Narala Venkata R, Ranga Rajesh, Smith Monica R, Berlin Aaron A, Standiford Theodore J, Lukacs Nicholas W, Reddy Raju C
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-2200, USA.
Respir Res. 2007 Dec 4;8(1):90. doi: 10.1186/1465-9921-8-90.
While glucocorticoids are currently the most effective therapy for asthma, associated side effects limit enthusiasm for their use. Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) activators include the synthetic thiazolidinediones (TZDs) which exhibit anti-inflammatory effects that suggest usefulness in diseases such as asthma. How the ability of TZDs to modulate the asthmatic response compares to that of glucocorticoids remains unclear, however, because these two nuclear receptor agonists have never been studied concurrently. Additionally, effects of PPAR-gamma agonists have never been examined in a model involving an allergen commonly associated with human asthma.
We compared the effectiveness of the PPAR-gamma agonist pioglitazone (PIO) to the established effectiveness of a glucocorticoid receptor agonist, dexamethasone (DEX), in a murine model of asthma induced by cockroach allergen (CRA). After sensitization to CRA and airway localization by intranasal instillation of the allergen, Balb/c mice were challenged twice at 48-h intervals with intratracheal CRA. Either PIO (25 mg/kg/d), DEX (1 mg/kg/d), or vehicle was administered throughout the period of airway CRA exposure.
PIO and DEX demonstrated similar abilities to reduce airway hyperresponsiveness, pulmonary recruitment of inflammatory cells, serum IgE, and lung levels of IL-4, IL-5, TNF-alpha, TGF-beta, RANTES, eotaxin, MIP3-alpha, Gob-5, and Muc5-ac. Likewise, intratracheal administration of an adenovirus containing a constitutively active PPAR-gamma expression construct blocked CRA induction of Gob-5 and Muc5-ac.
Given the potent effectiveness shown by PIO, we conclude that PPAR-gamma agonists deserve investigation as potential therapies for human asthma.
虽然糖皮质激素目前是治疗哮喘最有效的药物,但其相关副作用限制了人们对其使用的热情。过氧化物酶体增殖物激活受体γ(PPAR-γ)激动剂包括合成噻唑烷二酮类(TZDs),它们具有抗炎作用,提示其在哮喘等疾病中可能有用。然而,由于从未同时研究过这两种核受体激动剂,TZDs调节哮喘反应的能力与糖皮质激素相比如何仍不清楚。此外,从未在涉及与人类哮喘常见相关过敏原的模型中研究过PPAR-γ激动剂的作用。
在蟑螂过敏原(CRA)诱导的小鼠哮喘模型中,我们比较了PPAR-γ激动剂吡格列酮(PIO)与糖皮质激素受体激动剂地塞米松(DEX)的既定疗效。在用过敏原鼻内滴注致敏CRA并进行气道定位后,Balb/c小鼠在48小时间隔内接受两次气管内CRA激发。在气道CRA暴露期间,全程给予PIO(25mg/kg/d)、DEX(1mg/kg/d)或赋形剂。
PIO和DEX在降低气道高反应性、炎症细胞的肺募集、血清IgE以及肺中IL-4、IL-5、TNF-α、TGF-β、RANTES、嗜酸性粒细胞趋化因子、MIP3-α、Gob-5和Muc5-ac水平方面表现出相似的能力。同样,气管内给予含有组成型活性PPAR-γ表达构建体的腺病毒可阻断CRA诱导的Gob-5和Muc5-ac。
鉴于PIO显示出的强效疗效,我们得出结论,PPAR-γ激动剂值得作为人类哮喘的潜在治疗方法进行研究。