Journal of Otology & RhinologyISSN: 2324-8785

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Research Article, J Otol Rhinol S Vol: 0 Issue: 1

Peroxide Tone in Human Inferior Nasal Turbinate with Allergy

Masato Miwa1*, Noritsugu Ono1, Daisuke Sasaki1, Akihito Shiozawa1, Mayumi Miwa2 and Katsuhisa Ikeda1
1Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan
2Harimazaka Clinic, 4-20-2 Koishikawa, Tokyo, Japan
Corresponding author : Masato Miwa, MD
2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Tel: +81-3-5802-1094; Fax: +81-3-5689-0547
E-mail: [email protected]
Received: November 17, 2014 Accepted: January 16, 2015 Published: March 07, 2015
Citation: Miwa M, Ono N, Sasaki D, Shiozawa A, Miwa M, et al. (2015) Peroxide Tone in Human Inferior Nasal Turbinate with Allergy. J Otol Rhinol S1:1. doi:10.4172/2324-8785.S1-004

Abstract

Background: The nose is chronically exposed to oxidative stress, which can easily lead to reactive oxygen species (ROS)-mediated damage and lipid oxidative damage of the upper airway. ROS may also participate in various diseases, including those of the airway, although many details are not yet known.

ROS is generated by various enzymatic reactions and chemical processes. Superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) are representative scavengers. ROS are also generated through arachidonic acid cascades. One of the primary prostaglandins (PG), PGD2, is the major PG in most types of tissue, including the nose. We attempted to evaluate the peroxide tone by measuring these factors.

Methods: A total of 42 Japanese patients with and without nasal allergies were enrolled in this study. We determined the contents of lipid peroxide (LPO) and PGD2, as well as the activities of SOD, catalase, and GSH-Px of the anterior portion of the mucosa of the inferior turbinate, obtained by inferior turbinotomy.

Results: LPO and PGD2 contents increased significantly in the nasal allergy group. No statistically significant difference appeared in the activities of SOD, catalase, and GSH-Px were demonstrated in the nasal allergy group compared with the subjects without nasal allergy.

Conclusion: The imbalance of the peroxide tone in the nasal mucosa caused by stimulation of the cyclooxygenase pathway of the arachidonic acid cascade and ROS formation was demonstrated. Moreover, the increased number of ROS was not well metabolized in the nasal mucosa with allergy.

Keywords: Allergic rhinitis; Reactive oxygen species; Prostaglandin D2; Nasal mucosa; Superoxide dismutase; Catalase, Glutathione peroxidase; Lipid peroxide

Keywords

Allergic rhinitis; Reactive oxygen species; Prostaglandin D2; Nasal mucosa; Superoxide dismutase; Catalase, Glutathione peroxidase; Lipid peroxide

Abbreviations:

ROS: Reactive Oxygen Species; SOD: Superoxide Dismutase; GSHPx: Glutathione Peroxidase; PG: Primary Prostaglandins; LPO: Lipid Peroxide; TBA: Thiobarbituric Acid; TBA-RS: Thiobarbituric Acid Reactive Substances; RAST: Radioallergosorbent Test; TBA: Thiobarbituric Acid

Introduction

The nose is chronically exposed to oxidative stress, leading to reactive oxygen species (ROS)-mediated damage and lipid oxidative breakage of the upper airway. Many researchers have demonstrated that ROS can have a variety of physiological and deleterious effects within the airway [1]. It appears that ROS may participate in various diseases including those of the nose, although many details are not yet known.
ROS is a general term that includes a large variety of free oxygen radicals, generated by various enzymatic reactions and chemical processes. Superoxide dismutase (SOD, EC1.15.1.1) converts superoxide anion to hydrogen peroxide. Catalase (EC1.11.1.6) converts hydrogen peroxide into oxygen and water. Glutathione peroxidase (GSH-Px, EC1.11.1.9) inactivates hydrogen peroxide. ROS are also generated through arachidonic acid cascades. Peroxinitrite can activate both cyclooxygenase -1 and -2 [2]. Studies have demonstrated that prostaglandin (PG) D2is the major PG in most types of tissue, representing 50-96% of the total primary PGs [3]. We previously demonstrated the Immunohistochemical localization of PGD synthetase in nasal mucosa [4].
We couldn't find any studies in the literature that have conducted a comprehensive analysis of the metabolic pathway of ROS in human inferior nasal turbinate, the front line of the respiratory tract. In order to evaluate the relationship between the arachidonic acid cascade and oxygen radical formation,and demonstrate the peroxide tone in patients with allergic rhinitis, we investigated the contents of lipid peroxide (LPO) and PGD2, as well as the activities of representative antioxidant enzymes, such as SOD, GSH-Px and catalase in mucosa of human inferior turbinate obtained from patients with and without nasal allergy.

Methods

The subjects in this study were 42 patients in Juntendo University Faculty of Medicineand Harimazaka Clinic, who was all underwent bilateral inferior turbinotomy for chronic rhinitis with and without nasal allergy,due to nasal obstruction. The subjects were between 20 to 59 years of age, of either gender. The diagnosis of allergic rhinitis was based on clinical symptoms, a nasal smear test for eosinophils and Immuno CAP for house dust. A total of 22 patients were diagnosed with allergic rhinitis. The anterior portion of the mucosa of the inferior turbinate was obtained by inferior turbinotomy under general or local anesthesia from patients with and without nasal allergy. None of the subjects had abnormal blood examination data, including serum lipids. None of the subjects were taking systemic antihistamine or steroids prior to the surgery. On removal, specimens were put into liquid nitrogen and preserved in a deep freezer at − 80°C until the biochemical analysis was conducted. Because the study dealt with removed tissue and did not affect the patients themselves, the institutional review board granted exemption from the formal approval process.
LPO was measured using the fluorescent method with malondialdehyde as a standard, as described by Ohishi [5]. LPO contents were expressed as thiobarbituric acid (TBA) reactive substances. The assay of the total SOD activity in the nasal mucosa was performed using nitrous acid, as described by Oyanagui [6].The assay of the GSH-Px was performed employing Hochstein’s method. The assay of the catalase was performed employing Thomson’s method [7].
The extraction of the PGs was performed as described by Powell [8]. The concentrations of the PGs were measured by HPLC-RIA [3].
Protein measurement was made by the Lowry method [9].
Data were expressed as mean ± SEM. The paired t test was used to ascertain whether there was a statistically significant difference in the peroxide tone between rhinitis with and without nasal allergy. The chosen level of significance was 0.05 in all tests.

Results

The results for the LPO content were expressed as thiobarbituric acid reactive substances (TBA-RS). The TBA-RS value was 2.08 ± 0.28nmol/mg protein in subjects with allergic rhinitis and 1.20 ± 0.19 nmol/mg protein in the subjects with non-allergic rhinitis, showing a statistically significant difference (Figure 1). The total SOD activity was 27.8 ± 2.3 ng/mg protein in subjects with allergic rhinitis and 30.2 ± 2.1 ng/mg protein in subjects with non-allergic rhinitis (Figure 2).
Figure 1: The results concerning thelipid peroxide content in human nasal mucosa with and without allergic rhinitis. LPO are expressed as thiobarbituric acid reactive substance values. The TBA-RS value was 2.08 ± 0.28 nmol/mg protein in subjects with allergic rhinitis and 1.20 ± 0.19 nmol/mg protein in the subjects with non-allergic rhinitis showing a statistically significant difference.
Figure 2: The results of Total SOD activity in human nasal mucosa with and without allergic rhinitis. The total SOD activity was 27.8 ± 2.3 ng/mg protein in subjects with allergic rhinitis and 30.2 ± 2.1 ng/mg protein in subjects with non-allergic rhinitis. No statistically significant difference was seen between the total SOD activity in the subjects with allergic rhinitis, compared with the subjects with nonallergic rhinitis.
No statistically significant difference was seen between the total SOD activities in the subjects with allergic rhinitis, compared with the subjects with non-allergic rhinitis.
GSH-Px activity was 43.7 ± 4.14 U/mg protein in subjects with allergic rhinitis and 45.8 ± 2.23 U/mg protein in those with nonallergic rhinitis (Figure 3). No statistically significant difference was seen between the GSH-Pxactivity in the subjects with allergic rhinitis, compared with the subjects with non-allergic rhinitis.
Figure 3: The results of GSH-Px activity in human nasal mucosa with and without allergic rhinitis. GSH-Px activity was 43.7 ± 4.14 U/mg protein in subjects with allergic rhinitis and 45.8 ± 2.23 U/mg protein in those with non-allergic rhinitis. No statistically significant difference was seenbetween the GSH-Pxactivity in the subjects with allergic rhinitis, compared with the subjects with nonallergic rhinitis.
The catalase activity was 16.4 ± 2.54 U/mg protein in the subjects with allergic rhinitis and 12.0 ± 1.01 U/mg protein in the subjects with non-allergic rhinitis (Figure 4). No statistically significant difference was seen between the catalase activities in the subjects with allergic rhinitis, compared with the subjects with non-allergic rhinitis. The PGD2 content was 4.67 ± 0.58 ng/g tissues in the subjects with allergic rhinitis and 2.54 ± 0.27 ng/g tissues in those with non-allergic rhinitis (Figure 5). A significantly higher level of PGD2 was found in the nasal mucosa of the subjects with allergic rhinitis, compared with the subjects with non-allergic rhinitis.
Figure 4: The results concerning thecatalase activity in human nasal mucosa with and without allergic rhinitis. Thecatalase activity was 16.4 ± 2.54 U/mg protein in the subjects with allergic rhinitis and 12.0 ± 1.01 U/mg protein in the subjects with non-allergic rhinitis. No statistically significant difference was seen between the catalase activity in the subjects with allergic rhinitis compared with the subjects with non-allergic rhinitis.
Figure 5: The results concerning theprostaglandin D2 content in human nasal mucosa with and without allergic rhinitis. The PGD2 content was 4.67 ± 0.58 ng/g tissues in the subjects with allergic rhinitis and 2.54 ± 0.27 ng/g tissues in those with non-allergic rhinitis. A significantly higher level of PGD2 was found in the nasal mucosa of the subjects with allergic rhinitis compared with the subjects with non-allergic rhinitis.
Scheme 1: Schematic drawing of the formation and possible interaction between oxygen species inhuman nasal mucosa. An increase in the lipid peroxide (LPO, shown as LCCO here) and PG (prostaglandin) D2 contents, and a decrease in activities of superoxide dismutase (SOD ), catalase, and glutathione peroxidase (GSH-Px) were demonstrated in the inferior turbinate of patients with allergic rhinitis.

Discussion

It is considered that various chemical mediators, including ROS, are interrelated in the pathogenesis of nasal allergies. Moreover, many enzymes and interact with each other in the metabolism of eicosanoid formation. A redox-active protein, thioredoxin, plays a crucial role in the metabolism of the antioxidant system, regulating the reduction/ oxidation balance by scavenging ROS, which are implicated in the mechanism of asthma [10]. In order to evaluate the effect of ROS in the onset and development of diseases, it may be considered that a comprehensive analysis of the metabolic pathway in the formation of ROS is necessary.
Immune modulation targeting critical Th2 effector molecules has shown promise in allergic disease, particularly strategies directed against IgE, but also prostaglandin D2 (PGD2) and leukotriene D4 (LTD4). Targeting such molecules may provide better benefit-to-risk profiles over cytokine-directed therapies as they appear to be more specific to allergic driven processes [11]. Matsuoka et al. [12] have shown that PGD2 functions as a mediator of allergic asthma. In addition to being produced in the lung, PGD2 may also play an important role in other allergic disorders, such as allergic rhinitis and atopic dermatitis. The DP receptor may thus represent a new therapeutic target for the treatment of such allergic reactions. According to Hemler [13], the formation of PG and ROS is regulated by positive feedback control. He demonstrated that the balance between the formation and removal of cellular LPO sets a peroxide tone that can regulate the rate of PG formation in cells. Therapies directed against specific effector molecules, such as immunoglobulin E and prostaglandin D2, hold promise in the immune modulation of allergic diseases, as do therapies targeting the IL-4/IL-13 receptor and augmenting the Th1/Th2 balance with Toll-like receptor agonists [14].
We demonstrated that the PGD2 and LPO contents in the nasal mucosa are higher in subjects with perennial allergic rhinitis, compared with those with non-allergic rhinitis. High levels of malondialdehyde, one of the metabolites of free radical-mediated lipid peroxidation, were observed in nasal polyps.
On the other hand, the activities of SOD, GSH-Px and catalase in the nasal mucosa were similar in the tissues obtained from subjects with allergic rhinitis and those with non-allergic rhinitis.
It is well known that antioxidative enzymes (AOEs), such as catalase (CAT), glutathione peroxidase (GPX), glutathione reductase (GR), superoxide dismutase (SOD) and glutathione S-transferase (GST), are of great importance in the mucosal defense against reactive oxygen species [1]. Previous studies regarding the measurement of SOD activities in nasal polyps are still controversial [15]. Cannady et al. [16] reported that the enzyme activity of SOD was lower in the nasal polyps than in the normal inferior turbinate. In contrast, another study showed that SOD activity was unchanged in the nasal polyps, compared with the normal middle turbinate. The pathogenesis of nasal allergy is quite different from that of chronic Rhinosinusitis with polyp. To evaluate the activities of antioxidant enzymes in the inferior turbinate where allergic reaction may occur in the beginning of allergic rhinitis, we demonstrated that SOD activity in the inferior turbinate was statistically the same with and without nasal allergy. Several different iso forms of antioxidant enzymes have been identified in humans [17]. We evaluated the total activities of those enzymes, so it remains unclear which isozymes are dominant. These results suggested that the cyclooxygenase pathway of the arachidonic cascade is stimulated and ROS formation is accelerated in human nasal mucosa with allergies. This isconsistent with areport describing that combined antihistamine and cyclooxygenase-inhibiting drugs were effective for hay fever treatment [18]. Moreover, it may be considered that the increased number of ROS is not well metabolized in nasal mucosa with allergies.
The LPO contents in the nasal mucosa with chronic rhinosinusitis were not increased compared with nasal mucosa without rhinosinusitis, as reported by Friedman [19]. We have demonstrated adecrease of the total SOD activity ineosinophilic and noneosinophilic sinusitis [20]. In contrast, we demonstrated increased LPO in allergic rhinitis. These phenomena seem to be related to the pathogenesis of allergic rhinitis. Consequently, the control of PGD2 production and ROS may thus be quite useful in the treatment of allergic diseases involving the nose. It is hoped that further studies of the enzymes metabolizing ROS will supply new information regarding the mechanisms of allergies in the upper airway.
We conclude that the alteration of the peroxide tone in the nasal mucosa caused by stimulation of the cyclooxygenase pathway of the arachidonic acid cascade and ROS formation may be intimately related to the pathogenesis of allergic rhinitis.

Conclusion

The imbalance of the peroxide tone in the nasal mucosa caused by stimulation of the cyclooxygenase pathway of the arachidonic acid cascade and ROS formation was demonstrated. Moreover, the increased number of ROS was not well metabolized in the nasal mucosa with allergies.

Acknowledgment

Authors are grateful to Dr. Yoshihiro Urade of Department of Molecular Behavioral Biology, Osaka Bioscience Institute, Osaka, Japan, for checking the design of this study.

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