Abstract:
BACKGROUND:Although phosphodiesterase-4 (PDE4) inhibitors have been shown to reduce COPD exacerbation rate, their biological mechanism of action is not completely elucidated at the molecular level. We aimed to characterise the whole genome gene expression profile of the inhaled PDE4-inhibitor CHF6001 on top of triple therapy in sputum cells and whole blood of patients with COPD and chronic bronchitis. METHODS:Whole genome gene expression analysis was carried out by microarray in 54 patients before and after 32 days treatment with CHF6001 800 and 1600 μg and placebo twice daily (BID) in a randomised crossover study. RESULTS:CHF6001 had a strong effect in sputum, with 1471 and 2598 significantly differentially-expressed probe-sets relative to placebo (p-adjusted for False Discovery Rate < 0.05) with 800 and 1600 μg BID, respectively. Functional enrichment analysis showed significant modulation of key inflammatory pathways involved in cytokine activity, pathogen-associated-pattern-recognition activity, oxidative stress and vitamin D with associated inhibition of downstream inflammatory effectors. A large number of pro-inflammatory genes coding for cytokines and matrix-metalloproteinases were significantly differentially expressed for both doses; the majority (> 87%) were downregulated, including macrophage inflammatory protein-1-alpha and 1-beta, interleukin-27-beta, interleukin-12-beta, interleukin-32, tumour necrosis factor-alpha-induced-protein-8, ligand-superfamily-member-15, and matrix-metalloproteinases-7,12 and 14. The effect in blood was not significant. CONCLUSIONS:Inhaled PDE4 inhibition by CHF6001 on top of triple therapy in patients with COPD and chronic bronchitis significantly modulated key inflammatory targets and pathways in the lung but not in blood. Mechanistically these findings support a targeted effect in the lung while minimising unwanted systemic class-effects. TRIAL REGISTRATION:ClinicalTrial.gov, EudraCT, 2015-005550-35. Registered 15 July 2016.
journal_name
Respir Resjournal_title
Respiratory researchauthors
Govoni M,Bassi M,Vezzoli S,Lucci G,Emirova A,Nandeuil MA,Petruzzelli S,Jellema GL,Afolabi EK,Colgan B,Leaker B,Kornmann O,Beeh KM,Watz H,Singh Ddoi
10.1186/s12931-020-1329-ysubject
Has Abstractpub_date
2020-03-20 00:00:00pages
72issue
1eissn
1465-9921issn
1465-993Xpii
10.1186/s12931-020-1329-yjournal_volume
21pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Using guinea pig tracheal preparations, we have recently shown that endogenous arginase activity attenuates inhibitory nonadrenergic noncholinergic (iNANC) nerve-mediated airway smooth muscle relaxation by reducing nitric oxide (NO) production--due to competition with neuronal NO-synthase (nNOS) for the comm...
journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/1465-9921-7-6
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doi:10.1186/s12931-014-0089-y
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doi:10.1186/s12931-016-0457-x
更新日期:2016-11-04 00:00:00
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doi:10.1186/1465-9921-13-99
更新日期:2012-11-08 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2012-07-04 00:00:00
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doi:10.1186/s12931-017-0709-4
更新日期:2018-01-05 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2018-05-09 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-08-13 00:00:00
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更新日期:2014-11-29 00:00:00
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pub_type: 杂志文章
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更新日期:2005-02-10 00:00:00
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pub_type: 杂志文章
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更新日期:2018-04-27 00:00:00
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pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00