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<art>
   <ui>1465-9921-6-91</ui>
   <ji>RRJ</ji>
   <fm>
      <dochead>Research</dochead>
      <bibl>
         <title>
            <p>PPAR&#945; downregulates airway inflammation induced by lipopolysaccharide in the mouse</p>
         </title>
         <aug>
            <au id="A1">
               <snm>Delayre-Orthez</snm>
               <fnm>Carine</fnm>
               <insr iid="I1"/>
               <email>orthez@pharma.u-strasbg.fr</email>
            </au>
            <au id="A2">
               <snm>Becker</snm>
               <fnm>Julien</fnm>
               <insr iid="I1"/>
               <email>becker@pharma.u-strasbg.fr</email>
            </au>
            <au id="A3">
               <snm>Guenon</snm>
               <fnm>Isabelle</fnm>
               <insr iid="I2"/>
               <email>isabelle.guenon@rennes.inserm.fr</email>
            </au>
            <au id="A4">
               <snm>Lagente</snm>
               <fnm>Vincent</fnm>
               <insr iid="I2"/>
               <email>vincent.lagente@univ-rennes1.fr</email>
            </au>
            <au id="A5">
               <snm>Auwerx</snm>
               <fnm>Johan</fnm>
               <insr iid="I3"/>
               <email>auwerx@igbmc.u-strasbg.fr</email>
            </au>
            <au id="A6">
               <snm>Frossard</snm>
               <fnm>Nelly</fnm>
               <insr iid="I1"/>
               <email>frossard@pharma.u-strasbg.fr</email>
            </au>
            <au id="A7" ca="yes">
               <snm>Pons</snm>
               <fnm>Fran&#231;oise</fnm>
               <insr iid="I1"/>
               <email>pons@pharma.u-strasbg.fr</email>
            </au>
         </aug>
         <insg>
            <ins id="I1">
               <p>EA 3771, Inflammation et environnement dans l'asthme, Facult&#233; de Pharmacie, Universit&#233; Louis Pasteur-Strasbourg I, Illkirch, France</p>
            </ins>
            <ins id="I2">
               <p>INSERM U620, Facult&#233; des Sciences Pharmaceutiques, Universit&#233; de Rennes 1, Rennes, France</p>
            </ins>
            <ins id="I3">
               <p>Institut de G&#233;n&#233;tique et de Biologie Mol&#233;culaire et Cellulaire, CNRS/Inserm/ULP, Illkirch, France</p>
            </ins>
         </insg>
         <source>Respiratory Research</source>
         <issn>1465-9921</issn>
         <pubdate>2005</pubdate>
         <volume>6</volume>
         <issue>1</issue>
         <fpage>91</fpage>
         <url>http://respiratory-research.com/content/6/1/91</url>
         <xrefbib>
            <pubidlist>
               <pubid idtype="pmpid">16091136</pubid>
               <pubid idtype="doi">10.1186/1465-9921-6-91</pubid>
            </pubidlist>
         </xrefbib>
      </bibl>
      <history>
         <rec>
            <date>
               <day>26</day>
               <month>1</month>
               <year>2005</year>
            </date>
         </rec>
         <acc>
            <date>
               <day>09</day>
               <month>8</month>
               <year>2005</year>
            </date>
         </acc>
         <pub>
            <date>
               <day>09</day>
               <month>8</month>
               <year>2005</year>
            </date>
         </pub>
      </history>
      <cpyrt>
         <year>2005</year>
         <collab>Delayre-Orthez et al; licensee BioMed Central Ltd.</collab>
         <note>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</note>
      </cpyrt>
      <kwdg>
         <kwd>PPAR&#945;</kwd>
         <kwd>lipopolysaccharide</kwd>
         <kwd>inflammation</kwd>
         <kwd>neutrophil</kwd>
         <kwd>macrophage</kwd>
         <kwd>matrix metalloproteinase</kwd>
         <kwd>mouse</kwd>
      </kwdg>
      <abs>
         <sec>
            <st>
               <p>Abstract</p>
            </st>
            <sec>
               <st>
                  <p>Background</p>
               </st>
               <p>Inflammation is a hallmark of acute lung injury and chronic airway diseases. In chronic airway diseases, it is associated with profound tissue remodeling. Peroxisome proliferator-activated receptor-&#945; (PPAR&#945;) is a ligand-activated transcription factor, that belongs to the nuclear receptor family. Agonists for PPAR&#945; have been recently shown to reduce lipopolysaccharide (LPS)- and cytokine-induced secretion of matrix metalloproteinase-9 (MMP-9) in human monocytes and rat mesangial cells, suggesting that PPAR&#945; may play a beneficial role in inflammation and tissue remodeling.</p>
            </sec>
            <sec>
               <st>
                  <p>Methods</p>
               </st>
               <p>We have investigated the role of PPAR&#945; in a mouse model of LPS-induced airway inflammation characterized by neutrophil and macrophage infiltration, by production of the chemoattractants, tumor necrosis factor-&#945; (TNF-&#945;), keratinocyte derived-chemokine (KC), macrophage inflammatory protein-2 (MIP-2) and monocyte chemoattractant protein-1 (MCP-1), and by increased MMP-2 and MMP-9 activity in bronchoalveolar lavage fluid (BALF). The role of PPAR&#945; in this model was studied using both PPAR&#945;-deficient mice and mice treated with the PPAR&#945; activator, fenofibrate.</p>
            </sec>
            <sec>
               <st>
                  <p>Results</p>
               </st>
               <p>Upon intranasal exposure to LPS, PPAR&#945;<sup>-/- </sup>mice exhibited greater neutrophil and macrophage number in BALF, as well as increased levels of TNF-&#945;, KC, MIP-2 and MCP-1, when compared to PPAR&#945;<sup>+/+ </sup>mice. PPAR&#945;<sup>-/- </sup>mice also displayed enhanced MMP-9 activity. Conversely, fenofibrate (0.15 to 15 mg/day) dose-dependently reduced the increase in neutrophil and macrophage number induced by LPS in wild-type mice. In animals treated with 15 mg/day fenofibrate, this effect was associated with a reduction in TNF-&#945;, KC, MIP-2 and MCP-1 levels, as well as in MMP-2 and MMP-9 activity. PPAR&#945;<sup>-/- </sup>mice treated with 15 mg/day fenofibrate failed to exhibit decreased airway inflammatory cell infiltrate, demonstrating that PPAR&#945; mediates the anti-inflammatory effect of fenofibrate.</p>
            </sec>
            <sec>
               <st>
                  <p>Conclusion</p>
               </st>
               <p>Using both genetic and pharmacological approaches, our data clearly show that PPAR&#945; downregulates cell infiltration, chemoattractant production and enhanced MMP activity triggered by LPS in mouse lung. This suggests that PPAR&#945; activation may have a beneficial effect in acute or chronic inflammatory airway disorders involving neutrophils and macrophages.</p>
            </sec>
         </sec>
      </abs>
   </fm>
   <meta>
      <classifications>
         <classification type="bmc" subtype="user_supplied_xml" id="endnote"/>
      </classifications>
   </meta>
   <bdy>
      <sec>
         <st>
            <p>Background</p>
         </st>
         <p>Inflammation is a feature of both acute lung injury and chronic airway diseases. In chronic airway diseases such as chronic obstructive pulmonary disease (COPD), it is associated with profound tissue remodeling that contributes to impaired lung function <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>. Lipopolysaccharides (LPS), which are biological active components of the outer membrane of gram-negative bacteria, are important inducers of lung inflammation. Inflammatory response triggered by LPS is characterized by neutrophil and macrophage recruitment and by the release of chemoattractants including tumor necrosis factor-&#945; (TNF-&#945;), and the CXC and CC chemokines, interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1), respectively <abbrgrp><abbr bid="B2">2</abbr><abbr bid="B3">3</abbr><abbr bid="B4">4</abbr><abbr bid="B5">5</abbr></abbrgrp>. These inflammatory events reproduce some of the features of the inflammatory response observed during acute lung injury or COPD <abbrgrp><abbr bid="B1">1</abbr><abbr bid="B6">6</abbr></abbrgrp>.</p>
         <p>In mice, airway inflammation induced by LPS is associated with an increase of the matrix metalloproteinases (MMP), MMP-2 and MMP-9 <abbrgrp><abbr bid="B7">7</abbr><abbr bid="B8">8</abbr></abbrgrp>. MMP are a family of zinc- and calcium-dependent endopeptidases that play a major role in tissue remodeling <abbrgrp><abbr bid="B9">9</abbr><abbr bid="B10">10</abbr></abbrgrp>. Indeed, MMP degrade the majority of the extracellular matrix (ECM) proteins, including collagens, gelatins and proteoglycans, an activity which may contribute to lung injury by promoting infiltration accross basement membrane and activation of inflammatory cells <abbrgrp><abbr bid="B9">9</abbr><abbr bid="B11">11</abbr></abbrgrp>. Among MMP, MMP-2 (gelatinase A) preferentially produced by fibroblasts and other connective tissue cells, and MMP-9 (gelatinase B) mainly found in inflammatory cells, such as neutrophils and macrophages are of particular interest, since they cleave the major constituent of basement membrane, type IV collagen <abbrgrp><abbr bid="B9">9</abbr><abbr bid="B10">10</abbr></abbrgrp>.</p>
         <p>With the exception of neutrophils, normal tissues do not store MMP and constitutive expression is minimal. However, during inflammation and tissue remodeling, MMP expression is upregulated <abbrgrp><abbr bid="B9">9</abbr></abbrgrp>. Levels or activity of several MMP have been found to be raised in animal models of acute lung injury (for review: <abbrgrp><abbr bid="B12">12</abbr></abbrgrp>). Upregulation of MMP was also observed in chronic airway diseases associated with tissue remodeling, such as asthma and COPD (for review: <abbrgrp><abbr bid="B1">1</abbr><abbr bid="B13">13</abbr></abbrgrp>). Indeed, increased levels of MMP-9 have been reported in bronchoalveolar lavage fluid (BALF), blood or sputum from patients with asthma or COPD <abbrgrp><abbr bid="B14">14</abbr><abbr bid="B15">15</abbr><abbr bid="B16">16</abbr><abbr bid="B17">17</abbr></abbrgrp>.</p>
         <p>Peroxisome proliferator-activated receptor-&#945; (PPAR&#945;) is a ligand-activated transcription factor, that belongs to the nuclear receptor family. PPAR&#945; regulates gene expression by binding as a heterodimeric complex with the retinoid X receptor to specific DNA sequences known as peroxisome proliferator response elements. PPAR&#945; was first identified for its role in the regulation of lipid and carbohydrate metabolism (for reviews: <abbrgrp><abbr bid="B18">18</abbr><abbr bid="B19">19</abbr></abbrgrp>). However, subsequent data have demonstrated that it exhibits also a potent anti-inflammatory activity. Indeed, mice deficient in PPAR&#945; (PPAR&#945;<sup>-/-</sup>) were reported to display an exacerbated reaction to various inflammatory stimuli, including LPS in the skin and the vessel <abbrgrp><abbr bid="B20">20</abbr><abbr bid="B21">21</abbr><abbr bid="B22">22</abbr></abbrgrp>. Conversely, animals treated with PPAR&#945; activators such as fibrates exhibited a decreased response. Anti-inflammatory activity of fibrates appeared as unrelated to their lipid-lowering activity, since treatment with fenofibrate was shown to reduce inflammatory response associated with cerebral injury in absence of any improvement in plasma lipid levels in the mouse <abbrgrp><abbr bid="B23">23</abbr></abbrgrp>. More recently, PPAR&#945; agonists were shown to reduce LPS- and cytokine-induced MMP-9 secretion in human monocytes and rat mesangial cells, suggesting that PPAR&#945; may also play a beneficial role in tissue remodeling <abbrgrp><abbr bid="B24">24</abbr><abbr bid="B25">25</abbr></abbrgrp>.</p>
         <p>We have here investigated the role of PPAR&#945; in a mouse model of LPS-induced airway inflammation characterized by cell infiltration, production of chemoattractants and increased MMP activity. This study was undertaken using both PPAR&#945;-deficient mice and mice treated with the PPAR&#945; activator, fenofibrate.</p>
      </sec>
      <sec>
         <st>
            <p>Materials and methods</p>
         </st>
         <sec>
            <st>
               <p>Animals</p>
            </st>
            <p>Male wild-type (PPAR&#945;<sup>+/+</sup>) and homozygous knockout (PPAR&#945;<sup>-/-</sup>) mice (SV/129/C57BL/6) were expanded from breeding pairs <abbrgrp><abbr bid="B26">26</abbr></abbrgrp> and used at the age of 9 weeks. Nine-week-old male C57BL/6 mice were purchased from Charles River Laboratories (Saint-Germain-sur-l'Arbresle, France). Animals were maintained under controlled environmental conditions with a 12 h/12 h light/dark cycle according to the EU guide for use of laboratory animals. Food (UAR-Alimentation, Villemoisson, France) and tap water were available ad libitum. Animal experimentation was conducted with the approval of the government body that regulates animal research in France.</p>
         </sec>
         <sec>
            <st>
               <p>LPS administration</p>
            </st>
            <p>LPS (<it>Escherichia coli</it>, serotype 055:B5, Sigma Chemical, Saint Quentin Fallavier, France) prepared in saline was administered by i.n. instillation for 4 consecutive days at the dose of 40 &#956;g/kg. Control animals received saline instead of LPS. Instillations (12.5 &#956;l per nostril) were carried out under anaesthesia (50 mg/kg ketamine and 3.33 mg/kg xylazine given i.p.).</p>
         </sec>
         <sec>
            <st>
               <p>Treatment with fenofibrate</p>
            </st>
            <p>Fenofibrate (Sigma Chemical) suspended in 1% carboxymethylcellulose (low viscosity, Sigma) in water was administered per os once daily for 10 days at increasing doses (0.15 to 15 mg/day), as previously described <abbrgrp><abbr bid="B27">27</abbr></abbrgrp>. Duration of treatment was selected from a previous study showing protection against myocardial injury in mice <abbrgrp><abbr bid="B28">28</abbr></abbrgrp>. Control animals received equivalent volumes (100 &#956;l) of 1% carboxymethylcellulose (CMC) in similar conditions.</p>
         </sec>
         <sec>
            <st>
               <p>Collection of bronchoalveolar lavage fluids</p>
            </st>
            <p>Eighteen to twenty-four hours after the last LPS administration, mice were anaesthetized by i.p. injection of ketamine (150 mg/kg) and xylazine (10 mg/kg). A plastic cannula was inserted into the trachea and airways were lavaged by 10 instillations of 0.5 ml ice-cold saline supplemented with 2.6 mM EDTA (saline-EDTA). BALF recovered from the two first instillations were centrifuged (4100 rpm for 5 min at 4&#176;C), and the resulting supernatant was stored at -20&#176;C until MMP and cytokine measurements.</p>
         </sec>
         <sec>
            <st>
               <p>Determination of total and differential cell counts</p>
            </st>
            <p>BALF were centrifuged (1200 rpm for 5 min at 4&#176;C) to pellet cells and erythrocytes were lysed by hypotonic shock. Cells were then resuspended in 500 &#956;l ice-cold saline-EDTA and total cell counts were determined using a hemocytometer (Neubauer's chamber). Differential cell counts were assessed on cytologic preparations obtained by cytocentrifugation (Cytospin 3, Shandon Ltd, Runcorn, Chershire, UK) of 200 &#956;l of diluted BALF (250 000 cells/ml in ice-cold saline-EDTA). Slides were stained with Hemacolor (Merck, Dormstadt, Germany) and determinations were performed by counting at least 400 cells for each preparation. Cells were identified as macrophages and neutrophils, and expressed as absolute numbers from total cell counts.</p>
         </sec>
         <sec>
            <st>
               <p>Determination of cytokine and chemokine levels</p>
            </st>
            <p>Tumor necrosis factor-&#945; (TNF-&#945;), keratinocyte derived-chemokine (KC), macrophage inflammatory protein-2 (MIP-2) and monocyte chemoattractant protein-1 (MCP-1) were quantified in BALF using capture ELISA kits according to instructions provided by the manufacturers (PharMingen for TNF-&#945; and R&amp;D Systems Europe (Lille, France) for KC, MIP-2 and MCP-1).</p>
         </sec>
         <sec>
            <st>
               <p>Gelatin zymography for determination of gelatinase activity</p>
            </st>
            <p>BALF samples were separated under non-reducing conditions by electrophoresis on a 7% acrylamide-separating gel containing 1 mg/ml gelatin and sodium dodecyl sulfate, as previously described <abbrgrp><abbr bid="B7">7</abbr></abbrgrp>. After electrophoresis, gels were washed twice with 2.5% Triton X-100, rinsed with water and incubated overnight at 37&#176;C in 50 mM Tris pH 8.0 containing 5 mM CaCl<sub>2 </sub>and 1 nM ZnCl<sub>2</sub>. Gels were stained with Coomassie Brilliant blue and destained in a 25% ethanol and 10% acetic acid solution. Gelatinase (MMP-2 and MMP-9) activities that appeared as clear bands against a blue background were quantified by measuring intensity of the bands by densitometry using the Densylab software (Bioprobe Systems, Les Ulis, France). Results were expressed as percentages of the intensity of a given sample loaded as internal standard onto each gel.</p>
         </sec>
         <sec>
            <st>
               <p>Histology</p>
            </st>
            <p>Lungs were perfused <it>in situ</it>, collected and immersed in 4% paraformaldehyde for 24 h at 4&#176;C. Fixed lungs were rinsed in phosphate-buffered saline, dehydrated and embedded in paraffin using standard procedures. Five-micrometer tissue sections were stained with hematoxylin-eosin and observed under light microscopy.</p>
         </sec>
         <sec>
            <st>
               <p>Statistical analysis</p>
            </st>
            <p>Data are presented as means &#177; SEM. Statistical differences were analyzed from raw data by analysis of variance followed by unpaired two-tailed Student's t-test with a Bonferroni correction.</p>
         </sec>
      </sec>
      <sec>
         <st>
            <p>Results</p>
         </st>
         <sec>
            <st>
               <p>Increased cell infiltration, chemoattractant production and MMP activity in PPAR&#945;<sup>-/- </sup>mice upon exposure to LPS</p>
            </st>
            <p>Saline-exposed PPAR&#945;<sup>-/- </sup>mice exhibited no differences in total cell and macrophage count in BALF when compared to saline-exposed PPAR&#945;<sup>+/+ </sup>animals (Figure <figr fid="F1">1</figr>). Upon exposure to LPS, both PPAR&#945;<sup>+/+ </sup>and PPAR&#945;<sup>-/- </sup>mice displayed a significant increase in total cell, neutrophil and macrophage number, when compared to animals exposed to saline (Figure <figr fid="F1">1</figr>). However, these increases were 2.9- (p &lt; 0.0001), 5.0- (p &lt; 0.0001) and 1.9-fold (p &lt; 0.0001) greater, respectively in PPAR&#945;<sup>-/- </sup>mice than in PPAR&#945;<sup>+/+ </sup>mice (Figure <figr fid="F1">1</figr>).</p>
            <fig id="F1">
               <title>
                  <p>Figure 1</p>
               </title>
               <caption>
                  <p>Number of total cells, neutrophils and macrophages in BALF from PPAR&#945;<sup>+/+</sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</p>
               </caption>
               <text>
                  <p><b>Number of total cells, neutrophils and macrophages in BALF from PPAR&#945;<sup>+/+</sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</b>. Data are mean &#177; SEM of n = 10&#8211;13 animals. Statistically significant differences at &#945; = 0.05: (*) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with saline; (#) when compared to PPAR&#945;<sup>-/- </sup>mice treated with saline; and ($) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with LPS.</p>
               </text>
               <graphic file="1465-9921-6-91-1"/>
            </fig>
            <p>Cell infiltration induced by LPS was associated with a significant increase in BALF levels of the chemoattractants, TNF-&#945;, KC and MCP-1 in both PPAR&#945;<sup>+/+ </sup>and PPAR&#945;<sup>-/- </sup>mice (Figure <figr fid="F2">2</figr>). These levels were however 1.5- (p = 0.0003), 2.3- (p = 0.0008) and 3.5-fold (p = 0.0012) greater, respectively in PPAR&#945;<sup>-/- </sup>animals when compared to PPAR&#945;<sup>+/+ </sup>mice (Figure <figr fid="F2">2</figr>). PPAR&#945;<sup>-/- </sup>mice exposed to LPS also displayed a significant rise in MIP-2 in BALF (2.0-fold, p = 0.0065), whereas LPS-treated PPAR&#945;<sup>+/+ </sup>animals exhibited no changes in this chemokine.</p>
            <fig id="F2">
               <title>
                  <p>Figure 2</p>
               </title>
               <caption>
                  <p>Chemoattractant levels in BALF from PPAR&#945;<sup>+/+ </sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</p>
               </caption>
               <text>
                  <p><b>Chemoattractant levels in BALF from PPAR&#945;<sup>+/+ </sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</b>. Data are mean &#177; SEM of n = 9&#8211;12 animals. Statistically significant differences at &#945; = 0.05: (*) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with saline; (#) when compared to PPAR&#945;<sup>-/- </sup>mice treated with saline; and ($) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with LPS.</p>
               </text>
               <graphic file="1465-9921-6-91-2"/>
            </fig>
            <p>Saline-exposed PPAR&#945;<sup>-/- </sup>mice exhibited similar low MMP-2 (76 kDa) and MMP-9 (105 kDa) activity in BALF when compared to saline-exposed PPAR&#945;<sup>+/+ </sup>animals (Figure <figr fid="F3">3</figr>). Upon exposure to LPS, PPAR&#945;<sup>+/+ </sup>and PPAR&#945;<sup>-/- </sup>mice displayed a significant increase in both MMP-2 and MMP-9 activity, when compared to animals exposed to saline (Figure <figr fid="F3">3</figr>). MMP-2 levels were similar in LPS-treated PPAR&#945;<sup>-/- </sup>and PPAR&#945;<sup>+/+ </sup>mice (61 &#177; 8 <it>vs </it>58 &#177; 4). In contrast, MMP-9 levels were 1.8-fold (p &lt; 0.0001) greater in PPAR&#945;<sup>-/- </sup>animals than in PPAR&#945;<sup>+/+ </sup>mice.</p>
            <fig id="F3">
               <title>
                  <p>Figure 3</p>
               </title>
               <caption>
                  <p>MMP-2 (76 kDa) and MMP-9 (105 kDa) activity in BALF from PPAR&#945;<sup>+/+ </sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</p>
               </caption>
               <text>
                  <p><b>MMP-2 (76 kDa) and MMP-9 (105 kDa) activity in BALF from PPAR&#945;<sup>+/+ </sup>(+/+) and PPAR&#945;<sup>-/- </sup>(-/-) mice exposed to LPS or saline</b>. Upper panel shows gelatin zymogram from two representative animals in each group. Lower panel shows data of all animals in each group (n = 10&#8211;13) expressed as mean &#177; SEM. Statistically significant differences at &#945; = 0.05: (*) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with saline; (#) when compared to PPAR&#945;<sup>-/- </sup>mice treated with saline; and ($) when compared to PPAR&#945;<sup>+/+ </sup>mice treated with LPS.</p>
               </text>
               <graphic file="1465-9921-6-91-3"/>
            </fig>
         </sec>
         <sec>
            <st>
               <p>Reduced cell infiltration, chemoattractant production and MMP activity in wild-type mice upon PPAR&#945; activation by fenofibrate</p>
            </st>
            <p>Exposure to LPS resulted in marked increases in total cell, neutrophil and macrophage number in BALF from C57BL/6 mice (Figure <figr fid="F4">4</figr>). These increases were dose-dependently reduced by fenofibrate (0.15 to 15 mg/day). Reduction in total cell, neutrophil and macrophage number reached 80% (p &lt; 0.0001), 91% (p &lt; 0.0001) and 64% (p &lt; 0.0001), respectively in BALF from mice treated with 15 mg/kg of the PPAR&#945; activator when compared to mice treated with the vehicle, CMC (Figure <figr fid="F4">4</figr>). Fenofibrate (15 mg/day) inhibited also total cell (p = 0.0055), neutrophil (p &lt; 0.0001) and macrophage (p = 0.0064) infiltrate induced by LPS in PPAR&#945;<sup>+/+ </sup>mice (Table <tblr tid="T1">1</tblr>). In contrast, LPS-exposed PPAR&#945;<sup>-/- </sup>mice treated with 15 mg/day fenofibrate failed to exhibit changes in inflammatory cell infiltrate, demonstrating that PPAR&#945; mediates the anti-inflammatory activity of fenofibrate (Table <tblr tid="T1">1</tblr>).</p>
            <tbl id="T1">
               <title>
                  <p>Table 1</p>
               </title>
               <caption>
                  <p>Cell infiltration in LPS-exposed PPAR&#945;<sup>+/+ </sup>and PPAR&#945;<sup>-/- </sup>mice treated with fenofibrate.</p>
               </caption>
               <tblbdy cols="4">
                  <r>
                     <c ca="left">
                        <p>
                           <b>Group</b>
                        </p>
                     </c>
                     <c cspan="3" ca="center">
                        <p>
                           <b>Number of cells (&#215;10<sup>6</sup>)</b>
                        </p>
                     </c>
                  </r>
                  <r>
                     <c cspan="4">
                        <hr/>
                     </c>
                  </r>
                  <r>
                     <c>
                        <p/>
                     </c>
                     <c ca="center">
                        <p>
                           <b>Total</b>
                        </p>
                     </c>
                     <c ca="center">
                        <p>
                           <b>Neutrophils</b>
                        </p>
                     </c>
                     <c ca="center">
                        <p>
                           <b>Macrophages</b>
                        </p>
                     </c>
                  </r>
                  <r>
                     <c cspan="4">
                        <hr/>
                     </c>
                  </r>
                  <r>
                     <c ca="left">
                        <p>(+/+)-LPS-CMC</p>
                     </c>
                     <c ca="center">
                        <p>1.93 &#177; 0.11</p>
                     </c>
                     <c ca="center">
                        <p>0.95 &#177; 0.11</p>
                     </c>
                     <c ca="center">
                        <p>0.98 &#177; 0.13</p>
                     </c>
                  </r>
                  <r>
                     <c ca="left">
                        <p>(+/+)-LPS-FF</p>
                     </c>
                     <c ca="center">
                        <p>0.73 &#177; 0.08 (*)</p>
                     </c>
                     <c ca="center">
                        <p>0.23 &#177; 0.07 (*)</p>
                     </c>
                     <c ca="center">
                        <p>0.50 &#177; 0.05 (*)</p>
                     </c>
                  </r>
                  <r>
                     <c ca="left">
                        <p>(-/-)-LPS-CMC</p>
                     </c>
                     <c ca="center">
                        <p>3.46 &#177; 0.38 (*)</p>
                     </c>
                     <c ca="center">
                        <p>1.85 &#177; 0.28 (*)</p>
                     </c>
                     <c ca="center">
                        <p>1.60 &#177; 0.25 (*)</p>
                     </c>
                  </r>
                  <r>
                     <c ca="left">
                        <p>(-/-)-LPS-FF</p>
                     </c>
                     <c ca="center">
                        <p>3.13 &#177; 0.54 (n.s.)</p>
                     </c>
                     <c ca="center">
                        <p>1.73 &#177; 0.30 (n.s.)</p>
                     </c>
                     <c ca="center">
                        <p>1.39 &#177; 0.28 (n.s.)</p>
                     </c>
                  </r>
               </tblbdy>
               <tblfn>
                  <p>Data are mean &#177; SEM of n = 6&#8211;8 animals. (*): statistically significant differences at &#945; = 0.05 when compared to PPAR&#945;<sup>+/+ </sup>mice treated with CMC. (n.s.): non statistically different when compared to PPAR&#945;<sup>-/- </sup>mice treated with CMC.</p>
               </tblfn>
            </tbl>
            <fig id="F4">
               <title>
                  <p>Figure 4</p>
               </title>
               <caption>
                  <p>Dose-dependent reduction of cell infiltration in wild-type mice exposed to LPS upon PPAR&#945; activation by fenofibrate</p>
               </caption>
               <text>
                  <p><b>Dose-dependent reduction of cell infiltration in wild-type mice exposed to LPS upon PPAR&#945; activation by fenofibrate</b>. Number of total cells, neutrophils and macrophages in BALF from C57BL/6 mice exposed to LPS and treated with increasing doses of fenofibrate (0.15 to 15 mg/day) or its vehicle (1% CMC), when compared to mice exposed to saline and treated with CMC. Data are mean &#177; SEM of n = 6 animals. Statistically significant differences at &#945; = 0.05: (*) when compared to mice exposed to saline and treated with CMC; (#) when compared to mice exposed to LPS and treated with CMC.</p>
               </text>
               <graphic file="1465-9921-6-91-4"/>
            </fig>
            <p>Histological examination of lung tissue confirmed the anti-inflammatory effect of fenofibrate. Indeed, whereas a massive inflammatory cell infiltration was observed in perivascular and alveolar tissue of C57BL/6 mice exposed to LPS and treated with CMC when compared to mice exposed to saline (Figure <figr fid="F5">5A</figr> et <figr fid="F5">5B</figr>), a marked reduction in cell infiltration was observed on lung sections from mice exposed to LPS and treated with fenofibrate (Figure <figr fid="F5">5C</figr>).</p>
            <fig id="F5">
               <title>
                  <p>Figure 5</p>
               </title>
               <caption>
                  <p>Histological analysis of lung tissue from wild-type mice</p>
               </caption>
               <text>
                  <p><b>Histological analysis of lung tissue from wild-type mice</b>. Lung sections showing a massive inflammatory cell infiltrate in perivascular and alveolar tissue of C57BL/6 mice exposed to LPS and treated with CMC (B), when compared to mice exposed to saline (A). Reduced cell infiltrate in lung tissue from mice exposed to LPS and treated with fenofibrate (C).</p>
               </text>
               <graphic file="1465-9921-6-91-5"/>
            </fig>
            <p>C57BL/6 mice exposed to LPS and treated with CMC displayed also increases in TNF-&#945;, KC, MIP-2 and MCP-1 in BALF when compared to saline-exposed mice (Figure <figr fid="F6">6A</figr>). Treatment with fenofibrate (15 mg/day) inhibited these increases by 59% (p &lt; 0.0001), 50% (p = 0.0015), 30% (p = 0.0058) and 69% (p &lt; 0.0001), respectively (Figure <figr fid="F6">6A</figr>).</p>
            <fig id="F6">
               <title>
                  <p>Figure 6</p>
               </title>
               <caption>
                  <p>Reduced chemoattractant production and MMP activity in wild-type mice upon PPAR&#945; activation by fenofibrate</p>
               </caption>
               <text>
                  <p><b>Reduced chemoattractant production and MMP activity in wild-type mice upon PPAR&#945; activation by fenofibrate</b>. Chemoattractant levels (A) and MMP-2 and MMP-9 activity (B) in BALF from C57BL/6 mice exposed to LPS and treated with fenofibrate (15 mg/day, black bars) or its vehicle (1% CMC, grey bars), when compared to mice exposed to saline and treated with CMC (open bars). Data are mean &#177; SEM of n = 7&#8211;8 animals. Statistically significant differences at &#945; = 0.05: (*) when compared to mice exposed to saline and treated with CMC; (#) when compared to mice exposed to LPS and treated with CMC.</p>
               </text>
               <graphic file="1465-9921-6-91-6"/>
            </fig>
            <p>Treatment with fenofibrate (15 mg/day) also dramatically reduced LPS-induced increase in MMP-2 and MMP-9 activity (Figure <figr fid="F6">6B</figr>). Indeed, whereas MMP-2 and MMP-9 activity was increased by 1.8- (p &lt; 0.0001) and 3.6-fold (p &lt; 0.0001), respectively in BALF from LPS-exposed mice treated with CMC when compared to saline-exposed mice, animals exposed to LPS and treated with fenofibrate displayed MMP levels similar to those measured in saline-exposed animals.</p>
         </sec>
      </sec>
      <sec>
         <st>
            <p>Discussion</p>
         </st>
         <p>In this study, we have addressed the role of PPAR&#945; in a mouse model of LPS-induced airway inflammation. Using both genetic and pharmacological approaches, our data clearly showed that PPAR&#945; downregulates cell infiltration, chemoattractant production and enhanced MMP activity triggered by LPS in mouse lung.</p>
         <p>As expected, wild-type mice exposed to LPS exhibited a massive recruitment of inflammatory cells in the airways, composed of neutrophils and macrophages. This cell infiltration was associated with an increase in BALF levels of the pro-inflammatory and chemoattractant cytokine, TNF-&#945; and by a rise in the levels of the CXC chemokines, MIP-2 and KC and of the CC chemokine, MCP-1. Exposure to LPS also induced a marked increase in MMP-2 and MMP-9 activity in BALF, when compared to saline exposure. This model reproduced several features of the inflammatory response observed during acute lung injury or COPD <abbrgrp><abbr bid="B1">1</abbr><abbr bid="B6">6</abbr><abbr bid="B13">13</abbr></abbrgrp>. Using this model, we found that PPAR&#945;<sup>-/- </sup>mice exposed to LPS displayed enhanced neutrophil and macrophage number in BALF when compared to PPAR&#945;<sup>+/+ </sup>animals, whereas wild-type mice treated with the PPAR&#945; activator, fenofibrate exhibited reduced cell infiltrate. Furthermore, we demonstrated fenofibrate selectivity by showing absence of effect of fenofibrate in PPAR&#945;<sup>-/- </sup>animals. Taken together, these results suggest that PPAR&#945; activation may have a beneficial effect in airway inflammatory diseases involving neutrophil and monocyte recruitment. In agreement with our results, Birrell et al. recently proposed that agonists of another PPAR receptor, PPAR&#947; may have a therapeutic potential in respiratory diseases involving neutrophilia <abbrgrp><abbr bid="B29">29</abbr></abbrgrp>. Our study adds to these previous findings by showing that PPAR&#945; agonists may also be effective in blocking recruitment of monocytes, which play a pivotal role in the pathophysiology of COPD, as well as of pulmonary fibrosis. By contrast, Trifilieff et al. found that PPAR&#945; ligands failed to inhibit neutrophil recruitment induced by LPS in BALF from mice <abbrgrp><abbr bid="B30">30</abbr></abbrgrp>. Differences in the mode of exposure to LPS could explain this discrepancy. Indeed, whereas these authors exposed female mice intranasally to a single high dose of LPS (0.3 mg/kg) for a short period of time (3 h), the present study was carried out in male animals using four repeated instillations of a 7.5-fold lower dose of LPS (40 &#956;g/kg). Indeed, these modes of exposure may trigger different inflammatory responses. Likewise, nature (GW 9578 vs fenofibrate) and route of delivery (local vs oral) of PPAR&#945; agonists may be another source of discrepancy. Therefore, by both genetic and pharmacological approaches, our data clearly demonstrate that PPAR&#945; downregulates neutrophil and monocyte infiltration in mouse lung.</p>
         <p>We also found that PPAR&#945;<sup>-/- </sup>mice exposed to LPS displayed increased levels of TNF-&#945; in BALF when compared to PPAR&#945;<sup>+/+ </sup>animals, whereas wild-type mice treated with fenofibrate exhibited reduced TNF-&#945; levels. As a pro-inflammatory cytokine, TNF-&#945; that is released by macrophages or airway epithelial cells upon activation plays an important role in neutrophilic inflammation induced by LPS <abbrgrp><abbr bid="B4">4</abbr></abbrgrp>. Indeed, TNF-&#945; triggers the release of CXC chemokines, such as MIP-2 and KC that are involved in LPS-induced intrapulmonary recruitment of neutrophils <abbrgrp><abbr bid="B2">2</abbr><abbr bid="B3">3</abbr></abbrgrp>. As well, MCP-1, which plays a central role in monocyte recruitment to inflamed tissues, is produced by pulmonary macrophages and airway epithelial cells in response to TNF-&#945; or LPS <abbrgrp><abbr bid="B31">31</abbr><abbr bid="B32">32</abbr></abbrgrp>. In the present study, release of MIP-2, KC and MCP-1 triggered by LPS instillation was greater in BALF from PPAR&#945;<sup>-/- </sup>mice when compared to PPAR&#945;<sup>+/+ </sup>animals. Conversely, wild-type mice treated with fenofibrate displayed decreased levels of these chemokines when compared to vehicle-treated animals. Taken together, our results suggest that downregulation of TNF-&#945; and of the CXC and C-C chemokines, MIP-2, KC and MCP-1 contributes to PPAR&#945;-induced inhibition of neutrophil and macrophage airway recruitment in our model.</p>
         <p>PPAR&#945; agonists were recently reported to reduce LPS- and IL-1&#946;-induced secretion of MMP-9 in human monocytes and rat mesangial cells, respectively <abbrgrp><abbr bid="B24">24</abbr><abbr bid="B25">25</abbr></abbrgrp>. However, the effect of PPAR&#945; on MMP production in vivo is so far unknown. In the present study, we demonstrate that PPAR&#945; downregulates increase in MMP-2 and MMP-9 activity triggered by LPS in mouse lung. Indeed, whereas PPAR&#945;<sup>-/- </sup>mice displayed a greater increase in MMP activity in BALF upon exposure to LPS when compared to PPAR&#945;<sup>+/+ </sup>animals, wild-type mice exposed to LPS exhibited decreased levels of MMP when treated by fenofibrate. Sources of MMP in the lung are numerous, particularly under inflammatory conditions. Among them, neutrophils and macrophages are considered as the major sources of MMP-9 <abbrgrp><abbr bid="B11">11</abbr></abbrgrp>. Therefore, downregulation of MMP-9 production by PPAR&#945; may result from decreased cell infiltration. In neutrophils, MMP-9 is stored in specific granules from which it is readily released, in particular upon stimulation by LPS or chemoattractant factors, like IL-8 <abbrgrp><abbr bid="B33">33</abbr></abbrgrp>. Downregulation of MMP-9 production by PPAR&#945; could alternatively result from decreased neutrophil activation. MMP-9 is believed to play a major role in lung remodeling. Indeed, in addition to digestion of extracellular matrix proteins, MMP-9 increases the activity of other proteases, as well as of chemoattractants and growth factors (for review: <abbrgrp><abbr bid="B34">34</abbr></abbrgrp>). By providing evidence that PPAR&#945; downregulates MMP activity in vivo, our study reinforces the idea that the nuclear receptor PPAR&#945; may play a beneficial role in tissue remodeling.</p>
         <p>Several studies have reported that PPAR&#945; inhibits the NF-&#954;B pathway, which plays a critical role in LPS signaling as well as in the expression of the chemokines, MIP-2, KC and MCP-1 and of MMP-9 <abbrgrp><abbr bid="B35">35</abbr></abbrgrp>. This property could account for the beneficial effect of PPAR&#945; observed in the present study. However, several other mechanisms could be involved. This includes production of anti-inflammatory mediators, such as IL-10. Indeed, fenofibrate was reported to suppress autoimmune myocarditis in rats by stimulating expression of this cytokine <abbrgrp><abbr bid="B36">36</abbr></abbrgrp>. As well, inhibition of cell recruitment could be implicated. Thus, activation of PPAR&#945; was reported to inhibit chemotaxis of inflammatory cells, including macrophages <abbrgrp><abbr bid="B37">37</abbr><abbr bid="B38">38</abbr></abbrgrp>. Finally, resolution of inflammation through stimulation of inflammatory cell apoptosis may also be involved, since activation of PPAR&#945; was shown to induce apoptosis of macrophages <abbrgrp><abbr bid="B39">39</abbr></abbrgrp>.</p>
      </sec>
      <sec>
         <st>
            <p>Conclusion</p>
         </st>
         <p>In conclusion, using both genetic and pharmacological approaches, our study provides evidence that PPAR&#945; downregulates neutrophil and monocyte infiltration induced by LPS in mouse lung. Our data also demonstrated that this beneficial effect of PPAR&#945; involves downregulation of the production of neutrophil and monocyte chemoattractants, including the CXC and C-C chemokines, MIP-2, KC and MCP-1, and of MMP that play a major role in tissue remodeling. We postulate that PPAR&#945; agonists, and in particular fenofibrate may have a therapeutic potential in airway inflammatory disorders involving neutrophil and monocyte, such as acute lung injury and COPD.</p>
      </sec>
      <sec>
         <st>
            <p>List of abbreviations</p>
         </st>
         <p>BALF: bronchoalveolar lavage fluid</p>
         <p>CMC: carboxylmethylcellulose</p>
         <p>COPD: chronic obstructive pulmonary disease</p>
         <p>EDTA: ethylenediaminetetraacetic acid</p>
         <p>IL: interleukin</p>
         <p>KC: keratinocyte derived-chemokine</p>
         <p>LPS: lipopolysaccharide</p>
         <p>MIP-2: macrophage inflammatory protein-2</p>
         <p>MMP: matrix metalloproteinase</p>
         <p>PPAR: peroxisome proliferator-actived receptor</p>
         <p>MCP-1: monocyte chemoattractant protein-1</p>
         <p>TNF-&#945;: tumor necrosis factor-&#945;</p>
      </sec>
      <sec>
         <st>
            <p>Authors' contributions</p>
         </st>
         <p>CDO, JB and IG have made substantial contributions to acquisition and analysis of data.</p>
         <p>CDO, VL and FP have made substantial contributions to conception and design of the study.</p>
         <p>CDO and FP have been involved in drafting the article.</p>
         <p>JA, NF and VL have been involved in revising the article critically for important intellectual content.</p>
      </sec>
   </bdy>
   <bm>
      <ack>
         <sec>
            <st>
               <p>Acknowledgements</p>
            </st>
            <p>This work was supported by the Institut National de la Sant&#233; et de la Recherche M&#233;dicale, Universit&#233; Louis Pasteur and Fonds de Recherche GIP Aventis. Carine Delayre-Orthez was supported by a joint PhD grant from ADEME and R&#233;gion Alsace, and by the Soci&#233;t&#233; de Pneumologie de Langue Fran&#231;aise. The PPAR&#945;<sub>-/-</sub> mice used in this study were a kind gift of Dr F.Gonzalez at the NHCI in Bethesda.</p>
         </sec>
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