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Respiratory Immunopharmacology Group

Focused on studies investigating mechanisms of inflammation, tissue damage and repair in respiratory diseases

Respiratory Immunopharmacology Group

The respiratory immunopharmacology research group is focused on studies investigating mechanisms of inflammation, tissue damage and repair in respiratory diseases, including cystic fibrosis (CF), non-cystic fibrosis bronchiectasis (NCFBE), asthma and chronic obstructive pulmonary disease (COPD).

The group is lead by Professor Janis Shute.

Asthma research focuses on mechanisms of bronchial epithelial repair and, in particular, the role of coagulation factors and fibrin formation in models of epithelial wounding. In addition, the group are developing disease biomarker assays to monitor disease progression and response to therapy in clinical samples obtained non-invasively.

The destruction of collagen and elastin by neutrophil elastase plays a central role in the pathophysiology of both cystic fibrosis and COPD. The group is investigating novel therapeutic approaches to the pharmacological regulation of elastase activity.

In addition, the group is investigating novel mucolytic, anti-oxidant, anti-bacterial and anti-inflammatory properties of heparin and non-anticoagulant derivatives for novel therapeutic applications in the treatment of obstructive airways disease.

Clinical research is carried out in collaboration with Professor Anoop Chauhan, Respiratory Consultant at the Queen Alexandra Hospital in ºÚÁÏÈë¿Ú, and Dr Mary Carroll (CF) and Professor Tom Wilkinson (NCFBE) at Southampton General Hospital.

Our current laboratory research

The role played by coagulation cascade proteins in tissue damage and repair

Our research has revealed a previously unrecognised role for fibrin formation in normal bronchial epithelial repair. Using cell culture techniques we have shown that normal human bronchial epithelial cells (HBECs) are a local source of coagulation factors that are essential for the epithelial repair in response to mechanical wounding.

Using video microscopy we have found that neutralisation of coagulation factors inhibits normal epithelial repair, and that protease activated receptors play a role in the response. We are currently investigating the effect on fibrin formation of exposure of HBECs to models of virus and bacterial infection. In clinical studies we have profiled the expression of coagulation factors of the extrinsic cascade and found derangements in mild-moderate asthma that suggest excessive fibrinolysis and defective epithelial repair. In severe asthma and especially in acute exacerbations of severe asthma, fibrin formation is enhanced.

Cystic fibrosis research

Cystic fibrosis is the most common lethal genetically inherited disease affecting the Western world. Life expectancy is currently 47 years of age and most deaths are due to infection and inflammation in the lung. Airways become obstructed with dehydrated viscous mucus which patients find difficult to expectorate.

Contamination with the debris of the airway inflammatory response contributes to the excessive viscoelasticity of sputum. Patients require chest physiotherapy on a daily basis. Sputum expectoration is enhanced by the use of drugs that thin mucus (mucolytics) and our research has focused on this aspect of the disease.

The role of platelets in inflammatory airway disease

Platelets are activated in the circulation in asthma, cystic fibrosis and COPD. Previous studies have indicated the accumulation of platelets in the airway in asthma, and we find increased numbers in lung tissue from cases of fatal asthma, but their role in the airway is unknown. Using lung microvascular endothelial cells in models of inflammatory cell migration, we have shown that platelet-derived chemokines attract T-cells and neutrophils across the endothelium.

This pro-inflammatory role for platelets may be countered by a protective role in fibrin formation and epithelial repair. We are currently assessing the role of platelets in co-culture models with wounded bronchial epithelial cell layers, and the effect of anti-coagulants on the repair response. Using biopsy material we are investigating the presence of platelets and the provenance of coagulation factors in fatal and non-fatal asthma, and non-asthma deaths.

Novel applications of unfractionated inhaled heparin

Unfractionated heparin is a unique molecule in biology with interesting pharmacological properties beyond anti-coagulation. In addition to its well-known anti-inflammatory properties, we have shown that heparin has mucolytic activity when applied to sputum from patients with CF, and clinical trials have supported a role for inhaled heparin in sputum clearance strategies. We identified a previously unrecognised role for heparin in the activation of endogenous and exogenous, pharmaceutical, DNase activity and demonstrated, using atomic force microscopy and confocal microscopy, that extracellular DNA is the target for the mucolytic activity of heparin.

Rheological analysis of sputum samples confirmed an effect of heparin on the elastic properties of sputum, suggesting the mechanism for enhanced sputum clearance in patients with cystic fibrosis, and improved drug delivery through sputum. We are currently investigating the role of neutrophils in the release of DNA NETs when in contact with airway epithelial cells, and the application of novel mucolytics to disrupt DNase-resistant NETs supporting biofilm formation.

Fibroblast function in tissue repair

The degradation of the key matrix proteins, collagen and elastin, is a cardinal feature of lung tissue damage in patients with CF, NCFBE and COPD. Neutrophils are believed to play an important part in this matrix destruction.

However, we are now investigating the pharmacological regulation of elastin and collagen synthesis, and its degradation, by lung fibroblasts in culture. Using quantitative specific assays for collagen and elastin synthesis at the protein level, and evidence of their degradation by Western blotting and analysis of desmosine breakdown products of elastin we are examining the effects of antibiotics and collagen peptides on elastin and collagen synthesis in fibroblasts from the lung.

Regulation of expression and function of CFTR in epithelial and endothelial cells

CFTR is a chloride ion channel expressed by all epithelial cells and appears to be expressed by other cells at low levels. In a project funded by the Dunhill Medical Trust, we are investigating the expression and function of CFTR in human lung microvascular endothelial cells. The project involves the functional characterisation of CFTR using electrophysiology, molecular biology, pharmacology, immunohistochemistry and microscopy.

A role for normal CFTR in negative regulation of the inflammatory response is proposed. In this study we are investigating the effect of CFTR knockdown, using pharmacological inhibitors and siRNA approaches, to test the hypothesis that defective CFTR contributes to an enhanced inflammatory response at the endothelial level in patients with cystic fibrosis.

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