0022-3565/00/2931-0281$03.

00/0
THE JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS Vol. 293, No. 1
Copyright © 2000 by The American Society for Pharmacology and Experimental Therapeutics Printed in U.S.A.
JPET 293:281–288, 2000

SB 239063, a Potent p38 MAP Kinase Inhibitor, Reduces

Inflammatory Cytokine Production, Airways Eosinophil
Infiltration, and Persistence

DAVID C. UNDERWOOD, RUTH R. OSBORN, CHARLES J. KOTZER, JERRY L. ADAMS, JOHN C. LEE,
EDWARD F. WEBB, DONALD C. CARPENTER, STEVEN BOCHNOWICZ, HEATH C. THOMAS, DOUGLAS W. P. HAY,
and DON E. GRISWOLD
Departments of Pulmonary Pharmacology (D.C.U., R.R.O., C.J.K., E.F.W. D.C.C., S.B., D.W.P.H., D.E.G.), Medicinal Chemistry (J.L.A.), Bone
Biology (J.C.L.), and Safety Assessment (H.C.T.), SmithKline Beecham Pharmaceuticals, King of Prussia, Pennsylvania
Accepted for publication December 21, 1999 This paper is available online at http://www.jpet.org

ABSTRACT
The anti-inflammatory/antiallergic activity of a novel second- tized mice. In addition, p38 kinase was found by Western
generation p38 mitogen-activated protein kinase inhibitor, SB analysis to be activated in guinea pig lung. Administration of SB
239063 [trans-1-(4-hydroxycyclohexyl)-4-(4-fluorophenyl)-5-(2- 239063 (10 or 30 mg/kg p.o.) in conscious guinea pigs mark-
methoxypyridimidin-4-yl)imidazole], was investigated in vivo edly reduced (⬃50% inhibition) OA-induced pulmonary eosin-
and in vitro. SB 239063 had an IC50 of 44 nM for inhibition of ophil influx, measured by BAL 24 h after antigen. SB 239063 (10
recombinant purified human p38␣. In lipopolysaccharide-stim- mg/kg b.i.d. p.o.) administered after leukotriene D4 inhalation,
ulated human peripheral blood monocytes, SB 239063 inhib- reduced by 60% the persistent airway eosinophilia seen at 4
ited interleukin-1 and tumor necrosis factor-␣ production (IC50 days. Apoptosis of cultured eosinophils isolated from guinea
values ⫽ 0.12 and 0.35 ␮M, respectively). A role for p38 kinase pig BAL was increased by SB 239063 (1–10 ␮M) in the pres-
in cytokine-associated inflammation in the mouse was shown ence of interleukin-5. These results indicate that SB 239063 is
by p38 activation in the lung and inhibition of lipopolysaccha- a potent inhibitor of inflammatory cytokine production, inhibits
ride-induced tumor necrosis factor-␣ production by SB 239063 eosinophil recruitment, in addition to enhancing apoptosis of
(ED50 ⫽ 5.8 mg/kg p.o.). Antiallergic activity was demonstrated these cells. Collectively, the results support the potential utility
by essential abolition (⬃93% inhibition) of inhaled ovalbumin of p38 kinase inhibitors, such as SB 239063, for the treatment
(OA)-induced airway eosinophilia by SB 239063 (12 mg/kg of asthma and other inflammatory disorders.
p.o.), measured by bronchoalveolar lavage (BAL) in OA-sensi-

The mitogen-activated protein (MAP) p38 kinase is a ubiq- factor-␣ (TNF-␣), interferon gamma (IFN-␥), interleukin
uitous and highly conserved, proline-directed serine-threo- (IL)-4, IL-5, and chemokines such as IL-8, regulated on acti-
nine protein kinase. It appears to play an important role in a vation normal T-cell expressed and secreted (RANTES), and
variety of pathophysiological responses and has been sug- eotaxin have all been shown to be capable of regulating or
gested to be involved in many processes considered critical to supporting chronic airway inflammation (Barnes et al., 1988,
the inflammatory response and tissue remodeling (for re- 1998).
view, see Griswold and Young, 1996). Several of these events There is also evidence for an involvement of p38 kinase in
are hallmarks of pulmonary diseases such as chronic obstruc- allergic mechanisms. For example, human monocyte IL-4-
tive pulmonary disease and asthma (Barnes et al., 1998; induced release of soluble cellular differentiation antigen 23
Barnes, 1999) was dramatically inhibited by the p38 kinase inhibitor SB
Although there is a paucity of reports specifically address- 203580 (Marshall et al., 1998), suggesting IgE synthesis also
ing the role of p38 kinase in pulmonary disease, it is known might be regulated by p38 kinase activity. In addition, ag-
that inflammatory cytokines play an important role in air- gregated IgA- or IgG-stimulated eosinophil degranulation
ways inflammation. Thus, cytokines such as tumor necrosis has been shown to involve the MAP kinases and phosphati-
dylinositol 3-kinase (Bracke et al., 1998). As the eosinophil
Received for publication October 6, 1999. has been the focus of major recent antiasthma drug discovery

ABBREVIATIONS: MAP, mitogen-activated protein; TNF-␣, tumor necrosis factor-␣; IFN-␥, interferon-␥; IL, interleukin; RANTES, regulated on
activation normal T-cell expressed and secreted; SB 239063, trans-1-(4-hydroxycyclohexyl)-4-(4-fluorophenyl)-5-(2-methoxypyridimidin-4-yl)imi-
dazole; LPS, lipopolysaccharide; ELISA, enzyme linked immunosorbant assay; DPBS, diphosphate-bufferred saline; LTD4, leukotriene D4; FITC,
fluorescein isothiocyanate; PI, propidium iodide; BAL, bronchoalveolar lavage; OA, ovalbumin; PLSD, protected least significant difference.

281
282 Underwood et al. Vol. 293

efforts, the induction of apoptosis has been postulated to be a (R & D systems, Minneapolis, MN) as described previously (Lee et
potential therapeutic objective in the resolution of the harm- al., 1999). Data were calculated from the standard curve, and IC50
ful activities of this granulocyte (Anderson, 1996). The recent values were determined with regression analysis.
demonstration of the enhancement of peripheral human eo- Western Blot Analysis. Western blot analyses for p38 and phos-
sinophil apoptosis by SB 203580 suggests a novel therapeutic pho p38 were conducted on mouse and guinea pig lung samples. With
a Tissuemizer (Tekmar Company, Cinncinati, OH), lung homoge-
approach and opportunity for p38 MAP kinase inhibitors
nates were made by grinding 0.05 g of lung tissue in 1 ml of lysis
(Kankaanranta et al., 1999). buffer (200 mM Tris-HCl, pH 7.4; 1% Triton-X-100; 10% glycerol; 150
Collectively, these data suggest there is considerable po- mM NaCl; 2 mM EDTA; 25 mM ␤-glycerophosphate; 20 mM NaF; 1
tential for a p38 kinase inhibitor in the treatment of inflam- mM sodium orthovanadate; 2 mM pyrophosphate; 1 mM phenyl-
matory lung diseases. In this report, we describe the in vitro methylsulfonyl fluoride; 10 ␮g/ml Leupeptin). Homogenates were
and in vivo pharmacology of a novel, potent, and selective centrifuged at 25,000g for 15 min at 4°C, and the supernatant was
inhibitor of p38 MAP kinase, SB 239063 [trans-1-(4-hydroxy- collected and assayed for total protein concentration (Bio-Rad, Rich-
cyclohexyl)-4-(4-fluorophenyl)-5-(2-methoxypyridimidin-4-yl)- mond, CA). For mouse lung, samples of 35 ␮g of total protein was
imidazole] (Fig. 1), including effects in pulmonary disease loaded per lane, and for guinea pig lung, samples of 10 ␮g of protein
models. The results support the contention that this class of were loaded. Proteins were resolved on a 10% Tris-HCl gel (Bio-Rad)
and transferred onto a nitrocellulose membrane. The membranes
compound may have promise in the treatment of chronic
were blocked for 1 h at room temperature with a membrane-blocking
diseases of the airways. solution containing BSA and goat IgG (Zymed Laboratories, San
Francisco, CA), and incubated overnight at 4°C in primary antibody,
Materials and Methods either anti-p38 or antiphospho p38 (1:1000, rabbit polyclonal IgG;
New England Biolabs, Beverly, MA). The p38 antibody was raised
In Vitro Studies against a synthetic peptide corresponding to residues 341 to 360 of
Kinase Assays. Yeast-expressed, activated, and purified p38␣ human p38. The phospho-specific antibody detects p38 when phos-
(3.55 nM) was added to the reaction mixture (30 ␮l) containing 25 phorylated at both Thr180 and Tyr182. The secondary antibody was
mM HEPES, pH 7.5; 10 mM MgCl2; 0.2 mM sodium orthovanadate; an anti-rabbit IgG conjugated to horseradish peroxidase (1:2500;
1 mM dithiothreitol; 0.1% BSA; 10% (w/v) glycerol; 0.17 mM/2.5 ␮Ci New England Biolabs), and the detection reagent was enhanced
of [␥-32P]ATP; 0.67 mM the endothelial growth factor receptor-de- chemiluminescence (Amersham Life Sciences, Piscataway, NJ).
rived T669 peptide as the substrate in the presence or absence of SB Membranes were washed between incubations with 1⫻ diphosphate-
239063. Incubation was for 25 min at 37°C in 96-well plates, the bufferred saline (DPBS) without calcium/magnesium containing
reactions were stopped by adding 10 ␮l of 0.3 M phosphoric acid, and 0.05% Tween 20. Total cell extracts from C6 glioma cells stimulated
phosphorylated peptide was isolated from the reaction mixture on with or without anisomycin (New England Biolabs) were used as
phosphocellulose (p81) filters. Filters were washed three times with positive and negative controls, respectively.
75 mM phosphoric acid, followed by three times with H2O, and Measurement of Guinea Pig Airway Eosinophil Apoptosis.
counted for bound 32P. The inhibitor was preincubated with the Cell suspensions of fresh lavage fluid preparations from guinea pigs
reaction mixture on ice for 30 min before starting the reactions with that had been exposed 48 h earlier to an aerosol of leukotriene D4
[␥-32P]ATP. (LTD4) (1 ␮g/ml for 1 min) were pelleted by centrifugation at 300g,
The Km[ATP] for p38 was determined to be 0.166 mM. Other kinase and the cells were pooled by resuspension in 10 ml of saline in a
assays (CSBP/p38 kinase, extracellular signal receptor-activated ki- 50-ml tube. Ten milliliters of Percoll working solution (9 ml of Per-
nase, c-Jun NH2-terminal kinase 1, c-Raf, endothelial growth factor coll; Sigma P1644; 1 ml 10⫻ DPBS; 5.52 ml of saline) was layered
receptor tyrosine kinase, p56Lck, protein kinase C ␣, cdc2, cdk2, and underneath the cell suspension and the tube was centrifuged at 400g
cdk4) were performed as described previously (Lee et al., 1999). for 30 min at room temperature. The top layers, including the mono-
Cytokine Production in Human Monocytes. Highly enriched nuclear cell-containing interface, were aspirated and the pellet, con-
human peripheral blood monocytes were obtained from whole blood taining mostly eosinophils, was resuspended in 9 ml of cold milli-Q
buffy coat and enriched by differential Ficoll and Percoll density water to lyse erythrocytes. One milliliter of 10⫻ DPBS was immedi-
centrifugation. Monocytes were cultured in RPMI 1640 (Life Tech- ately added and cells were pelleted at 300g. Cells were then washed
nologies-BRL, Long Island, NY) and supplemented with L-glutamine with 10 ml of DPBS and cell number, viability, and purity were
and 1% human A-B serum and were stimulated with bacterial en- assessed by hemacytometer counts with trypan blue and differential
dotoxin [lipopolysaccharide (LPS); Escherichia coli, type W, 055:B5; staining of cytospin preparations. Yields were 1 to 2 ⫻ 107 total cells
Difco, Detroit, MI] in the presence or absence of different concentra- per two guinea pigs, and cells were ⬎95% in terms of both viability
tions of SB 239063. Twenty-four-hour culture supernatants were and eosinophil purity. Cells were resuspended in medium (RPMI,
assessed for cytokine content (IL-1, granulocyte/macrophage colony- 10% fetal bovine serum, and gentamycin) at 0.5 to 1.0 ⫻ 106/ml and
stimulating factor, granulocyte colony-stimulating factor, TNF-␣) 500 ␮l was added to wells of 24-well plates. Cells were treated by
with appropriate enzyme-linked immunosorbent assay (ELISA) kits addition of 0.5 ml of medium with or without IL-5 (Pharmingen, San
Diego, CA; final concentration 10 pM) and with SB 239063 or vehicle
(0.1% ethanol). At various time points, cells were harvested and
prepared for flow cytometric analysis with the ApoAlert Annexin V
fluorescein isothiocyanate (FITC) Apoptosis Kit (Clontech, Palo Alto,
CA) as per instructions. Briefly, each cell sample was washed with
200 ␮l of binding buffer, resuspended in 200 ␮l of binding buffer, and
then 5 ␮l of Annexin V FITC and 10 ␮l of propidium iodide (PI) stocks
were added. Samples were incubated for 10 min at room temperature
in the dark with agitation. Two hundred microliters of the sample
was diluted to 500 ␮l with binding buffer just before flow analysis.
Samples were analyzed with a FACScan (Becton-Dickinson, San
Jose, CA) and CellQuest cell analysis software (Becton-Dickinson).
Forward angle light scatter and side scatter were used to gate on
Fig. 1. Structure of SB 239063. eosinophil population and exclude debris. Gate was large enough to
2000 Anti-Asthmatic Effects of p38 MAP Kinase Inhbitor SB 239063 283
ensure collection of all cells at all time points because changes in were sensitized by i.p. injections of 10 ␮g of ovalbumin (OA) in 200 ␮l
light scatter properties accompany the onset of apoptosis and necro- of Rehsorptar aluminum hydroxide gel (Intergen, Purghase, NY) on
sis. At each time point, an unlabeled control also was prepared to days 0, 7, and 14. On day 21, mice were placed into a Plexiglas
ensure that observed fluorescence was not due to any changes in exposure chamber with an internal volume of 4 liters. An aerosol of
autofluorescence. Color compensation was set to eliminate FITC spill OA (1% in normal saline), generated with an Opti-Mist nebulizer
into the FL2 detector and PI spill into the FL1 detector. Green (Hospitak, Farmingdale, NY) was delivered into the box at a rate of
(Annexin V FITC) versus Red (PI) fluorescence was assessed to 4 l/min for 30 min. SB 239063 (12 mg/kg) or vehicle (acidified 0.5%
monitor onset of apoptosis or necrosis. Analysis was accomplished by Tragacanth) was administered p.o. through a 22-gauge gavage nee-
use of quadrant stats in CellQuest software. Quadrants were set so dle 1 h before and 4 h after antigen challenge and b.i.d. thereafter for
that cells in lower left (LL) quadrant were unlabeled, viable cells; 3 days. BAL was performed 96 h after OA exposure. Mice were
cells in lower right (LR) were FITC positive only (apoptotic), and cells euthanized with an overdose of sodium pentobarbital (100 mg/kg
in upper right (UR) quadrant were both FITC and PI positive. Ne- i.p.), and the lungs were lavaged with 3.5 ml of Dulbecco’s PBS with
crotic cells will be PI positive and also take up Annexin V FITC, but 100 ␮M EDTA (5 ⫻ 0.7 ml), which was aspirated after gentle chest
apoptotic cells, initially FITC positive/PI negative also will eventu- massage. The BAL fluid was centifuged, and the pellet was resus-
ally have compromised membranes and incorporate PI. Preliminary pended in 1 ml of 0.9% NaCl. After a total cell count, slides were
studies at 29 h demonstrated that very few cells (⬍5%) were truly prepared, stained, and differentiated as eosinophils, neutrophils,
necrotic (“PI bright”), and this number varied by only 1 or 2% among and mononuclear cells by counting a minimum of 200 cells and
treatment groups. Therefore, the LR quadrant numbers (definite expressing the results as percentage of total cells as well as actual
apoptotic cells) were in approximately the same ratio between treat- numbers of each type. This measurement and expression technique
ment groups as total FITC positive (LR ⫹ UR). Because the majority has been previously validated as accurately reflecting endothelial
of PI-positive cells at all time points were not “true necrotic” (PI and subendothelial airway eosinophilia documented by histological
bright), but clearly FITC positive with increasing PI positivity, total methodology (Underwood et al., 1996).
FITC positive (LR ⫹ UR) was used for comparative quantitation and Guinea Pig Studies. Sensitization Procedure. Male Hartley
graphing of apoptosis among groups. guinea pigs (200 –250 g) were sensitized by i.m. injection of 0.35 ml
Cells isolated from guinea pig bronchoalveolar lavages (BALs)
of a 5% (w/v) OA/saline solution into each thigh (0.7 ml total) on days
were cultured in the presence of IL-5 with and without various
1 and 4. Guinea pigs were available for use after day 25.
concentrations of SB 239063. Additionally, some cells were cultured
Antigen-Induced Bronchoconstriction and Airway Eosinophil In-
without IL-5 so that maximal apoptosis levels could be observed. At
flux. Conscious animal body plethysmography. Male Hartley guinea
designated time points, cultures were harvested, dual labeled with
pigs (550 –750 g), actively sensitized to OA, were pretreated with
Annexin-V-FITC and PI and assessed by flow cytometry.
chlorpheniramine (0.1 mg/kg s.c.) 15 min before antigen challenge
Histology. The trachea and lungs of LTD4-challenged guinea pigs
and placed into a double-flow body plethysmograph (Penn-Century,
(according to in vivo methodology described in a following section)
Philadelphia, PA), consisting of a nasal (head) chamber and a tho-
were collected intact for qualitative assessment of airway eosino-
racic (body) chamber, each equipped with a pneumotachograph. The
philia. The lungs were gently inflated by tracheal cannula with 10%
plethysmograph was connected to a noninvasive respiratory ana-
buffered formalin until no pleural creases were visible, and the
lyzer (Buxco Electronics, Sharon, CN) via a Validyne differential
trachea was ligated followed by immersion in 10% buffered formalin.
pressure transducer (⫾2 cm) that calculated specific airway conduc-
The lungs were sectioned longitudinally to include trachea, airways,
and both right and left lungs. The tissue was paraffin embedded and tance. After a 10-min stabilization period, an aerosol of OA (1% in
sectioned at 5-␮m thickness followed by Luna’s stain for eosinophils normal saline) was generated by an ultrasonic nebulizer (Pul-
(Luna, 1968); the microscopic image was taken at a magnification of mosonic; DeVilbiss Corporation, Somerset, PA) and delivered for 10 s
830⫻. at a rate of 250 ml/min via a nosecone built into the plethysmograph.
Bronchoconstriction was calculated as average maximum decrease
In Vivo Studies as well as area-under-the-curve analysis of the percentage decrease
Animals. BALB/c mice and Hartley Guinea pigs, obtained from in specific airway conductance from baseline over the 10-min period
Charles River Breeding Laboratories (Raleigh, MA), were main- after antigen inhalation. SB 239063 (3, 10, or 30 mg/kg) or vehicle
tained in a barrier facility. All experimental procedures conform to (acidified 0.5% Tragacanth) was administered intragastrically via a
Animal Care and Use Committee protocols filed at SmithKline size 8 French feeding tube 1 h before and 4 h after antigen challenge.
Beecham Pharmaceuticals (King of Prussia, PA). BAL. BALs were performed 24 h after OA exposure. Guinea pigs
Mouse Studies. LPS-Induced TNF-␣ Release. Age-matched, male were euthanized by an overdose of sodium pentobarbital. The lungs
BALB/c mice (n ⫽ 5 or 6/group, 22–25 g) from Charles River Breed- were lavaged with 50 ml of Dulbecco’s PBS (5 ⫻ 10 ml), which was
ing Laboratories were pretreated orally with compound or vehicle. aspirated after a gentle chest massage. The BAL fluid was centri-
Thirty minutes after pretreatment, the mice were given LPS (from fuged and the pellet was resuspended in 0.25% NaCl to lyse residual
Escherichia coli serotype 055-85; Sigma Chemical Co., St Louis, erythrocytes; after centrifugation, the pellet was resuspended again
MO), 25 ␮g/mouse in 25 ␮l of PBS, pH 7.0 i.p. Two hours later, the in 0.9% NaCl. After a total cell count, slides were prepared, stained,
mice were sacrificed by CO2 inhalation, and blood samples were and differentiated as eosinophils, neutrophils, and mononuclear cells
collected by exsanguination into heparinized blood collection tubes as outlined above.
and stored on ice. The blood samples were centrifuged, and the Inhaled LTD4-Induced Persistent Airway Eosinophilia. Male
plasma collected for analysis by ELISA for TNF-␣ levels. Hartley guinea pigs were placed into a double-flow body plethysmo-
TNF-␣ levels were measured with a sandwich ELISA (Olivera et graph, as outlined above for antigen challenge studies, and an aero-
al., 1992) with a hamster monoclonal antimurine TNF-␣ (Genzyme, sol of LTD4 (10 ␮g/ml) was administered to guinea pigs for 1 min.
Cambridge, MA) as the capture antibody and a polyclonal rabbit Inflammatory cell influx was measured with the aforementioned
antimurine TNF-␣ (Genzyme) as the second antibody. For detection, protocol in the antigen experiments. Because we have previously
a peroxidase-conjugated goat anti-rabbit antibody (Pierce, Rockford, shown that a single exposure to LTD4 results in a persistent airway
IL) was added, followed by a substrate for peroxidase (1 mg/ml eosinophilia that peaks between 2 and 4 days and remains elevated
orthophenylenediamine with 1% urea peroxide). TNF-␣ levels in the for 2 to 4 weeks (Underwood et al., 1996), airway eosinophilia was
plasma samples from each animal were calculated from a standard measured on day 5 as outlined above. SB 239063 (10 mg/kg p.o.) or
curve generated with recombinant murine TNF-␣ (Genzyme). vehicle was administered 2 and 6 h after aerosol LTD4 exposure (10
Antigen-Induced Airway Eosinophilia. Male BALB/c mice (18 –20 g) ␮g/ml for 1 min) and b.i.d. thereafter for 3 days.
284 Underwood et al. Vol. 293

Statistical Analysis. As appropriate, Student’s t test, ANOVA, or

Fisher’s protected least significant difference (PLSD) were used to
determine statistical significance, with *P ⬍ .05, **P ⬍ .01, or
***P ⬍ .001 considered to be statistically significant based on ran-
dom probabilities of 5 in 100, 1 in 100, and 1 in 1000, respectively.
Drugs. LPS, chlorpheniramine, and OA were obtained from
Sigma Chemical Co. TNF-␣ was purchased from Genzyme. LTD4 and
SB 239063 (Fig. 1) were synthesized by colleagues in the Department
of Medicinal Chemistry, SmithKline Beecham Pharmaceuticals
(King of Prussia, PA).

Results
p38 MAP Kinase Inhibition and Selectivity Profile.
SB 239063 is a potent and selective inhibitor of p38 MAP
kinase. Thus, SB 239063 displayed specific and high-affinity
binding to p38 MAP kinase, resulting in potent inhibition of
its catalytic activity, with an ID50 of 44 nM (n ⫽ 4; Table 1). Fig. 2. Effects of SB 239063 on cytokine production from human mono-
cytes. Human monocytes (as described in Materials and Methods) were
Because p38 MAP kinase exists as four distinct isoforms (␣, incubated for 24 h with bacterial endotoxin in the presence and absence
␤, ␥, and ␦), SB 239063 exibits equipotent inhibitory activity of SB 239063. Cytokine production was assayed by ELISA as described
against ␣- and ␤-isoform, and no activity (up to 100 ␮M) and means (without standard errors for clarity) are depicted; n ⫽ 4.
against the ␥- and ␦-kinase isoforms. A panel of protein TABLE 2
kinases, including lipid kinases, tyrosine kinases, and extra- Effect of SB 239063 in LPS-induced TNF-␣ production in mice
cellular signal receptor-activated kinase and c-Jun NH2-ter- Male BALB/c mice were pretreated 30 min with various doses of SB 239063 or
minal kinase 1, which are closely related members of the vehicle (0.5% Tragacanth). After a 30-min pretreatment time, LPS, 25 ␮g/mouse was
administered i.p. Two hours later, heparinized blood was collected, and the plasma
MAP kinase family, were not inhibited by SB 239063 in was analyzed for TNF-␣ levels by ELISA. Data are shown as the mean ⫾ S.E.; n ⫽
concentrations up to 10 ␮M (Table 1). 5– 6.
In Vitro Inhibition of Cytokine Production. SB TNF-␣
Treatment Dose %Inhibition
239063 potently inhibited IL-1 and TNF-␣ production in (mean ⫾ S.E.)

LPS-stimulated human peripheral blood monocytes with mg/kg p.o. pg/ml

IC50 values of 120 and 350 nM, respectively (Fig. 2). Impor- Vehicle control 9512 ⫾ 843
tantly, inhibition of cytokine production by SB 239063 was SB 239063 2.5 6149 ⫾ 764 ⫺35a
5 5014 ⫾ 376 ⫺47b
also selective. Thus, GM-CSF production was inhibited by SB 10 4117 ⫾ 209 ⫺57b
239063, albeit less potently (IC50 ⫽ 1.6 ␮M) than for IL-1 and 20 2201 ⫾ 288 ⫺77b
TNF-␣, whereas G-CSF production was not affected. a
Statistically significant at P ⬍ .01.
In Vivo Inhibition of TNF-␣ Production. As seen in b
Statistically significant at P ⬍ .001.
Table 2, oral SB 239063 was a potent inhibitor of LPS-
induced TNF-␣ production in the mouse peritoneal cavity respectively). Lane 1 contains anisomycin-stimulated C6 gli-
with an ED50 of 5.8 mg/kg (2.8 –10.3; 95% CL). oma cell extracts as a positive control (Fig. 3B).
Western Blot Analyses of Mouse and Guinea Pig Effect on Antigen-Induced Airway Eosinophilia in
Lungs. As seen in Fig. 3A, lung homogenates from sensitized Mice. Aerosol administration of OA to sensitized mice in-
mice were electrophoresed (lane 3) along with anisomycin- creased eosinophil number recovered by BAL, 96 h after OA
stimulated C6 glioma cell lysates (lane 1) and a nonstimu- challenge, from 0.02 ⫾ 0.02 ⫻ 104 in control, unchallenged
lated C6 cell lysate (lane 2). Western blotting of this gel and mice to 7.3 ⫾ 1.1 ⫻ 104 in vehicle-treated animals that had
development with antibody detecting p38 (left) or phospho received OA. Treatment with SB 239063 (12 mg/kg p.o., 1 h
p38 (right) clearly showed the presence of both p38 and before and 4 h after OA challenge, then b.i.d. for 3 days)
phospho p38 in mouse lung homogenates. Similar results are significantly inhibited (93% decrease) the resultant antigen-
shown in Fig. 3B with guinea pig lung homogenates where induced airway eosinophilia (0.25 ⫻ 104 eosinophils; P ⬍
p38 and phospho p38 were seen (lane 2 on the left and right, .001, Fisher’s PLSD; n ⫽ 4 – 6) (Fig. 4). Antigen exposure also
increased total leukocyte number recovered by BAL, 96 h
TABLE 1 after OA challenge, from 3.1 ⫾ 0.3 ⫻ 105 in control, unchal-
Effect of SB 239063 on selected protein kinases lenged mice to 8.6 ⫾ 1.3 ⫻ 105. In animals treated with SB
Protein Kinase IC50
239063, 4.6 ⫾ 1.5 ⫻ 105 total leukocytes were recovered by
BAL, representing a 47% reduction in leukocytes recovered
nM
compared with OA-exposed, vehicle treated animals (data
p38␣ kinase 44
not shown).
Extracellular signal-regulated kinase ⬎10,000
JNK1 ⬎50,000 Effect on Antigen-Induced Airway Eosinophilia in
c-Raf ⬎50,000 Guinea Pigs. Aerosol administration of OA to sensitized
Endothelial growth factor receptor tyrosine kinase ⬎10,000 guinea pigs increased airway eosinophil number recovered by
p56Lck ⬎10,000
Protein kinase C␣ 83,000 BAL from 0.50 ⫾ 0.26 ⫻ 106 (⬃4% of total leukocytes) in
cdc2 ⬎50,000 unchallenged animals to 3.22 ⫻ 106 (⬃23%) in OA-chal-
cdk2 ⬎50,000 lenged, vehicle-treated control animals, representing a 550%
cdk4 ⬎50,000
increase in airway eosinophilia 24 h after antigen challenge
2000 Anti-Asthmatic Effects of p38 MAP Kinase Inhbitor SB 239063 285

Fig. 4. Effect of SB 239063 (12 mg/kg p.o., b.id. for 3 days) on inhaled
OA-induced eosinophilia in mice. Data are expressed as total cell number
of eosinophils (mean ⫾ S.E.) recovered by BAL 96 h after challenge (n ⫽
4 – 6). ⴱⴱⴱ, significantly different from vehicle control, P ⬍ .05 (Fisher’s
PLSD).

Fig. 3. Western blots of mouse and guinea pig lung homogenates. A,

Western blots of mouse lung homogenates stained with anti-p38 (left) and
antiphospho p38 (right) indicate the presence of phospho p38 in mouse
lung. Lane 1 was loaded with anisomycin-stimulated C6 cell extracts that
serve as markers for both p38 and phospho p38. Lane 2 was loaded with
nonstimulated C6 cell extracts (does not show band reacting with an-
tiphospho p38). Lane 3 contains the mouse lung samples (35 ␮g of
protein). B, Western blots of guinea pig lung homogenates stained with Fig. 5. Effect of SB 239063 on inhaled OA-induced airway eosinophilia in
anti-p38 (left) and antiphospho p38 (right) indicate the presence of phos- guinea pigs. SB 239063 (3, 10, or 30 mg/kg p.o.) was administered 1 h
pho p38 in guinea pig lung. Lane 1 was loaded with anisomycin-stimu- before and 4 h after antigen challenge and airway eosinophilia was
lated C6 cell extracts. Lane 2 contains the guinea pig lung samples (10 ␮g assessed by BAL 24 h after OA in guinea pigs. Data are expressed as total
of protein). number of eosinophils (mean ⫾ S.E.; n ⫽ 5– 8. ⴱ, significantly different
from vehicle control, P ⬍ .05 (ANOVA and Fisher’s PLSD).

(Fig. 5). SB 239063, administered orally 1 h before and 4 h LTD4 challenge (ANOVA, Fisher’s PLSD; n ⫽ 4 – 6; P ⬍ .05;
postantigen inhalation, significantly inhibited, by ⬃50%, the Fig. 6).
airway eosinophil influx at both 10 and 30 mg/kg; a lower Effect on Apoptosis of Cultured Guinea Pig Airway
dose (3 mg/kg) was without significant effect (Fig. 5). In Eosinophils. Using a technique of flow cytometric analysis
contrast to the potent inhibitory activity of SB 239063 of apoptosis, a dose-related increase in apoptosis of eosino-
against OA-induced eosinophilia, there was no significant phils was observed at multiple time points with SB 239063
inhibition of the acute bronchoconstriction elicited by OA (0.1–10 ␮M) (**P ⬍ .01 or ***P ⬍ .001; Fig. 7). The time
inhalation; thus, maximum decreases (occurring at 2– 4-min points depicted in Fig. 7 are 29- and 47-h postintroduction of
post-OA exposure) or area-under-the-curve measurements guinea pig eosinophils into culture in the presence of IL-5. As
(computed 0 –10-min post-OA exposure) of specific airway observed in preliminary studies, very few cells (⬍5%) were
resistance were not different (data not shown). truly necrotic (“PI bright”), and necrotic cell number varied
Effect on Inhaled LTD4-Induced Persistent Airway less than 2% among treatment groups. A statistically signif-
Eosinophilia in Guinea Pigs. Inhalation of LTD4 (10 icant increase in apoptotic cells was observed (P ⬍ .05 or less)
␮g/ml for 15 min) by guinea pigs resulted in a persistent with either 1 or 10 ␮M SB 239063 compared with untreated
airway inflammation as demonstrated by a doubling of total control, at every time point from 21 h onwards.
leukocyte recovery and a 6-fold increase in eosinophil num- Histology. The microscopic scan of the airways of LTD4-
ber by BAL 96 h after LTD4 challenge (Fig. 6). SB 239063 (10 challenged guinea pigs revealed several unique observations
mg/kg p.o.), administered 2 and 6 h after LTD4 inhalation of phagocytosis of eosinophils by alveolar macrophages (Fig.
and b.i.d. for 4 more days, substantially reduced (by 50%) the 8), not recognized in a previous study (Underwood et al.,
recovery of eosinophils by BAL of the airways at 96 h post- 1996). As shown in Fig. 8, the granules of the macrophage-
286 Underwood et al. Vol. 293

engulfed eosinophils remained intact. Although histological

quantitation of airway eosinophilia was not the focus of the
present studies, generally increased numbers of eosinophils
were observed in the epithelium and subepithelial connective
tissue of bronchi and bronchioles in LTD4-exposed guinea
pigs compared with those of representative unexposed ani-
mals.

Discussion
The results of the present study clearly demonstrate the
efficacy of the novel, potent, and selective p38 MAP kinase
inhibitor SB 239063 in reducing proinflammmatory cytokine
production, leading to diminished leukocytes trafficking to-
ward and enhanced clearance from a pulmonary inflamma-
tory site. The major findings of this study include 1) the
Fig. 6. Effect of SB 239063 on inhaled LTD4-induced persistent airway
eosinophilia in guinea pigs. Data are expressed as total number of eosin-
demonstration of potent inhibitory activity against p38 MAP
ophils (mean ⫾ S.E.) recovered by BAL 96 h after LTD4 challenge (n ⫽ kinase (␣- and ␤- but not ␥- and ␦-isoforms) without direct
4 – 6). ⴱ, significantly different from vehicle control, P ⬍ .05 (Fisher’s inhibition of other kinases involved in the inflammatory pro-
PLSD). cess, e.g., c-Jun NH2-terminal kinase; 2) inhibition of proin-
flammatory cytokine production in intact cells; 3) in vivo
inhibition of LPS-induced TNF-␣ production in mice; 4) inhi-
bition of antigen-induced airway eosinophilia in both mice
and guinea pigs; 5) enhanced clearance of inhaled LTD4-
induced persistent airway eosinophilia; 6) augmented apo-
ptosis of eosinophils cultured from guinea pig airways; and 7)
demonstration of activated p38 kinase in mouse and guinea
pig lung.
SB 239063 demonstrates comparable potency, but im-
proved selectivity, toward the p38 MAP kinase than the
earlier generation p38 kinase inhibitor SB 203580. Unlike
SB 203580, SB 239063 was inactive against c-Raf; SB 203580
Fig. 7. Effect of SB239063 on the onset of apoptosis in cultured eosino- had an IC50 of 360 nM (Lee et al., 1999). Although multiple
phils isolated from guinea pig BALs. Eosinophils were isolated from cell types, both inflammatory and structural, have been pos-
lavages as described in Materials and Methods and cultured in the tulated to be involved in the pathology of asthma, clearly the
presence of 10 pM IL-5 with and without various SB 239063 concentra-
tions. At various time points, cultures were harvested and dual-labeled
eosinophil has received the most attention recently. In air-
with PI and Annexin-V-FITC. Each column represents the mean percent- ways disease, especially asthma, the accumulation and acti-
age of Annexin-V-positive cells from three separate experiments at the 29 vation of eosinophils appear to contribute to the development
and 47 h time points. Asterisks indicate differences from vehicle control and maintenance of airway inflammation by releasing proin-
⫹ IL-5 (**P ⬍ .01; ***P ⬍ .001).
flammatory cytokines, lipid mediators, cytotoxic cationic pro-
teins, and oxygen radicals (Giembycz and Lindsay, 1999). In

Fig. 8. Phagocytosis of eosinophils by alveolar mac-

rophages in the guinea pig airway. Guinea pig tra-
chea and lungs were fixed, sectioned at 5-␮m thick-
ness, and stained with Luna’s stain for eosinophils.
The photomicrograph shown was taken at 830⫻
magnification. The arrow indicates an engulfed eo-
sinophil with intact granules.
2000 Anti-Asthmatic Effects of p38 MAP Kinase Inhbitor SB 239063 287
addition, although more than 50 different mediators have the doses used in these experiments. Because modest release
been implicated in asthma, the eicosanoids (e.g., leukotriene of cysteinyl leukotrienes may occur with mast cell degranu-
B4, LTD4), cytokines (TNF-␣, IL-5, etc.), and chemokines lation, this direct chemotactic activity of this eicosanoid may
(RANTES, eotaxin, and IL-8) have received recent focus be- account for the small residual eosinophilia remaining in SB
cause of the availability of appropriate detection antibodies 239063-treated animals.
and the demonstrated efficacy of selective antagonists and Only recently has the persistence and maintenance of lung
inhibitors (Barnes et al., 1998). The ability of the p38 MAP eosinophilia been evaluated. Although allergen-induced eo-
kinase inhibitor SB 239063 to inhibit antigen-induced accu- sinophilia may be fleeting (i.e., 12– 48 h) with a single prov-
mulation of eosinophils in the airways of both mice and ocation, and multiple provocations may help maintain some
guinea pigs was demonstrated in the present study, suggest- degree of low-level chronicity, the recent development of a
ing an inhibition of chemotaxis. Over the past decade, eosin- chronic model in guinea pigs exposed to inhaled LTD4 in
ophil trafficking in the guinea pig lung has been comprehen- which airway accumulation peaks after 96 h and remains
sively studied in our laboratory. Although other mediators plateaued for at least 2 weeks has allowed us to test the
are probably involved, much of the activity has been associ- efficacy of drugs on the persistence of eosinophils in the
ated with the formation and action of lipoxygenase products, airways (Underwood et al., 1996, 1998a). In the present
especially the cysteinyl leukotrienes, and cytokines such as experiments, SB 239063 substantially reduced the persistent
IL-5 (Underwood et al., 1996). Similar studies in mice have airway eosinophilia, suggesting a more complex activity ad-
provided strong evidence of the involvement of Th2-depen- ditional to simple inhibition of chemotaxis into the airways.
dent cytokines IL-4 and IL-5 in allergen-mediated lung eo- The demonstration of enhanced apoptosis that may signal for
sinophilia (for review, see Selig and Chapman, 1999). Al- phagic capture by alveolar macrophages (Stern et al., 1992),
though these cytokines were not measured in the present as shown histologically in the present study, provides an
study, the potent inhibitory activity of a close structurally additional unique mechanism by which p38 kinase inhibitors
related p38 kinase inhibitor HEP689 (SB 235699) against may provide a therapeutic benefit in chronic airways inflam-
IL-4 production in a murine allergic skin model has been mation. It has been consistently demonstrated that human
demonstrated (Aaes et al., 1999). In other studies from our cultured eosinophils purified from peripheral blood undergo
own laboratory with a murine chronic contact sensitivity rapid apoptosis when placed into primary culture (Stern et
model featuring a Th2-dependent up-regulation of IL-4 pro- al., 1992; Walsh, 1997; Kankaanranta et al., 1999); this phe-
duction that correlates with an inflammatory infiltrate that nomenon is diminished with IL-5 supplementation (Yamagu-
includes eosinophils (Webb et al., 1998), we demonstrated a chi et al., 1991). Although some variability occurred with
marked reduction (52%) in tissue levels of IL-4 and inflam- respect to spontaneous apoptosis among eosinophil popula-
mation by topical treatment with SB 239063 (unpublished tions from subsets of patients, enhanced in vitro apoptosis
observations). In addition, chemokines such as RANTES and was clearly shown in the presence of the earlier generation
eotaxin have been recognized as potential contributors to the p38 MAP kinase inhibitors, SB 203580 and SB 202190 Kan-
pathophysiology of asthma (Barnes et al., 1998). Additional kaanranta et al., 1999). The present study with the more
support for a role for p38 MAP kinase comes from a recent selective inhibitor SB 239063 in a persistent population of
study by Hashimoto et al. (1999) who demonstrated that guinea pig eosinophils isolated from the lung is consistent
TNF-␣ stimulates RANTES production in human pulmonary with that finding. However, SB 239063 was capable of en-
vascular endothelial cells. This effect is inhibited by the p38 hancing apoptosis in guinea pig eosinophils isolated from
MAP kinase inhibitor SB 203580. Because RANTES plays an lung in the presence of IL-5, thereby overcoming the surviv-
important role through its chemotactic activity for eosino- al-enhancing activity of low concentrations of this cytokine,
phils, this study supports the contention that the p38 path- an observation different from the findings by Kankaanranta
way is important in the production of allergic inflammation et al. (1999). Whether this difference is due to the source of
of the airways. Further evidence for a role for p38 kinase in eosinophils (human peripheral versus guinea pig lung), the
allergic disorders was the demonstrated inhibition of IgE greater selectivity of SB 239063 compared with SB 203580
synthesis via inhibition of cellular differentiation antigen 23 relative to other kinase pathways such as c-Raf, or to other
expression by the p38 MAP kinase inhibitor SB 203580 (Mar- technique differences is not known. Nonetheless, both stud-
shall et al. 1998). ies have demonstrated that p38 activation plays an impor-
In the conscious guinea pig model, SB 239063 had no tant role in eosinophil survival.
inhibitory activity against the antigen-induced acute bron- Of major importance is the present demonstration of acti-
choconstriction. Acute bronchospasm in this model is pro- vated p38 MAP kinase in the lung where cell-cell interactions
duced almost exclusively by mast-cell mediators, predomi- may play an equally important role in not only the survival of
nantly histamine, with modest contributions from inflammatory cells but also in the activation state of these
eicosanoids such as prostaglandin D2 and cysteinyl leukotri- cells. The consistent histologic finding of eosinophils, infil-
enes in later phases (Selig and Chapman, 1999). The present trated in response to aerosol exposure to LTD4, in lung tissue
animals had been pretreated with only enough antihistamine engulfed by macrophages, with demonstrable granules in-
to prevent apnea and collapse due to anaphylaxis; we have tact, is evidence of the potential to enhance a naturally oc-
demonstrated that higher doses of antihistamine provide curring neutralization of the pathogenesis of this granulo-
additional attenuation of bronchospasm (Underwood et al., cyte.
1998b). Therefore, acute treatment with SB 239063 appears The combined activities of p38 kinase inhibition, that is,
to provide no substantial direct stabilization of mast cell attenuation of proinflammatory cytokine formation, inhibi-
release of preformed histamine or H1 histamine receptor tion of chemotaxis of eosinophils into the airways, and the
antagonism or inhibition of cysteinyl leukotriene release at enhancement of apoptosis to signal phagic engulfment by
288 Underwood et al. Vol. 293

alveolar macrophages, may provide a multipronged potential Lee JC, Kassis S, Kumar S, Badger A and Adams JL (1999) p38 Mitogen-activated
protein kinase inhibitors—Mechanisms and therapeutic potentials. Pharmacol
therapeutic approach toward chronic airways disease man- Ther 82:389 –397.
agement. Thus, potent and selective p38 kinase inhibitors, Luna LG (1968) Luna’s method for erythrocytes and eosinophil granules, in Manual
such as SB 239063, may have therapeutic utility in lung of Histologic Staining Methods of the Armed Forces Institute of Pathology. (Luna
LG ed) pp 111–112, McGraw-Hill Book Company, New York.
diseases such as chronic obstructive pulmonary disease and Marshall LA, Hansbury MJ, Bolognese BJ, Gum RJ, Young PR and Mayer RJ (1998)
asthma. Inhibitors of the p38 mitogen-activated kinase modulate IL-4 induction of low
affinity IgE receptor (CD23) in human monocytes. J Immunol 161:6005– 6013.
Olivera DL, Esser KM, Lee JC, Greig RG and Badger AM (1992) Benefical effects of
Acknowledgments SK&F 105809, a novel cytokine-suppressive agent, in murine models of endotoxin
We thank Brendan O’Connell and Thomas Covatta for technical shock. Circ Shock 37:301–306.
Selig W and Chapman R (1999) Animal models of asthma, in In Vivo Models of
assistance in tissue analysis and photography, respectively, for this
Inflammation (Morgan DW and Marshal LA eds) pp 111–135, Birkhauser, Basel.
manuscript. Stern M, Meagher L, Savill J and Haslett C (1992) Apoptosis in human eosinophils.
Programmed cell death in the eosinophil leads to phagocytosis by macrophages
References and is modulated by IL-5. J Immunol 148:3543–3549.
Aaes H, Griswold DE, Skak-Nielsen T, Hansen JR, Jensen L, Bramm E and Bind- Underwood DC, Bochnowicz S, Osborn RR, Kotzer CJ, Luttman MA, Hay DWP,
erup L (1999) Topical antiinflammatory activites of HEP689 in 3 murine models of Gorycki PD, Christensen SB and Torphy TJ (1998a) Anti-asthmatic activity of the
dermatitis. 4th World Congress on Inflammation Paris, France. Mediators In- second generation phosphodiesterase 4 inhibitor, SB 207499 (Ariflo), in the guinea
flamm 8:S117. pig. J Pharmacol Exp Ther 287:988 –995.
Anderson GP (1996) Resolution of chronic inflammation by therapeutic induction of Underwood DC, Osborn RR, Bochnowicz S, Christensen SB, Torphy TJ and Hay
apoptosis. Trends Pharmacol Sci 17:438 – 442. DWP (1998b) The second generation phosphodiesterase (PDE) 4 inhibitor, SB
Barnes PJ (1999) New therapies for chronic obstructive pulmonary disease. Thorax 207499, inhibits antigen-induced bronchoconstriction and eosinophilia and LPS-
53:137–147.
induced airway neutrophilia and edema in the guinea pig. World Asthma Meeting,
Barnes PJ, Chung KF and Page CP (1988) Inflammatory mediators and asthma.
Barcelona, Spain.
Pharmacol Rev 40:49 – 84.
Barnes PJ, Chung KF and Page CP (1998) Inflammatory mediators of asthma: An Underwood DC, Osborn RR, Newsholme SJ, Torphy TJ and Hay DWP (1996) Per-
update. Pharmacol Rev 50:515–596. sistent airway eosinophilia after leukotriene (LT) D4 administration in the guinea
Bracke M, Coffer PJ, Lammers JW and Koenderman L (1998) Analysis of signal pig. Am J Resp Crit Care Med 154:850 – 857.
transduction pathways regulating cytokine-mediated Fc receptor activation on Walsh GM (1997) Mechanisms of human eosinophil survival and apoptosis. Clin Exp
human eosinophils. J Immunol 161:6768 – 6774. Allergy 27:482– 487.
Giembycz MA and Lindsay MA (1999) Pharmacology of the eosinophil. Pharmacol Webb EF, Tzimas MN, Newsholme S and Griswold DE (1998) Intralesional cytokines
Rev 51:213–339. in chronic oxazolone-induced contact sensitivity suggest roles for tumor necrosis
Griswold DE and Young PR (1996) Pharmacology of cytokine suppressive anti- factor ␣ and interleukin-4. J Invest Dermatol 111:86 –92.
inflammatory drug binding protein (CSBP), a novel stress-induced kinase. Phar- Yamaguchi Y, Suda T, Ohta S, Tominaga K, Miura Y and Kasahara T (1991)
macol Commun 7:323–329. Analysis of the survival of mature human eosinophils: Interleukin-5 prevents
Hashimoto S, Gon Y, Asai Y, Machino T, Jibiki I, Takeshita I, Anazawa H and Horie apoptosis in mature human eosinophils. Blood 78:2542–2547.
T (1999) p38 MAP kinase regulates RANTES production by TNF-alpha-stimulated
human pulmonary vascular endothelial cells. Allergy 54:1168 –1172.
Kankaanranta H, De Souza PM, Barnes PJ, Salmon M, Giembycz MA and Lindsay Send reprint requests to: David C. Underwood, Ph.D., SmithKline Beecham Phar-
MA (1999) SB 203580, an inhibitor of p38 mitogen-activated protein kinase, maceuticals, Department of Pulmonary Pharmacology, UW2532, 709 Swedeland Rd.,
enhances constituitive apoptosis of cytokine-deprived human eosinophils. J Phar- King of Prussia, PA 19406-0939. E-mail: David_C_Underwood@sbphrd.com
macol Exp Ther 290:621– 628.