-[3-(1-methyl-1H-indoyl)]propionyl]amino-3-(2-pyridyl) propionic acid (FR 139317; endothelin ETA receptor antagonist) inhibit contractions of human airway smooth muscle induced by endothelin-1 or Suc-[Glu9,Ala11,15]enthothelin-1-(8–21) (IRL 1620; endothelin ETB receptor agonist). Endothelin-1 and IRL 1620 were equipotent. Bosentan and FR 139317 (each 10 μM) produced a small shift in response curves to endothelin-1 (1.6- and 1.5-fold, respectively). However, bosentan was more potent against contractions elicited by IRL 1620 (10 μM, 11.2-fold shift) suggesting that these agonists exhibit different kinetic interactions with endothelin receptors or implying an interaction with a novel endothelin ETB receptor subtype in human airways.

Cyclo-oxygenase (COX) is the enzyme that converts arachidonic acid to prostaglandin H2 (PGH2) which can then be further metabolized to prostanoids which modulate various airway functions. COX exists in at least two isoforms. COX-1 is expressed constitutively, whereas COX-2 is expressed in response to pro-inflammatory stimuli. Prostanoids are produced under physiological and pathophysiological conditions by many cell types in the lung. However, the regulation of the different COX isoforms in human airway smooth muscle (HASM) cells has not yet been determined. COX-1 and COX-2 protein were measured by Western blot analysis with specific antibodies for COX-1 and COX-2. COX-2 mRNA levels were assessed by Northern blot analysis by use of a COX-2 cDNA probe. COX activity was determined by measuring conversion of either endogenous or exogenous arachidonic acid to three metabolites, PGE2, thromboxane B2 or 6-ketoPGF1α by radioimmunoassay. Under control culture conditions HASM cells expressed COX-1, but not COX-2, protein. However, a mixture of cytokines (interleukin-1β (IL-1β), tumour necrosis factor α (TNFα) and interferon γ (IFNγ) each at 10 ng ml−1) induced COX-2 mRNA expression, which was maximal at 12 h and inhibited by dexamethasone (1 μm; added 30 min before the cytokines). Furthermore, COX-2 protein was detected 24 h after the cytokine treatment and the expression of this protein was also inhibited by dexamethasone (1 μm) and cyclohexamide (10 μg ml−1; added 30 min before the cytokines). Untreated HASM cells released low or undetectable amounts of all COX metabolites measured over a 24 h period. Incubation of the cells with the cytokine mixture (IL-1β, TNFα, IFNγ each at 10 ng ml−1 for 24 h) caused the accumulation of PGE2 and 6-keto-PGF1α. In experiments where COX-2 metabolized endogenous stores of arachidonic acid, treatment of HASM cells with IL-1β in combination with TNFα caused a similar release of PGE2 to that when the three cytokines were given in combination. In other experiments designed to measure COX-2 activity directly, cells were treated with cytokines for 24 h before fresh culture medium was added containing exogenous arachidonic acid (30 μm for 15 min) after which PGE2 was measured. IL-1β and TNFα increased COX-2 activity and an additional small increase was produced by the three cytokines in combination. These findings suggest that the increased expression of COX-2 is intimately involved in the exaggerated release of prostanoids from HASM cells exposed to pro-inflammatory cytokines. These data indicate a role for airway smooth muscle cells, in addition to their contractile function, as inflammatory cells involved in the production of mediators which may contribute to the inflammatory response seen in diseases such as asthma. British Journal of Pharmacology (1997) 120, 910–916; doi:10.1038/sj.bjp.0700963

Sensory nerves play an important role in airway disease by mediating central reflexes such as cough, and local axon reflexes resulting in the peripheral release of neuropeptides. We have tested whether the benzimidazolone compound, NS1619, an opener of large conductance calcium-activated potassium (BK Ca) channels, inhibits the activity of sensory fibers, and central and local airway reflexes in guinea pig airways. In in vitro single fiber recording experiments, NS1619 applied to identified receptive fields in the trachea inhibited the firing of A(delta)-fibers evoked by hypertonic saline and distilled water, and bradykinin-evoked firing of C-fibers. Electrically evoked nonadrenergic noncholinergic contractions of isolated bronchi mediated by the release of neurokinin A (NKA) from C-fibers, but not those elicited by exogenous NKA, were inhibited by NS1619. These effects of NS1619 were prevented by iberiotoxin, a selective blocker of BK Ca channels. In conscious guinea pigs, cough evoked by aerosolized citric acid was also inhibited by NS1619. These data show that BK Ca channel activation inhibits sensory nerve activity, resulting in a reduction of both afferent and efferent function. BK Ca channel openers may therefore be of potential benefit in reducing neurogenic inflammation and central reflexes seen during inflammatory conditions of the airways, and may represent a new class of antitussive drug.

The running title in the PDF is missing a κ. The correct running title is: Role of NF-κB in Smoke Driven Inflammation All instances of NF-4444B in the text and Reference 8 should appear as NF-κB. IL-1444 in the Discussion section should appear as IL-1β. All instances of ul throughout the text should appear as μl. In the first paragraph of the Methods section, "Immunohistochemical staining of NF-kB(p65) in IKK-2ΔEpi mice," μM should be μm.

Cough accompanied by an increased sensitivity of the cough reflex is the most common symptom of inflammatory airway disease. This symptom is also frequently reported in patients receiving angiotensin-converting enzyme (ACE) inhibitors as therapy for heart failure or hypertension, although the underlying mechanism is unknown. We have investigated the possibility that the inflammatory peptide bradykinin, normally degraded by ACE, causes sensitization of airway sensory nerves and an enhancement of the cough reflex in conscious guinea pigs. Treatment of guinea pigs for two weeks with captopril led to an increased cough response to inhaled citric acid, which was prevented by concomitant treatment with the bradykinin receptor antagonist icatibant. A similar icatibant-sensitive enhancement of citric acid-evoked cough was seen in untreated animals after prior inhalation of bradykinin, although cough evoked by hypertonic saline was unaffected. In electrophysiological studies performed in vitro, responses of single vagal C fibers to capsaicin, applied to receptive fields of single-fiber units in the trachea, were also markedly increased after perfusion with bradykinin, whereas A delta fiber responses to hypertonic saline were unaffected. These results indicate that bradykinin-evoked sensitization of airway sensory nerves may underlie the pathogenesis of ACE-inhibitor cough. Bradykinin receptor antagonists may be of benefit in treating chronic cough seen with this and other inflammatory conditions.

1. Previous studies have provided evidence that activation of beta-adrenoceptors on cholinergic nerve terminals can inhibit neurotransmission in the airways. However, in most cases, this conclusion has been based on indirect evidence obtained from mechanical experiments where changes in airways smooth muscle tone were measured. 2. We have assessed whether modulation of cholinergic neurotransmission by beta-adrenoceptor agonists is due to a pre- or post-junctional action by investigating the effect of isoprenaline on contractile responses evoked by exogenous acetylcholine (ACh) and electrical field stimulation (EFS; 4 Hz, 40 V, 0.5 ms pulse width every 15 s), and on EFS-induced ACh release from cholinergic nerves innervating guinea-pig and human trachea. Furthermore, the subtype of beta-adrenoceptor which modulates neurotransmission and the potential role of cyclic AMP in this response were evaluated. 3. In guinea-pig trachea, isoprenaline (1 nM-1 microM) inhibited the contractile response evoked by exogenous ACh (1 microM) to a similar extent to that evoked by EFS (EC50 = 19.9 and 23 nM, respectively). 4. In epithelium-denuded guinea-pig strips treated with indomethacin (10 microM), isoprenaline significantly enhanced EFS-induced ACh release from cholinergic nerve terminals (by 36% at 0.3 microM). This effect was blocked by propranolol and ICI 118, 551 (each 0.1 microM). In contrast, isoprenaline failed to affect EFS-induced ACh release from parasympathetic nerves innervating human trachea. 5. To evaluate the role of cyclic AMP in the beta-adrenoceptor-induced facilitation of cholinergic neurotransmission, the effects of various cyclic AMP elevating drugs on ACh release were studied. Forskolin (10 microM) significantly augmented (by 17%) EFS-induced ACh release, an effect which was not reproduced by 1,9-dideoxyforskolin (10 microM) which does not activate adenylyl cyclase. Similarly, the cyclic AMP analogue, 8-bromo-cyclic AMP (1 mM) and cholera toxin (1 microgram ml-1) facilitated ACh output by 22 and 47% respectively, whereas prostaglandin E2 (PGE2, 0.1 nM-1 microM) inhibited this response (by 67% at 1 microM). 6. Zardaverine (10 microM), a dual inhibitor of the phosphodiesterase (PDE)3 and PDE4 isoenzyme families, did not affect EFS-induced ACh release and failed to facilitate the actions of either isoprenaline or PGE2. Similarly, neither SK&F 94120 (10 microM) nor rolipram (10 microM), selective inhibitors of PDE3 and PDE4 respectively, significantly affected the release of ACh in response to EFS. 7. The result of this study suggests that isoprenaline facilitates cholinergic neurotransmission in guinea-pig, but not human, trachea by activation of pre-junctional beta 2-adrenoceptors, an effect that may be mediated via activation of the cyclic AMP/cyclic AMP-dependent protein kinase cascade. Furthermore, the data presented herein illustrate the need to undertake direct measurements of neurotransmitter release when examining the effect of agents purported to act pre-junctionally.

8-Epi-prostaglandin F2 alpha (8-epi-PGF2 alpha) is an F2-isoprostane formed via a noncyclooxygenase pathway. We investigated whether 8-epi-PGF2 alpha has any effects on isolated guinea-pig and human airway smooth-muscle tone, and characterized the receptor involved in these effects. Cumulative concentration responses to 8-epi-PGF2 alpha in the absence or presence of prostanoid TP- and EP1-receptors antagonists (ICI 192, 605 and AH 6809, respectively) were compared with the responses to U46619 (a thromboxane A2 mimetic) and PGF2 alpha. 8-epi-PGF2 alpha contracted airway smooth muscle with a rank order of potency of U46619 > PGF alpha > 8-epi-PGF2 alpha for guinea pig and U46619 > 8-epi-PGF2 alpha > PGF2 alpha for human smooth muscle. ICI 192,605 inhibited guinea-pig tracheal contraction produced by U46619 (pA2 = 10.0) with a similar potency to its inhibition of the contraction induced by 8-epi-PGF2 alpha (apparent pKB = 10.2, 10.3), but not that induced by PGF2 alpha (apparent pKB = 6.6). AH 6809 inhibited contraction induced by PGF2 alpha (pA2 = 6.6) with a greater potency than contraction induced by U46619 (apparent pKB = 5.1, 5.2) or 8-epi-PGF2 alpha (apparent pKB = 5.3). In human airways, ICI 192,605 inhibited contraction induced by U46619 and 8-epi-PGF2 alpha with apparent pKB values of 9.5 and 9.4, respectively, and AH 6809 inhibited contraction induced by 8-epi-PGF2 alpha with apparent pKB values of 5.7 and 5.4. We conclude that 8-epi-PGF2 alpha contracts human and guinea-pig airways via prostanoid TP receptors. However, if 8-epi-PGF2 alpha is formed in asthma, its production, unlike that of other prostanoids, would not be inhibited by cyclooxygenase inhibitors.

There are currently no effective treatments for controlling the cough response with an acceptable therapeutic ratio. However, several new mechanisms have been identified which may lead to the development of new drugs.

Background Sensory nerves innervating the airways play an important role in regulating various cardiopulmonary functions, maintaining homeostasis under healthy conditions and contributing to pathophysiology in disease states. Hypo-osmotic solutions elicit sensory reflexes, including cough, and are a potent stimulus for airway narrowing in asthmatic patients, but the mechanisms involved are not known. Transient receptor potential cation channel, subfamily V, member 4 (TRPV4) is widely expressed in the respiratory tract, but its role as a peripheral nociceptor has not been explored. Objective We hypothesized that TRPV4 is expressed on airway afferents and is a key osmosensor initiating reflex events in the lung. Methods We used guinea pig primary cells, tissue bioassay, in vivo electrophysiology, and a guinea pig conscious cough model to investigate a role for TRPV4 in mediating sensory nerve activation in vagal afferents and the possible downstream signaling mechanisms. Human vagus nerve was used to confirm key observations in animal tissues. Results Here we show TRPV4-induced activation of guinea pig airway–specific primary nodose ganglion cells. TRPV4 ligands and hypo-osmotic solutions caused depolarization of murine, guinea pig, and human vagus and firing of Aδ-fibers (not C-fibers), which was inhibited by TRPV4 and P2X3 receptor antagonists. Both antagonists blocked TRPV4-induced cough. Conclusion This study identifies the TRPV4-ATP-P2X3 interaction as a key osmosensing pathway involved in airway sensory nerve reflexes. The absence of TRPV4-ATP–mediated effects on C-fibers indicates a distinct neurobiology for this ion channel and implicates TRPV4 as a novel therapeutic target for neuronal hyperresponsiveness in the airways and symptoms, such as cough.

1. We have investigated the correlation between relaxation and changes in cyclic nucleotide content of human tracheal smooth muscle (HTSM) in vitro following inhibitory non-adrenergic non-cholinergic (i-NANC) neural bronchodilator responses evoked by electrical field stimulation (EFS), and compared these with changes seen with sodium nitroprusside (SNP), 3-morpholinosydnonimine (SIN-1) and vasoactive intestinal peptide (VIP). The effects of N omega-nitro-L-arginine methyl ester (L-NAME), Methylene Blue and alpha-chymotrypsin (alpha-CT) were studied. 2. EFS (10 Hz, 1 ms, 40 V for 30 s) evoked a time-dependent relaxation accompanied by a concurrent rise in cGMP, both of which were maximal at 30 s and unaffected by epithelium removal. Levels of cAMP were more variable than those of cGMP and were not significantly changed at any time point. 3. SIN-1 (1 mM) and SNP (100 microM) also produced time-dependent relaxations which were maximal between 2 and 8 min, accompanied by concomitant rises in cGMP; however, these changes were larger than those associated with i-NANC relaxations. cAMP levels were unchanged at all time points. 4. EFS-evoked i-NANC relaxations and cGMP increases (time, t = 30 s) were inhibited by L-NAME. The effects were partially reversed by L-arginine (1 mM), but not by D-arginine. D-NAME and alpha-CT (2 u ml-1) had no effect on either relaxation or cGMP accumulation. Tetrodotoxin (TTX, 3 microM) inhibited both relaxation and cGMP accumulation. 5. VIP (1 microM) also produced a time-dependent relaxation associated with a concurrent rise in cAMP levels with no change in cGMP levels. 6. Methylene Blue (10 microM) partially inhibited EFS (10 Hz)-evoked i-NANC relaxation and cGMP accumulation, and almost completely inhibited both relaxation and cGMP accumulation evoked by SIN-1 (1 mM). Methylene Blue had no significant effect on relaxation or cGMP accumulation evoked by SNP (100 microM). 7. Neural i-NANC relaxations in HTSM are associated with a concurrent selective accumulation of cGMP which is unaffected by epithelium removal. This is inhibited in a stereoselective manner by L-NAME and mimicked by SNP and SIN-1; however, cGMP accumulation was greatly increased with SNP and SIN-1 suggesting compartmentalized changes in cGMP content. VIP also caused relaxation associated with an increase of cAMP; however, no evidence was found for VIP being involved in i-NANC relaxation. Hence nitric oxide (NO), or a NO-containing complex, appears to mediate i-NANC responses in human trachea in vitro.

A single cytosine-guanine dinucleotide (CpG) site within coagulation factor II (thrombin) receptor-like 3 (F2RL3) was recently found to be hypomethylated in peripheral blood genomic DNA from smokers compared with former and non-smokers. We performed two epigenome-wide association studies (EWAS) nested in a prospective healthy cohort using the Illumina 450K Methylation Beadchip. The two populations consisted of matched pairs of healthy individuals (n = 374), of which half went on to develop breast or colon cancer. The association was analysed between methylation and smoking status, as well as cancer risk. In addition to the same locus in F2RL3, we report several loci that are hypomethylated in smokers compared with former and non-smokers, including an intragenic region of the aryl hydrocarbon receptor repressor gene (AHRR; cg05575921, P = 2.31 × 10(-15); effect size = 14-17%), an intergenic CpG island on 2q37.1 (cg21566642, P = 3.73 × 10(-13); effect size = 12%) and a further intergenic region at 6p21.33 (cg06126421, P = 4.96 × 10(-11), effect size = 7-8%). Bisulphite pyrosequencing validated six loci in a further independent population of healthy individuals (n = 180). Methylation levels in AHRR were also significantly decreased (P < 0.001) and expression increased (P = 0.0047) in the lung tissue of current smokers compared with non-smokers. This was further validated in a mouse model of smoke exposure. We observed an association with breast cancer risk for the 2q37.1 locus (P = 0.003, adjusted for the smoking status), but not for the other loci associated with smoking. These data show that smoking has a direct effect on the epigenome in lung tissue, which is also detectable in peripheral blood DNA and may contribute to cancer risk.

We investigated the effect of Ba 679 BR, a novel long-acting antimuscarinic agent, on cholinergic neural responses in guinea pig and human airways. Ba 679 BR, atropine, and ipratropium bromide inhibited electrical field stimulation (EFS)-induced contraction with IC50 values of 0.17, 0.74, and 0.58 nM, respectively, in guinea pig trachea. Ba 679 BR had a slower onset and longer duration of action than atropine or ipratropium bromide (the times required to attain 50% of the maximum response were 34.8, 3.8, and 7.6 min, respectively, and the times required for 50% recovery of the response were 540, 31.6, and 81.2 min, respectively). Ba 679 BR, as well as atropine and ipratropium bromide, facilitated evoked [3H]acetylcholine release (an inhibitory effect on prejunctional muscarinic M2 receptors). The facilitation of acetylcholine release by Ba 679 BR was lost 2 h after washout, however, when there was still complete blockade of cholinergic contractile responses evoked by EFS (an effect on airway smooth muscle M3 receptors), confirming binding studies that suggest that Ba 679 BR shows "kinetic receptor subtype selectivity" for M3 over M2 receptors. The high potency, slow onset, and long duration of action of Ba 679 BR were also observed in human bronchi, suggesting that Ba 679 BR may be a useful drug to provide convenient therapy for patients with obstructive airway disease.

Background Asthma and chronic obstructive pulmonary disease are airway inflammatory diseases characterised by airflow obstruction. Currently approved bronchodilators such as long-acting β 2 adrenoceptor agonists are the mainstay treatments but often fail to relieve symptoms of chronic obstructive pulmonary disease and severe asthma and safety concerns have been raised over long-term use. The aim of the study was to identify the receptor involved in prostaglandin E 2 (PGE 2 )-induced relaxation in guinea pig, murine, monkey, rat and human airways in vitro . Methods Using an extensive range of pharmacological tools, the relaxant potential of PGE 2 and selective agonists for the EP 1–4 receptors in the presence and absence of selective antagonists in guinea pig, murine, monkey, rat and human isolated airways was investigated. Results In agreement with previous studies, it was found that the EP 2 receptor mediates PGE 2 -induced relaxation of guinea pig, murine and monkey trachea and that the EP 4 receptor mediates PGE 2 -induced relaxation of the rat trachea. These data have been confirmed in murine airways from EP 2 receptor-deficient mice ( Ptger2 ). In contrast to previous publications, a role for the EP 4 receptor in relaxant responses in human airways in vitro was found. Relaxant activity of AH13205 (EP 2 agonist) was also demonstrated in guinea pig but not human airway tissue, which may explain its failure in clinical studies. Conclusion Identification of the receptor mediating PGE 2 -induced relaxation represents a key step in developing a novel bronchodilator therapy. These data explain the lack of bronchodilator activity observed with selective EP 2 receptor agonists in clinical studies.

Background In allergic asthma, exposure to relevant antigens leads to an early asthmatic response (EAR) followed, in certain subjects, by a late asthmatic response (LAR). Although many subjects with asthma consider LAR to be one of the defining symptoms of their disease, and despite its widespread use in the clinical assessment of new therapeutic entities, the mechanism underlying the LAR remains unclear. Method A study was undertaken using ovalbuminsensitised and challenged Brown Norway rat and C57BL/ 6J mouse models which recapitulate phenotypic features of allergic asthma including the LAR and its susceptibility to clinically effective agents. Results In conscious animals an EAR was followed by a LAR. The LAR was subjectively evidenced by audible (wheeze) and visual signs of respiratory distress associated with quantifiable changes in non-invasive lung function assessment. Treatments that attenuated the EAR failed to impact on the LAR and, while anaesthesia did not impact on EAR, it abolished LAR. A key role for airway sensory neuronal reflexes in the LAR was therefore hypothesised, which was confirmed by the blockade observed after administration of ruthenium red (non-selective cation channel blocker), HC-030031 (TRPA1 inhibitor) and tiotropium bromide (anticholinergic) but not JNJ-17203212 (TRPV1 inhibitor). Conclusion These results suggest that LAR involves the following processes: allergen challenge triggering airway sensory nerves via the activation of TRPA1 channels which initiates a central reflex event leading to a parasympathetic cholinergic constrictor response. These data are supported by recent clinical trials suggesting that an anticholinergic agent improved symptoms and lung function in patients with asthma.

776 volume 17 | number 7 | july 2011 nature medicine To the Editor: We read with interest the article by Deshpande et al.1 on bitter taste receptors (TAS2Rs) in the lungs and the expression of TAS2Rs on human airway smooth muscle (ASM). The authors describe experiments in which TAS2R agonists, such as chloroquine, evoked relaxation of mouse tracheal rings that was threefold greater in magnitude than that elicited by b-adrenergic receptor agonists1 (the current gold-standard bronchodilator therapy for asthma and chronic obstructive pulmonary disease2). We sought to investigate the uncharacteristically weak bronchodilator activity of isoproterenol in human tissue. After repeating key experiments from the paper by Deshpande et al.1 in our laboratories in the UK and in the laboratories of our collaborator in the US (B.J.C.), we obtained data that is consistent with a body of literature3 and clinical practice that suggests that isoproterenol is a potent and efficacious relaxant of human airway smooth muscle, eliciting a relaxation 4 log fold (10,000×) more potent than chloroquine, although both agents had similar efficacy (Fig. 1a,b). This difference in potency was apparent when we precontracted the human airway smooth muscle to 60–80% of the maximum attainable contraction with either 10 μM histamine (Fig. 1a) or 1 μM carbachol (Fig. 1b). We obtained comparable results in studies using airway smooth muscle preparations from guinea pigs, a species in which relaxation to b-agonists is elicited through the b2-adrenergic receptor (M.G.B., N.D., M.A.B. and B.J.C., unpublished observations). Several explanations could be proffered as to why there is a discrepancy between our results and those obtained by Deshpande et al.1 When performing in vitro tissue bath experiments to investigate the relaxant properties of agonists on ASM, standard practice is to precontract the tissue to establish a baseline level of bronchoconstrictor tone. The tone induced would normally be submaximal to avoid functional antagonism of the potential relaxant response4. However, the concentration of acetylcholine used by Deshpande et al.1 (0.1 mM) is supramaximal, which could functionally antagonize the relaxant response to isoproterenol, thereby making it appear smaller than expected. When we repeated these experiments under conditions of supramaximal tension (0.1 mM ACh), we also found that the relaxation to isoproterenol was compromised (60% of the maximal relaxation evoked by papaverine instead of 100%; Fig. 1c,d). We should emphasize that we do not question the author’s conclusions that airway smooth muscle from humans and mice express bitter taste receptors. This is potentially a physiologically important observation. We would respectfully suggest, however, that our data and the published literature cast doubt on the claim that TAS2R agonists are more effective bronchodilators than currently prescribed b2-adrenergic receptor agonists. Note: Supplementary information is available on the Nature Medicine website.

Due to recent safety concerns with beta 2 adrenoceptor agonists (e.g. salbutamol), there has been an ongoing attempt to identify novel bronchodilator agents for use in asthma and COPD. Due to its beneficial action on airway calibre, prostaglandin E2 (PGE2) was previously investigated as a potential therapy, however in addition to bronchodilator activity, in clinical studies PGE2 also produced tussive effects and bronchial irritancy. As PGE2 mediates its actions via a number of different prostanoid receptors, it was hoped that by selectively targeting individual receptors, the beneficial actions could be selected. In a previous study (Nials et al 1993), the EP2 receptor was identified as mediating PGE2-induced relaxation however when tested clinically, an EP2 agonist (AH13205) produced disappointing results.

Chronic Obstructive Pulmonary Disease (COPD) is a cigarette smoke (CS)-driven inflammatory airway disease with an increasing global prevalence. Currently there is no effective medication to stop the relentless progression of this disease. It has recently been shown that an activator of the P2X7/inflammasome pathway, ATP, and the resultant products (IL-1β/IL-18) are increased in COPD patients. The aim of this study was to determine whether activation of the P2X7/caspase 1 pathway has a functional role in CS-induced airway inflammation. Mice were exposed to CS twice a day to induce COPD-like inflammation and the role of the P2X7 receptor was investigated. We have demonstrated that CS-induced neutrophilia in a pre-clinical model is temporally associated with markers of inflammasome activation, (increased caspase 1 activity and release of IL-1β/IL-18) in the lungs. A selective P2X7 receptor antagonist and mice genetically modified so that the P2X7 receptors were non-functional attenuated caspase 1 activation, IL-1β release and airway neutrophilia. Furthermore, we demonstrated that the role of this pathway was not restricted to early stages of disease development by showing increased caspase 1 activation in lungs from a more chronic exposure to CS and from patients with COPD. This translational data suggests the P2X7/Inflammasome pathway plays an ongoing role in disease pathogenesis. These results advocate the critical role of the P2X7/caspase 1 axis in CS-induced inflammation, highlighting this as a possible therapeutic target in combating COPD.

Airway epithelial cells regulate immune reactivity of local dendritic cells (DCs), thus contributing to microenvironment homeostasis. In this study, we set out to identify factors that mediate this regulatory interaction. We show that tracheal epithelial cells secrete soluble factors that downregulate TNF-α and IL-12p40 secretion by bone marrow-derived DCs but upregulate IL-10 and arginase-1. Size exclusion chromatography identified small secreted molecules having high modulatory activity on DCs. We observed that airway tracheal epithelial cells constitutively release the lipid mediator PGE2. Blocking the synthesis of PGs within airway epithelial cells relieved DCs from inhibition. Cyclooxygenase-2 was found to be expressed in primary tracheal epithelial cell cultures in vitro and in vivo as shown by microdissection of epithelial cells followed by real-time PCR. Paralleling these findings we observed that DCs treated with an antagonist for E-prostanoid 4 receptor as well as DCs lacking E-prostanoid 4 receptor showed reduced inhibition by airway epithelial cells with respect to secretion of proinflammatory cytokines measured by ELISA. Furthermore, PGE2 mimicked the effects of epithelial cells on DCs. The results indicate that airway epithelial cell-derived PGE2 contributes to the modulation of DCs under homeostatic conditions.

Human airway smooth muscle possesses an inhibitory nonadrenergic noncholinergic neural bronchodilator response mediated by nitric oxide (NO). In guinea pig trachea both endogenous NO and vasoactive intestinal peptide (VIP) modulate cholinergic neural contractile responses. To identify whether endogenous NO or VIP can modulate cholinergic contractile responses in human airways in vitro, we studied the effects of specific NO synthase inhibitors and the peptidase alpha-chymotrypsin on contractile responses evoked by electrical field stimulation (EFS) at three airway levels. Endogenous NO, but not VIP, was shown to inhibit cholinergic contractile responses at all airway levels but this inhibition was predominantly in trachea and main bronchus and less marked in segmental and subsegmental bronchi. To elucidate the mechanism of this modulation we then studied the effects of endogenous NO on acetylcholine (ACh) release evoked by EFS from tracheal smooth muscle strips. We confirmed that release was neural in origin, frequency dependent, and that endogenous NO did not affect ACh release. These findings show that endogenous NO, but not VIP, evoked by EFS can inhibit cholinergic neural responses via functional antagonism of ACh at the airway smooth muscle and that the contribution of this modulation is less marked in lower airways.

Background An increase in cough reflex sensitivity to capsaicin in COPD has been described in some studies, suggesting a role for TRPV1 in the disease phenotype. We utilised a guinea-pig cigarette-smoke (CS) exposure COPD model to investigate an enhanced cough phenotype, and evaluate the role of TRPV1 using a novel clinical-ready inhibitor, XEN-D0501. 1 Furthermore, we confirmed enhanced cough responses in COPD patients using a dose-response capsaicin challenge to determine E Max . Methods Guinea-pigs were exposed to air/cigarette smoke (CS) for 1 h, twice daily, for 8 days. Coughs evoked by aerosolised capsaicin (30 μM), depolarisation of isolated vagus nerve tissue induced by capsaicin (1 μM), or increases in intracellular calcium [Ca 2+ ] i to capsaicin (1 μM) in airway-terminating (i.n. DiI stained) jugular and nodose neurons were evaluated. Vagus nerve was obtained from human non-smoker/smoker subjects for similar assessment. Coughs evoked by capsaicin (4 inhalations, 0.49–1000 µM) were recorded in COPD and compared with healthy controls. Results Capsaicin-evoked cough was increased in COPD patients (Fig.1A) and in CS-exposed guinea-pigs (Fig.1B) compared to controls. Capsaicin induced greater depolarisation in nerve tissue from CS-exposed guinea-pigs, and in human vagus nerves from smokers, compared to controls. Capsaicin also induced greater [Ca 2+ ] i increases in airway-terminating jugular and nodose (which are normally capsaicin-unresponsive) neurons from CS-exposed guinea-pigs. XEN-D0501 (i.p. 1 h before cough recording) almost completely inhibited the cough response to capsaicin in both air- and CS-exposed guinea-pigs (Fig.1B). Conclusions CS-exposure evoked increased cough to capsaicin in guinea-pigs, mimicking the enhanced cough phenotype observed in COPD patients. This was paralleled by enhanced capsaicin responses in isolated vagus nerves and airway neurons from CS-exposed guinea-pigs and in human vagus from smokers suggesting the enhanced cough phenotype is due to increased TRPV1-mediated sensory nerve responsiveness. Inhibition of the CS-enhanced cough response by XEN-D0501 further implicated a role for TRPV1. This data, together with the finding that TRPV1 KO mice display less inflammation in a similar pre-clinical model of CS-exposure 2 , indicates the potential utility of TRPV1 antagonists in the treatment of COPD, which is currently being evaluated in an ongoing COPD clinical trial. References Round. Br J Clin Pharmacol. 2011;72:921–931 Baxter ATS. 2014;A2079

Introduction Asthma is a debilitating disease of the airways characterised by symptoms such as bronchoconstriction, hyperresponsiveness and cough. Current therapies are associated with significant side effects and are ineffective in severe disease highlighting the need for novel treatments. Menthol, a cooling compound found in medicinal products, is commonly thought to activate the thermo-sensing cation-permeable Transient Receptor Potential Melastatin 8 (TRPM8) channel. Furthermore, menthol is known for its beneficial effects in the airways such as bronchodilation 1 and suppression of nerve activation and cough, 2 however the mechanism of action is unknown. Aim To pharmacologically characterise the role of TRPM8 and menthol in the airways. Methods TRPM8 gene expression was measured using Taqman real-time PCR. Mouse and guinea pig isolated vagal nerves were mounted in a grease-gap chamber and depolarisation (mV) recorded as an indicator of sensory nerve activity. Segments of murine and guinea pig trachea were attached to a force transducer in an organ bath and relaxation of carbachol-induced tone recorded (mg). Results TRPM8 is expressed in mouse and guinea pig vagal ganglia. The selective TRPM8 agonist, WS3, caused activation of guinea pig and mouse isolated vagal nerves, which was inhibited by the TRPM8 antagonist, JNJ41876666. Furthermore, WS3-induced depolarisation was abolished in isolated vagal nerves from Trpm8 -/- mice. (-)-menthol (active form) caused a small depolarisation of mouse and guinea pig isolated vagal nerves, which was blocked by JNJ41876666. Interestingly, pre-incubation of (-)-menthol inhibited vagal nerve activation induced by the tussive stimulus, capsaicin, an effect that was not inhibited by JNJ41876666. WS3 and (-)-menthol caused a concentration-dependent relaxation of murine and guinea pig trachea, which was not abolished by JNJ41876666 nor in the Trpm8 -/- mouse airway. No expression of TRPM8 was detected in guinea pig or mouse airway smooth muscle. Conclusions (-)-menthol caused a small TRPM8-dependent activation but a robust TRPM8-independent inhibition of vagal sensory nerve activity and relaxation of airway smooth muscle. Elucidating the mechanism behind the beneficial effects of (-)-menthol could lead to the development of promising new therapeutic targets for airway diseases such as asthma. References Ito et al. Pulm Pharmacol Ther 2008;21(5):812–817 Plekova et al. J Appl Physiol 2013;115(2):268–274

Guinea-pig tracheal smooth muscle possesses an inhibitory non-adrenergic, non-cholinergic (i-NANC) innervation and the neurotransmitters involved in this response may be vasoactive intestinal peptide (VIP) and nitric oxide (NO). Since i-NANC mechanisms may co-exist with cholinergic nerves we have investigated whether endogenous VIP and NO modulate cholinergic neurotransmission. alpha-Chymotrypsin enhanced the cholinergic contractile responses to electrical field stimulation (EFS at 4 Hz by 38.6 +/- 4.8% (P0.05, n = 6) but did not produce a shift in the concentration-response curve to acetylcholine (ACh). L-NG-Nitro-arginine methyl ester (L-NAME) and L-NG-monomethyl arginine (L-NMMA) produced a concentration-dependent enhancement of cholinergic responses to EFS (4 Hz) (at 100 microM, 40.9 +/- 6.6 and 30.2 +/- 5.8%, P0.01) with no effect on response curves to ACh. This enhancement was reversed by L-arginine but not D-arginine (1 mM). D-NAME and D-NMMA and L-arginine had no effect on cholinergic neurotransmission. alpha-Chymotrypsin and L-NAME had no effect on excitatory NANC (e-NANC) neural responses in guinea-pig bronchi. These results suggest that endogenous NO and VIP may modulate cholinergic neurotransmission by either functional antagonism at the level of the airway smooth muscle or via a pre-junctional inhibition of ACh release from cholinergic nerve terminals or by both mechanisms.

The relative roles of the endosomal TLR3/7/8 versus the intracellular RNA helicases RIG-I and MDA5 in viral infection is much debated. We investigated the roles of each pattern recognition receptor in rhinovirus infection using primary bronchial epithelial cells. TLR3 was constitutively expressed; however, RIG-I and MDA5 were inducible by 8–12 h following rhinovirus infection. Bronchial epithelial tissue from normal volunteers challenged with rhinovirus in vivo exhibited low levels of RIG-I and MDA5 that were increased at day 4 post infection. Inhibition of TLR3, RIG-I and MDA5 by siRNA reduced innate cytokine mRNA, and increased rhinovirus replication. Inhibition of TLR3 and TRIF using siRNA reduced rhinovirus induced RNA helicases. Furthermore, IFNAR1 deficient mice exhibited RIG-I and MDA5 induction early during RV1B infection in an interferon independent manner. Hence anti-viral defense within bronchial epithelium requires co-ordinated recognition of rhinovirus infection, initially via TLR3/TRIF and later via inducible RNA helicases., Author Summary Host-pathogen interactions are mediated by pattern recognition receptors that identify conserved structures of micro-organisms that are distinct from self. During a viral infection, important pattern recognition receptors include the endosomal Toll-like receptors (TLRs), and a second set of cytoplasmic pattern recognition receptors known as the RNA helicases. Many studies have highlighted the importance of TLR3, TLR7/8 and the RNA helicases in providing robust anti-viral immunity via interferon induction and inflammation. Both endosomal TLR and cytoplasmic RNA helicase mediated pathways are believed to exist as separate yet non-redundant entities; however, little thought is given to why both systems exist, and few studies also consider how both pathways together contribute to anti-viral immunity. Using models of rhinovirus infection in primary bronchial epithelial cell culture in vitro and experimental infection in mouse and human models in vivo, we show that the RNA helicases are preferentially induced early in the infection cycle via TLR3 mediated signaling events, and work in a co-ordinated, systematic manner. The results help understand the complex events that determine effective innate immunity to rhinovirus infection and how these processes contribute to virus induced exacerbations of asthma and chronic obstructive pulmonary disease.

To the Editors: Animal models play a key role in helping us determine the pathogenesis of diseases, and are vital for the discovery of new therapies and the improvement of existing medication. To do this, the model(s) need to closely mimic the clinical features and, where possible, be relevant to the disease in humans. Classically, the innocuous antigen ovalbumin (OVA) has been used to induce an allergic reaction in animals, and whilst it is possible to reproduce many of the features of the asthmatic lung, i.e. specific immunoglobulin (Ig)E levels, T-helper cell (Th)2-associated eosinophilic inflammation, early and late asthmatic responses (EAR and LAR, respectively), and airway hyperresponsiveness and associated tissue remodelling, researchers began to question the clinical relevance of using OVA as a model allergen 1. In addition, it was commonly felt that the need for systemic delivery of OVA, with an adjuvant such as aluminium hydroxide, did not …

In the early 1990's ion channels of the Transient Receptor Potential (TRP) class were implicated in the afferent sensory loop of the cough reflex and in the heightened cough sensitivity seen in disease. Agonists of the TRPV1 capsaicin receptor such as vanilloids and protons were demonstrated to be amongst the most potent chemical stimuli which cause cough. However, more recently, the TRPA1 receptor (not activated by capsaicin) has become of interest in the cough field because it is known to be activated by ligands such as acrolein which is present in air pollution and the acrid smoke from organic material. TRPA1 is a Ca(2+)-permeant non-selective cation channel with 14 ankyrin repeats in its amino terminus which belongs to the larger TRP family. TRPA1 has been characterised as a thermoreceptor which is activated by cold temperature, environmental irritants and reactive electrophilic molecules which can be generated by oxidant stress and inflammation. TRPA1 is primarily expressed in small diameter, nociceptive neurons where its activation probably contributes to the perception of noxious stimuli and the phenomena known as inflammatory hyperalgesia and neurogenic inflammation. The respiratory tract is innervated by primary sensory afferent nerves which are activated by mechanical and chemical stimuli. Activation of these vagal sensory afferents leads to central reflexes including dyspnoea, changes in breathing pattern and cough. Recently, it has been demonstrated that stimulating TRPA1 channels activates vagal bronchopulmonary C-fibres in the guinea pig and rodent lung, and recent data have shown that TRPA1 ligands cause cough in both animal models and normal volunteers. In summary, due to their activation by a wide range of irritant and chemical substances, either by exogenous agents, endogenously produced mediators during inflammation or by oxidant stress, we suggest TRPA1 channels should be considered as one of the most promising targets currently identified for the development of novel anti-tussive drugs.