Citations

Abstract Rationale: Asthma involves airway inflammation, hyperresponsiveness (AHR), and remodeling (cell proliferation and fibrosis), with both aspects not fully alleviated by current therapies. GPCR-based drugs represent a major aspect of current asthma therapy. Asthmatic airways express several orphan receptors with unknown physiological roles, highlighting a potentially novel and significant area for therapeutic exploration. Herein, we focus on orphan retinoic acid (RA)-induced Class C GPCR members GPRC5A (RAIG1; 5A) and GPRC5B (RAIG2; 5B). We leveraged recently identified 5A agonists to test the hypothesis that these GPCRs have alleviating effects in airways. Methods: Primary human airway smooth muscle cells (ASM) originating from non-asthmatic (NA) and asthmatic (Asth) individuals were obtained post-surgery from lung tissues after approval by the Mayo Clinic Institutional Review Board. PRESTO-Tango assay was used to determine 5A and 5B activity. cADDis assay was used to assess cAMP levels. Fluorescence imaging was used to determine calcium regulation. Recently identified 5A agonists [tryptamine, 7 fluoro-tryptamine (7FT), L-tryptophan, N-methyltryptamine, and indole-3-acetic acid] were used in assays, along with RA and 5A vs. 5B siRNAs. Results: PRESTO-Tango assay showed that tryptamine (10/100 µM) and 7FT (1/10/100 µM) increased 5A activity while high concentrations of 7FT (100 µM) increased 5B activity as well. cADDis assay showed 100 µM tryptamine increased cAMP more than 1/10 µM tryptamine and that 10 µM 7FT increased cAMP more than 1/100 µM 7FT in NA ASM.Calcium imaging showed that 5A agonist blunts responses to histamine, especially in Asth ASM. Calcium responses were higher in Asth ASM and 5A siRNA-treated ASM while 5B siRNA had an alleviating effect. Conclusions: Class C GPCRs 5A and 5B interestingly have opposing effects in human ASM towards blunting calcium responses to bronchoconstrictor agonists in the context of asthma. Thus, 5A agonists and 5B antagonists may represent novel GPCR-based approaches in airway diseases.

Abstract Rationale: Moderate hyperoxia (<60% O2) in premature infants promotes bronchial airway hyperresponsiveness (AHR) and impaired bronchodilation involving airway smooth muscle (ASM). Understanding mechanisms by which hyperoxia initiates long-term bronchial airway changes in prematurity is critical for novel therapies for wheezing disorders and asthma in children. Underdeveloped lungs in prematurity have immature antioxidant systems, which may be due to disrupted dynamics that promote susceptibility to oxidative stress from O2. Cytoplasmic and mitochondrial calcium signaling mechanisms and O2 metabolism are pathways highly relevant to ASM and airway disease. We propose that the novel gasotransmitter hydrogen sulfide (H2S) attenuates effects of O2 in developing ASM and hypothesize that hyperoxia in prematurity promotes cellular and mitochondrial calcium signaling dysfunction, effects which are counteracted by H2S.Methods: Human fetal (fASM) cells isolated from tracheobronchial samples of de-identified 18-22 week fetuses following fetal demise (Mayo IRB approved as exempt) were exposed to 21% vs 40% O2. fASM were treated 24-72 hours with H2S donor GYY4137, mitochondrial-specific H2S donor AP39, cystathione-β-synthase (CBS) stabilizer AdoMet, cAMP inhibitors SQ22536 or KT5720, or vehicle control (DMSO). CBS shRNA lentiviral particles were used to generate stable knockdown cell lines. Protein markers were measured by Western blot. Intracellular calcium ([Ca2+]i) was measured using 5μM Fura-2/AM and mitochondrial calcium ([Ca2+]m) with 1μM Rhod-2 AM using fluorescence microscopy. Results: CBS expression was lower in fASM exposed to 40% O2 compared to 21% O2. Lentivirus induced CBS KD was exacerbated by 40% O2. Hyperoxia increased [Ca2+]i and [Ca2+]m response to histamine (10μM) in vehicle and Scr controls compared to normoxia. CBS KD increased [Ca2+]i and [Ca2+]m responses to histamine compared to Scr fASM in 21% O2. CBS KD fASM exposed to hyperoxia showed increased [Ca2+]i and [Ca2+]m responses to histamine, but the effect was not amplified by CBS KD. [Ca2+]i and [Ca2+]m responses to histamine were decreased in normoxia by H2S donors GYY4137 (50μM) and AP39 (100nM) and CBS stabilizer AdoMet (100nM); effects which also blunted hyperoxia induced increases. SQ22536 and KT5720 inhibited effects of AP39 and GYY4137 in hyperoxia. Conclusions:Our findings suggest hyperoxia leads to [Ca2+]i and [Ca2+]m dysfunction in developing airway cells, which can be alleviated through modulation of H2S pathways, offering potential targets for future therapies to blunt hyperoxia effects on bronchoconstriction and bronchodilation. Acknowledgment: Supported by AHA Postdoctoral Fellowship 20POST35210002 (Bartman), NIH R01 HL-056470 (Prakash), and HL-160570 (Pabelick).

Abstract Background: Kisspeptins (Kp) are a group of hypothalamic peptides that aid in regulating pubertal development and sex hormone signaling. In our recent studies, we observed the important role of Kp-10 (Kp peptide) and its receptor KISS1R signaling in regulating the airway smooth muscle (ASM) structure and function. In these studies, we observed significantly reduced expression of KISS1R during asthma pathophysiology suggesting a loss of protective mechanism and exogeneous Kp-10 may be protective in the context of asthma. Studies have shown that specific modifications to the amino acids of Kp peptides can result in increased binding efficiency and receptor activation. Accordingly, we developed three novel Kp peptides, named KpSATs (13A, 13B, and 13C), and tested the potential effects/efficiency on ASM cell remodeling. Methods: The Molecular docking of the KpSAT peptides (13A, 13B and 13C) with the receptor KISS1R were performed using HPEPDOCK. KpSATs were synthesized by GenScript (New Jersey, US) with purity of ≥97%. Primary human ASM cells isolated from surgical lung resections (Mayo Clinic IRB-approved) were cultured in DMEM-F12. Cells were treated with PDGF (2ng/mL) and/or TGF-β (2ng/mL) with/without treatments of KpSATs (13A, 13B, and 13C: 250nM-1µM) and Kp-10 (1µM). ASM cell proliferation was measured using MTT. Extracellular matrix (ECM) deposition (fibronectin and collagen-I/III) studies were performed using In-Cell Western (LiCor-odyssey). The mechanistic signaling pathway (phospho-PKC-δ) were measured using Western blot analysis. Results: In the novel KpSATs, we substituted three amino acids in the endogenous Kp-13 sequence, Y10W and P12T for KpSAT-13A; S6A and P12T for KpSAT-13B; and S6A and Y10W for KpSAT-13C. The peptides dock in the orthosteric ligand binding pocket attained with docking scores ranging from -250 to -280. The MTT assay indicated a reduction in PDGF-induced ASM cell proliferation upon exposure to KpSATs. Notably, we found that KpSAT-13A and KpSAT-13B had significant effects in reducing proliferation at lower concentrations of 500nM compared to 1µM of Kp-10. Furthermore, ECM deposition studies showed a significant reduction of TGF-β1-induced collagen-I/III and fibronectin in ASM cells exposed to KpSAT-13A and 13B. In addition, we observed significant inhibition of PDGF-induced phospho-PKC-δ by KpSAT-13A and 13B. Conclusion: Overall, these findings highlight that modification in amino acid sequence in endogenous Kp-13 sequence significantly increases the potency of synthesized novel KpSATs on ASM cells. In addition, KpSATs showed better inhibitory effects with a lower concentration compared to Kp-10 and could be considered as a promising therapeutic strategy to mitigate asthma.

Abstract Rationale: Asthma in the elderly (AIE) presents a unique challenge characterized by hyperreactive and thickened, fibrotic airways (remodeling) that is not adequately addressed by current therapies. Thus, understanding mechanisms that drive AIE become important. Here, airway smooth muscle (ASM) cells play important roles in normal airway physiology and asthma pathophysiology. Recent discoveries have highlighted the significance of mechanosensitive Piezo (Pz) in health and disease. The lung generates mechanical forces of normal breathing and other maneuvers that are transmitted to bronchial airways via tethering parenchyma. While Pz channels are highly expressed in the lung, their specific role in ASM function remains largely unexplored. In this study, we used human ASM cells to test the hypothesis that increased airway stiffness associated with normal aging blunts Pz expression and mechanosensitive functionality, whereas asthmatic triggers (e.g. inflammation) enhance Pz expression and downstream signaling. Methods: Primary human ASM cells isolated from lungs of young (<45y) vs. aged (>65y) non-asthmatic vs. asthmatic individuals were obtained post-surgery (Mayo Clinic IRB approved). Cells were exposed to mechanical stretch (mimicking breathing) and mediators relevant to asthma (TNFα, IL-13) or fibrosis (TGFβ) to determine expression of Pz1/2 across the age spectrum. Separately, intracellular Ca2+ and contractility responses, proliferation and extracellular matrix (ECM) deposition across age/asthma groups were assessed in response to mechanical stretch and Pz1/2 modulation (inhibitors/activators, genetic approaches). Manipulation of Pz1/2 expression or function in ASM accompanied by mechanical stretch was used to assess impact on canonical Wnt/β-catenin signaling. Results: We observed increased Pz1/2 expression with age and asthma as well as with inflammation and mitogenic stimuli. Functionally, Pz1 agonist, Yoda1 induced increase in intracellular Ca2+, ASM proliferation and ECM deposition with greater effects observed in aging asthmatic ASM. Towards linking mechanosensation (via Pz) to remodeling via Wnt signaling, we find that Wnt3a is upregulated by Yoda1 but suppressed by Pz1 shRNA. Yoda1 stimulates TGFβ-induced Wnt3a and β-catenin, an effect further enhanced under mechanical stretch. Conclusions: By elucidating the role of Pz channels in ASM, we aimed to identify novel therapeutic targets for airway diseases. Understanding how mechanical forces and inflammatory stimuli influence Pz-mediated signaling pathways will lead to the development of innovative strategies to prevent or reverse airway remodeling in elderly asthmatic patients. Acknowledgement: Supported by 24POST1241979 (NAB) and NIH grants R01-HL142061 (CMP and YSP), R01- HL088029 (YSP).

Abstract Rationale: In premature infants, continuous positive airway pressure (CPAP) serves as an effective respiratory support strategy in the NICU. However, the static stretch induced by CPAP may negatively impact bronchial airway development, leading to hyperreactivity and remodeling, key proponents of asthma. Here, epithelial and airway smooth muscle cells are affected by stretch, but the mechanisms by which effects occur are not well-known. In airway smooth muscle contractility, stromal interaction molecule 1 (STIM1) at the endoplasmic reticulum and plasma membrane Orai1 channels are important mediators of the store operated calcium entry (SOCE) microdomain signaling pathway, facilitating movement of calcium into the cell and triggering downstream remodeling effects. Recently discovered mechanosensitive Piezo (PZ) channels play a critical role in calcium influx upon mechanical stimulation. In this study, we investigated the hypothesis that interplay between mechanosensitive channels such as PZ and the SOCE microdomain promotes calcium in human fetal airway smooth muscle cells (fASM) towards increasing contractility by stretch. Methods: fASM were obtained from 18-22 week abortus following fetal demise (exempt per Mayo IRB). Cells were pretreated with either PZ1 inhibitor GsMTx4 [1uM] or PZ2 inhibitor D-GsMTx4 [1uM] 45 minutes before stretch. Cells were exposed to normal breathing stretch conditions on a FlexCell System at a 5% cyclic strain (40 cycles/minute) and CPAP with static stretch superimposed for 24 hours. Protein expression of PZ channels and key SOCE proteins were quantified. SOCE responses of stretched and control cells were determined using established protocols in fura-2 loaded cells using fluorescence microscopy. Results: Mechanical stretching of fASM increased protein expression of PZ1, STIM1, and Orai1 in a dose dependent manner. Stretch increased intracellular SOCE responses compared to non-stretched controls. PZ1 antagonist GsMTx4 and PZ2 antagonist D-GsMTx4 inhibited stretch-induced Piezo1, STIM1, and Orai1 upregulation. GsMTx4 and D-GsMTx4 blunted stretch and non-stretched induced calcium SOCE responses relative to unstretched control. Conclusions: Our findings suggest that in the context of mechanical stretch, Piezo channels and the downstream SOCE signaling pathway increase in expression and functionality in the fetal airway which may contribute to CPAP associated changes in airway contractility.

Abstract Rationale: With an increasing elderly population, understanding mechanisms that contribute to structural and functional changes in aging lung is important in the context of healthy aging and diseases such as asthma and pulmonary fibrosis that disproportionately affect the elderly. Asthma in the elderly (AIE) is a particular challenge, with thickened fibrotic bronchial airways (remodeling) and inflammation compared to non-asthmatic elderly: issues not addressed by current therapies. Factors such as iron regulation that are critical for normal physiology can become dysregulated in disease. Iron overload can catalyze a Fenton reaction that increases ROS which oxidizes lipids and proteins, i.e. iron-mediated lipid peroxidation cell death (ferroptosis).The goal of this study was to determine iron regulation in aging- and AIE-associated in human ASM (hASM), a cell type important in airway contractility and remodeling. Methods: hASM cells and lung tissues from young (<45y), and aged (>65y) male/female patients with/without asthma were used (approved by Mayo IRB #16-009655). Cells were treated with ferroptosis inhibitor deferoxamine (DFO) [100µM], inducer RSL3 [125 nM] or vehicle (DMSO) for 24 hrs. Levels of intracellular iron (Fe2+) were determined using FerroOrange. Cell lysates were examined for iron accumulation and ferroptosis markers (4-HNE, FTH1, TfR1, SLC7A11, and KEAP1), cell proliferation, and ECM production (COL1A1 and FN1), and supernatants analyzed for proinflammatory mediators IL-6 and IL-8. Results: Non-asthmatic and asthmatic elderly hASM cells showed a higher cytosolic Fe2+ and lower end-product of lipid peroxidation (4-HNE), higher level of SLC7A11 and KEAP1 (regulators of redox systems) compared to cells from young individuals. High level of iron storage (FTH1) was observed in asthmatics compared to non-asthmatic elderly, but no difference was observed for iron transporters (TfR1). Furthermore, COL1A1 and FN1 were higher in AIE hASM, compared to young hASM. COL1A1 was higher in aging hASM compared to young. DFO reduced COL1A1 in elderly, but upregulated in AIE. Cell proliferation was inhibited by DFO in aging hASM but not in young and AIE. The ferroptosis inducer RLS3 impaired antioxidant system and increased lipid peroxidation and IL-8 levels. Conclusions: Our findings suggest that iron regulation is impaired in aging and AIE hASM, resulting in iron accumulation which modulates airway remodeling via cell proliferation and ECM production. While ferroptosis per se can be targeted, it will be important to explore modulation of specific iron regulatory pathways in alleviating the impact of aging and asthma.

Abstract Rationale : Airway remodeling in asthma involves increased airway smooth muscle (ASM) mass, changes to bronchial epithelial cell (BEC) layer, and increased fibrosis. ASM and BECs actively contribute by secreting growth factors and cytokines, regulating extracellular matrix (ECM) composition and enhancing cell proliferation/migration. Altering mechanisms which modulate remodeling presents a key to novel therapeutic strategies. BDNF increases ASM [Ca2+]i and contractility, and potentiates the effects of inflammation. Importantly, studies show that ASM is not only a target, but also a source of BDNF, raising the possibility of local autocrine/paracrine effects. Arginase 1 and 2 are expressed by BECs, but their roles in asthma are still under investigation with studies showing arginase 1 inhibition blunting epithelial remodeling and ASM hyperplasia. Knockdown of appealing targets such as ASM BDNF and epithelial arginases using small interfering RNA (siRNA) is a promising approach to combating inflammatory lung remodeling. Polymer based nanoparticles have been constructed which demonstrate cell-type specificity and high efficiency in delivering siRNA. Thus, we hypothesize that BDNF and arginases are central to airway remodeling and can be targeted via nanopartiacles.Methods: Primary human ASM and BEC cells from non-asthmatic vs. asthmatic individuals were obtained post-surgery from lung tissues after approval Mayo Clinic IRB. PONI-Guan NP were generated using block copolymer engineering. PCR, immunoblotting and ELISA were performed using standard techniques. Contractility studies were conducted in adult mouse precision cut lung slices. In vivo lung function studies were conducted in 6-8 week old mice, with or without mixed allergen (MA) treatment and Scireq Flexivent system. Results: PONI-Guan NP uptake demonstrates cell-type specificity in BEC/ASM co-culture and mouse lung. Arginase I/II and ECM expression is upregulated in BECs when exposed to BDNF and cytokines. In ASM, BDNF is increased in asthmatics compared to non-asthmatic controls; ECM expression is increased in response to BDNF and TNF-α. In BEC, PONI-Guan NP/siRNA inhibits Arg I/II expression, even in the presence of TNF-α. In ASM, TNF-α increases in BDNF secretion and ECM deposition are blunted by NP-delivered siRNA. PCLS and mouse lung function studies show contractility to MCh: effects suppressed by NP-delivered BDNF and Arg I siRNA. Conclusions: Our studies show the importance of BDNF/Arginase pathways in airway remodeling and efficacy of PONI-based siRNA delivery vectors in blunting remodeling processes.

Abstract Rationale: Within the asthmatic lung, inflammatory signaling alters the contractile capacity of airway smooth muscle (ASM). In chronic inflammation, ASM become hypercontractile and are a key contributor toward airway hyperresponsiveness (AHR). As a heterogenous disorder, several asthmatic endotypes have been defined. A severe ASM endotype is partly defined as being glucocorticoid insensitive. We have reported the role of Kisspeptin (Kp)/KISS1R signaling in the lung in the context of airway fibrosis. In this study, KISS1R and Kp-10 were investigated for a potential interactions with intracellular calcium [Ca2+]i signaling and ASM contractility in the in vitro setting of severe asthmatic endotypes. Methods: Primary ASM were obtained from non-pathological samples from the Mayo Clinic. ASM cells were treated with inflammatory cytokines (TNFα 20 ng/ml, or IL-13 50 ng/mL)± Kp-10 (1 μM). The steroid-insensitive asthma endotype was investigated using pro-inflammatory cytokines (TNFα 20 ng/ml and IFN-γ 25 ng/mL) ± a corticosteroid (Fluticasone Propionate 100 nM). Β2-Adrenergic Receptor (β2-AR) desensitized endotypes were developed by treating cells with a β2-AR agonist (Salbutamol 1 μM) for 24 hours prior to and along with cytokine treatments (TNFα 20 ng/ml and IFN-γ 25 ng/mL or IL-13 50 ng/mL) ± Kp-10. [Ca2+]i was measured via Fura-2AM (4 μM) labeling on an Olympus Fluoview 300 microscope. Myosin light chain (MLC) phosphorylation studies were used to quantify downstream mechanics of ASM contractility. Results: KISS1R activation in IL-13 treated cells reduced [Ca2+]i in response to histamine. In contrast, TNFα treated cells were responsive to Kp-10 for acute treatments, however this effect was lost after 24 hours of Kp-10 treatment. TNFα and IFN-γ treated cells showed a robust [Ca2+]i response to histamine, and both fluticasone (∼20% reduction) and Kp-10 (∼10% reduction) alone had a minimal effect in reducing [Ca2+]i. Fluticasone and Kp-10 co-exposure significantly reduced [Ca2+]i and significantly reduced the effect of TNFα/IFN-γ (∼45% reduction). In B2-AR desensitized cells, Kp-10 exposure maintained the effect of reducing [Ca2+]i, suggesting Kp-10/KISS1R signaling works through an alternate or independent pathway. Kp-10 treatments on cytokine exposed cells reduced p-MLC in response to histamine, suggesting a role in ASM contractility. Conclusion: The increase of [Ca2+]i in inflamed cells is associated with AHR; Kp-10/KISS1R signaling showed varying efficacy in reducing [Ca2+]i within inflammatory endotypes. These results also highlight that Kp-10 acts synergistically with the current therapeutics available for asthma.

Abstract RATIONALE: Endothelial-to-mesenchymal transition (EndMT) is a cellular process in which endothelial cells (ECs) transition into mesenchymal cells, a mechanism recently linked to pulmonary vascular remodeling in pulmonary hypertension (PH). However, the regulatory mechanisms driving EndMT in PH remain largely undefined. MicroRNA-153 (miR-153), a small non-coding RNA, regulates gene expression by targeting the 3'-untranslated region (3'-UTR) of mRNA, affecting mRNA translation and stability. This study investigates miR-153's role in modulating EndMT in PH. METHODS: Human lung vascular endothelial cells (LVECs) were isolated from healthy individuals and patients with idiopathic pulmonary arterial hypertension (IPAH). In vitro, normal LVECs were exposed to hypoxia (3% O₂) for 72 hours or treated with TGF-β1 (10 ng/mL) for 7 days to induce EndMT. Levels of miR-153 and EndMT markers were quantified by qPCR, Western blotting, or immunostaining. Proliferation and apoptosis of ECs were assessed using EdU and TUNEL assays, respectively. LVECs were transfected with miR-153 inhibitor or mimic, then exposed to normoxic or hypoxic conditions, respectively for 72 hours. In vivo, mice were subjected to either hypoxia (10% O₂ for 6 weeks, Hx-PH) or Sugen5416/hypoxia (20 mg/kg i.p. plus 10% O₂ for 6 weeks, SuHx-PH) to induce PH. The PH phenotype in mice was evaluated by hemodynamic measurements and histological analysis of H&E-stained lung tissues. RESULTS:In silico analysis identified miR-153 as a direct regulator of human SNAI1 and SNAI2 genes via binding to their 3'-UTR. Downregulation of miR-153 in IPAH LVECs was correlated with elevated SNAI1/2 expression, increased EndMT, and higher proliferation compared to normal LVECs. Hypoxia or TGF-β1 treatment reduced miR-153 expression, increased EndMT transcription factors (SNAI1/2), mesenchymal markers (SM-22, vimentin), and reduced EC markers (CD31, VE-cadherin). In normoxic LVECs, miR-153 inhibition significantly upregulated SNAI1/2, increased EndMT and EC proliferation, and reduced apoptosis. Conversely, miR-153 mimic abolished hypoxia- and TGF-β1-induced EndMT. Overexpression of miR-153 attenuated hypoxia-induced EC survival. In PH mouse models, reduced miR-153 levels were associated with activated SNAI1/2, EndMT, and pulmonary vascular remodeling. CONCLUSIONS: Downregulation of miR-153 drives phenotypic transition of LVECs to proliferative mesenchymal cells via SNAI-mediated EndMT, contributing to pulmonary vascular remodeling and PH. Therefore, miR-153 could be a potential therapeutic target for PH treatment.

EndMT has been reported to contribute to the pathogenesis of PAH. In this study, we aimed to determine the role of Ca 2+ signaling in the development of EndMT in human lung vascular endothelial cells. Our data suggest that TGF-β 1 requires store-operated Ca 2+ entry through STIM1/Orai channels to induce SNAI-mediated EndMT. For the first time, we demonstrated that TGF-β 1 -induced EndMT is a Ca 2+ -dependent event, whereas inhibition of STIM1/Orai interaction attenuated EndMT in response to TGF-β 1 .