Treatment with rhDNase in patients with cystic fibrosis alters in-vitro CHIT-1 activity of isolated leucocytes

Clin Exp Immunol. 2016 Sep;185(3):382-91. doi: 10.1111/cei.12827. Epub 2016 Jul 28.

Abstract

Recent data suggest a possible relationship between cystic fibrosis (CF) pharmacotherapy, Aspergillus fumigatus colonization (AC) and/or allergic bronchopulmonary aspergillosis (ABPA). The aim of this study was to determine if anti-fungal defence mechanisms are influenced by CF pharmacotherapy, i.e. if (1) neutrophils form CF and non-CF donors differ in their ability to produce chitotriosidase (CHIT-1); (2) if incubation of isolated neutrophils with azithromycin, salbutamol, prednisolone or rhDNase might influence the CHIT-1 activity; and (3) if NETosis and neutrophil killing efficiency is influenced by rhDNase. Neutrophils were isolated from the blood of CF patients (n = 19; mean age 26·8 years or healthy, non-CF donors (n = 20; 38·7 years) and stimulated with phorbol-12-myristate-13-acetate (PMA), azithromycin, salbutamol, prednisolone or rhDNase. CHIT-1 enzyme activity was measured with a fluorescent substrate. NETosis was induced by PMA and neutrophil killing efficiency was assessed by a hyphae recovery assay. Neutrophil CHIT-1 activity was comparable in the presence or absence of PMA stimulation in both CF and non-CF donors. PMA stimulation and preincubation with rhDNase increased CHIT-1 activity in culture supernatants from non-CF and CF donors. However, this increase was significant in non-CF donors but not in CF patients (P < 0·05). RhDNase reduced the number of NETs in PMA-stimulated neutrophils and decreased the killing efficiency of leucocytes in our in-vitro model. Azithromycin, salbutamol or prednisolone had no effect on CHIT-1 activity. Stimulation of isolated leucocytes with PMA and treatment with rhDNase interfered with anti-fungal defence mechanisms. However, the impact of our findings for treatment in CF patients needs to be proved in a clinical cohort.

Keywords: fungal; human; inflammation; lung; neutrophils.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Albuterol / pharmacology
  • Albuterol / therapeutic use
  • Aspergillus fumigatus / isolation & purification
  • Azithromycin / pharmacology
  • Azithromycin / therapeutic use
  • Bacteria / isolation & purification
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / immunology*
  • Cystic Fibrosis / microbiology
  • Deoxyribonucleases / genetics
  • Deoxyribonucleases / therapeutic use*
  • Extracellular Traps / drug effects
  • Female
  • Fungi / isolation & purification
  • Hexosaminidases / analysis
  • Hexosaminidases / biosynthesis
  • Hexosaminidases / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Neutrophils / drug effects
  • Neutrophils / enzymology*
  • Neutrophils / pathology*
  • Neutrophils / physiology
  • Phorbol Esters / pharmacology
  • Prednisolone / pharmacology
  • Prednisolone / therapeutic use
  • Sputum / microbiology
  • Young Adult

Substances

  • Phorbol Esters
  • phorbol-12-myristate
  • Azithromycin
  • Prednisolone
  • Deoxyribonucleases
  • Hexosaminidases
  • chitotriosidase
  • Albuterol