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      The Chitinase-Like Protein YKL-40 Modulates Cystic Fibrosis Lung Disease

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          Abstract

          The chitinase-like protein YKL-40 was found to be increased in patients with severe asthma and chronic obstructive pulmonary disease (COPD), two disease conditions featuring neutrophilic infiltrates. Based on these studies and a previous report indicating that neutrophils secrete YKL-40, we hypothesized that YKL-40 plays a key role in cystic fibrosis (CF) lung disease, a prototypic neutrophilic disease. The aim of this study was (i) to analyze YKL-40 levels in human and murine CF lung disease and (ii) to investigate whether YKL-40 single-nucleotide polymorphisms (SNPs) modulate CF lung disease severity. YKL-40 protein levels were quantified in serum and sputum supernatants from CF patients and control individuals. Levels of the murine homologue BRP-39 were analyzed in airway fluids from CF-like βENaC-Tg mice. YKL-40SNPs were analyzed in CF patients. YKL-40 levels were increased in sputum supernatants and in serum from CF patients compared to healthy control individuals. Within CF patients, YKL-40 levels were higher in sputum than in serum. BRP-39 levels were increased in airways fluids from βENaC-Tg mice compared to wild-type littermates. In both CF patients and βENaC-Tg mice, YKL-40/BRP-39 airway levels correlated with the severity of pulmonary obstruction. Two YKL-40 SNPs (rs871799 and rs880633) were found to modulate age-adjusted lung function in CF patients. YKL-40/BRP-39 levelsare increased in human and murine CF airway fluids, correlate with pulmonary function and modulate CF lung disease severity genetically. These findings suggest YKL-40 as a potential biomarker in CF lung disease.

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          Most cited references28

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          Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986.

          Chronic obstructive pulmonary disease (COPD) and asthma are the major causes of pulmonary disability in the United States, with at least 10 million Americans suffering form COPD and up to 5% of the population afflicted with asthma. Over the past 20 years, major strides have been made in our understanding of the pathophysiology of these disorders, although there are still large gaps in our knowledge. While a number of position papers and statements have been promulgated by the American Thoracic Society concerning various aspects of the diagnosis and treatment of COPD and asthma, it was felt that a review of the overall topic was timely. This statement represents the combined efforts of a Task Group appointed by the Scientific Assemble of Clinical Problems of the American Thoracic Society to accomplish this task. Clearly, we could not cover every aspect of this broad topic nor even provide a detailed review of those areas addressed. We elected instead to concentrate on clinically relevant topics and to provide sufficient data to be useful as a guide as well as to include selected, but in no was exhaustive, references. The first two chapters define the entities and set forth recommendations for diagnosis, hospital admission, and discharge. The remaining four chapters critically review the various facets of therapy. We have noted controversial areas and those were conclusive experimental data are not yet available. In these situations, the committee often decided to take a position on one side or the other based upon the best available information.
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            Increased airway epithelial Na+ absorption produces cystic fibrosis-like lung disease in mice.

            Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene result in defective epithelial cAMP-dependent Cl(-) secretion and increased airway Na(+) absorption. The mechanistic links between these altered ion transport processes and the pathogenesis of cystic fibrosis lung disease, however, are unclear. To test the hypothesis that accelerated Na(+) transport alone can produce cystic fibrosis-like lung disease, we generated mice with airway-specific overexpression of epithelial Na(+) channels (ENaC). Here we show that increased airway Na(+) absorption in vivo caused airway surface liquid (ASL) volume depletion, increased mucus concentration, delayed mucus transport and mucus adhesion to airway surfaces. Defective mucus transport caused a severe spontaneous lung disease sharing features with cystic fibrosis, including mucus obstruction, goblet cell metaplasia, neutrophilic inflammation and poor bacterial clearance. We conclude that increasing airway Na(+) absorption initiates cystic fibrosis-like lung disease and produces a model for the study of the pathogenesis and therapy of this disease.
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              From genotypes to genes: doubling the sample size.

              This paper considers the analysis of genetic case-control data. One approach considers the allele frequency in cases and controls. Because each individual has two alleles at any autosomal locus, there will be twice as many alleles as people. Another approach considers the risk of the disease in those who do not have the allele of interest (A), those who have a single copy (heterozygous), and those who are homozygous for A. A third approach does not differentiate between individuals with one or two copies of A. This was common when alleles were determined serologically and one could not distinguish between homozygotes and those with one copy of A and one of an unknown allele. All three approaches have been used in the literature, but this is the first systematic comparison of them. The different interpretations of the odds ratios from such analyses are explored and conditions are given under which the first two approaches are asymptotically equivalent. The chi-squared statistics from the three approaches are discussed. Both the odds ratio and the chi-squared statistic from the analysis that treats alleles rather than genotypes as individual entities are appropriate only when the Hardy-Weinberg equilibrium holds. When the equilibrium holds, the allele-based test statistic is asymptotically equivalent to the test for trend using the genotype data. Thus, analyses that treat alleles rather than people as observations should not be used. Instead, we recommend that such data should be analyzed by genotype.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                20 September 2011
                : 6
                : 9
                : e24399
                Affiliations
                [1 ]Department I, Children's Hospital, University of Tübingen, Tübingen, Germany
                [2 ]Department of Paediatrics, University of Berne, Inselspital, Berne, Switzerland
                [3 ]Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Pediatrics III, University of Heidelberg, Heidelberg, Germany
                [4 ]Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
                [5 ]Comprehensive Pneumology Center, Institute of Lung Biology and Disease (iLBD), University Hospital, Ludwig Maximilians University and Helmholtz ZentrumMünchen, Munich, Germany
                [6 ]Department of Dermatology and Allergy, Ludwig-Maximilians-University, Munich, Germany
                [7 ]Department of Pediatric Pulmonology, Allergy and Cystic Fibrosis, Children's Hospital, Frankfurt, Germany
                [8 ]Research Center, Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
                [9 ]Respiratory and Allergic Disease Division, Paediatric Department, Medical University of Graz, Graz, Austria
                Johns Hopkins School of Medicine, United States of America
                Author notes

                Conceived and designed the experiments: O. Eickelberg MAM DH. Performed the experiments: AH MSDK PL EK CC MK BK IM. Contributed reagents/materials/analysis tools: PL EK CC MK BK EE O. Eickmeier SZ NR MG. Wrote the paper: DH MAM AH. Analyzed the human data: AH MSDK IM DH. Analyzed the murine data: ZZ AÖY AB.

                Article
                PONE-D-11-09541
                10.1371/journal.pone.0024399
                3176766
                21949714
                23aef3a1-3d3b-4145-9ed8-8eaec5e066b2
                Hector et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 2 June 2011
                : 8 August 2011
                Page count
                Pages: 6
                Categories
                Research Article
                Biology
                Genetics
                Human Genetics
                Autosomal Recessive
                Cystic Fibrosis
                Immunology
                Immunity
                Inflammation
                Allergy and Hypersensitivity
                Immune Cells
                Immune Response
                Immunomodulation
                Model Organisms
                Animal Models
                Mouse
                Medicine
                Clinical Genetics
                Autosomal Recessive
                Cystic Fibrosis
                Clinical Immunology
                Immune Cells
                Immune Response
                Clinical Research Design
                Animal Models of Disease
                Diagnostic Medicine
                Pathology
                General Pathology
                Biomarkers
                Pulmonology

                Uncategorized
                Uncategorized

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