Cited by 163Chronic Obstructive Pulmonary Disease (COPD) ResearchAsthma and respiratory diseasesRespiratory Support and Mechanisms

Serum amyloid A opposes lipoxin A 4 to mediate glucocorticoid refractory lung inflammation in chronic obstructive pulmonary disease

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Bozinovski, Steven, Uddin, Mohib, Vlahos, Ross, Thompson, Michelle, McQualter, Jonathan L., Merritt, Anne-Sophie, Wark, Peter A. B., Hutchinson, Anastasia +3 more·2012·Proceedings of the National Academy of Sciences

Abstract

Chronic obstructive pulmonary disease (COPD) will soon be the third most common cause of death globally. Despite smoking cessation, neutrophilic mucosal inflammation persistently damages the airways and fails to protect from recurrent infections. This maladaptive and excess inflammation is also refractory to glucocorticosteroids (GC). Here, we identify serum amyloid A (SAA) as a candidate mediator of GC refractory inflammation in COPD. Extrahepatic SAA was detected locally in COPD bronchoalveolar lavage fluid, which correlated with IL-8 and neutrophil elastase, consistent with neutrophil recruitment and activation. Immunohistochemistry detected SAA was in close proximity to airway epithelium, and in vitro SAA triggered release of IL-8 and other proinflammatory mediators by airway epithelial cells in an ALX/FPR2 (formyl peptide receptor 2) receptor-dependent manner. Lipoxin A 4 (LXA 4 ) can also interact with ALX/FPR2 receptors and lead to allosteric inhibition of SAA-initiated epithelial responses (pA 2 13 nM). During acute exacerbation, peripheral blood SAA levels increased dramatically and were disproportionately increased relative to LXA 4 . Human lung macrophages (CD68 + ) colocalized with SAA and GCs markedly increased SAA in vitro (THP-1, pEC 50 43 nM). To determine its direct actions, SAA was administered into murine lung, leading to induction of CXC chemokine ligand 1/2 and a neutrophilic response that was inhibited by 15-epi-LXA 4 but not dexamethasone. Taken together, these findings identify SAA as a therapeutic target for inhibition and implicate SAA as a mediator of GC-resistant lung inflammation that can overwhelm organ protective signaling by lipoxins at ALX/FPR2 receptors.

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Authors
Bozinovski, S., Uddin, M., Vlahos, R., Thompson, M., McQualter, J. L., Merritt, A.-S., Wark, P. A. B., Hutchinson, A., Irving, L. B., Levy, B. D., & Anderson, G. P.
Affiliations
  • The University of Melbourne (AU)
  • Brigham and Women's Hospital (US)
  • Department of Pharmacology, and
  • The Royal Melbourne Hospital (AU)
  • John Hunter Hospital (AU)
Venue
Proceedings of the National Academy of Sciences
Published
2012-01-03
Volume
109
Issue
3
Pages
935-940
ISSN
  • 0027-8424 (ISSN-L)
  • 1091-6490
OpenAlex
W1969944763
Cited by
163
References
35
Citations by year
2026: 7 · 2025: 10 · 2024: 4 · 2023: 8 · 2022: 11 · 2021: 10 · 2020: 14 · 2019: 9 · 2018: 16 · 2017: 11 · 2016: 12 · 2015: 11 · 2014: 12 · 2013: 21 · 2012: 7
FWCI
13.14
Type
journal article
Language
en
Open access
Locations
  • Proceedings of the National Academy of Sciences (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • RMIT Research Repository (RMIT University Library) (submittedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL090927, HL-68669, P50HL107166, HL090927, R01HL068669)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
serum amyloid A, lipoxin A4, chronic obstructive pulmonary disease, glucocorticoid resistance, lung inflammation, neutrophil recruitment, airway epithelial cells, interleukin-8, neutrophil elastase, acute exacerbation, lung macrophages, bronchoalveolar lavage fluid
MeSH terms
Serum Amyloid A Protein, Animals, Bronchoalveolar Lavage Fluid, Epithelial Cells, Epithelium, Glucocorticoids, Humans, Lung, Macrophages, Mucous Membrane, Neutrophils, Pneumonia, Interleukin-8, Neutrophil Activation, Pulmonary Disease, Chronic Obstructive, Receptors, Formyl Peptide, Lipoxins, Receptors, Lipoxin, Mice

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