An aspirin-triggered lipoxin A4 stable analog displays a unique topical anti-inflammatory profile

Lipoxins and 15-epi-lipoxins are counter-regulatory lipid mediators that modulate leukocyte trafficking and promote the resolution of inflammation. To assess the potential of lipoxins as novel anti-inflammatory agents, a stable 15-epi-lipoxin A4 analog, 15-epi-16-p-fluorophenoxy-lipoxin A4 methyl ester (ATLa), was synthesized by total organic synthesis and examined for efficacy relative to a potent leukotriene B4 (LTB4) receptor antagonist (LTB4R-Ant) and the clinically used topical glucocorticoid methylprednisolone aceponate. In vitro, ATLa was 100-fold more potent than LTB4R-Ant for inhibiting neutrophil chemotaxis and trans-epithelial cell migration induced by fMLP, but was ∼10-fold less potent than the LTB4R-Ant in blocking responses to LTB4. A broad panel of cutaneous inflammation models that display pathological aspects of psoriasis, atopic dermatitis, and allergic contact dermatitis was used to directly compare the topical efficacy of ATLa with that of LTB4R-Ant and methylprednisolone aceponate. ATLa was efficacious in all models tested: LTB4/Iloprost-, calcium ionophore-, croton oil-, and mezerein-induced inflammation and trimellitic anhydride-induced allergic delayed-type hypersensitivity. ATLa was efficacious in mouse and guinea pig skin inflammation models, exhibiting dose-dependent effects on edema, neutrophil or eosinophil infiltration, and epidermal hyperproliferation. We conclude that the LXA4 and aspirin-triggered LXA4 pathways play key anti-inflammatory roles in vivo. Moreover, these results suggest that ATLa and related LXA4 analogs may have broad therapeutic potential in inflammatory disorders and could provide an alternative to corticosteroids in certain clinical settings.