Statins enhance the anti-inflammatory effects of inhaled corticosteroids in asthmatic patients through increased induction of indoleamine 2, 3-dioxygenase

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Statins enhance the anti-inflammatory effects of inhaled corticosteroids in asthmatic patients through increased induction of indoleamine 2, 3-dioxygenase Kittipong Maneechotesuwan, MD, PhD, Wuttichai Ekjiratrakul, MD, Kanda Kasetsinsombat, MSc, Adisak Wongkajornsilp, MD, PhD, Peter J. Barnes, DSc, FRS Journal of Allergy and Clinical Immunology Volume 126, Issue 4, Pages 754-762.e1 (October 2010) DOI: 10.1016/j.jaci.2010.08.005 Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 A, Signaling pathways regulating IDO expression and activity. B, Flow of subjects through the study. IRF7, IFN-regulatory factor 7; T reg, regulatory T cell. Journal of Allergy and Clinical Immunology 2010 126, 754-762.e1DOI: (10.1016/j.jaci.2010.08.005) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Sputum eosinophil percentages after budesonide (Bud) treatment in comparison with that after combined budesonide-simvastatin treatment (Bud+simvas). Results are expressed as medians (interquartile ranges), and Mann-Whitney P values are presented. Journal of Allergy and Clinical Immunology 2010 126, 754-762.e1DOI: (10.1016/j.jaci.2010.08.005) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Gene expressions (mRNA) as indicated after inhaled budesonide (Bud; A) and combined budesonide-simvastatin treatment (Bud+simvas; B). Percentages of macrophages expressing IDO, NF-κB p52, and GITRL (C and D) are shown. Results are expressed as medians (interquartile ranges), and Mann-Whitney P values are presented. Journal of Allergy and Clinical Immunology 2010 126, 754-762.e1DOI: (10.1016/j.jaci.2010.08.005) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 A, IDO activity after treatment with budesonide (Bud) and combined budesonide-simvastatin therapy (Bud+simvas). B and C, Correlation between IDO activity and sputum eosinophil count after budesonide (Fig 4, B) and combined budesonide-simvastatin treatment (Fig 4, C) are also shown. Results are expressed as medians (interquartile ranges), and Mann-Whitney P values are presented. Journal of Allergy and Clinical Immunology 2010 126, 754-762.e1DOI: (10.1016/j.jaci.2010.08.005) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Association between IL-10 and IDO activity and sputum eosinophil count. Nuclear translocation of NF-κB p52 (A) and NF-κB p65 (B) Spearman rank correlation between sputum IL-10 and IDO activity (C and D) and absolute eosinophil counts (E and F) are shown. Results are expressed as medians (interquartile ranges), and Mann-Whitney P values are presented. Journal of Allergy and Clinical Immunology 2010 126, 754-762.e1DOI: (10.1016/j.jaci.2010.08.005) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions