Role of hyaluronan and hyaluronan-binding proteins in human asthma

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Role of hyaluronan and hyaluronan-binding proteins in human asthma Jiurong Liang, MD, Dianhua Jiang, MD, PhD, Yoosun Jung, MS, Ting Xie, MD, Jennifer Ingram, PhD, Tony Church, BS, Simone Degan, PhD, Maura Leonard, BS, Monica Kraft, MD, Paul W. Noble, MD Journal of Allergy and Clinical Immunology Volume 128, Issue 2, Pages 403-411.e3 (August 2011) DOI: 10.1016/j.jaci.2011.04.006 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Sections of endobronchial biopsies from patients with asthma (FEV1: 95% ± 5% predicted; n = 6) and healthy subjects (FEV1: 102% ± 5% predicted; n = 6) were stained for hyaluronan (HA). A and B, Healthy. D and E, Asthmatic. C, Section from a patient with asthma was preincubated with HYAL. F, Flow chart to show quantitation of HA staining. G, Quantitation of HA staining of bronchial sections (n = 6 each; ∗P < .05). Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Asthmatic fibroblasts produce increased concentrations of hyaluronan. A, Hyaluronan levels in 48-hour culture media of untreated airway fibroblasts from patients with asthma and healthy controls (n = 9/10; ∗P < .05). B, Hyaluronan in 48-hour culture media of fibroblasts from patients with asthma and healthy controls treated with IL-13, TNF-α, or TGF-β (n = 5; ∗P < .05; ∗∗P < .01; NS, not significant). Within the asthma group, there was no significant difference comparing treatment versus no treatment. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 HAS and HYAL mRNA expression in fibroblasts from patients with asthma and healthy controls was compared by quantitative PCR. A, HAS2 (n = 8/10; ∗P < .05). B, HAS3 (n = 9/10; P = .563). C, HYAL1 (n = 10/13; P = .210). D, HYAL2 (n = 11/13; P = .129). NS, Not significant. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Molecular mass of hyaluronan (HA) produced by fibroblasts from patients with asthma and healthy controls. A, Size of HA in conditioned media of fibroblasts from subjects with asthma and healthy subjects. Std, Standard. B, Graph showing HA size represents 3 identical experiments with a total of 7 samples from asthmatic fibroblasts and 10 samples from normal fibroblasts (∗∗P < .01). Mol, Molecular. C, NOX4 mRNA expression in fibroblasts from subjects with asthma and healthy subjects was determined with quantitative PCR (n = 7; ∗P < .05). Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Flow-cytometric analysis of cell-surface hyaluronan-binding protein expression on alveolar macrophages from BAL of subjects with asthma and healthy subjects. A, Live macrophage population (P1) was gated on the basis of forward (FSC) and side scatters (SSC). Overlay of histograms of macrophages stained with specific antibodies to CD44, TLR2, or TLR4 (blue lines) and respective control IgG (red lines) is shown. The mean fluorescence intensity (MFI; B) and the percentages (C) of CD44, TLR2, and TLR4–staining positive cells were calculated by comparing with control IgG (CD44, n = 10/13; TLR2, n = 12/15; TLR4, n = 12/14; ∗P < .05, ∗∗P < .01, ∗∗∗P < .0001). Max, Maximum. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Cytokine production by alveolar macrophages from subjects with asthma and healthy subjects. A, IL-8 levels in 24-hour conditioned media from BAL alveolar macrophages from subjects with asthma and healthy subjects treated with either hyaluronan (HA) or LPS (n = 8; ∗P < .05). B-D, IL-8 levels in 24-hour conditioned media from BAL alveolar macrophages from patients with asthma treated with HA or LPS in the presence or absence of TLR2 (B), TLR4 (C), or CD44 (D) antibody pretreatment (n = 3; ∗P < .05, ∗∗P < .01, ∗∗∗P < .001). M, Medium only; Unst, unstimulated. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Molecular mass of hyaluronan from 48-hour conditioned media of fibroblasts from patients with asthma and healthy controls (A–C). Hyaluronan molecular mass peaks are shown on the right. Std, Standard. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 IL-10 levels in 24-hour conditioned media collected from BAL alveolar macrophages from subjects with asthma and healthy subjects treated with either hyaluronan (HA) or LPS (n = 7-8; P > .05 between healthy and asthma). Unst, Unstimulated. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Cytokine production by macrophages is altered in response to hyaluronan (HA) fragments and is TLR2-dependent and TLR4-dependent. U937 cells were incubated with 100 nm PMA at 37°C for 24 hours. Adherent cells were then washed 3 times with PBS and incubated in complete media (without PMA) for an additional 24 hours before use for experiments. Cells were incubated with antihuman TLR2 (clone TL2.1) or mouse IgG2a isotype control (20 μg/mL) at room temperature for 30 minutes (A) or with antihuman TLR4 (clone HTA125) or mouse IgG2a isotype control (20 μg/mL) at 37°C for 1 hour (B). Thereafter cells were treated with low-molecular-weight HA 100 μg/mL or LPS 100 ng/mL in serum-free medium. Twenty-four–hour culture media were collected for measuring human IL-8 concentration. All antibodies were from eBioscience (n = 7-8; *P < .05, **P < .01). M, Medium only; Unst, unstimulated. Journal of Allergy and Clinical Immunology 2011 128, 403-411.e3DOI: (10.1016/j.jaci.2011.04.006) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions