Y-27632 is associated with corticosteroid-potentiated control of pulmonary remodeling and inflammation in guinea pigs with chronic allergic inflammation

Abstract\ud \ud Background\ud Previously, we showed that treatment with the Rho-kinase inhibitor Y-27632 was able to control airway responsiveness, inflammation, remodeling, and oxidative stress in an animal model of asthma, suggesting that this drug is beneficial in asthma. However, studies evaluating the effects of these inhibitors in conjunction with corticosteroids on chronic pulmonary inflammation have not been conducted. Therefore, we evaluated the effects of treatment with the Rho-kinase inhibitor Y-27632, with or without concurrent dexamethasone treatment, on airway and lung tissue mechanical responses, inflammation, extracellular matrix remodeling, and oxidative stress in guinea pigs with chronic allergic inflammation.\ud \ud \ud Methods\ud The guinea pigs were subjected to seven ovalbumin or saline inhalation exposures. Treatment with Y-27632 (1 mM) and dexamethasone (2 mg/kg) started at the fifth inhalation. Seventy-two hours after the seventh inhalation, the pulmonary mechanics were evaluated and exhaled nitric oxide (ENO) levels were determined. The lungs were removed and histological analysis was performed using morphometry.\ud \ud \ud Results\ud The treatment of guinea pigs with the Rho-kinase inhibitor and dexamethasone (ORC group) decreased ENO, the maximal mechanical responses after antigen challenge, inflammation, extracellular matrix remodeling and oxidative stress in the lungs.\ud This therapeutic strategy reduced the levels of collagen and IFN-γ in the airway walls, as well as IL-2, IFN-γ, 8-iso-PGF2α and NF-κB in the distal parenchyma, when compared to isolated treatment with corticosteroid or Rho-kinase inhibitor (P < 0.05) and reduced the number of TIMP-1-positive cells and eosinophils in the alveolar septa compared to corticosteroid-treated animals (P < 0.05). The combined treatment with the Rho-kinase inhibitor and the corticosteroid provided maximal control over the remodeling response and inflammation in the airways and parenchyma.\ud \ud \ud Conclusions\ud Rho-kinase inhibition, alone or in combination with corticosteroids, can be considered a future pharmacological tool for the control of asthma.We thank Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) for their financial support

Treatment with Rho-kinase inhibitor associated or not with corticosteroids in guinea pigs with chronic allergic pulmonary inflammation: modulation of inflammation, oxidative stress, extracellular matrix remodeling, and responses of the airways and lung parenchyma

INTRODUÇÃO: Embora os corticosteróides sejam considerados tratamento padrão-ouro na asma, pacientes com asma grave não são totalmente controlados com este tratamento. Estudos prévios com inibidores da Rho quinase sugeriram uma influência benéfica destas drogas na asma, atuando como uma possível alternativa anti-inflamatória. No entanto, não há estudos anteriores avaliando os efeitos destes inibidores, associados ou não com corticosteróides, na modulação da mecânica do sistema respiratório e oscilatória do tecido pulmonar distal, assim como nas alterações histopatológicas, em modelo animal de inflamação pulmonar crônica. OBJETIVOS: Avaliar se o tratamento com o inibidor específico da Rho (Y- 27632), associado ou não com a dexametasona modula a resposta de mecânica pulmonar, inflamatória, de remodelamento da matriz extracelular e ativação do estresse oxidativo em cobaias com inflamação alérgica crônica. MÉTODOS: As cobaias receberam sete inalações de ovoalbumina (1-5mg/ml; grupo OVA) durante 4 semanas. A partir da quinta inalação, os animais do grupo da Rho quinase receberam inalação de Y-27632 (1mM) (grupo OVA-RHO) e ou dexametasona (2 mg.kg-1) associada ou não a Y-27632 (grupos OVA-C ou grupos ORC), 10 minutos antes de cada inalação com OVA. Setenta e duas horas depois da sétima inalação, os animais foram anestesiados, exsanguinados, o óxido nítrico exalado foi coletado e a mecânica do sistema respiratório (Ers e Rrs) e oscilatória do tecido pulmonar distal (Et e Rt) foram realizadas em condições basais e após desafio com OVA (0,1%). Após, as fatias de pulmão foram removidas e submetidas à avaliação histopatológica. RESULTADOS: Houve um aumento no óxido nítrico exalado, nas respostas máximas de Ers, Rrs, Rt e Et após desafio antigênico, nos eosinófilos, nas células positivas para IL-2, IL-4, IL-5, IL-13, IFN-?, iNOS, MMP-9, TIMP-1,TGF- ß, NF?B e no conteúdo do 8-iso-PGF2?, no conteúdo de fibras elásticas, colágenas e de actina em vias aéreas e no parênquima pulmonar distal do grupo OVA comparado ao controle (P<0,05). Nos grupos OVA-RHO, OVA-C e ORC houve uma diminuição em todos os parâmetros comparados ao grupo OVA (P<0,05). A associação do Y-27632 com o tratamento com corticosteróide (grupo ORC) potencializou a atenuação do conteúdo de colágeno e IFN-? na parede das vias aéreas e IL-2, IFN-?, 8-iso-PGF2? e NF-?B no parênquima distal comparado aos grupos OVA-RHO e OVA-C (P<0,05). No grupo ORC houve uma redução nas células positivas para TIMP-1 e eosinófilos no septo alveolar comparado ao grupo OVA-C (P<0,05). CONCLUSÕES: A inibição da Rho quinase ou o tratamento com corticosteróides contribuíram para o controle da resposta de mecânica pulmonar, da resposta eosinofílica e linfocitária Th1 e Th2, do remodelamento da matriz extracelular e da ativação do estresse oxidativo nas vias aéreas e parênquima distal neste modelo animal. A associação do inibidor da Rho quinase com o corticosteróide potencializou o controle de parte da resposta de remodelamento e de inflamação nas vias aéreas e parênquima. A inibição da Rho quinase associada ou não a corticosteróides pode ser considerada uma ferramenta farmacológica futura para o tratamento de doenças pulmonares crônicasINTRODUCTION: Although corticosteroids are considered gold standard of asthma treatment, patients with serious asthma are not totally controlled with this treatment. Previous studies with Rho-kinase inhibitors suggested a beneficial influence of these drugs on asthma, being a possible anti-inflammatory alternative. However, there are no previous studies evaluating in an animal model of chronic pulmonary inflammation the effects of such inhibitors, combined or not with corticosteroids, on the mechanics modulation of the respiratory system and oscillation of distal pulmonary tissue, as well as on histopathological alterations. OBJECTIVES: To evaluate whether treatment with the specific Rho inhibitor (Y-27632), combined or not with dexamethasone, modulates the responses of pulmonary mechanics, inflammation, extracellular matrix remodeling, and oxidative stress activation in guinea pigs with chronic allergic inflammation. METHODS: Guinea pigs received seven ovalbumin inhalations (1-5mg/ml; OVA group) during 4 weeks. After the fifth inhalation, the animals of the Rho-kinase group received inhalation of Y-27632 (1mM) (OVA-RHO group) and/or dexamethasone (2 mg.kg-1), combined or not with Y-27632 (OVA-C groups or ORC groups), 10 minutes before each inhalation with OVA. Seventy-two hours following the seventh inhalation, the animals were anesthetized, exsanguinated, the exhaled nitric oxide was collected, and mechanics of the respiratory system (Ers and Rrs) and oscillation of the distal lung tissue (Et e Rt) were performed in basal conditions and after challenge with OVA (0.1%). Afterwards, lung slices were removed and submitted to histopathological evaluation. RESULTS: There was an increase of exhaled nitric oxide, maximum responses of Ers, Rrs, Et and Rt after antigen challenge, eosinophil counts, cells positive for IL-2, IL-4, IL-5, IL-13, IFN-?, iNOS, MMP-9, TIMP-1,TGF-ß, NF?B, and in the content of 8-iso-PGF2?, elastic fibers, collagen fibers and actin in the airways in distal lung parenchyma of the OVA group, compared to the control (P<0.05). In the OVA-RHO, OVA-C and ORC groups there was a decrease in all parameters, when compared to the OVA group (P<0.05). The treatment combining Y-27632 with corticosteroid (ORC group) maximized the attenuation of the content of collagen and IFN-y in the airways walls, and of IL-2, IFN-?, 8-iso-PGF2? and NF-?B in distal parenchyma, when compared to the OVA-RHO and OVA-C groups (P<0.05). In the ORC group, there was a reduction of cells positive for TIMP-1 and eosinophils in the alveolar septum, compared to the OVA-C group (P<0.05). CONCLUSIONS: Rho kinase or treatment with corticosteroids contributed to the control of the pulmonary mechanics response, Th1 and Th2 lymphocyte and eosinophil responses, extracellular matrix remodeling, and activation of the oxidative stress in the airways and distal parenchyma of this animal model. The combined treatment with Rho kinase and corticosteroid maximized the control of part of the remodeling response and inflammation of the airways and parenchyma. Rho-kinase inhibition combined or not with corticosteroids can be considered a future pharmacological tool for treatment of chronic pulmonary disease

Resilience Improves the Quality of Life and Subjective Happiness of Physiotherapists during the COVID-19 Pandemic

Resilience is an individual characteristic that protects mental health. However, its impact on the lives of Brazilian physiotherapists during COVID-19 is not known. This study aimed to analyze whether resilience modulates the perceived quality of life (QoL) and subjective happiness (SH) of physiotherapists who work with COVID-19 patients, compared with those who do not. A cross-sectional study was conducted between 22 August and 22 October 2020. Physiotherapists working in critical and non-critical hospital sectors were invited to participate in the study. The participants completed sociodemographic questionnaires and were graded on the 14-item Resilience Scale, 36-item Short-Form Health Survey (SF-36), and the Subjective Happiness Scale. In total, 519 physiotherapists were enrolled in the study. Physiotherapists with low resilience who worked with COVID-19 patients reported lower scores on the SF-36 subscales (except for social functioning) and the Subjective Happiness Scale, compared with those with high resilience who did not work with COVID-19 patients. These responses were modulated by age, sex, absence from work, receipt of personal protective equipment, host leadership, and practice and maintenance of regular physical activity. In conclusion, physiotherapists with low resilience who worked with COVID-19 patients presented lower perceptions of QoL and SH, compared with the other study participants

Effects of Rho-kinase inhibition in lung tissue with chronic inflammation

We evaluated whether Rho-kinase inhibition (Y-27632) modulated distal lung responsiveness, inflammation, extracellular matrix remodeling and oxidative stress activation in guinea pigs (GPs) with chronic allergic inflammation. GPs were submitted to inhalation of ovalbumin (OVA-2x/week/4 weeks). From the 5th inhalation on, the Rho-kinase inhibitor group animals were submitted to Y-27632 inhalation 10 min before each inhalation of OVA. Seventy-two hours after the seventh inhalation, the oscillatory mechanics of the distal lung strips were assessed under the baseline condition and after the ovalbumin challenge. Subsequently, the lung slices were submitted to morphometry. Rho-kinase inhibition in the ovalbumin-exposed animals attenuated distal lung elastance and resistance, eosinophils, IL-2, IL-4, IL-5, IL-13, TIMP-1, MMP-9, TGF-beta, IFN-gamma, NF-kappa B and iNOS-positive cells and the volume fraction of 8-iso-PGF2 alpha, elastic, collagen and actin in alveolar walls compared with the OVA group (P < 0.05). Rho-kinase inhibition contributed to the control of distal lung responsiveness, eosinophilic and Th1/Th2 responses and extracellular matrix remodeling in an animal model of chronic allergic inflammation. (C) 2014 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Sch Med, Dept Med, BR-01246903 São Paulo, BrazilUniv Fed Rio de Janeiro, Ilha Fundao, Carlos Chagas Filho Inst Biophys, Lab Pulm Invest, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, BR-09972270 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, BR-09972270 São Paulo, BrazilWeb of Scienc