Recent advance of medications and devices brings more effective treatment intervention to the patients with asthma. As far as obeying guidelines, approximately 90% of patients with asthma acquire good control. However, there are still small number of patients with asthma who resist conventional treatment. Most of them are corticosteroid-insensitive. It would be thought that there are two ways to deal with this problem. The first one is biologics. However, these are very expensive. The second way is a treatment intervention focusing on cancellation of corticosteroid-resistance. In early 2010s, a new-intracellular signaling pathway (phosphatydilinositol-3-kinese: PI3K pathway) is proven to be closely associated with corticosteroid-resistance. PI3K-inhibitor should be one of the promising candidates to attenuate corticosteroid-resistance. But PI3K-inhibitor also has a toxicity when given systemically. Drug-repositioning (DR) is a good option to deal with it. To find out PI3K-inhibitor from numerous medicines gives an answer how to inhibit PI3K pathway. The presenter has found both low-dose theophylline and long-acting beta-2 agonist have a potential to antagonize PI3K. These medicines have been prescribed for decades and their safety has already been proved. It is possible for clinicians to inhibit PI3K activation in patients with asthma associated with corticosteroid-resistance using these medicines without waiting for development of bran-new PI3K inhibitors. DR revealed that nortriptyline acts as a steroid-enhancer via its anti-PI3K activity. Calcium-channel blocker saves lung function in patients with asthma in long-term observation. DR promises us to find cheap and safe options to treat difficult asthma by inhibiting specific intracellular signaling pathways.
Asthma therapy in general has improved a lot in recent years, but it is still a major problem that severe asthma, which accounts for 10 to 20%, still suffers from strong symptoms on a daily basis despite all therapeutic agents used in combination. American SARP and European ENFUMOSA started in 2000 to advance pathophysiological insights of severe asthma. Clinical usage of antibodies and inhibitors against IgE, TNF, IL-5, IL-4, IL-13, and TSLP are also accumulating. Some of these molecular-targeted drugs improve respiratory function and reduce acute exacerbations in patients with severe asthma. Until now, cytokines have been assumed to be involved in chronic inflammation, but it is also interesting to elucidate the pathways of how cytokines are involved in respiratory function and acute exacerbations. We registered approximately 100 steroid-dependent asthma patients in Japan. Although long-lasting poor control of the disease was considered the cause of severe asthma in the past, steroid dependence in one third of the cases occurred within 2–3 years after the onset. Steroid resistance seems a key process from the early stage of the disease. Steroid resistance of T cell level was induced by extracellular co-stimulation and cytokine signals. The inhibition may improve steroid sensitivity and treat steroid-resistant asthma. Therefore, we established a steroid-resistant asthma model for the first time by transferring steroid resistant T cell clones, and analyzed the steroid sensitivity recovery effect of CTLA4-Ig. In addition, a multicenter, double-blind, placebo-controlled exploratory trial was performed as a POC study investigating the efficacy of abatacept in treatment-resistant severe asthma. Elucidation of the pathophysiology and mechanism by which steroids do not work is expected to be a breakthrough for the prevention and treatment of severe asthma.
There is a certain population of intractable asthma patients, who can not be controlled by corticosteroid therapy. It has been suggested that 5–10% of asthma patients have been suffered from steroid resistance. Since it has been difficult to develop a steroid-resistant asthma model, the detailed mechanisms have been unclear. Recently, an intractable asthma model showing steroid insensitivity was developed by the author and colleagues. We found that pathogenic changes in type 2 innate lymphoid cells (ILC2) were induced in the intractable asthma. When ovalbumin (OVA) + Al(OH)3-sensitized BALB/c mice were intratracheally challenged with OVA at 5 μg/animal, development of airway remodeling as well as lung eosinophilia and neutrophilia were markedly suppressed by treatment with dexamethasone. In contrast, when increasing the dose of OVA for challenges to 500 μg/animal, those asthmatic responses turned to be steroid insensitive. When Th2 cells and ILC2 in the lung were stimulated in vitro, ILC2 produced larger amounts of type 2 cytokines than Th2 cells. Interestingly, amounts of type 2 cytokines produced by the steroid-insensitive model-derived ILC2 were significantly larger than those by the steroid-sensitive, and that the former ILC2 exhibited higher expression of thymic stromal lymphopoietin (TSLP) receptor and signal transducer and activator of transcription (STAT) 5a gene. Treatment with anti-IL-5 antibody improved the steroid sensitivity. Taken together, ILC2 have been transformed to be pathogenic in the intractable asthma. IL-5 hyper-produced from ILC2 may be involved in the development of steroid resistance. The molecules related to the above mentioned are expected to be targets for development of new therapeutic drugs for intractable asthma.
Bronchial asthma (asthma) is characterized by chronic airway inflammation, reversible obstruction, and hyperresponsive conditions. Although most asthma patients have been becoming controllable by virtue of inhaled corticosteroid (ICS), substantial number of patients still do not respond to the steroid-based therapy. Mast cells, eosinophils, and helper T (Th) 2 cells have been considered as key players in asthma pathogenesis. However, emerging studies have revealed that Th subsets other than Th2, as well as various other immune cells, significantly contribute to the development of steroid-resistant intractable asthma. T cells and other inflammatory cells require incorporating a large amount of nutrients such as amino acids and glucose to exhibit their full function following activation. Based on this remarkable character, it has recently been suggested that the pharmacological inhibition of amino acid transporters is promising for treating immunological and inflammatory disorders through the suppression of inflammatory cell activation. In this review, we explore the possible management of intractable asthma by developing a selective inhibitor for L-type amino acid transporter (LAT) 1.
Emerging evidences indicate that a microbial imbalance (dysbiosis) is linked to several diseases including metabolic cardiovascular diseases. A fecal microbiota transplantation from hypertensive human donor to germ-free mice caused blood pressure elevation. In addition, there is a report demonstrating that angiotensin II-induced hypertension and vascular dysfunction were attenuated in germ-free mice, suggesting that gut microbiome may mediate development of hypertension. Although detailed mechanism by which the dysbiosis induces an increased blood pressure remains unknown, changes in microbiome may modify host immune systems and induce inflammatory dysfunction in cardiovascular system, resulting in dysregulation of blood pressure. Some cohort studies demonstrated an association between a higher abundance of Streptococcaceae spp. and blood pressure. One recent report demonstrated that an increasing number of gram-positive Streptococcus was found in the feces of adult spontaneously hypertensive rats with an increased intestinal permeability. We hypothesized that increased bacterial toxin levels derived from gut Streptococcus may be a factor inducing blood pressure dysregulation. In this review, we discuss the possible role of microbiome in cardiovascular disease, especially hypertension.
Emerging evidences suggest that gut microbiota-derived substances play a pivotal role in the regulation of host homeostasis including vascular function. Actually, these substances and/or their metabolites can be presented in circulation and local tissue and their levels are often abnormal in the pathophysiological states. Therefore, to determine the role of them in physiological function is important in human health. On the other hand, vascular dysfunction is a key event in the initiation and progression of systematic complications of cardiovascular, kidney and metabolic diseases including hypertension, dyslipidemia, diabetes, and atherosclerosis. Although abnormalities in endothelial and vascular smooth muscle cells play an important role on vascular dysfunction, emerging evidences has suggested that gut microbiota-derived substances can directly or indirectly affect these cellular functions. The present review will focus on the relationship between vascular function and indoxyl sulfate or trimethylamine-N-oxide (TMAO).
The living body is composed of diverse organ systems, each of which has its own characteristic control mechanisms and complex in vivo responses. Between the brain and organs such as the heart, kidney, liver, pancreas, gastrointestinal tract, and even muscles, there is a sophisticated and complex regulatory system. Coordinated interactions through communication between organs are essential for maintaining health. In this review, we introduce four research trends in inter-organ networks, with a focus on the digestive system: 1) Inter-organ networks on metabolic systems, 2) Inter-organ networks originating from the gastrointestinal tract, 3) Intestinal bacteria, that is one of the biggest topics in recent years, 4) Research results on the involvement of gut microbiota in the inter-organ network between the kidney and the gastrointestinal tract. An integrated understanding and investigation of the regulatory mechanisms of inter-organ communication networks are expected to extend healthy life span and improve quality of life.
Experimental animals have been used so very often on science studies from the late 19th centuries. Especially since Wistar rat was produced in the 1890s as an experimental animal, various kinds of experimental animals have been developed and made enormous contribution to human beings. It is not an exaggeration to say that experimental animals have made us alive and rich, so to speak. However, the number of uses of experimental animals has decreased since its peak in 1990s. One of the reasons is the existence of Alternatives to animal experiments. Around 1980, Importance of 3Rs has been increased among its support, and the trend of animal experiments has moved to ones without using animals all over the world. It is because animal experiments cost and take time, but the biggest reason is the concern towards overuse of experimental animals. There is a rooting ethical doubt among many researchers that we can sacrifice other animals to save human lives. Human beings have hunted, and domesticated other animals as means of surviving. But today, we are trying to find a way to live not only for ourselves but for other animals on the whole earth. As a mean of the living, Alternatives to animal experiments have significant meanings and it will get even more important in the future. In this article, I would like to briefly explain the history and movements on Alternatives to animal experiments that took place here in Japan.
With the remarkable scientific advances in stem cells technologies and culture systems, it is no longer a dream to construct in vitro cultured tissue/organ models that respond completely as if they were in vivo. The microphysiological system (MPS) is a symbol of the growing worldwide momentum to promote the use of in vitro methods. The development of MPS devices as a culture system itself has been almost completed both in Japan and overseas, thus, the focus from now on is on the construction of prediction systems and evaluation of their applicability in accordance with the specific requirements (context of use: CoU), for example, of the drug discovery process of pharmaceutical companies. A notable trend at this stage is the close communication between developers (companies and researchers), users, and regulatory authorities, and the organization of the European Organ on a Chip Society (EUROoCS) and the International MPS Summit involving these stakeholders has begun. It is strongly expected that academic studies on in vitro systems symbolized by MPS and their results for the evaluation and prediction of individual responses and their application in society will continue to advance, leading to the promotion of alternatives to animal experiments.
The skin is not only the site of drug application, but also the site of exposure to various chemical substances. Prediction of skin permeability, body absorption, and local skin concentration of chemicals are very important to assure efficacy and safety. Most in silico models for skin permeation of chemical are based on the prediction of its permeability coefficient (P, unit cm/s), and a certain level of prediction accuracy has been obtained. On the other hand, the amount absorbed in the body of a chemical is calculated from the sum of the amount of skin permeation and the amount under the stratum corneum (viable epidermis and dermis). The amount of skin permeation can be calculated from the P value as mentioned above, however, the amount under the stratum corneum, which is related to the local skin safety of the chemical, cannot be predicted. This article describes the principles of permeation of chemicals across the skin, the relationship between skin permeability and concentration in the skin, and the method for calculating the chemical concentration under the stratum corneum using skin permeation parameters.
We have ongoing projects that are developing New Approach Methods (NAMs) for systematic toxicology. One NAM is to develop the immunotoxicity evaluation with non-animal test methods for the Organisation for Economic Co-operation and Development (OECD)Test Guideline (TG). The development of this evaluation includes the following steps: 1) adverse outcome pathway (AOP), 2) detailed review paper, 3) test methods based on AOP, 4) validation study of test methods for developing TGs, and 5) integrated approaches to testing and assessment (IATA). I believe that the NAMs developed on these steps may enable risk assessment of a chemical with non-animal test methods in near future.
Amino acid Derivative Reactivity Assay (ADRA) is an alternative method developed based on the principle of covalent bonding between sensitizer and proteins in the early stage of the mechanism of skin sensitization. The Direct Peptide Reactivity Assay (DPRA) with same principle previously listed in the OECD test guidelines (TG) have some problems such as precipitation of the test chemical in the reaction solution and co-elution of the peptide with the test chemical. While, instead of DPRA, the ADRA was developed using two chemically synthesized nucleophilic reagents-namely, NAC and NAL in which naphthalene rings with a high molar absorbance coefficient (MAC) in the ultraviolet range have been introduced to N-termini of the cysteine and lysine that can react with the test chemical. Therefore, in March 2016, we set up a validation team with the aim for adoption in the OECD TG, ADRA’s validation tests were conducted. After reporting the results of validation study, holding a third-party evaluation meeting and two commenting rounds, ADRA was able to be adopted in the OECD TG in June 2019. In addition, since the introduction of naphthalene with a high MAC has made it possible to reduce the concentration, enabling the following items. 1) Decrease in the frequency of precipitation of the test chemicals in the reaction solution. 2) Decrease in the frequency of co-eluting of the nucleating reagent and the chemical. 3) Evaluation of chemicals with unknown molecular weight using the gravimetric approach. 4) High-sensitivity detection of nucleophilic reagents by the fluorescence method. 5) Evaluation of the mixture by a combination of the gravimetric approach and fluorescence detection.
The epidermal growth factor receptor (EGFR) is the most extensively examined receptor tyrosine kinase. Several EGFR mutations and modifications have been shown to induce self-activation, which plays a central role in carcinogenesis. Recently, environmental chemicals such as PM2.5 can also activate EGFR and become risk factors for cancer. Although, the detailed mechanism remains unknown. In this study, we focused on 1,2-naphthoquinone (1,2-NQ) which is a secondary metabolite of naphthalene. Humans are exposed to 1,2-NQ through the combustion of fossil and diesel fuel and from tobacco smoke and PM2.5. Here, we demonstrate that 1,2-NQ is a novel EGFR-specific activator. We found that 1,2-NQ forms a covalent bond called N-arylation with EGFR Lys80 which is in the extracellular domain by LC-MS/MS. This modification activates the EGFR-Akt signaling pathway, which inhibits serum deprivation-induced apoptosis in A549 cells. Our study reveals an original mode of EGFR activation via covalent binding. We propose the correlation between EGFR activation without ligands and environmental pollutant-associated diseases such as cancer.
G protein-coupled receptors (GPCRs) play pivotal roles in converting physicochemical stimuli due to environmental changes to intracellular responses. After ligand stimulation, many GPCRs are desensitized and then recycled or degraded through phosphorylation and β-arrestin-dependent internalization, an important process to maintain protein quality control of GPCRs. However, it is unknown how GPCRs with low β-arrestin sensitivity are controlled. Here we unmasked a β-arrestin-independent GPCR internalization, named Redox-dependent Alternative Internalization (REDAI), focusing on β-arrestin-resistant purinergic P2Y6 receptor (P2Y6R). P2Y6R is highly expressed in macrophage and pathologically contributes to the development of colitis in mice. Natural electrophiles including in functional foods induce REDAI-mediated P2Y6R degradation leading to anti-inflammation in macrophages. Prevention of Cys220 modification on P2Y6R resulted in aggravation of the colitis. These results strongly suggest that targeting REDAI on GPCRs will be a breakthrough strategy for the prevention and treatment of inflammatory diseases.
Covalent drug forms a covalent bond with desease-related target proteins irreversibly inhibits their function. In order to develop a safe and non-toxic covalent drug, it is important to device new reaction chemistry that realizes a sufficient reactivity and high target selectivity for targeted protein under the complicated biological systems such as our body. Currently, new reaction chemistry is being actively developed all over the world to achieve excellent target selectivity of covalent drugs. In this essay, we intoroduce α-chlorofluoroacetamide and bicyclobutane amide as the new reactive groups for proteineous cysteine of targeted protein and their application to develop targeted covalent inhibitors for the treatment of cancer and infecsious deseases.
Transmembrane receptors transmit extracellular information into cells. In many cases, protein families are composed of highly homologous subtypes, each of which has unique cellular functions. Therefore, it is highly desired for understanding the physiological roles of the receptor in tissues or animals. However, it is difficult to control the activity of receptors in a cell-type- and subtype-specific manner with high temporal resolution using traditional pharmacological or genetic engineering methods. Recently, chemogenetics has been focused on controlling the cellular signaling in a cell-type-specific manner, which allows for elucidating the function of specific cell types with high temporal resolution. However, conventional chemogenetics are not suitable for understanding the roles of each receptor. Therefore, we have developed a chemogenetic method, termed coordination chemogenetics, in which coordination chemistry and genetic engineering are combined. The coordination chemogenetics enabled artificial activation of ionotropic glutamate receptor (GluA2) and metabotropic glutamate receptor (mGlu1). A palladium (Pd) complex successfully activated mGlu1 in mGlu1(N264H) knock-in mice, demonstrating that endogenous mGlu1 activation is sufficient to evoke a key cellular mechanism of synaptic plasticity that underlies motor learning in the cerebellum. We also expanded the coordination chemogenetics for orthogonal activation of mGlu1 activity using Cu2+, Zn2+, and Pd complexes for analyzing the individual roles of mGlu1 simultaneously. Notably, coordination chemogenetics can be expanded to apply selective inhibition of transmembrane receptors, and the dissociation is much slower than that of conventional inhibitors. Thus, coordination chemogenetics would be a unique method for controlling mGlu1 in a cell-type-specific manner.
Visualization and measurement of drugs themselves as well as biological responses to those drugs are crucial in pharmacological research. To this end, various fluorescent dyes and proteins have been developed. Despite such progresses, there still remains technical difficulties to overcome in bioimaging that keep many pharmacological targets and phenomena invisible. Outside the fields of biology where fluorescence and luminescence prevail, variety of other optical phenomena are well known and utilized. These optical phenomena can shed unique lights on biological phenomena based on their specific physical and chemical properties. Although applications of these optical phenomena to biology are yet to be explored, they have high potentials in realizing visualization and measurement of currently invisible targets and phenomena, and thereby bringing new insights into pharmacological research. Thus, here I will introduce Raman scattering microscopy that visualize vibration of functional groups as an alternative imaging platform to fluorescence and luminescence. Special focus will be put on two recent technical advancements; namely, nonlinear Raman scattering microscopy that utilizes multi-photon effect of highly tissue penetrating near-infrared lights, and Raman-tag that realizes tagging of targets that could not have been labeled, combination of which is expected to pave a way toward imaging previously invisible targets in pharmacology.
Denileukin Diftitox (DD) is a recombinant fusion protein of diphtheria toxin (DT) fragments and human interleukin-2 (IL-2). DD binds to IL-2 receptor (IL-2R) expressed on tumor cells and is taken up into the cells. Subsequently, DT fragments with adenosine diphosphate ribosylation enzyme inhibit protein synthesis, then ultimately trigger cell death. DD binds to both high- and intermediate-affinity IL-2Rs via IL-2 domain and inhibits growth of human T-cell lymphomas cell lines. E7777, which contains DD as an active component, has improved purity and an increased percentage of active monomer compared with the approved drug E7272 (ONTAK in the US, not approved in Japan). In the phase I clinical study in Japanese patients with relapsed or refractory peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL), the maximum tolerated dose and recommended dose of E7777 were 9 μg/kg/day (administered on Days 1-5 of each cycle) based on the evaluation of dose-limiting toxicity. In the phase II clinical study, the objective response rate was 36.1%, showing comparable efficacy to existing therapies. E7777 showed anti-tumor activity observed across the range of CD25 expression. Grade 3 or higher adverse events (AE) occurred in 94.6%, and serious AE such as capillary leak syndrome and rhabdomyolysis were reported. Therefore, safety monitoring activities have been continued along with alerting related events. Based on these results, E7777 obtained a new drug approval in Japan in March 2021 for the indication of relapsed or refractory PTCL/CTCL.