Department of Pulmonary Medicine, Erasmus MC, 's-Gravendijkwal, Rotterdam, Netherlands.
Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland USA.
JCI Insight. 2018 Jan 25;3(2). doi: 10.1172/jci.insight.94888.
Phosphodiesterase 3 (PDE3) and PDE4 regulate levels of cyclic AMP, which are critical in various cell types involved in allergic airway inflammation. Although PDE4 inhibition attenuates allergic airway inflammation, reported side effects preclude its application as an antiasthma drug in humans. Case reports showed that enoximone, which is a smooth muscle relaxant that inhibits PDE3, is beneficial and lifesaving in status asthmaticus and is well tolerated. However, clinical observations also showed antiinflammatory effects of PDE3 inhibition. In this study, we investigated the role of PDE3 in a house dust mite-driven (HDM-driven) allergic airway inflammation (AAI) model that is characterized by T helper 2 cell activation, eosinophilia, and reduced mucosal barrier function. Compared with wild-type (WT) littermates, mice with a targeted deletion of the PDE3A or PDE3B gene showed significantly reduced HDM-driven AAI. Therapeutic intervention in WT mice showed that all hallmarks of HDM-driven AAI were abrogated by the PDE3 inhibitors enoximone and milrinone. Importantly, we found that enoximone also reduced the upregulation of the CD11b integrin on mouse and human eosinophils in vitro, which is crucial for their recruitment during allergic inflammation. This study provides evidence for a hitherto unknown antiinflammatory role of PDE3 inhibition in allergic airway inflammation and offers a potentially novel treatment approach.
磷酸二酯酶 3(PDE3)和 PDE4 调节环 AMP 的水平,这在涉及过敏性气道炎症的各种细胞类型中至关重要。尽管 PDE4 抑制可减轻过敏性气道炎症,但报道的副作用排除了其作为人类抗哮喘药物的应用。病例报告表明,抑制 PDE3 的平滑肌松弛剂依诺昔酮在哮喘持续状态下是有益和救命的,且耐受性良好。然而,临床观察也显示了 PDE3 抑制的抗炎作用。在这项研究中,我们研究了 PDE3 在屋尘螨驱动(HDM 驱动)过敏性气道炎症(AAI)模型中的作用,该模型的特征是辅助性 T 细胞激活、嗜酸性粒细胞增多和粘膜屏障功能降低。与野生型(WT)同窝仔相比,靶向缺失 PDE3A 或 PDE3B 基因的小鼠显示出明显减轻的 HDM 驱动的 AAI。WT 小鼠的治疗干预表明,PDE3 抑制剂依诺昔酮和米力农可消除 HDM 驱动的 AAI 的所有特征。重要的是,我们发现依诺昔酮还可减少体外小鼠和人嗜酸性粒细胞上 CD11b 整合素的上调,这对于它们在过敏性炎症期间的募集至关重要。这项研究为 PDE3 抑制在过敏性气道炎症中的抗炎作用提供了迄今为止未知的证据,并提供了一种潜在的新型治疗方法。