<!DOCTYPE article
PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD with MathML3 v1.3 20210610//EN" "JATS-archivearticle1-3-mathml3.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="1.3" xml:lang="en" article-type="research-article"><?properties manuscript?><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-journal-id">9805461</journal-id><journal-id journal-id-type="pubmed-jr-id">20941</journal-id><journal-id journal-id-type="nlm-ta">Toxicol Sci</journal-id><journal-id journal-id-type="iso-abbrev">Toxicol Sci</journal-id><journal-title-group><journal-title>Toxicological sciences : an official journal of the Society of Toxicology</journal-title></journal-title-group><issn pub-type="ppub">1096-6080</issn><issn pub-type="epub">1096-0929</issn></journal-meta><article-meta><article-id pub-id-type="pmid">40796177</article-id><article-id pub-id-type="pmc">12406230</article-id><article-id pub-id-type="doi">10.1093/toxsci/kfaf114</article-id><article-id pub-id-type="manuscript">HHSPA2102340</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Circular RNA <italic toggle="yes">hsa_circ_0099188</italic> Regulates Inducible Nitric Oxide Synthase and Chemokine Transcription in Macrophages by Targeting the <italic toggle="yes">hsa-miR-381-3p/PPP3CA</italic> and <italic toggle="yes">hsa-miR-381-3p/KLF4</italic> Pathways in Response to 4,4&#x02019;-Methylene Diphenyl Diisocyanate-Glutathione Conjugate Exposure</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-5686-2169</contrib-id><name><surname>Lin</surname><given-names>Chen-Chung</given-names></name></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-3658-6547</contrib-id><name><surname>Law</surname><given-names>Brandon F.</given-names></name></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-9143-1513</contrib-id><name><surname>Hettick</surname><given-names>Justin M.</given-names></name></contrib><aff id="A1">Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505</aff></contrib-group><author-notes><corresp id="CR1">Contact: Chen-Chung Lin, Ph.D., NIOSH/HELD/ACIB, 1095 Willowdale Rd., MS L4020, Morgantown, WV 26505, (304) 285-6126 (fax), <email>mjy2@cdc.gov</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>18</day><month>8</month><year>2025</year></pub-date><pub-date pub-type="ppub"><day>01</day><month>11</month><year>2025</year></pub-date><pub-date pub-type="pmc-release"><day>04</day><month>9</month><year>2025</year></pub-date><volume>208</volume><issue>1</issue><fpage>122</fpage><lpage>135</lpage><abstract id="ABS1"><p id="P1">Workplace exposure to 4,4&#x02019;-methylene diphenyl diisocyanate (MDI), the most used monomeric diisocyanate, can lead to the development of occupational asthma (OA). However, the molecular mechanisms by which MDI induces OA remain poorly understood. Previous studies have shown that exposure to MDI or MDI-glutathione (GSH) conjugate reduces the levels of endogenous human (<italic toggle="yes">hsa</italic>)/murine (<italic toggle="yes">mmu</italic>)-microRNA(<italic toggle="yes">miR</italic>)-<italic toggle="yes">206/381-3p</italic>, triggering the activation of calcineurin/nuclear factor of activated T cells (NFAT)/inducible nitric oxide synthase (<italic toggle="yes">NOS2</italic>) regulatory axis and Kr&#x000fc;ppel-Like Factor 4 (KLF4)/chemokine pathways in macrophages. Circular RNAs (circRNAs) play important roles on miR and miR-mediated functions in the cells. CircRNA <italic toggle="yes">hsa_circ_0008726</italic> is induced by MDI-glutathione (GSH) to downregulate endogenous <italic toggle="yes">hsa-miR-206-3p</italic> in macrophages; however, the MDI-GSH mediated circRNA response to downregulate <italic toggle="yes">hsa-miR-381-3p</italic> is currently unknown. The expression of previously identified candidate circRNAs that bind <italic toggle="yes">hsa-miR-381-3p</italic> were analyzed in differentiated/enhanced THP-1 macrophages treated with MDI-GSH conjugates using RT-qPCR. MDI-GSH exposure induces endogenous <italic toggle="yes">hsa_circ_0099188</italic> and its host gene thyrotropin-releasing hormone-degrading ectoenzyme (<italic toggle="yes">TRHDE</italic>); however, other candidate circRNAs were neither detected nor altered. RNA immunoprecipitation (RIP) experiments confirmed the binding of <italic toggle="yes">hsa-miR-381-3p</italic> to <italic toggle="yes">hsa_circ_0099188</italic>. Further experiments demonstrate that modulating <italic toggle="yes">hsa_circ_0099188</italic> expression through siRNAs or overexpression plasmids alter the levels of endogenous <italic toggle="yes">hsa-miR-381-3p, PPP3CA</italic>, and <italic toggle="yes">KLF4</italic>, as well as <italic toggle="yes">NOS2</italic> and M2 macrophage-associated markers and chemokine transcripts. These findings suggest that MDI/MDI-GSH exposure leads to the downregulation of <italic toggle="yes">hsa-miR-381-3p</italic> by inducing the expression of <italic toggle="yes">hsa_circ_0099188/TRHDE</italic>, thereby enhancing the regulatory effects of <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p></abstract><kwd-group><kwd>4,4&#x02019;-methylene diphenyl diisocyanate (MDI)</kwd><kwd>Circular RNAs (circRNAs)</kwd><kwd><italic toggle="yes">hsa-miR-381-3p</italic></kwd><kwd>Occupational Asthma (OA)</kwd><kwd>Kr&#x000fc;ppel-Like Factor 4 (KLF4)</kwd><kwd>protein phosphatase 3 catalytic subunit alpha (PPP3CA)</kwd></kwd-group></article-meta></front><body><sec id="S1"><title>INTRODUCTION</title><p id="P2">Diisocyanates (dNCOs) are highly reactive crosslinking agents that are essential to the manufacture of polyurethane (PU) products (<xref rid="R2" ref-type="bibr">Allport et al. 2003</xref>). Among these, 4,4&#x02019;-methylene diphenyl diisocyanate (MDI) is the most widely produced and utilized globally, with demand anticipated to continue to increase (<xref rid="R51" ref-type="bibr">Statista 2024</xref>). MDI exposure during manufacture and utilization of PU products is a leading cause of occupational asthma (OA) development (<xref rid="R14" ref-type="bibr">Engfeldt et al. 2013</xref>; <xref rid="R26" ref-type="bibr">Jan et al. 2008</xref>; <xref rid="R43" ref-type="bibr">NIOSH 1994</xref>; <xref rid="R58" ref-type="bibr">Wisnewski et al. 2022</xref>); however the underlying molecular mechanisms by which MDI exposure triggers OA are still being actively investigated.</p><p id="P3">In the occupational clinic, physicians diagnose dNCO-induced occupational asthma (dNCO-OA) by reviewing patient histories of dNCO exposure, changes in lung function, and in some cases, isocyanate-specific IgG or IgE. The gold standard for confirming the OA diagnosis is a dNCO-specific inhalation challenge (SIC) (<xref rid="R55" ref-type="bibr">Vandenplas et al. 2014</xref>); however, this test is only available at a few specialized institutions worldwide (<xref rid="R57" ref-type="bibr">Wisnewski 2007</xref>). In the context of OA, elevated fractional exhaled nitric oxide (FeNO) levels have been observed in MDI-OA subjects following MDI-SIC (<xref rid="R1" ref-type="bibr">Allmers et al. 2000</xref>; <xref rid="R6" ref-type="bibr">Baur and Barbinova 2005</xref>; <xref rid="R15" ref-type="bibr">Ferrazzoni et al. 2009</xref>). Nitric oxide (NO) production in the airways primarily originates from the induction of inducible nitric oxide synthase (iNOS; encoded by <italic toggle="yes">NOS2</italic>) in airway cells (<xref rid="R10" ref-type="bibr">Brindicci et al. 2007</xref>; <xref rid="R28" ref-type="bibr">Lane et al. 2004</xref>). Our previous study demonstrated that <italic toggle="yes">NOS2</italic> expression is induced via downregulation of either <italic toggle="yes">hsa-miR-206-3p</italic> or <italic toggle="yes">hsa-miR-381-3p</italic>, resulting in the upregulation of protein phosphatase 3 catalytic subunit alpha (<italic toggle="yes">PPP3CA</italic>), and activation of calcineurin/NFAT signaling after exposure to MDI/MDI-GSH in macrophages (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>).</p><p id="P4">Immune cells infiltrate into the lung microenvironment following inhalation of irritants/allergens and their interaction with lung airway cells plays a crucial role in the development of asthma (<xref rid="R4" ref-type="bibr">Barnes 2008</xref>; <xref rid="R9" ref-type="bibr">Boonpiyathad et al. 2019</xref>; <xref rid="R24" ref-type="bibr">Holgate 2008</xref>). Following inhalation into the distal lung microenvironment, irritants/allergens first encounter alveolar macrophages, and this is linked to asthma pathogenesis (<xref rid="R17" ref-type="bibr">Fricker and Gibson 2017</xref>). Cell populations of alternatively activated (M2) macrophages are elevated in the airways of patients with asthma (<xref rid="R19" ref-type="bibr">Girodet et al. 2016</xref>). Both <italic toggle="yes">in vitro</italic>/<italic toggle="yes">vivo</italic> studies have shown that exposure to MDI/MDI-GSH induces M2 macrophage-associated gene signatures (<xref rid="R59" ref-type="bibr">Wisnewski et al. 2015</xref>; <xref rid="R61" ref-type="bibr">Wisnewski et al. 2020</xref>) which are potentially mediated through the transcriptional activation of Kr&#x000fc;ppel-Like Factor 4 (KLF4) (<xref rid="R33" ref-type="bibr">Lin et al. 2023</xref>). Previous study has suggested that endogenous microRNAs (miRs) may play a role in the regulation of MDI/MDI-GSH-induced KLF4 activation in macrophages (<xref rid="R35" ref-type="bibr">Lin et al. 2024b</xref>); yet the detailed mechanisms through which MDI/MDI-GSH exposure alters miR levels in macrophages remain largely unknown.</p><p id="P5">Circular RNAs (circRNAs) are a class of noncoding RNA (ncRNA) characterized by their circular structure. They have been implicated in the pathogenesis of various diseases, including asthma (<xref rid="R25" ref-type="bibr">Huang et al. 2019</xref>; <xref rid="R63" ref-type="bibr">Zeng et al. 2021</xref>) mainly through regulation of endogenous miR function and downstream targeting of biological processes (<xref rid="R47" ref-type="bibr">Salmena et al. 2011</xref>). Previous studies identified that MDI/MDI-GSH exposure results in the downregulation of two endogenous miRs, <italic toggle="yes">hsa-miR-206-3p</italic>/<italic toggle="yes">hsa-miR-381-3p</italic>, and the upregulation of endogenous KLF4 and KLF4-mediated M2 macrophage-associated genes in macrophages (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R36" ref-type="bibr">Lin et al. 2019</xref>). We discovered a putative mechanism for circRNA <italic toggle="yes">hsa_circ_0008726</italic>-mediated downregulation of endogenous <italic toggle="yes">hsa-miR-206-3p</italic> following MDI/MDI-GSH exposure in macrophages (<xref rid="R34" ref-type="bibr">Lin et al. 2024a</xref>); however, the mechanism(s) by which MDI downregulates endogenous <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages remains to be elucidated. Given that one of the key functions of endogenous circRNA is to degrade or downregulate endogenous miRs through binding (<xref rid="R45" ref-type="bibr">Patop et al. 2019</xref>), we hypothesize that circRNA may respond to MDI/MDI-GSH exposure to regulate endogenous <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p><p id="P6">This report continues our prior investigation of how MDI/MDI-GSH exposure downregulates endogenous <italic toggle="yes">hsa-miRs-206-3p/-381-3p</italic> in macrophages. We have identified a potential circRNA-mediated regulatory mechanism of endogenous <italic toggle="yes">hsa-miR-206-3p</italic> downregulation (<xref rid="R34" ref-type="bibr">Lin et al. 2024a</xref>), and the current report focuses on characterizing the MDI-mediated responses of candidate circRNAs that sponge/target <italic toggle="yes">hsa-miR-381-3p</italic> and verifying the interactions between <italic toggle="yes">hsa-miR-381-3p</italic> and these candidate circRNAs. Additionally, this report explores the downstream molecular effects of MDI/MDI-GSH-induced circRNA changes on the regulation of calcineurin/NFAT signaling mediated <italic toggle="yes">NOS2</italic> transcripts as well as <italic toggle="yes">KLF4</italic> transcripts and KLF4-mediated regulation of M2 macrophage-associated markers and chemokine responses in <italic toggle="yes">in vitro</italic> human THP-1 macrophage culture. Exposure to MDI-GSH conjugates <italic toggle="yes">in vitro</italic> results in the downregulation of endogenous <italic toggle="yes">hsa-miR-381-3p</italic> and upregulation of <italic toggle="yes">hsa_circ_0099188</italic> and its host gene, thyrotropin-releasing hormone-degrading enzyme (<italic toggle="yes">TRHDE</italic>) transcript. This, in turn, leads to the induction of <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">NOS2</italic> transcription and activation of KLF4 signaling and the induction of M2 macrophage-associated markers and chemokines. This report proposes a circRNA-regulated mechanism to explain how MDI/MDI-GSH exposure downregulates endogenous <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p></sec><sec id="S2"><title>MATERIALS AND METHODS</title><sec id="S3"><title>Chemicals and Reagents</title><p id="P7">Acetone (HPLC grade; CAS No. 67-64-1), 4,4&#x02019;-methylene diphenyl diisocyanate (MDI, 98%; CAS No. 101-68-8), 3&#x000c5; molecular sieve (4-8 mesh; CAS No. 308080-99-1), Tween-20 (CAS No. 9005-64-5), dimethyl sulfoxide (DMSO; CAS No. 67-68-5), phorbol 12-myristate 13-acetate (PMA; CAS No. 16561-29-8), butyric acid (Cas No. 107-92-6), bovine serum albumin (BSA; CAS No. 9048-46-8), tris-buffered saline (TBS), and reduced-glutathione (GSH; CAS No. 70-18-8) were acquired from MilliporeSigma (St. Louis, MO). Roswell Park Memorial Institute (RPMI)-1640 culture medium, Phosphate buffered saline (PBS), and Penicillin-Streptomycin-Glutamine (PSG; 100&#x000d7;) were acquired from ThermoFisher Scientific (Waltham, MA). Hyclone<sup>&#x02122;</sup> fetal bovine serum (FBS) was obtained from Cytiva Life Sciences (Marlborough, MA). Dry acetone was prepared by incubating HPLC grade acetone with 3&#x000c5; molecular sieves for a minimum of 24 h to adsorb water.</p></sec><sec id="S4"><title>Cell culture and differentiation</title><p id="P8">Cell culture and differentiation were carried out as previously described (<xref rid="R32" ref-type="bibr">Lin et al. 2021</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, THP-1 (ATCC<sup>&#x000ae;</sup> TIB-202<sup>&#x02122;</sup>), Clone 15 HL-60 (HL-60_C15; ATCC<sup>&#x000ae;</sup> CRL-1964<sup>&#x02122;</sup>), and Jurkat Clone E6-1 (Jurkat_E6-1; ATCC<sup>&#x000ae;</sup> TIB-152<sup>&#x02122;</sup>) cells were obtained from American Type Culture Collection (ATCC; Manassas, VA) and maintained at 0.5 &#x02013; 1 &#x000d7; 10<sup>6</sup>/ml in complete RPMI media (RPMI-1640 media supplement, 10% FBS, 1 &#x000d7; PSG) at 37&#x000b0;C in a humidified atmosphere with 5% CO2 (<xref rid="R32" ref-type="bibr">Lin et al. 2021</xref>). THP-1 cells (2 &#x000d7; 10<sup>6</sup> cells) were differentiated using 10 ng/ml PMA in 10-cm culture dishes for 72 h. The PMA-differentiated THP-1 macrophages were enhanced by washing twice with PBS following removal of PMA and incubation of the cells in PMA-free fresh complete media for another 72 h. A concentration of 10 ng/ml PMA has been shown to enhance the macrophage response to polarizing stimuli (<xref rid="R7" ref-type="bibr">Baxter et al. 2020</xref>; <xref rid="R40" ref-type="bibr">Maess et al. 2014</xref>). All <italic toggle="yes">in vitro</italic> cell experiments described in this study used differentiated/enhanced THP-1 macrophages. For eosinophil differentiation in chemotaxis experiments, HL-60_C15 cells (5 &#x000d7; 10<sup>5</sup> cells/ml) were cultured in complete RPMI-1640 media containing 0.5 mM butyric acid for 7 days as previously described (<xref rid="R3" ref-type="bibr">Badewa et al. 2002</xref>; <xref rid="R16" ref-type="bibr">Fischkoff 1988</xref>; <xref rid="R53" ref-type="bibr">Tiffany et al. 1995</xref>).</p></sec><sec id="S5"><title>MDI-GSH conjugation reactions</title><p id="P9">MDI-GSH conjugate was prepared as previously described (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>; <xref rid="R60" ref-type="bibr">Wisnewski et al. 2013</xref>). Briefly, 10 mM GSH in 200 mM sodium phosphate buffer (pH = 7.4) was prepared. Dry acetone was freshly prepared and 50 &#x003bc;l 10% MDI (w/v) in dry acetone were added to 25 mL of GSH solution dropwise with stirring. In our early studies, treatment of THP-1 macrophages directly with 10 &#x003bc;M of MDI in dry acetone induced extensive cytotoxicity (data not shown), however, the THP-1 macrophages tolerate MDI-GSH reaction products with little observed cytotoxicity. MDI-GSH conjugate reactions were performed at 25 &#x000b0;C with end-over-end mixing for 1 h and then centrifuged 5 min at 10,000 &#x000d7; g and filtered with a 0.2 &#x003bc;m syringe filter to remove any precipitate that may have formed during the conjugation procedure. Of note, this reaction generates a mixture of products including mono and bis-MDI-GSH and methylenedianiline (MDA) (<xref rid="R60" ref-type="bibr">Wisnewski et al. 2013</xref>), however the relative amounts of each of these components has not been determined. Freshly prepared MDI-GSH conjugate was immediately added into differentiated/enhanced THP-1 macrophages at 0, 1, and 10 &#x003bc;M nominal MDI concentration as indicated.</p></sec><sec id="S6"><title>Plasmid construction</title><p id="P10">Plasmids were constructed similar to previous reports (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>; <xref rid="R35" ref-type="bibr">2024b</xref>). The circRNA overexpression vector, pcDNA3.1<sup>(+)</sup>_CircRNA_Mini Vector, was obtained from Addgene (plasmid id#60648; Watertown, MA), deposited by Dr. Jeremy Wilusz at Baylor College of Medicine (<xref rid="R29" ref-type="bibr">Liang and Wilusz 2014</xref>). To generate a wildtype (WT) <italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid, a 0.34-kb cDNA fragment representing the full length of human circRNA <italic toggle="yes">hsa_circ_0099188</italic> was amplified by PCR using forward and reverse primers containing <italic toggle="yes">PacI</italic> and <italic toggle="yes">HpaI</italic> restriction sites, respectively. The forward and reverse primers are: <italic toggle="yes">PacI</italic> restriction site containing forward primer (cccttaattaaTACCTAAAAATAACTGAGATACAG) and <italic toggle="yes">HpaI</italic> restriction site containing reverse primer (cccgttaacCTTAATTCAACTTTCCTTTATGTA). The PCR product was treated with <italic toggle="yes">PacI</italic> and <italic toggle="yes">HpaI</italic>. This fragment was inserted into pcDNA3.1<sup>(+)</sup>_CircRNA_Mini Vector that was prepared by sequential enzyme treatments with <italic toggle="yes">PacI, SacII</italic>, and calf intestinal alkaline phosphatase (CIP) to generate pcDNA3.1<sup>(+)</sup>_Circ_Mini-<italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid.</p></sec><sec id="S7"><title>Plasmid, microRNA mimics/inhibitors and siRNA transfection</title><p id="P11">Nucleic acid transfections were performed as previously described (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, for the circRNA overexpression study, 1 &#x000d7; 10<sup>6</sup> differentiated/enhanced THP-1 macrophages were reverse transfected with 2.5 &#x003bc;g of either pcDNA3.1<sup>(+)</sup>_CircRNA_Mini-<italic toggle="yes">hsa_circ_0099188</italic>, or pcDNA3.1<sup>(+)</sup>_CircRNA_Mini Vector using Mirus <italic toggle="yes">Trans</italic>IT<sup>&#x000ae;</sup>-2020 transfection reagent for 48 h. Total RNA was then isolated using the <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR Isolation Kit (ThermoFisher Scientific) according to the manufacturer&#x02019;s instructions. For functional analyses on binding and regulation with <italic toggle="yes">hsa_circ_0099188</italic>, the following <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miRNA inhibitors (MH; Cat#4464084) and miR-mimics (MC; Cat#4464066) were obtained from ThermoFisher Scientific and diluted to 20 &#x003bc;M in nuclease-free water: <italic toggle="yes">hsa-miR-206-3p</italic> (MH10409, MC10409), <italic toggle="yes">hsa-miR-381-3p</italic> (MH10242, MC10242), <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miRNA Inhibitor, negative control #1 (Cat#4464076), and <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miRNA Mimic, negative control #1 (Cat#4464058). For circRNA <italic toggle="yes">hsa_circ_0099188</italic> knockdown studies, two Dharmacon custom siRNAs targeting <italic toggle="yes">hsa_circ_0099188</italic> were synthesized and the ON-TARGETplus Non-targeting Control Pool (Cat# D-001810-10-05) were purchased from Horizon Discovery (Lafayette, CO). The custom-designed siRNA sequences are: si-<italic toggle="yes">hsa_circ_0099188</italic>#1 (Sense): 5&#x02019;-GGAAAGUUGAAUUAAGUACCUUU-3&#x02019;; si-<italic toggle="yes">hsa_circ_0099188</italic>#1 (Antisense) 5&#x02019;-AGGUACUUAAUUCAACUUUCCUU-3&#x02019;; si-<italic toggle="yes">hsa_circ_0099188</italic>#2 (Sense): 5&#x02019;-AUUAAGUACCUAAAAAUAACUUU-3&#x02019;; <italic toggle="yes">si-hsa_circ_0099188</italic>#2 (Antisense): 5&#x02019;-AGUUAUUUUUAGGUACUUAAUUU-3&#x02019;. As previously described, differentiated/enhanced THP-1 macrophages were reverse transfected and forward transfected after 24 h (<xref rid="R37" ref-type="bibr">Lin et al. 2011</xref>). Total RNA was prepared for RT-qPCR expression analyses 24 h following forward transfection.</p></sec><sec id="S8"><title>Expression analyses</title><p id="P12">To assess the expression of endogenous circRNA <italic toggle="yes">hsa_circ_0099188</italic> in differentiated/enhanced THP-1 macrophages, total RNA was extracted using <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR Isolation Kit (ThermoFisher Scientific). First, linear RNA species were depleted by treating 3 &#x003bc;g of purified THP-1 total RNA with 20 U Ribonuclease R (RNase R; LGC Biosearch Technologies, Teddington, UK). 3 &#x003bc;g total RNA, 20 U of RNase inhibitor (Cat# N8080119; ThermoFisher Scientific), 1 &#x000d7; RNase R buffer and 20 U of RNase R in a total volume of 20 &#x003bc;l was incubated at 37&#x000b0;C for 30 min. Control reactions were performed without RNase R. After RNase R treatment, the RNA was further purified using <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR Isolation Kit (ThermoFisher Scientific) according to manufacturer&#x02019;s instructions. RNase R protein was removed during the second RNA purification step using the <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR Isolation Kit to ensure the sample was free of proteins. Total RNA, with or without RNAse R treatment, was reverse transcribed to cDNA using a High-Capacity cDNA Synthesis Kit (Thermo Fisher Scientific) following the manufacturer&#x02019;s protocol. PCR reactions were carried out using either <italic toggle="yes">TRHDE</italic> convergent primers (<italic toggle="yes">TRHDE</italic>-F: AGAGCACCACAGAATAACTTATTTG; <italic toggle="yes">TRHDE</italic>-R: GGTCATAGTTGACTCTAAAATAGCC) or circRNA <italic toggle="yes">hsa_circ_0099188</italic> divergent primers (di-<italic toggle="yes">hsa_circ_0099188</italic>-F: TGACTAGAATGAGAAGCTGGGT; di-<italic toggle="yes">hsa_circ_0099188</italic>-R: CCCTTCCCAGGAGGTCTGTA).</p><p id="P13">The mRNA, circRNA and miR levels in THP-1 total RNA were analyzed using RT-qPCR as previously described (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>; <xref rid="R35" ref-type="bibr">2024b</xref>; <xref rid="R36" ref-type="bibr">Lin et al. 2019</xref>; <xref rid="R37" ref-type="bibr">Lin et al. 2011</xref>). Briefly, all RT-qPCR reactions were normalized to human beta-2 microglobulin (<italic toggle="yes">B2M</italic>) for mRNA analysis, or to <italic toggle="yes">U6</italic> snRNA for circRNA and miR analysis. TaqMan gene expression and miR specific assays were purchased from ThermoFisher Scientific and include human <italic toggle="yes">PPP3CA</italic> (Cat#4331182; Assay ID: Hs00174223_m1), <italic toggle="yes">KLF4</italic> (Hs00358836_m1), <italic toggle="yes">TRHDE</italic> (Hs01072025_m1), <italic toggle="yes">NOS2</italic> (Hs01075529_m1), <italic toggle="yes">CD206</italic> (Hs00267207_m1), <italic toggle="yes">TGM2</italic> (Hs01096681_m1), <italic toggle="yes">CCL17</italic> (Hs00171074_m1), <italic toggle="yes">CCL22</italic> (Hs01574247_m1), <italic toggle="yes">CCL24</italic> (Hs00171082_m1), and <italic toggle="yes">B2M</italic> (Hs00187842_m1), <italic toggle="yes">hsa-miR-381-3p</italic> (Cat# 4427975; Assay ID No. 000571; <italic toggle="yes">hsa</italic>/<italic toggle="yes">Homo sapiens</italic>), and <italic toggle="yes">U6</italic> snRNA (No. 001973). For circRNA assays, SYBR Green-based qPCR was performed using <italic toggle="yes">PowerTrack</italic><sup>&#x02122;</sup> SYBR Green Master Mix from ThermoFisher Scientific (Cat#A46110) with divergent primer sets listed in <xref rid="SD1" ref-type="supplementary-material">Supplemental Table 1</xref> and normalized using <italic toggle="yes">U6</italic> snRNA with following primer sequences: <italic toggle="yes">U6</italic>_snRNA-F: CTCGCTTCGGCAGCACA; <italic toggle="yes">U6</italic>_snRNA-R: AACGCTTCACGAATTTGCGT. PCR reactions were conducted on an ABI 7500 Real-Time PCR System (ThermoFisher Scientific, Waltham, MA, USA). Expression of circRNA, mRNAs and miRs were determined using the <sup>&#x00394;&#x00394;</sup>CT method (<xref rid="R39" ref-type="bibr">Livak and Schmittgen 2001</xref>) and presented as fold change.</p></sec><sec id="S9"><title>Validation of miR-circRNA interaction by RNA-immunoprecipitation (RIP)</title><p id="P14">The miR-containing RNA inducing silencing complex (miR/RISC) and its targeting circRNA(s) were immunoprecipitated (IP) using the miRNA target IP kit (Active Motif, Carlsbad, CA) as previously described (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, differentiated/enhanced THP-1 macrophages were trypsinized and seeded at 8 &#x000d7; 10<sup>6</sup> cells in a 10-cm dish. The macrophages were transfected with 25 nM of either miR-mimic-206-3p, miR-mimic-381-3p or miR-mimic negative control #1 (Cat# 4464058) for 24 h. For each IP reaction, two 10-cm dishes containing an equal number of 1.6 &#x000d7; 10<sup>7</sup> cells were used. The cells were lysed, and the lysates were divided into two equal aliquots. Each aliquot underwent IP using either a pan-AGO antibody (to precipitate the RISC containing AGOs/miRs/mRNAs/circRNAs) or an isotype IgG antibody control. The precipitate was collected, and RNA was purified from the precipitate using the <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR Isolation Kit (ThermoFisher Scientific). The RNA was then reverse transcribed to cDNA using the High-Capacity cDNA Reverse Transcription Kit (ThermoFisher Scientific) and <italic toggle="yes">hsa_circ_0099188</italic> divergent primer was combined with <italic toggle="yes">PowerTrack</italic><sup>&#x02122;</sup> SYBR Green Master Mix for RT-qPCR reactions. Data was analyzed by comparing the cells transfected with miR-mimics or non-target miR-mimic-control and the fold enrichment of <italic toggle="yes">hsa_circ_0099188</italic> was calculated from the anti-panAGO and the IgG isotype antibody IP preparations as per manufacturer&#x02019;s instructions.</p></sec><sec id="S10"><title>Chemokine ELISA</title><p id="P15">Secreted protein concentrations of CCL17, CCL22 and CCL24 in conditioned media were determined as previously described (<xref rid="R33" ref-type="bibr">Lin et al. 2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, conditioned media was collected 48 h after transfecting differentiated/enhanced THP-1 macrophages with 2.5 &#x003bc;g of either pcDNA3.1<sup>(+)</sup>_CircRNA_Mini-<italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid or empty pcDNA3.1<sup>(+)</sup>_CircRNA_Mini vector. The following enzyme-linked immunosorbent assay (ELISA) kits were obtained from R&#x00026;D systems (Minneapolis, MN): Human CCL17/TARC ELISA kit (Cat#DY364); Human CCL22/MDC (Cat#DY336), and human CCL24/Eotaxin-2 (#DY343). The sensitivity of each chemokine is as follows: CCL17 (7.8 pg/ml), CCL22 (7.8 pg/ml), and CCL24 (31.2 pg/ml). The levels of human CCL17, CCL22, and CCL24 chemokines released into the conditioned media from plasmid-transfected THP-1 macrophages were determined by ELISA according to manufacturer&#x02019;s directions.</p></sec><sec id="S11"><title>Chemotaxis assays and quantification of migrated cells</title><p id="P16">Chemotaxis/cell migration in response to conditioned media collected from THP-1 macrophages treated with pcDNA3.1<sup>(+)</sup>_CircRNA_Mini-<italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid or pcDNA3.1<sup>(+)</sup>_CircRNA_Mini vector were performed as previously described (<xref rid="R32" ref-type="bibr">Lin et al. 2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, chemotaxis/cell migration assays were conducted in a 24-well plate with Transwell<sup>&#x02122;</sup> inserts (3 &#x003bc;m pore, Corning<sup>&#x02122;</sup> Transwell<sup>&#x02122;</sup> plates, ThermoFisher Scientific). Naive T-cells (Jurkat_E6-1 T cells) or eosinophils (butyric acid differentiated HL-60_C15 cells) were seeded at 1 &#x000d7; 10<sup>6</sup> cells in 100 &#x003bc;l serum-free RPMI 1640 media in the upper chamber while 500 &#x003bc;L of cell-free conditioned media from THP-1 macrophages was transfected with either pcDNA3.1<sup>(+)</sup>_CircRNA_Mini-<italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid or the empty vector was added into the lower chamber as chemoattractant. The cells were incubated for 6 h at 37 &#x000b0;C in a 5% CO<sub>2</sub> humidified incubator. Cells that migrated into the lower chamber media were collected and stored on ice. Cells that failed to migrate from the upper chamber were aspirated and discarded. The Transwell inserts were washed twice with PBS, and 500 &#x003bc;l cell detaching media (0.25% Trypsin-EDTA, Cat#25200056, ThermoFisher Scientific) was added to the lower chambers followed by reinstallation of the upper chamber. The whole plate was further incubated for 30 min at 37 &#x000b0;C to detach the remaining migrated cells. After incubation, detached cells were combined with the previously collected migrated cells in conditioned media, centrifuged at 300 &#x000d7; g for 5 min, washed twice with PBS, and stored at &#x02212;80 &#x000b0;C. The total number of migrated cells was quantified using CyQUANT<sup>&#x000ae;</sup> Cell proliferation assay (ThermoFisher Scientific) according to manufacturer&#x02019;s instructions.</p></sec><sec id="S12"><title>Statistical analysis</title><p id="P17">Statistical analysis was performed as previously described (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>; <xref rid="R34" ref-type="bibr">2024a</xref>). Briefly, data were analyzed using either the unpaired t-test (two-tailed) when comparing two groups, or one-way analysis of variance followed by Tukey&#x02019;s multiple comparison ad hoc post-test when comparing multiple groups. Statistical analyses were performed in GraphPad Prism 10.3.0 (GraphPad Software, La Jolla, CA, USA.). <italic toggle="yes">P</italic> &#x0003c; 0.05 was used to assign significance.</p></sec></sec><sec id="S13"><title>RESULTS</title><sec id="S14"><title>MDI/MDI-GSH exposure upregulates endogenous <italic toggle="yes">hsa_circ_0099188</italic> in differentiated/enhanced THP-1 human macrophages.</title><p id="P18">Our previous reports demonstrated that exposure to MDI/MDI-GSH conjugates, both <italic toggle="yes">in vivo</italic> and <italic toggle="yes">in vitro</italic>, leads to the downregulation of endogenous <italic toggle="yes">mmu/hsa-miR-381-3p</italic> in bronchoalveolar lavage cells (BALCs) from an MDI-exposed mouse model and in THP-1 macrophages treated with acute MDI-GSH conjugates (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>). These findings suggest that MDI/MDI-GSH conjugates downregulate endogenous <italic toggle="yes">hsa-miR-381-3p</italic> through an unknown mechanism in alveolar macrophages. Through a PubMed literature search (09/2024), we identified four endogenous circRNAs including <italic toggle="yes">hsa_circ_0021593</italic> (<xref rid="R23" ref-type="bibr">Gu et al. 2020</xref>), <italic toggle="yes">hsa_circ_0038467</italic> (<xref rid="R62" ref-type="bibr">Yang et al. 2024</xref>), <italic toggle="yes">hsa_circ_0084003</italic> (<xref rid="R64" ref-type="bibr">Zhang et al. 2019</xref>), and <italic toggle="yes">hsa_circ_0099188</italic> (<xref rid="R52" ref-type="bibr">Sun et al. 2022</xref>) that have been reported to bind/sponge and regulate the levels and function of <italic toggle="yes">hsa-miR-381-3p</italic> in various cell types. To investigate whether MDI/MDI-GSH conjugate exposure alters the expression of these candidate circRNAs, we used differentiated/enhanced human THP-1 macrophages as an <italic toggle="yes">in vitro</italic> model. The circRNA responses to MDI-GSH conjugate exposure and subsequent cellular signaling pathways were examined in the following experiments. Differentiated/enhanced THP-1 macrophages were treated with MDI-GSH conjugates at concentrations of 0, 1, and 10 &#x003bc;M for 24 hours. Endogenous <italic toggle="yes">hsa-miR-381-3p</italic> and candidate circRNA levels were quantified by RT-qPCR using TaqMan assays for <italic toggle="yes">hsa-miR-381-3p</italic> and specific divergent primers for the candidate circRNAs (<xref rid="SD1" ref-type="supplementary-material">Supplemental Table 1</xref>). Consistent with our previous findings, MDI-GSH conjugate treatments significantly downregulated endogenous <italic toggle="yes">hsa-miR-381-3p</italic> levels, with reductions ranging from 16.3% to 6.1% of control (<xref rid="F1" ref-type="fig">Fig. 1A</xref>). Among the four identified candidate circRNAs, MDI-GSH treatment upregulated the levels of <italic toggle="yes">hsa_circ_0099188</italic> by 1.42- to 3.04-fold (<xref rid="F1" ref-type="fig">Fig. 1E</xref>), while the levels of <italic toggle="yes">hsa_circ_0021593</italic> remained unchanged (<xref rid="F1" ref-type="fig">Fig. 1B</xref>). We were unable to detect the other candidate circRNAs, <italic toggle="yes">hsa_circ_0038467</italic> and <italic toggle="yes">hsa_circ_0084003</italic>, in THP-1 macrophages with or without MDI-GSH treatment (<xref rid="F1" ref-type="fig">Fig. 1C</xref> and <xref rid="F1" ref-type="fig">D</xref>). These results indicate that exposure to MDI-GSH conjugates can upregulate endogenous <italic toggle="yes">hsa_circ_0099188</italic> while downregulating <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p></sec><sec id="S15"><title>MDI-GSH conjugates upregulate the endogenous <italic toggle="yes">hsa_circ_0099188</italic> host gene <italic toggle="yes">TRHDE</italic> RNA transcripts in macrophages.</title><p id="P19"><italic toggle="yes">In silico</italic> queries (09/2024) of the circBase (<xref rid="R20" ref-type="bibr">Gla&#x0017e;ar et al. 2014</xref>) and Circular RNA Interactome database (<xref rid="R13" ref-type="bibr">Dudekula et al. 2016</xref>) showed that the mature <italic toggle="yes">hsa_circ_0099188</italic> consists of 341 nucleotides and is backspliced from intron 2 of the host gene <italic toggle="yes">TRHDE</italic>, located on chromosome 12 (<xref rid="F2" ref-type="fig">Fig. 2A</xref>). The <italic toggle="yes">TRHDE</italic> mRNA transcript (NM_013381) includes 19 exons after splicing and spans 11,047 nucleotides (<xref rid="F2" ref-type="fig">Fig. 2B</xref>). CircRNA <italic toggle="yes">hsa_circ_0099188</italic> is derived from intron 2 of the <italic toggle="yes">TRHDE</italic> RNA transcript via a backsplicing mechanism during <italic toggle="yes">TRHDE</italic> mRNA maturation in the nucleus (<xref rid="F2" ref-type="fig">Fig. 2B</xref>). To confirm the expression of <italic toggle="yes">hsa_circ_0099188</italic> in THP-1 macrophages, total RNA isolated from differentiated/enhanced THP-1 macrophages was treated with RNase R to degrade linear RNA species, and RT-PCR was performed using <italic toggle="yes">TRHDE</italic> convergent primers (designed to detect mature <italic toggle="yes">TRHDE</italic> mRNA) and <italic toggle="yes">hsa_circ_0099188</italic> divergent primers (designed to detect mature <italic toggle="yes">hsa_circ_0099188</italic>) (<xref rid="F2" ref-type="fig">Fig. 2B</xref>). We successfully detected <italic toggle="yes">hsa_circ_0099188</italic> in THP-1 RNA, whether treated with or without RNase R, using the <italic toggle="yes">hsa_circ_0099188</italic> divergent primers. However, we could not detect <italic toggle="yes">TRHDE</italic> mRNA expression in RNase R-treated THP-1 RNA using the <italic toggle="yes">TRHDE</italic> convergent primers (<xref rid="F2" ref-type="fig">Fig. 2C</xref>). This result confirms that <italic toggle="yes">hsa_circ_0099188</italic> is expressed in THP-1 macrophages. To determine whether MDI-GSH conjugate exposure regulates <italic toggle="yes">hsa_circ_0099188</italic> by upregulating its host gene <italic toggle="yes">TRHDE</italic>, differentiated/enhanced THP-1 macrophages were treated with MDI-GSH conjugates at concentrations of 0, 1, and 10 &#x003bc;M for 24 hours. The results showed that <italic toggle="yes">TRHDE</italic> transcript levels were significantly upregulated by MDI-GSH treatment, with increases ranging from 1.22- to 1.68-fold (<xref rid="F2" ref-type="fig">Fig. 2D</xref>). These findings suggest that <italic toggle="yes">hsa_circ_0099188</italic> is expressed in THP-1 macrophages, and exposure to MDI-GSH conjugates upregulates <italic toggle="yes">hsa_circ_0099188</italic> through induction of <italic toggle="yes">TRHDE</italic> RNA transcription in macrophages.</p></sec><sec id="S16"><title>Circular RNA <italic toggle="yes">hsa_circ_0099188</italic> binds with <italic toggle="yes">hsa-miR-381-3p</italic> in THP-1 macrophages.</title><p id="P20">Previous studies have shown that <italic toggle="yes">hsa_circ_0099188</italic> can target and sponge <italic toggle="yes">hsa-miR-381-3p</italic> in human lung fibroblast WI-38 cells (<xref rid="R52" ref-type="bibr">Sun et al. 2022</xref>). However, it is not certain whether <italic toggle="yes">hsa_circ_0099188</italic> regulates <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages. To explore the molecular mechanism by which <italic toggle="yes">hsa_circ_0099188</italic> may regulate <italic toggle="yes">hsa-miR-381-3p</italic> through sponging or targeting, we analyzed the potential binding between <italic toggle="yes">hsa_circ_0099188</italic> and <italic toggle="yes">hsa-miR-381-3p</italic> using the <italic toggle="yes">in silico</italic> tool Circbank (<ext-link xlink:href="http://www.circbank.cn/" ext-link-type="uri">http://www.circbank.cn/</ext-link>)(<xref rid="R38" ref-type="bibr">Liu et al. 2019</xref>). We identified one potential miR response element (MRE) site for <italic toggle="yes">hsa-miR-381-3p</italic> located at position 158&#x02013;181 of <italic toggle="yes">hsa_circ_0099188</italic> (<xref rid="F3" ref-type="fig">Fig. 3A</xref>), but no MRE site for <italic toggle="yes">hsa-miR-206-3p</italic> was found (data not shown).</p><p id="P21">CircRNAs are usually stable with long half-lives due to their closed circular structure (lacking the 5&#x02019;- or 3&#x02019;-ends of linear RNA species that can be targeted for degradation by exonucleases). However, studies have shown that circRNA degradation can occur when miRs bind to them. This binding facilitates the recruitment of Argonaute (AGO) proteins from RNA-induced silencing complexes (RISC) to circRNAs through the MRE sites, leading to direct RNA cleavage by AGO proteins. This cleavage generates free ends on the circRNA, exposing it to exonucleases for degradation (<xref rid="R65" ref-type="bibr">Zhou et al. 2021</xref>). To investigate whether <italic toggle="yes">hsa_circ_0099188</italic> is directly regulated by <italic toggle="yes">hsa-miR-206-3p</italic> or <italic toggle="yes">hsa-miR-381-3p</italic>, we first confirmed the binding of <italic toggle="yes">hsa-miR-206-3p</italic> or <italic toggle="yes">hsa-miR-381-3p</italic> to <italic toggle="yes">hsa_circ_0099188</italic> by performing an AGO antibody pulldown assay. This method precipitates RISC containing AGOs, miRs, and circRNAs (RISC-IP; RIP), followed by analysis of the regulatory roles of these miRs on <italic toggle="yes">hsa_circ_0099188</italic> using gain- or loss-of-function studies with miR mimics or inhibitors. Consistent with the <italic toggle="yes">in-silico</italic> prediction, which suggested that <italic toggle="yes">hsa_circ_0099188</italic> contains an MRE site for <italic toggle="yes">hsa-miR-381-3p</italic> but not for <italic toggle="yes">hsa-miR-206-3p</italic>, transfection of miR-mimic-381-3p resulted in a 5.16-fold increase in the precipitation of <italic toggle="yes">hsa_circ_0099188</italic> compared to a non-targeting miR-mimic control. In contrast, transfection of miR-mimic-206-3p did not increase the precipitation of <italic toggle="yes">hsa_circ_0099188</italic> compared to the control (<xref rid="F3" ref-type="fig">Fig. 3B</xref>). These results confirm that <italic toggle="yes">hsa_circ_0099188</italic> binds to <italic toggle="yes">hsa-miR-381-3p</italic> but not to <italic toggle="yes">hsa-miR-206-3p</italic> within RISC complexes.</p><p id="P22">To further investigate whether <italic toggle="yes">hsa-miR-381-3p</italic> regulates endogenous <italic toggle="yes">hsa_circ_0099188</italic> through sponging or miR-mediated degradation in differentiated/enhanced THP-1 macrophages, we conducted gain- and loss-of-function experiments by transfecting miR mimics or inhibitors of <italic toggle="yes">hsa-miR-206-3p</italic> and <italic toggle="yes">hsa-miR-381-3p</italic> into the macrophages. Transfection of miR-mimic-381-3p caused a 51.9% reduction of endogenous <italic toggle="yes">hsa_circ_0099188</italic> (<xref rid="F3" ref-type="fig">Fig. 3C</xref>), whereas transfection of miR-inhibitor-381-3p upregulated <italic toggle="yes">hsa_circ_0099188</italic> by 4.96-fold (<xref rid="F3" ref-type="fig">Fig. 3D</xref>), compared with the non-targeting controls. To further examine the binding/sponging/degradation mechanism, we transfected THP-1 macrophages with miR mimics or inhibitors for <italic toggle="yes">hsa-miR-206-3p</italic>. Because <italic toggle="yes">hsa_circ_0099188</italic> does not contain an MRE site for <italic toggle="yes">hsa-miR-206-3p</italic>, neither miR-mimic-206-3p nor miR-inhibitor-206-3p altered the levels of <italic toggle="yes">hsa_circ_0099188</italic> (<xref rid="F3" ref-type="fig">Fig. 3C</xref> and <xref rid="F3" ref-type="fig">D</xref>). These findings provide further evidence that <italic toggle="yes">hsa_circ_0099188</italic> interacts with <italic toggle="yes">hsa-miR-381-3p</italic> through the MRE site on <italic toggle="yes">hsa_circ_0099188</italic> and can be regulated by endogenous <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p></sec><sec id="S17"><title>MDI-GSH conjugates upregulate the endogenous <italic toggle="yes">hsa_circ_0099188</italic> host gene <italic toggle="yes">TRHDE</italic> RNA transcripts in macrophages.</title><p id="P23">To investigate the endogenous roles of <italic toggle="yes">hsa_circ_0099188</italic> in regulating <italic toggle="yes">hsa-miR-381-3p</italic>, we designed two distinct siRNAs targeting <italic toggle="yes">hsa_circ_0099188</italic> and performed a loss-of-function experiment. Differentiated/enhanced THP-1 macrophages were transfected with either si-<italic toggle="yes">hsa_circ_0099188</italic>#1 or si-<italic toggle="yes">hsa_circ_0099188</italic>#2, which target different regions of the circRNA <italic toggle="yes">hsa_circ_0099188</italic>. Transfection of si-<italic toggle="yes">hsa_circ_0099188</italic>#1 resulted in a significant reduction of endogenous <italic toggle="yes">hsa_circ_0099188</italic> levels by 64.3%, while si-<italic toggle="yes">hsa_circ_0099188</italic>#2 reduced <italic toggle="yes">hsa_circ_0099188</italic> levels by 32.9% (<xref rid="F4" ref-type="fig">Fig. 4A</xref>). In line with our previous findings that <italic toggle="yes">hsa_circ_0099188</italic> acts as a sponge/target for <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages (<xref rid="F3" ref-type="fig">Fig. 3</xref>), silencing of <italic toggle="yes">hsa_circ_0099188</italic> with si-<italic toggle="yes">hsa_circ_0099188</italic>#1 significantly increased endogenous <italic toggle="yes">hsa-miR-381-3p</italic> expression by 3.53-fold, whereas transfection with si-<italic toggle="yes">hsa_circ_0099188</italic>#2 resulted in a 1.56-fold increase in <italic toggle="yes">hsa-miR-381-3p</italic> levels (<xref rid="F4" ref-type="fig">Fig. 4B</xref>). These results suggest that endogenous <italic toggle="yes">hsa_circ_0099188</italic> plays a role in regulating the levels of <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages.</p></sec><sec id="S18"><title>Circular RNA <italic toggle="yes">hsa_circ_0099188</italic> regulates endogenous <italic toggle="yes">PPP3CA, NOS2, KLF4</italic> and M2 macrophage-associated markers <italic toggle="yes">CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcript levels.</title><p id="P24">Our previous studies demonstrated that MDI/MDI-GSH exposure upregulates calcineurin/NFAT signaling activation, leading to <italic toggle="yes">NOS2</italic> upregulation through <italic toggle="yes">hsa-miR-206/381-3p</italic>-mediated PPP3CA upregulation (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>). Furthermore, MDI/MDI-GSH exposure upregulates the transcription factor KLF4, as well as M2 macrophage-associated markers and chemokines, including <italic toggle="yes">CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic>, through KLF4-mediated activation in macrophages (<xref rid="R33" ref-type="bibr">Lin et al. 2023</xref>). Further investigation revealed that KLF4 transcription factor can be regulated by endogenous <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages (<xref rid="R35" ref-type="bibr">Lin et al. 2024b</xref>). To examine the role of <italic toggle="yes">hsa_circ_0099188</italic> in regulating the MDI-GSH conjugate-induced activation of calcineurin/NFAT signaling mediated <italic toggle="yes">NOS2</italic> transcription, and M2 macrophage-related gene expression, we performed a loss-of-function experiment using si-<italic toggle="yes">hsa_circ_0099188</italic> siRNA to knock down endogenous <italic toggle="yes">hsa_circ_0099188</italic> in macrophages. Since si-<italic toggle="yes">hsa_circ_0099188</italic>#1 exhibited stronger knockdown of <italic toggle="yes">hsa_circ_0099188</italic> compared to si-<italic toggle="yes">hsa_circ_0099188</italic>#2 (<xref rid="F4" ref-type="fig">Fig. 4A</xref>), we focused on the use of si-<italic toggle="yes">hsa_circ_0099188</italic>#1 for subsequent experiments. Transfection with si-<italic toggle="yes">hsa_circ_0099188</italic>#1 reduced the expression of endogenous <italic toggle="yes">hsa_circ_0099188, PPP3CA, KLF4</italic>, and <italic toggle="yes">TGM2</italic> mRNAs by 59.0%, 45.6%, 65.9%, and 40.8%, respectively (<xref rid="F5" ref-type="fig">Fig. 5 A</xref>, <xref rid="F5" ref-type="fig">C</xref>, <xref rid="F5" ref-type="fig">D</xref>, and <xref rid="F5" ref-type="fig">G</xref>), and increased <italic toggle="yes">hsa-miR-381-3p</italic> expression by 1.61-fold (<xref rid="F5" ref-type="fig">Fig. 5 B</xref>) compared to control nontargeting siRNA (siCtl)-treated THP-1 macrophages. Consistent with our previous findings that MDI-GSH conjugate exposure upregulates <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">NOS2</italic> (<xref rid="R31" ref-type="bibr">Lin et al. 2020</xref>), KLF4 and M2 macrophage-related markers and chemokines in THP-1 macrophages (<xref rid="R33" ref-type="bibr">Lin et al. 2023</xref>), as well as <italic toggle="yes">hsa_circ_0099188</italic> (<xref rid="F1" ref-type="fig">Fig. 1</xref>), treatment with 10 &#x003bc;M MDI-GSH conjugates in siCtl-transfected macrophages increased the expression of <italic toggle="yes">hsa_circ_0099188, PPP3CA, KLF4, NOS2, CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> mRNAs by 6.09-, 2.80-,1.96-, 7.02, 1.97-, 1.52-, 2.14-, 4.04-, and 2.75-fold, respectively (<xref rid="F5" ref-type="fig">Fig. 5 A</xref>, <xref rid="F5" ref-type="fig">C</xref>&#x02013;<xref rid="F5" ref-type="fig">J</xref>), and downregulated <italic toggle="yes">hsa-miR-381-3p</italic> by 37.9% (<xref rid="F5" ref-type="fig">Fig. 5 B</xref>) compared to untreated siCtl-transfected THP-1 macrophages. However, when THP-1 macrophages were transfected with si-<italic toggle="yes">hsa_circ_0099188</italic>#1, MDI-GSH treatment did not induce the expression of <italic toggle="yes">hsa_circ_0099188, PPP3CA, KLF4, NOS2, CD206, TGM2, CCL17, CCL22</italic>, or <italic toggle="yes">CCL24</italic> mRNAs (<xref rid="F5" ref-type="fig">Fig. 5A</xref>, <xref rid="F5" ref-type="fig">C</xref>&#x02013;<xref rid="F5" ref-type="fig">J</xref>). These results suggest that <italic toggle="yes">hsa_circ_0099188</italic> plays a role in regulating <italic toggle="yes">NOS2</italic> expression through calcineurin/NFAT signaling pathways activation via <italic toggle="yes">PPP3CA</italic> and the expression of the M2 macrophage-associated transcription factor KLF4, as well as the markers <italic toggle="yes">CD206, TGM2</italic>, and the chemokines <italic toggle="yes">CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic>, following exposure of macrophages to MDI-GSH conjugates.</p></sec><sec id="S19"><title>Overexpression of <italic toggle="yes">hsa_circ_0099188</italic> induced endogenous <italic toggle="yes">PPP3CA, NOS2, KLF4</italic> as well as M2 macrophage-associated markers and chemokines transcripts.</title><p id="P25">To explore whether <italic toggle="yes">hsa_circ_0099188</italic> regulates the expression of calcineurin-NFAT signaling mediated expression of <italic toggle="yes">NOS2</italic> via <italic toggle="yes">PPP3CA</italic> and M2 macrophage-associated markers and chemokines via KLF4, we assessed the expression of <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">NOS2</italic> as well as the markers and chemokines <italic toggle="yes">KLF4, CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcripts in an <italic toggle="yes">in vitro</italic> overexpression model of <italic toggle="yes">hsa_circ_0099188</italic> in THP-1 macrophages. Compared to the vector-transfected differentiated/enhanced THP-1 macrophages, transfection with <italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmids for 48 hours resulted in a 7.01-fold increase in <italic toggle="yes">hsa_circ_0099188</italic> expression (<xref rid="F6" ref-type="fig">Fig. 6A</xref>) and a 2.41- and 6.33-fold increase in the mRNA levels of <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">NOS2</italic> (<xref rid="F6" ref-type="fig">Fig. 6C</xref>, <xref rid="F6" ref-type="fig">E</xref>), and 2.02-, 5.26-, and 2.30-fold increase in the mRNA levels of <italic toggle="yes">KLF4, CD206</italic>, and <italic toggle="yes">TGM2</italic>, respectively (<xref rid="F6" ref-type="fig">Fig. 6 D</xref>, <xref rid="F6" ref-type="fig">F</xref>&#x02013;<xref rid="F6" ref-type="fig">G</xref>). In addition, <italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid transfection led to a 69.2% reduction of endogenous <italic toggle="yes">hsa-miR-381-3p</italic> levels in macrophages (<xref rid="F6" ref-type="fig">Fig. 6 B</xref>). Moreover, overexpression of <italic toggle="yes">hsa_circ_0099188</italic> significantly upregulated the mRNA expression of the chemokines <italic toggle="yes">CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> by 3.81-, 1.75-, and 1.62-fold, respectively (<xref rid="F6" ref-type="fig">Figure 6 H</xref>&#x02013;<xref rid="F6" ref-type="fig">J</xref>). These findings suggest that exposure to MDI-GSH conjugates induces <italic toggle="yes">hsa_circ_0099188</italic>, which may reduce endogenous <italic toggle="yes">hsa-miR-381-3p</italic> levels and simultaneously enhance the transcription and expression of calcineurin-NFAT signaling mediated induction of <italic toggle="yes">NOS2</italic> via <italic toggle="yes">PPP3CA</italic> upregulation. In addition, the M2 macrophage-associated transcription factor <italic toggle="yes">KLF4</italic>, as well as the markers and chemokines <italic toggle="yes">CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcripts can be induced by MDI-GSH conjugates induced <italic toggle="yes">hsa_circ_0099188</italic> in human macrophages.</p></sec><sec id="S20"><title>Circular RNA <italic toggle="yes">hsa_circ_0099188</italic> induces na&#x000ef;ve T-cell and eosinophil chemoattraction by induced secretion of chemokine CCL17, CCL22, and CCL24 in macrophages.</title><p id="P26">Previous studies demonstrate that exposure to MDI-GSH conjugates induces chemotactic activity in both na&#x000ef;ve T-cells and eosinophils (<xref rid="R32" ref-type="bibr">Lin et al. 2021</xref>; <xref rid="R33" ref-type="bibr">2023</xref>). In addition, we found that the KLF4 transcription factor plays a critical role in regulating the expression of M2 macrophage-associated chemokines (CCL17, CCL22, and CCL24) following MDI-GSH exposure, and that MDI-GSH exposure increases the levels of <italic toggle="yes">hsa_circ_0099188, KLF4, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcripts (<xref rid="F5" ref-type="fig">Figure 5</xref>). Since these chemokines are involved in the recruitment of T-cells, eosinophils, and other immune cells, we hypothesize that endogenous <italic toggle="yes">hsa_circ_0099188</italic> may regulate T-cell and/or eosinophil chemotaxis in macrophages exposed to MDI-GSH by enhancing the secretion of CCL17, CCL22, and CCL24 proteins -- similar to previous findings that <italic toggle="yes">hsa_circ_0008726</italic> regulates <italic toggle="yes">CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcripts through targeting the <italic toggle="yes">hsa-miR-206-3p</italic>/KLF4 regulatory axis (<xref rid="R35" ref-type="bibr">Lin et al. 2024b</xref>). To test this hypothesis, we first assessed the protein levels of CCL17, CCL22, and CCL24 in the conditioned media from macrophages transfected with the <italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid. The overexpression of <italic toggle="yes">hsa_circ_0099188</italic> significantly increased the secretion of CCL17, CCL22, and CCL24 proteins by 10.01-, 5.03-, and 2.26-fold, respectively, compared to the vector-transfected THP-1 macrophages (<xref rid="F7" ref-type="fig">Fig. 7 A</xref>&#x02013;<xref rid="F7" ref-type="fig">C</xref>). Next, we performed chemotaxis/migration assays using conditioned media from these macrophages. Compared to the conditioned media from vector-transfected THP-1 macrophages, media from <italic toggle="yes">hsa_circ_0099188</italic> overexpressing macrophages promoted T-cell (Jurkat_E6-1 cells) migration by 1.57-fold (<xref rid="F7" ref-type="fig">Fig. 7 D</xref>) and eosinophil (butyric acid-differentiated HL-60_C15 cells) migration by 2.04-fold (<xref rid="F7" ref-type="fig">Fig. 7 E</xref>). These results suggest that MDI-GSH-induced <italic toggle="yes">hsa_circ_0099188</italic> plays a key role in regulating macrophage-mediated chemotaxis and migration of T-cells and eosinophils.</p></sec></sec><sec id="S21"><title>DISCUSSION</title><p id="P27">Our previous studies have shown that MDI/MDI-GSH exposure leads to the downregulation of endogenous <italic toggle="yes">hsa-miR-206-3p</italic> and <italic toggle="yes">hsa-miR-381-3p</italic> levels (<xref rid="R36" ref-type="bibr">Lin et al. 2019</xref>; <xref rid="R31" ref-type="bibr">2020</xref>; <xref rid="R32" ref-type="bibr">2021</xref>), while upregulating <italic toggle="yes">PPP3CA</italic>/Calcineurin/NFAT signaling activation mediated <italic toggle="yes">NOS2</italic> expression as well as KLF4 transcription factor-mediated M2 macrophage-associated markers and chemokines <italic toggle="yes">in vivo</italic> and <italic toggle="yes">in vitro</italic>. However, the precise molecular mechanisms behind the downregulation of <italic toggle="yes">hsa-miR-206-3p</italic> and <italic toggle="yes">hsa-miR-381-3p</italic> following MDI-GSH-exposure remain unclear. Our prior work identified circRNA <italic toggle="yes">hsa_circ_0008726</italic> as a potential regulator of <italic toggle="yes">hsa-miR-206-3p</italic> downregulation in response to MDI-GSH exposure (<xref rid="R34" ref-type="bibr">Lin et al. 2024a</xref>). In this study, we explore the role of another circRNA, <italic toggle="yes">hsa_circ_0099188</italic>, in regulating <italic toggle="yes">hsa-miR-381-3p</italic>. In our <italic toggle="yes">in vitro</italic> MDI-GSH exposure model using human THP-1 macrophages, we observed that MDI-GSH exposure upregulates both <italic toggle="yes">hsa_circ_0099188</italic> and its host gene <italic toggle="yes">TRHDE</italic> transcript (<xref rid="F1" ref-type="fig">Figs. 1</xref> and <xref rid="F2" ref-type="fig">2</xref>), while <italic toggle="yes">hsa_circ_0099188</italic> contains a <italic toggle="yes">hsa-miR-381-3p</italic> MRE site, enabling it to sponge and downregulate <italic toggle="yes">hsa-miR-381-3p</italic>. This downregulation of <italic toggle="yes">hsa-miR-381-3p</italic> leads to the upregulation of <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">KLF4</italic> expression, which in turn activates downstream gene transcription, enhancing <italic toggle="yes">NOS2</italic> as well as M2 macrophage associated markers and chemokines including <italic toggle="yes">CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic> transcripts. (<xref rid="F8" ref-type="fig">Fig. 8</xref>). Additionally, we demonstrated that <italic toggle="yes">hsa_circ_0099188</italic> sponges <italic toggle="yes">hsa-miR-381-3p</italic> in macrophages, resulting in its degradation and subsequent PPP3CA and KLF4 upregulation. Although <italic toggle="yes">hsa_circ_0099188</italic> has been reported to target <italic toggle="yes">hsa-miR-381-3p</italic> in other cell types, including WI-38 human fetal lung cells (<xref rid="R52" ref-type="bibr">Sun et al. 2022</xref>), to our knowledge, the current report is the first to identify and verify that <italic toggle="yes">hsa_circ_0099188</italic> is expressed in human macrophages and can regulate the expression of endogenous <italic toggle="yes">hsa-miR-381-3p</italic> and <italic toggle="yes">hsa-miR-381-3p</italic>-mediated posttranscriptional regulation of endogenous gene function in macrophages.</p><p id="P28">Exposure of macrophages to MDI-GSH conjugates leads to the induction of endogenous <italic toggle="yes">hsa_circ_0099188</italic> through upregulation of its host gene, <italic toggle="yes">TRHDE</italic>, primary transcript production (<xref rid="F2" ref-type="fig">Fig. 2</xref>). While the precise mechanism by which MDI-GSH conjugates induce <italic toggle="yes">TRHDE</italic> remains unclear, this induction could represent a protective response in macrophages to MDI/MDI-GSH conjugate exposure. The <italic toggle="yes">TRHDE</italic> gene encodes the thyrotropin-releasing hormone-degrading enzyme, a member of the peptidase M1 family that degrades and inactivates the neuropeptide thyrotropin-releasing hormone (TRH) (<xref rid="R48" ref-type="bibr">Schomburg et al. 1999</xref>). TRH, produced by the hypothalamus, stimulates the release of thyroid-stimulating hormone (TSH) from the pituitary gland into the bloodstream. Additionally, <italic toggle="yes">TRHDE</italic> mRNA is expressed in various human organs, including the brain, pancreas, connective tissue, bone marrow, lymphoid tissue, respiratory system, and gastrointestinal tract based on the Human Protein Atlas database V.24 (<ext-link xlink:href="https://www.proteinatlas.org/" ext-link-type="uri">https://www.proteinatlas.org/</ext-link>) (<xref rid="R54" ref-type="bibr">Uhlen et al. 2015</xref>). TRH, regulated/degraded by TRHDE, is crucial for maintaining thyroid hormone (TH) homeostasis by controlling TSH release from the pituitary gland, which in turn stimulates the thyroid gland to produce and release TH into bloodstream (<xref rid="R42" ref-type="bibr">Nikrodhanond et al. 2006</xref>). For several decades, studies have shown a positive correlation between worsening of asthma and thyrotoxicosis, a condition where the patient&#x02019;s thyroid gland produces too much TH (<xref rid="R8" ref-type="bibr">Bonneh and Lowenthal 1988</xref>; <xref rid="R21" ref-type="bibr">Gomez Huelgas et al. 1989</xref>; <xref rid="R44" ref-type="bibr">Parshad et al. 1985</xref>; <xref rid="R49" ref-type="bibr">Settipane et al. 1972</xref>). More recently, Gau et al. found an increased risk of hyperthyroidism in individuals with asthma (<xref rid="R18" ref-type="bibr">Gau et al. 2022</xref>), suggesting a link between elevated TH levels and asthma pathogenesis. Since TRHDE is released into the bloodstream and can travel to the hypothalamus to inactivate TRH, thereby inhibiting TSH release from the pituitary gland, decreased TSH levels in the bloodstream would affect TH production and secretion from the thyroid gland. Thus, the observed induction of <italic toggle="yes">TRHDE</italic> transcripts in MDI/MDI-GSH exposed macrophages may act as a protective mechanism to reduce TH levels systematically and within the lung microenvironment. Further research is needed to explore the potential roles of TRHDE in alveolar macrophages and the potential protective roles of the secreted TRHDE as well as the molecular mechanisms behind the MDI/MDI-GSH conjugate-induced <italic toggle="yes">TRHDE</italic> transcription to be better understand its role in the pathogenesis of MDI-OA.</p><p id="P29">Alveolar macrophage dysfunction has been identified as a critical factor in the pathogenesis and treatment of asthma (<xref rid="R17" ref-type="bibr">Fricker and Gibson 2017</xref>). Disruptions in molecular gene regulation and the maintenance of gene expression homeostasis can significantly impact the function of alveolar macrophages, including their polarization and production/secretion of key mediators. In recent years, circRNAs have emerged as a key class of endogenous regulatory molecules contributing to alveolar macrophage dysfunction in asthma. Several circRNAs have been implicated in regulating macrophage dysfunction in asthma, including circRNA <italic toggle="yes">mmu_circ_0001359</italic> (<xref rid="R50" ref-type="bibr">Shang et al. 2020</xref>), <italic toggle="yes">mmu_circ_S100A11</italic> (<xref rid="R30" ref-type="bibr">Liang et al. 2023</xref>), <italic toggle="yes">hsa_circ_0001326</italic> (<xref rid="R22" ref-type="bibr">Gong et al. 2022</xref>), <italic toggle="yes">hsa_circ_0008726</italic> (<xref rid="R34" ref-type="bibr">Lin et al. 2024a</xref>) and others. The current study suggests endogenous circRNA <italic toggle="yes">hsa_circ_0099188</italic> in macrophages may participate in asthma pathogenesis by modulating M2 macrophage polarization by targeting the <italic toggle="yes">hsa-miR-381-3p</italic> involved. Given that MDI exposure, in the form of MDI-GSH conjugates, promotes M2 macrophage-associated markers and chemokines indicative of M2 polarization, future studies will explore whether MDI-GSH conjugate exposure influences the human homologs of murine circRNAs, such as <italic toggle="yes">mmu_circ_0001359</italic>, and <italic toggle="yes">mmu_circ_S100A11</italic>, as well as the human circRNAs <italic toggle="yes">hsa_circ_0001326</italic> or other M2 macrophage promoting circRNA(s).</p><p id="P30">Because a single miR can target and regulate multiple different mRNAs through imperfect binding to MRE sites on its target transcripts (<xref rid="R5" ref-type="bibr">Bartel 2018</xref>), <italic toggle="yes">hsa-miR-381-3p</italic> may target other important immune regulatory genes beyond <italic toggle="yes">PPP3CA</italic> and <italic toggle="yes">KLF4</italic> in macrophages exposed to MDI/MDI-GSH, as discussed here. Wen et al. showed that <italic toggle="yes">hsa-miR-381-3p</italic> was induced in the blood of <italic toggle="yes">Mycobacterium tuberculosis</italic>-infected patients, where it targeted <italic toggle="yes">CD1C</italic> transcripts and downregulated antigen-presenting capability of the dendritic cells (DCs) (<xref rid="R56" ref-type="bibr">Wen et al. 2016</xref>). The allergen-induced upregulation of CD1C in airway DCs plays a key role in presenting inhaled allergens to other immune cells and triggering inflammatory responses in the small airways, which is crucial for the development of atopic asthma (<xref rid="R41" ref-type="bibr">McCarthy et al. 2007</xref>). Furthermore, Jiang et al. found that elevated levels of <italic toggle="yes">hsa-miR-381-3p</italic> in keratinocyte-derived small vesicles promoted Th1 and Th17 polarization in T cells in psoriasis by targeting the <italic toggle="yes">FOXO1</italic> transcription factor mRNA and inhibiting FOXO1 protein expression. (<xref rid="R27" ref-type="bibr">Jiang et al. 2021</xref>). FOXO1 has been identified as a key regulator of asthmatic inflammation and asthma pathogenesis in macrophages (<xref rid="R11" ref-type="bibr">Chung et al. 2019</xref>; <xref rid="R12" ref-type="bibr">Chung et al. 2016</xref>; <xref rid="R46" ref-type="bibr">Rong et al. 2022</xref>). Here, we found that MDI-GSH conjugate exposure upregulated endogenous <italic toggle="yes">hsa_circ_0099188</italic>, which downregulated <italic toggle="yes">hsa-miR-381-3p</italic> while increasing the expression of <italic toggle="yes">PPP3CA</italic>/calcineurin/NFAT signaling and the <italic toggle="yes">KLF4</italic> transcription factor and its downstream chemokines. Whether the endogenous CD1C and FOXO1 are induced through MDI-GSH-mediated activation of the <italic toggle="yes">hsa_circ_0099188/hsa-miR-381-3p</italic> regulatory axis remains to be investigated in the context of MDI-OA pathogenesis.</p><p id="P31">The current <italic toggle="yes">in vitro</italic> model using THP-1 macrophages exposed to MDI-GSH conjugates offers several strengths, including the ability to conduct gain- and loss-of-function experiments with miR mimics/inhibitors, overexpression plasmid transfections of circRNA <italic toggle="yes">hsa_circ_0099188</italic>, and siRNA transfections to knock down endogenous <italic toggle="yes">hsa_circ_0099188</italic>. These experiments allow for the investigation of molecular regulatory mechanisms mediated by circRNA in macrophages exposed to MDI-GSH conjugates within a single immune cell type. However, THP-1 cells are derived from human leukemia monocytes, making these cells transformed and tumorigenic rather than normal. Although these cells are widely used in research to study the function of monocytes and macrophages; a key limitation of this <italic toggle="yes">in vitro</italic> differentiated/enhanced THP-1 macrophage model is that it may not exhibit the same physiological properties as the primary human lung alveolar macrophages. Other limitations of this THP-1 macrophage model include uncertainty regarding whether the observed induction of <italic toggle="yes">KLF4</italic> via <italic toggle="yes">hsa_circ_0099188</italic> mediated-downregulation of <italic toggle="yes">hsa-miR-381-3p</italic> and the resulting <italic toggle="yes">hsa_circ_0099188</italic>/<italic toggle="yes">hsa-miR-381-3p</italic>/KLF4 regulatory axis, which promotes M2 macrophage-associated markers and chemokines, as well as the <italic toggle="yes">NOS2</italic> induction via <italic toggle="yes">hsa_circ_0099188/hsa-miR-381-3p/PPP3CA</italic> regulatory axis reflects immune responses similar to those in the early stages of asthma pathogenesis and elevated FeNO in MDI-OA. Additionally, the current study primarily relies on the identification of potential <italic toggle="yes">hsa-miR-381-3p</italic>-targeting circRNAs from existing literature, which excludes the possibility of other circRNAs that may be regulated by MDI-GSH conjugates in macrophages. The current experimental design omits other potential <italic toggle="yes">hsa-miR-381-3p</italic> targeting circRNAs that may be regulated by MDI-GSH conjugate exposure in macrophages that contribute to MDI-OA pathogenesis. Future research using <italic toggle="yes">in vivo</italic> MDI-OA animal models and/or alveolar macrophages collected from MDI-OA patients is needed to further explore the connection between diisocyanate exposure and circRNA/miR/miR-target gene regulatory mechanisms in the context of MDI exposure among workers. Finally, the MDI-GSH conjugation reaction produces a small amount of methylenedianiline (MDA, a suspected carcinogen) due to hydrolysis of MDI. Future studies are needed to elucidate what effect, if any, MDA contributes to this model system.</p><p id="P32">In conclusion, this study identifies <italic toggle="yes">hsa_circ_0099188</italic> as a potential regulator of <italic toggle="yes">hsa-miR-381-3p</italic>, <italic toggle="yes">PPP3CA, KLF4</italic> transcripts, and calcineurin/NFAT signaling and KLF4-mediated signaling, ultimately influencing <italic toggle="yes">NOS2</italic> and macrophage markers and associated chemokine transcription following MDI-GSH conjugate exposure. In an <italic toggle="yes">in vitro</italic> THP-1 macrophage model, MDI-GSH exposure induces <italic toggle="yes">hsa_circ_0099188</italic> and downregulates <italic toggle="yes">hsa-miR-381-3p</italic>. This <italic toggle="yes">hsa_circ_0099188/hsa-miR-381-3p</italic>/KLF4 regulatory axis may contribute to the upregulation of M2-associated markers and chemokines, such as <italic toggle="yes">CD206, TGM2, CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic>, in macrophages. In addition, <italic toggle="yes">hsa_circ_0099188/hsa-miR-381-3p/PPP3CA</italic> regulatory axis may contribute to the upregulation of <italic toggle="yes">NOS2</italic> expression. The circRNA <italic toggle="yes">hsa_circ_0099188</italic> may play a significant role in MDI-OA pathogenesis by regulating macrophage-mediated chemokine and NOS2 expression and promoting immune cell chemotaxis to the lung microenvironment and elevated FeNO in MDI-OA patients.</p></sec><sec sec-type="supplementary-material" id="SM1"><title>Supplementary Material</title><supplementary-material id="SD1" position="float" content-type="local-data"><label>1</label><media xlink:href="NIHMS2102340-supplement-1.pdf" id="d67e2063" position="anchor"/></supplementary-material></sec></body><back><ack id="S22"><title>FUNDING</title><p id="P33">This research was funded by intramural funds (CAN#19390BN8 and #39390KK5) from the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.</p></ack><fn-group><fn fn-type="COI-statement" id="FN1"><p id="P34">DECLARATION OF CONFLICTING INTERESTS</p><p id="P35">The authors declare that they have no conflicting financial interests. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.</p></fn></fn-group><ref-list><title>REFERENCES</title><ref id="R1"><mixed-citation publication-type="journal"><name><surname>Allmers</surname><given-names>H</given-names></name>, <name><surname>Chen</surname><given-names>Z</given-names></name>, <name><surname>Barbinova</surname><given-names>L</given-names></name>, <name><surname>Marczynski</surname><given-names>B</given-names></name>, <name><surname>Kirschmann</surname><given-names>V</given-names></name>, <name><surname>Baur</surname><given-names>X</given-names></name>. <year>2000</year>. <article-title>Challenge from methacholine, natural rubber latex, or 4,4-diphenylmethane diisocyanate in workers with suspected sensitization affects exhaled nitric oxide [change in exhaled no levels after allergen challenges]</article-title>. <source>Int Arch Occup Environ Health</source>. <volume>73</volume>(<issue>3</issue>):<fpage>181</fpage>&#x02013;<lpage>186</lpage>.<pub-id pub-id-type="pmid">10787133</pub-id>
</mixed-citation></ref><ref id="R2"><mixed-citation publication-type="book"><name><surname>Allport</surname><given-names>DC</given-names></name>, <name><surname>Gilbert</surname><given-names>DS</given-names></name>, <name><surname>Outterside</surname><given-names>SM</given-names></name>. <year>2003</year>. <source>Mdi and tdi : A safety, health and the environment : A source book and practical guide</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>J. Wiley</publisher-name>.</mixed-citation></ref><ref id="R3"><mixed-citation publication-type="journal"><name><surname>Badewa</surname><given-names>AP</given-names></name>, <name><surname>Hudson</surname><given-names>CE</given-names></name>, <name><surname>Heiman</surname><given-names>AS</given-names></name>. <year>2002</year>. <article-title>Regulatory effects of eotaxin, eotaxin-2, and eotaxin-3 on eosinophil degranulation and superoxide anion generation</article-title>. <source>Exp Biol Med (Maywood)</source>. <volume>227</volume>(<issue>8</issue>):<fpage>645</fpage>&#x02013;<lpage>651</lpage>.<pub-id pub-id-type="pmid">12192108</pub-id>
</mixed-citation></ref><ref id="R4"><mixed-citation publication-type="journal"><name><surname>Barnes</surname><given-names>PJ</given-names></name>. <year>2008</year>. <article-title>Immunology of asthma and chronic obstructive pulmonary disease</article-title>. <source>Nat Rev Immunol</source>. <volume>8</volume>(<issue>3</issue>):<fpage>183</fpage>&#x02013;<lpage>192</lpage>.<pub-id pub-id-type="pmid">18274560</pub-id>
</mixed-citation></ref><ref id="R5"><mixed-citation publication-type="journal"><name><surname>Bartel</surname><given-names>DP</given-names></name>. <year>2018</year>. <article-title>Metazoan micrornas</article-title>. <source>Cell</source>. <volume>173</volume>(<issue>1</issue>):<fpage>20</fpage>&#x02013;<lpage>51</lpage>.<pub-id pub-id-type="pmid">29570994</pub-id>
</mixed-citation></ref><ref id="R6"><mixed-citation publication-type="journal"><name><surname>Baur</surname><given-names>X</given-names></name>, <name><surname>Barbinova</surname><given-names>L</given-names></name>. <year>2005</year>. <article-title>Increase of exhaled nitric oxide (eno) after methylene diphenyl diisocyanate (mdi) exposure in isocyanate workers with bronchial hyperresponsiveness</article-title>. <source>Allergol Int</source>. <volume>54</volume>:<fpage>151</fpage>&#x02013;<lpage>158</lpage>.</mixed-citation></ref><ref id="R7"><mixed-citation publication-type="journal"><name><surname>Baxter</surname><given-names>EW</given-names></name>, <name><surname>Graham</surname><given-names>AE</given-names></name>, <name><surname>Re</surname><given-names>NA</given-names></name>, <name><surname>Carr</surname><given-names>IM</given-names></name>, <name><surname>Robinson</surname><given-names>JI</given-names></name>, <name><surname>Mackie</surname><given-names>SL</given-names></name>, <name><surname>Morgan</surname><given-names>AW</given-names></name>. <year>2020</year>. <article-title>Standardized protocols for differentiation of thp-1 cells to macrophages with distinct m(ifngamma+lps), m(il-4) and m(il-10) phenotypes</article-title>. <source>J Immunol Methods</source>. <volume>478</volume>:<fpage>112721</fpage>.<pub-id pub-id-type="pmid">32033786</pub-id>
</mixed-citation></ref><ref id="R8"><mixed-citation publication-type="journal"><name><surname>Bonneh</surname><given-names>DY</given-names></name>, <name><surname>Lowenthal</surname><given-names>MN</given-names></name>. <year>1988</year>. [<article-title>thyroid disease and bronchial asthma: Is their simultaneous occurrence casual?</article-title>]. <source>Harefuah</source>. <volume>114</volume>(<issue>10</issue>):<fpage>490</fpage>&#x02013;<lpage>492</lpage>.<pub-id pub-id-type="pmid">3396980</pub-id>
</mixed-citation></ref><ref id="R9"><mixed-citation publication-type="journal"><name><surname>Boonpiyathad</surname><given-names>T</given-names></name>, <name><surname>Sozener</surname><given-names>ZC</given-names></name>, <name><surname>Satitsuksanoa</surname><given-names>P</given-names></name>, <name><surname>Akdis</surname><given-names>CA</given-names></name>. <year>2019</year>. <article-title>Immunologic mechanisms in asthma</article-title>. <source>Semin Immunol</source>. <volume>46</volume>:<fpage>101333</fpage>.<pub-id pub-id-type="pmid">31703832</pub-id>
</mixed-citation></ref><ref id="R10"><mixed-citation publication-type="journal"><name><surname>Brindicci</surname><given-names>C</given-names></name>, <name><surname>Ito</surname><given-names>K</given-names></name>, <name><surname>Barnes</surname><given-names>PJ</given-names></name>, <name><surname>Kharitonov</surname><given-names>SA</given-names></name>. <year>2007</year>. <article-title>Effect of an inducible nitric oxide synthase inhibitor on differential flow-exhaled nitric oxide in asthmatic patients and healthy volunteers</article-title>. <source>Chest</source>. <volume>132</volume>(<issue>2</issue>):<fpage>581</fpage>&#x02013;<lpage>588</lpage>.<pub-id pub-id-type="pmid">17550932</pub-id>
</mixed-citation></ref><ref id="R11"><mixed-citation publication-type="journal"><name><surname>Chung</surname><given-names>S</given-names></name>, <name><surname>Kim</surname><given-names>JY</given-names></name>, <name><surname>Song</surname><given-names>MA</given-names></name>, <name><surname>Park</surname><given-names>GY</given-names></name>, <name><surname>Lee</surname><given-names>YG</given-names></name>, <name><surname>Karpurapu</surname><given-names>M</given-names></name>, <name><surname>Englert</surname><given-names>JA</given-names></name>, <name><surname>Ballinger</surname><given-names>MN</given-names></name>, <name><surname>Pabla</surname><given-names>N</given-names></name>, <name><surname>Chung</surname><given-names>HY</given-names></name>
<etal/>
<year>2019</year>. <article-title>Foxo1 is a critical regulator of m2-like macrophage activation in allergic asthma</article-title>. <source>Allergy</source>. <volume>74</volume>(<issue>3</issue>):<fpage>535</fpage>&#x02013;<lpage>548</lpage>.<pub-id pub-id-type="pmid">30288751</pub-id>
</mixed-citation></ref><ref id="R12"><mixed-citation publication-type="journal"><name><surname>Chung</surname><given-names>S</given-names></name>, <name><surname>Lee</surname><given-names>TJ</given-names></name>, <name><surname>Reader</surname><given-names>BF</given-names></name>, <name><surname>Kim</surname><given-names>JY</given-names></name>, <name><surname>Lee</surname><given-names>YG</given-names></name>, <name><surname>Park</surname><given-names>GY</given-names></name>, <name><surname>Karpurapu</surname><given-names>M</given-names></name>, <name><surname>Ballinger</surname><given-names>MN</given-names></name>, <name><surname>Qian</surname><given-names>F</given-names></name>, <name><surname>Rusu</surname><given-names>L</given-names></name>
<etal/>
<year>2016</year>. <article-title>Foxo1 regulates allergic asthmatic inflammation through regulating polarization of the macrophage inflammatory phenotype</article-title>. <source>Oncotarget</source>. <volume>7</volume>(<issue>14</issue>):<fpage>17532</fpage>&#x02013;<lpage>17546</lpage>.<pub-id pub-id-type="pmid">27007158</pub-id>
</mixed-citation></ref><ref id="R13"><mixed-citation publication-type="journal"><name><surname>Dudekula</surname><given-names>DB</given-names></name>, <name><surname>Panda</surname><given-names>AC</given-names></name>, <name><surname>Grammatikakis</surname><given-names>I</given-names></name>, <name><surname>De</surname><given-names>S</given-names></name>, <name><surname>Abdelmohsen</surname><given-names>K</given-names></name>, <name><surname>Gorospe</surname><given-names>M</given-names></name>. <year>2016</year>. <article-title>Circinteractome: A web tool for exploring circular rnas and their interacting proteins and micrornas</article-title>. <source>RNA biology</source>. <volume>13</volume>(<issue>1</issue>):<fpage>34</fpage>&#x02013;<lpage>42</lpage>.<pub-id pub-id-type="pmid">26669964</pub-id>
</mixed-citation></ref><ref id="R14"><mixed-citation publication-type="journal"><name><surname>Engfeldt</surname><given-names>M</given-names></name>, <name><surname>Isaksson</surname><given-names>M</given-names></name>, <name><surname>Zimerson</surname><given-names>E</given-names></name>, <name><surname>Bruze</surname><given-names>M</given-names></name>. <year>2013</year>. <article-title>Several cases of work-related allergic contact dermatitis caused by isocyanates at a company manufacturing heat exchangers</article-title>. <source>Contact Dermatitis</source>. <volume>68</volume>(<issue>3</issue>):<fpage>175</fpage>&#x02013;<lpage>180</lpage>.<pub-id pub-id-type="pmid">23046053</pub-id>
</mixed-citation></ref><ref id="R15"><mixed-citation publication-type="journal"><name><surname>Ferrazzoni</surname><given-names>S</given-names></name>, <name><surname>Scarpa</surname><given-names>MC</given-names></name>, <name><surname>Guarnieri</surname><given-names>G</given-names></name>, <name><surname>Corradi</surname><given-names>M</given-names></name>, <name><surname>Mutti</surname><given-names>A</given-names></name>, <name><surname>Maestrelli</surname><given-names>P</given-names></name>. <year>2009</year>. <article-title>Exhaled nitric oxide and breath condensate ph in asthmatic reactions induced by isocyanates</article-title>. <source>Chest</source>. <volume>136</volume>(<issue>1</issue>):<fpage>155</fpage>&#x02013;<lpage>162</lpage>.<pub-id pub-id-type="pmid">19225065</pub-id>
</mixed-citation></ref><ref id="R16"><mixed-citation publication-type="journal"><name><surname>Fischkoff</surname><given-names>SA</given-names></name>. <year>1988</year>. <article-title>Graded increase in probability of eosinophilic differentiation of hl-60 promyelocytic leukemia cells induced by culture under alkaline conditions</article-title>. <source>Leuk Res</source>. <volume>12</volume>(<issue>8</issue>):<fpage>679</fpage>&#x02013;<lpage>686</lpage>.<pub-id pub-id-type="pmid">3184985</pub-id>
</mixed-citation></ref><ref id="R17"><mixed-citation publication-type="journal"><name><surname>Fricker</surname><given-names>M</given-names></name>, <name><surname>Gibson</surname><given-names>PG</given-names></name>. <year>2017</year>. <article-title>Macrophage dysfunction in the pathogenesis and treatment of asthma</article-title>. <source>Eur Respir J</source>. <volume>50</volume>(<issue>3</issue>). <fpage>1700196</fpage><pub-id pub-id-type="pmid">28899935</pub-id>
</mixed-citation></ref><ref id="R18"><mixed-citation publication-type="journal"><name><surname>Gau</surname><given-names>SY</given-names></name>, <name><surname>Huang</surname><given-names>JY</given-names></name>, <name><surname>Yong</surname><given-names>SB</given-names></name>, <name><surname>Cheng-Chung Wei</surname><given-names>J</given-names></name>. <year>2022</year>. <article-title>Higher risk of hyperthyroidism in people with asthma: Evidence from a nationwide, population-based cohort study</article-title>. <source>J Allergy Clin Immunol Pract</source>. <volume>10</volume>(<issue>3</issue>):<fpage>751</fpage>&#x02013;<lpage>758</lpage>
<fpage>e751</fpage>.<pub-id pub-id-type="pmid">34563740</pub-id>
</mixed-citation></ref><ref id="R19"><mixed-citation publication-type="journal"><name><surname>Girodet</surname><given-names>PO</given-names></name>, <name><surname>Nguyen</surname><given-names>D</given-names></name>, <name><surname>Mancini</surname><given-names>JD</given-names></name>, <name><surname>Hundal</surname><given-names>M</given-names></name>, <name><surname>Zhou</surname><given-names>X</given-names></name>, <name><surname>Israel</surname><given-names>E</given-names></name>, <name><surname>Cernadas</surname><given-names>M</given-names></name>. <year>2016</year>. <article-title>Alternative macrophage activation is increased in asthma</article-title>. <source>Am J Respir Cell Mol Biol</source>. <volume>55</volume>(<issue>4</issue>):<fpage>467</fpage>&#x02013;<lpage>475</lpage>.<pub-id pub-id-type="pmid">27248771</pub-id>
</mixed-citation></ref><ref id="R20"><mixed-citation publication-type="journal"><name><surname>Gla&#x0017e;ar</surname><given-names>P</given-names></name>, <name><surname>Papavasileiou</surname><given-names>P</given-names></name>, <name><surname>Rajewsky</surname><given-names>N</given-names></name>. <year>2014</year>. <article-title>Circbase: A database for circular rnas</article-title>. <source>Rna</source>. <volume>20</volume>(<issue>11</issue>):<fpage>1666</fpage>&#x02013;<lpage>1670</lpage>.<pub-id pub-id-type="pmid">25234927</pub-id>
</mixed-citation></ref><ref id="R21"><mixed-citation publication-type="journal"><name><surname>Gomez Huelgas</surname><given-names>R</given-names></name>, <name><surname>Garcia Calvo</surname><given-names>MI</given-names></name>, <name><surname>Martin Villasclaras</surname><given-names>JJ</given-names></name>, <name><surname>Hidalgo San Juan</surname><given-names>MV</given-names></name>. <year>1989</year>. [<article-title>bronchial asthma and thyroid dysfunction</article-title>]. <source>Med Clin (Barc)</source>. <volume>92</volume>(<issue>18</issue>):<fpage>718</fpage>.</mixed-citation></ref><ref id="R22"><mixed-citation publication-type="journal"><name><surname>Gong</surname><given-names>B</given-names></name>, <name><surname>Zheng</surname><given-names>Y</given-names></name>, <name><surname>Li</surname><given-names>J</given-names></name>, <name><surname>Lei</surname><given-names>H</given-names></name>, <name><surname>Liu</surname><given-names>K</given-names></name>, <name><surname>Tang</surname><given-names>J</given-names></name>, <name><surname>Peng</surname><given-names>Y</given-names></name>. <year>2022</year>. <article-title>Luteolin activates m2 macrophages and suppresses m1 macrophages by upregulation of hsa_circ_0001326 in thp-1 derived macrophages</article-title>. <source>Bioengineered</source>. <volume>13</volume>(<issue>3</issue>):<fpage>5079</fpage>&#x02013;<lpage>5090</lpage>.<pub-id pub-id-type="pmid">35152837</pub-id>
</mixed-citation></ref><ref id="R23"><mixed-citation publication-type="journal"><name><surname>Gu</surname><given-names>F</given-names></name>, <name><surname>Zhang</surname><given-names>J</given-names></name>, <name><surname>Yan</surname><given-names>L</given-names></name>, <name><surname>Li</surname><given-names>D</given-names></name>. <year>2020</year>. <article-title>Circhipk3/mir-381-3p axis modulates proliferation, migration, and glycolysis of lung cancer cells by regulating the akt/mtor signaling pathway</article-title>. <source>Open Life Sci</source>. <volume>15</volume>(<issue>1</issue>):<fpage>683</fpage>&#x02013;<lpage>695</lpage>.<pub-id pub-id-type="pmid">33817257</pub-id>
</mixed-citation></ref><ref id="R24"><mixed-citation publication-type="journal"><name><surname>Holgate</surname><given-names>ST</given-names></name>. <year>2008</year>. <article-title>Pathogenesis of asthma</article-title>. <source>Clin Exp Allergy</source>. <volume>38</volume>(<issue>6</issue>):<fpage>872</fpage>&#x02013;<lpage>897</lpage>.<pub-id pub-id-type="pmid">18498538</pub-id>
</mixed-citation></ref><ref id="R25"><mixed-citation publication-type="journal"><name><surname>Huang</surname><given-names>Z</given-names></name>, <name><surname>Cao</surname><given-names>Y</given-names></name>, <name><surname>Zhou</surname><given-names>M</given-names></name>, <name><surname>Qi</surname><given-names>X</given-names></name>, <name><surname>Fu</surname><given-names>B</given-names></name>, <name><surname>Mou</surname><given-names>Y</given-names></name>, <name><surname>Wu</surname><given-names>G</given-names></name>, <name><surname>Xie</surname><given-names>J</given-names></name>, <name><surname>Zhao</surname><given-names>J</given-names></name>, <name><surname>Xiong</surname><given-names>W</given-names></name>. <year>2019</year>. <article-title>Hsa_circ_0005519 increases il-13/il-6 by regulating hsa-let-7a-5p in cd4(+) t cells to affect asthma</article-title>. <source>Clin Exp Allergy</source>. <volume>49</volume>(<issue>8</issue>):<fpage>1116</fpage>&#x02013;<lpage>1127</lpage>.<pub-id pub-id-type="pmid">31148290</pub-id>
</mixed-citation></ref><ref id="R26"><mixed-citation publication-type="journal"><name><surname>Jan</surname><given-names>RL</given-names></name>, <name><surname>Chen</surname><given-names>SH</given-names></name>, <name><surname>Chang</surname><given-names>HY</given-names></name>, <name><surname>Yeh</surname><given-names>HJ</given-names></name>, <name><surname>Shieh</surname><given-names>CC</given-names></name>, <name><surname>Wang</surname><given-names>JY</given-names></name>. <year>2008</year>. <article-title>Asthma-like syndrome in school children after accidental exposure to xylene and methylene diphenyl diisocyanate</article-title>. <source>J Microbiol Immunol Infect</source>. <volume>41</volume>(<issue>4</issue>):<fpage>337</fpage>&#x02013;<lpage>341</lpage>.<pub-id pub-id-type="pmid">18787742</pub-id>
</mixed-citation></ref><ref id="R27"><mixed-citation publication-type="journal"><name><surname>Jiang</surname><given-names>M</given-names></name>, <name><surname>Fang</surname><given-names>H</given-names></name>, <name><surname>Dang</surname><given-names>E</given-names></name>, <name><surname>Zhang</surname><given-names>J</given-names></name>, <name><surname>Qiao</surname><given-names>P</given-names></name>, <name><surname>Yu</surname><given-names>C</given-names></name>, <name><surname>Yang</surname><given-names>A</given-names></name>, <name><surname>Wang</surname><given-names>G</given-names></name>. <year>2021</year>. <article-title>Small extracellular vesicles containing mir-381-3p from keratinocytes promote t helper type 1 and t helper type 17 polarization in psoriasis</article-title>. <source>J Invest Dermatol</source>. <volume>141</volume>(<issue>3</issue>):<fpage>563</fpage>&#x02013;<lpage>574</lpage>.<pub-id pub-id-type="pmid">32712160</pub-id>
</mixed-citation></ref><ref id="R28"><mixed-citation publication-type="journal"><name><surname>Lane</surname><given-names>C</given-names></name>, <name><surname>Knight</surname><given-names>D</given-names></name>, <name><surname>Burgess</surname><given-names>S</given-names></name>, <name><surname>Franklin</surname><given-names>P</given-names></name>, <name><surname>Horak</surname><given-names>F</given-names></name>, <name><surname>Legg</surname><given-names>J</given-names></name>, <name><surname>Moeller</surname><given-names>A</given-names></name>, <name><surname>Stick</surname><given-names>S</given-names></name>. <year>2004</year>. <article-title>Epithelial inducible nitric oxide synthase activity is the major determinant of nitric oxide concentration in exhaled breath</article-title>. <source>Thorax</source>. <volume>59</volume>(<issue>9</issue>):<fpage>757</fpage>&#x02013;<lpage>760</lpage>.<pub-id pub-id-type="pmid">15333851</pub-id>
</mixed-citation></ref><ref id="R29"><mixed-citation publication-type="journal"><name><surname>Liang</surname><given-names>D</given-names></name>, <name><surname>Wilusz</surname><given-names>JE</given-names></name>. <year>2014</year>. <article-title>Short intronic repeat sequences facilitate circular rna production</article-title>. <source>Genes Dev</source>. <volume>28</volume>(<issue>20</issue>):<fpage>2233</fpage>&#x02013;<lpage>2247</lpage>.<pub-id pub-id-type="pmid">25281217</pub-id>
</mixed-citation></ref><ref id="R30"><mixed-citation publication-type="journal"><name><surname>Liang</surname><given-names>Q</given-names></name>, <name><surname>Fu</surname><given-names>J</given-names></name>, <name><surname>Wang</surname><given-names>X</given-names></name>, <name><surname>Liu</surname><given-names>L</given-names></name>, <name><surname>Xiao</surname><given-names>W</given-names></name>, <name><surname>Gao</surname><given-names>Y</given-names></name>, <name><surname>Yang</surname><given-names>L</given-names></name>, <name><surname>Yu</surname><given-names>H</given-names></name>, <name><surname>Xie</surname><given-names>X</given-names></name>, <name><surname>Tu</surname><given-names>Z</given-names></name>
<etal/>
<year>2023</year>. <article-title>Circs100a11 enhances m2a macrophage activation and lung inflammation in children with asthma</article-title>. <source>Allergy</source>. <volume>78</volume>(<issue>6</issue>):<fpage>1459</fpage>&#x02013;<lpage>1472</lpage>.<pub-id pub-id-type="pmid">36104951</pub-id>
</mixed-citation></ref><ref id="R31"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2020</year>. <article-title>Acute 4,4&#x02019;-methylene diphenyl diisocyanate exposure-mediated downregulation of mir-206-3p and mir-381-3p activates inducible nitric oxide synthase transcription by targeting calcineurin/nfat signaling in macrophages</article-title>. <source>Toxicol Sci</source>. <volume>173</volume>(<issue>1</issue>):<fpage>100</fpage>&#x02013;<lpage>113</lpage>.<pub-id pub-id-type="pmid">31609387</pub-id>
</mixed-citation></ref><ref id="R32"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2021</year>. <article-title>Microrna-mediated calcineurin signaling activation induces ccl2, ccl3, ccl5, il8, and chemotactic activities in 4,4&#x02019;-methylene diphenyl diisocyanate exposed macrophages</article-title>. <source>Xenobiotica</source>. <volume>51</volume>(<issue>12</issue>):<fpage>1436</fpage>&#x02013;<lpage>1452</lpage>.<pub-id pub-id-type="pmid">34775880</pub-id>
</mixed-citation></ref><ref id="R33"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2023</year>. <article-title>4,4&#x02019;-methylene diphenyl diisocyanate exposure induces expression of alternatively activated macrophage-associated markers and chemokines partially through kruppel-like factor 4 mediated signaling in macrophages</article-title>. <source>Xenobiotica</source>. <volume>53</volume>(<issue>12</issue>):<fpage>653</fpage>&#x02013;<lpage>669</lpage>.<pub-id pub-id-type="pmid">38014489</pub-id>
</mixed-citation></ref><ref id="R34"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2024a</year>. <article-title>Circular rna hsa_circ_0008726 targets the hsa-mir-206-3p/klf4 axis to modulate 4,4&#x02019;-methylene diphenyl diisocyanate-glutathione conjugate-induced chemokine transcription in macrophages</article-title>. <source>Cells</source>. <volume>13</volume>(<issue>20</issue>):<fpage>1725</fpage>.<pub-id pub-id-type="pmid">39451243</pub-id>
</mixed-citation></ref><ref id="R35"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2024b</year>. <article-title>Microrna-mediated kruppel-like factor 4 upregulation induces alternatively activated macrophage-associated marker and chemokine transcription in 4,4&#x02019;-methylene diphenyl diisocyanate exposed macrophages</article-title>. <source>Xenobiotica</source>. <volume>54</volume>(<issue>9</issue>):<fpage>730</fpage>&#x02013;<lpage>748</lpage>.<pub-id pub-id-type="pmid">38568505</pub-id>
</mixed-citation></ref><ref id="R36"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Law</surname><given-names>BF</given-names></name>, <name><surname>Siegel</surname><given-names>PD</given-names></name>, <name><surname>Hettick</surname><given-names>JM</given-names></name>. <year>2019</year>. <article-title>Circulating mirs-183-5p, -206-3p and -381-3p may serve as novel biomarkers for 4,4&#x02019;-methylene diphenyl diisocyanate exposure</article-title>. <source>Biomarkers</source>. <volume>24</volume>(<issue>1</issue>):<fpage>76</fpage>&#x02013;<lpage>90</lpage>.<pub-id pub-id-type="pmid">30074411</pub-id>
</mixed-citation></ref><ref id="R37"><mixed-citation publication-type="journal"><name><surname>Lin</surname><given-names>CC</given-names></name>, <name><surname>Liu</surname><given-names>LZ</given-names></name>, <name><surname>Addison</surname><given-names>JB</given-names></name>, <name><surname>Wonderlin</surname><given-names>WF</given-names></name>, <name><surname>Ivanov</surname><given-names>AV</given-names></name>, <name><surname>Ruppert</surname><given-names>JM</given-names></name>. <year>2011</year>. <article-title>A klf4-mirna-206 autoregulatory feedback loop can promote or inhibit protein translation depending upon cell context</article-title>. <source>Mol Cell Biol</source>. <volume>31</volume>(<issue>12</issue>):<fpage>2513</fpage>&#x02013;<lpage>2527</lpage>.<pub-id pub-id-type="pmid">21518959</pub-id>
</mixed-citation></ref><ref id="R38"><mixed-citation publication-type="journal"><name><surname>Liu</surname><given-names>M</given-names></name>, <name><surname>Wang</surname><given-names>Q</given-names></name>, <name><surname>Shen</surname><given-names>J</given-names></name>, <name><surname>Yang</surname><given-names>BB</given-names></name>, <name><surname>Ding</surname><given-names>X</given-names></name>. <year>2019</year>. <article-title>Circbank: A comprehensive database for circrna with standard nomenclature</article-title>. <source>RNA biology</source>. <volume>16</volume>(<issue>7</issue>):<fpage>899</fpage>&#x02013;<lpage>905</lpage>.<pub-id pub-id-type="pmid">31023147</pub-id>
</mixed-citation></ref><ref id="R39"><mixed-citation publication-type="journal"><name><surname>Livak</surname><given-names>KJ</given-names></name>, <name><surname>Schmittgen</surname><given-names>TD</given-names></name>. <year>2001</year>. <article-title>Analysis of relative gene expression data using real-time quantitative pcr and the 2(-delta delta c(t)) method</article-title>. <source>Methods</source>. <volume>25</volume>(<issue>4</issue>):<fpage>402</fpage>&#x02013;<lpage>408</lpage>.<pub-id pub-id-type="pmid">11846609</pub-id>
</mixed-citation></ref><ref id="R40"><mixed-citation publication-type="journal"><name><surname>Maess</surname><given-names>MB</given-names></name>, <name><surname>Wittig</surname><given-names>B</given-names></name>, <name><surname>Cignarella</surname><given-names>A</given-names></name>, <name><surname>Lorkowski</surname><given-names>S</given-names></name>. <year>2014</year>. <article-title>Reduced pma enhances the responsiveness of transfected thp-1 macrophages to polarizing stimuli</article-title>. <source>J Immunol Methods</source>. <volume>402</volume>(<issue>1&#x02013;2</issue>):<fpage>76</fpage>&#x02013;<lpage>81</lpage>.<pub-id pub-id-type="pmid">24269601</pub-id>
</mixed-citation></ref><ref id="R41"><mixed-citation publication-type="journal"><name><surname>McCarthy</surname><given-names>NE</given-names></name>, <name><surname>Jones</surname><given-names>HA</given-names></name>, <name><surname>Marks</surname><given-names>NA</given-names></name>, <name><surname>Shiner</surname><given-names>RJ</given-names></name>, <name><surname>Ind</surname><given-names>PW</given-names></name>, <name><surname>Al-Hassi</surname><given-names>HO</given-names></name>, <name><surname>English</surname><given-names>NR</given-names></name>, <name><surname>Murray</surname><given-names>CM</given-names></name>, <name><surname>Lambert</surname><given-names>JR</given-names></name>, <name><surname>Knight</surname><given-names>SC</given-names></name>
<etal/>
<year>2007</year>. <article-title>Inhaled allergen-driven cd1c up-regulation and enhanced antigen uptake by activated human respiratory-tract dendritic cells in atopic asthma</article-title>. <source>Clin Exp Allergy</source>. <volume>37</volume>(<issue>1</issue>):<fpage>72</fpage>&#x02013;<lpage>82</lpage>.<pub-id pub-id-type="pmid">17210044</pub-id>
</mixed-citation></ref><ref id="R42"><mixed-citation publication-type="journal"><name><surname>Nikrodhanond</surname><given-names>AA</given-names></name>, <name><surname>Ortiga-Carvalho</surname><given-names>TM</given-names></name>, <name><surname>Shibusawa</surname><given-names>N</given-names></name>, <name><surname>Hashimoto</surname><given-names>K</given-names></name>, <name><surname>Liao</surname><given-names>XH</given-names></name>, <name><surname>Refetoff</surname><given-names>S</given-names></name>, <name><surname>Yamada</surname><given-names>M</given-names></name>, <name><surname>Mori</surname><given-names>M</given-names></name>, <name><surname>Wondisford</surname><given-names>FE</given-names></name>. <year>2006</year>. <article-title>Dominant role of thyrotropin-releasing hormone in the hypothalamic-pituitary-thyroid axis</article-title>. <source>J Biol Chem</source>. <volume>281</volume>(<issue>8</issue>):<fpage>5000</fpage>&#x02013;<lpage>5007</lpage>.<pub-id pub-id-type="pmid">16339138</pub-id>
</mixed-citation></ref><ref id="R43"><mixed-citation publication-type="book"><collab>NIOSH</collab>. <year>1994</year>. <part-title>Letter from niosh to distinctive designs international inc</part-title>. <source>With a study report</source>. <publisher-loc>Cincinnati, OH</publisher-loc>: <publisher-name>US Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health</publisher-name>.</mixed-citation></ref><ref id="R44"><mixed-citation publication-type="journal"><name><surname>Parshad</surname><given-names>O</given-names></name>, <name><surname>Kumar</surname><given-names>M</given-names></name>, <name><surname>Melville</surname><given-names>GN</given-names></name>. <year>1985</year>. <article-title>Thyroid-gonad relationship in bronchial asthma</article-title>. <source>West Indian Med J</source>. <volume>34</volume>(<issue>2</issue>):<fpage>109</fpage>&#x02013;<lpage>113</lpage>.<pub-id pub-id-type="pmid">4036096</pub-id>
</mixed-citation></ref><ref id="R45"><mixed-citation publication-type="journal"><name><surname>Patop</surname><given-names>IL</given-names></name>, <name><surname>Wust</surname><given-names>S</given-names></name>, <name><surname>Kadener</surname><given-names>S</given-names></name>. <year>2019</year>. <article-title>Past, present, and future of circrnas</article-title>. <source>EMBO J</source>. <volume>38</volume>(<issue>16</issue>):<fpage>e100836</fpage>.<pub-id pub-id-type="pmid">31343080</pub-id>
</mixed-citation></ref><ref id="R46"><mixed-citation publication-type="journal"><name><surname>Rong</surname><given-names>SJ</given-names></name>, <name><surname>Yang</surname><given-names>CL</given-names></name>, <name><surname>Wang</surname><given-names>FX</given-names></name>, <name><surname>Sun</surname><given-names>F</given-names></name>, <name><surname>Luo</surname><given-names>JH</given-names></name>, <name><surname>Yue</surname><given-names>TT</given-names></name>, <name><surname>Yang</surname><given-names>P</given-names></name>, <name><surname>Yu</surname><given-names>Q</given-names></name>, <name><surname>Zhang</surname><given-names>S</given-names></name>, <name><surname>Wang</surname><given-names>CY</given-names></name>. <year>2022</year>. <article-title>The essential role of foxo1 in the regulation of macrophage function</article-title>. <source>Biomed Res Int</source>. <volume>2022</volume>:<fpage>1068962</fpage>.<pub-id pub-id-type="pmid">35993049</pub-id>
</mixed-citation></ref><ref id="R47"><mixed-citation publication-type="journal"><name><surname>Salmena</surname><given-names>L</given-names></name>, <name><surname>Poliseno</surname><given-names>L</given-names></name>, <name><surname>Tay</surname><given-names>Y</given-names></name>, <name><surname>Kats</surname><given-names>L</given-names></name>, <name><surname>Pandolfi</surname><given-names>PP</given-names></name>. <year>2011</year>. <article-title>A cerna hypothesis: The rosetta stone of a hidden rna language?</article-title>
<source>Cell</source>. <volume>146</volume>(<issue>3</issue>):<fpage>353</fpage>&#x02013;<lpage>358</lpage>.<pub-id pub-id-type="pmid">21802130</pub-id>
</mixed-citation></ref><ref id="R48"><mixed-citation publication-type="journal"><name><surname>Schomburg</surname><given-names>L</given-names></name>, <name><surname>Turwitt</surname><given-names>S</given-names></name>, <name><surname>Prescher</surname><given-names>G</given-names></name>, <name><surname>Lohmann</surname><given-names>D</given-names></name>, <name><surname>Horsthemke</surname><given-names>B</given-names></name>, <name><surname>Bauer</surname><given-names>K</given-names></name>. <year>1999</year>. <article-title>Human trh-degrading ectoenzyme cdna cloning, functional expression, genomic structure and chromosomal assignment</article-title>. <source>Eur J Biochem</source>. <volume>265</volume>(<issue>1</issue>):<fpage>415</fpage>&#x02013;<lpage>422</lpage>.<pub-id pub-id-type="pmid">10491199</pub-id>
</mixed-citation></ref><ref id="R49"><mixed-citation publication-type="journal"><name><surname>Settipane</surname><given-names>GA</given-names></name>, <name><surname>Schoenfeld</surname><given-names>E</given-names></name>, <name><surname>Hamolsky</surname><given-names>MW</given-names></name>. <year>1972</year>. <article-title>Asthma and hyperthyroidism</article-title>. <source>J Allergy Clin Immunol</source>. <volume>49</volume>(<issue>6</issue>):<fpage>348</fpage>&#x02013;<lpage>355</lpage>.<pub-id pub-id-type="pmid">4554357</pub-id>
</mixed-citation></ref><ref id="R50"><mixed-citation publication-type="journal"><name><surname>Shang</surname><given-names>Y</given-names></name>, <name><surname>Sun</surname><given-names>Y</given-names></name>, <name><surname>Xu</surname><given-names>J</given-names></name>, <name><surname>Ge</surname><given-names>X</given-names></name>, <name><surname>Hu</surname><given-names>Z</given-names></name>, <name><surname>Xiao</surname><given-names>J</given-names></name>, <name><surname>Ning</surname><given-names>Y</given-names></name>, <name><surname>Dong</surname><given-names>Y</given-names></name>, <name><surname>Bai</surname><given-names>C</given-names></name>. <year>2020</year>. <article-title>Exosomes from mmu_circ_0001359-modified adscs attenuate airway remodeling by enhancing foxo1 signaling-mediated m2-like macrophage activation</article-title>. <source>Mol Ther Nucleic Acids</source>. <volume>19</volume>:<fpage>951</fpage>&#x02013;<lpage>960</lpage>.<pub-id pub-id-type="pmid">32018116</pub-id>
</mixed-citation></ref><ref id="R51"><mixed-citation publication-type="journal"><collab>Statista</collab>. <year>2024</year>. <source>Demand for methylene diphenyl diisocyanate worldwide from 2011 to 2023</source>. <volume>2024</volume>. [accessed <date-in-citation>2024 October 10</date-in-citation>].</mixed-citation></ref><ref id="R52"><mixed-citation publication-type="journal"><name><surname>Sun</surname><given-names>L</given-names></name>, <name><surname>Liu</surname><given-names>J</given-names></name>, <name><surname>Sun</surname><given-names>X</given-names></name>, <name><surname>Zhang</surname><given-names>Y</given-names></name>, <name><surname>Cui</surname><given-names>X</given-names></name>. <year>2022</year>. <article-title>Circtrhde knockdown protects wi-38 cells against lps-induced inflammatory injury</article-title>. <source>Autoimmunity</source>. <volume>55</volume>(<issue>4</issue>):<fpage>233</fpage>&#x02013;<lpage>242</lpage>.<pub-id pub-id-type="pmid">35481453</pub-id>
</mixed-citation></ref><ref id="R53"><mixed-citation publication-type="journal"><name><surname>Tiffany</surname><given-names>HL</given-names></name>, <name><surname>Li</surname><given-names>F</given-names></name>, <name><surname>Rosenberg</surname><given-names>HF</given-names></name>. <year>1995</year>. <article-title>Hyperglycosylation of eosinophil ribonucleases in a promyelocytic leukemia cell line and in differentiated peripheral blood progenitor cells</article-title>. <source>J Leukoc Biol</source>. <volume>58</volume>(<issue>1</issue>):<fpage>49</fpage>&#x02013;<lpage>54</lpage>.<pub-id pub-id-type="pmid">7616105</pub-id>
</mixed-citation></ref><ref id="R54"><mixed-citation publication-type="journal"><name><surname>Uhlen</surname><given-names>M</given-names></name>, <name><surname>Fagerberg</surname><given-names>L</given-names></name>, <name><surname>Hallstrom</surname><given-names>BM</given-names></name>, <name><surname>Lindskog</surname><given-names>C</given-names></name>, <name><surname>Oksvold</surname><given-names>P</given-names></name>, <name><surname>Mardinoglu</surname><given-names>A</given-names></name>, <name><surname>Sivertsson</surname><given-names>A</given-names></name>, <name><surname>Kampf</surname><given-names>C</given-names></name>, <name><surname>Sjostedt</surname><given-names>E</given-names></name>, <name><surname>Asplund</surname><given-names>A</given-names></name>
<etal/>
<year>2015</year>. <article-title>Proteomics. Tissue-based map of the human proteome</article-title>. <source>Science</source>. <volume>347</volume>(<issue>6220</issue>):<fpage>1260419</fpage>.<pub-id pub-id-type="pmid">25613900</pub-id>
</mixed-citation></ref><ref id="R55"><mixed-citation publication-type="journal"><name><surname>Vandenplas</surname><given-names>O</given-names></name>, <name><surname>Suojalehto</surname><given-names>H</given-names></name>, <name><surname>Aasen</surname><given-names>TB</given-names></name>, <name><surname>Baur</surname><given-names>X</given-names></name>, <name><surname>Burge</surname><given-names>PS</given-names></name>, <name><surname>de Blay</surname><given-names>F</given-names></name>, <name><surname>Fishwick</surname><given-names>D</given-names></name>, <name><surname>Hoyle</surname><given-names>J</given-names></name>, <name><surname>Maestrelli</surname><given-names>P</given-names></name>, <name><surname>Munoz</surname><given-names>X</given-names></name>
<etal/>
<year>2014</year>. <article-title>Specific inhalation challenge in the diagnosis of occupational asthma: Consensus statement</article-title>. <source>Eur Respir J</source>. <volume>43</volume>(<issue>6</issue>):<fpage>1573</fpage>&#x02013;<lpage>1587</lpage>.<pub-id pub-id-type="pmid">24603815</pub-id>
</mixed-citation></ref><ref id="R56"><mixed-citation publication-type="journal"><name><surname>Wen</surname><given-names>Q</given-names></name>, <name><surname>Zhou</surname><given-names>C</given-names></name>, <name><surname>Xiong</surname><given-names>W</given-names></name>, <name><surname>Su</surname><given-names>J</given-names></name>, <name><surname>He</surname><given-names>J</given-names></name>, <name><surname>Zhang</surname><given-names>S</given-names></name>, <name><surname>Du</surname><given-names>X</given-names></name>, <name><surname>Liu</surname><given-names>S</given-names></name>, <name><surname>Wang</surname><given-names>J</given-names></name>, <name><surname>Ma</surname><given-names>L</given-names></name>. <year>2016</year>. <article-title>Mir-381-3p regulates the antigen-presenting capability of dendritic cells and represses antituberculosis cellular immune responses by targeting cd1c</article-title>. <source>J Immunol</source>. <volume>197</volume>(<issue>2</issue>):<fpage>580</fpage>&#x02013;<lpage>589</lpage>.<pub-id pub-id-type="pmid">27296666</pub-id>
</mixed-citation></ref><ref id="R57"><mixed-citation publication-type="journal"><name><surname>Wisnewski</surname><given-names>AV</given-names></name>. <year>2007</year>. <article-title>Developments in laboratory diagnostics for isocyanate asthma</article-title>. <source>Curr Opin Allergy Clin Immunol</source>. <volume>7</volume>(<issue>2</issue>):<fpage>138</fpage>&#x02013;<lpage>145</lpage>.<pub-id pub-id-type="pmid">17351466</pub-id>
</mixed-citation></ref><ref id="R58"><mixed-citation publication-type="journal"><name><surname>Wisnewski</surname><given-names>AV</given-names></name>, <name><surname>Cooney</surname><given-names>R</given-names></name>, <name><surname>Hodgson</surname><given-names>M</given-names></name>, <name><surname>Giese</surname><given-names>K</given-names></name>, <name><surname>Liu</surname><given-names>J</given-names></name>, <name><surname>Redlich</surname><given-names>CA</given-names></name>. <year>2022</year>. <article-title>Severe asthma and death in a worker using methylene diphenyl diisocyanate mdi asthma death</article-title>. <source>Am J Ind Med</source>. <volume>65</volume>(<issue>3</issue>):<fpage>166</fpage>&#x02013;<lpage>172</lpage>.<pub-id pub-id-type="pmid">35028957</pub-id>
</mixed-citation></ref><ref id="R59"><mixed-citation publication-type="journal"><name><surname>Wisnewski</surname><given-names>AV</given-names></name>, <name><surname>Liu</surname><given-names>J</given-names></name>, <name><surname>Colangelo</surname><given-names>CM</given-names></name>. <year>2015</year>. <article-title>Glutathione reaction products with a chemical allergen, methylene-diphenyl diisocyanate, stimulate alternative macrophage activation and eosinophilic airway inflammation</article-title>. <source>Chem Res Toxicol</source>. <volume>28</volume>(<issue>4</issue>):<fpage>729</fpage>&#x02013;<lpage>737</lpage>.<pub-id pub-id-type="pmid">25635619</pub-id>
</mixed-citation></ref><ref id="R60"><mixed-citation publication-type="journal"><name><surname>Wisnewski</surname><given-names>AV</given-names></name>, <name><surname>Liu</surname><given-names>J</given-names></name>, <name><surname>Redlich</surname><given-names>CA</given-names></name>. <year>2013</year>. <article-title>Connecting glutathione with immune responses to occupational methylene diphenyl diisocyanate exposure</article-title>. <source>Chem Biol Interact</source>. <volume>205</volume>(<issue>1</issue>):<fpage>38</fpage>&#x02013;<lpage>45</lpage>.<pub-id pub-id-type="pmid">23791970</pub-id>
</mixed-citation></ref><ref id="R61"><mixed-citation publication-type="journal"><name><surname>Wisnewski</surname><given-names>AV</given-names></name>, <name><surname>Liu</surname><given-names>J</given-names></name>, <name><surname>Redlich</surname><given-names>CA</given-names></name>. <year>2020</year>. <article-title>Analysis of lung gene expression reveals a role for cl(&#x02212;) channels in diisocyanate-induced airway eosinophilia in a mouse model of asthma pathology</article-title>. <source>Am J Respir Cell Mol Biol</source>. <volume>63</volume>(<issue>1</issue>):<fpage>25</fpage>&#x02013;<lpage>35</lpage>.<pub-id pub-id-type="pmid">32101465</pub-id>
</mixed-citation></ref><ref id="R62"><mixed-citation publication-type="journal"><name><surname>Yang</surname><given-names>LJ</given-names></name>, <name><surname>Sui</surname><given-names>SX</given-names></name>, <name><surname>Zheng</surname><given-names>QH</given-names></name>, <name><surname>Wang</surname><given-names>M</given-names></name>. <year>2024</year>. <article-title>Circuqcrc2 promotes asthma progression in children by activating the vegfa/nf-kappab pathway by targeting mir-381-3p</article-title>. <source>Kaohsiung J Med Sci</source>. <volume>40</volume>(<issue>8</issue>):<fpage>699</fpage>&#x02013;<lpage>709</lpage>.<pub-id pub-id-type="pmid">39031804</pub-id>
</mixed-citation></ref><ref id="R63"><mixed-citation publication-type="journal"><name><surname>Zeng</surname><given-names>H</given-names></name>, <name><surname>Gao</surname><given-names>H</given-names></name>, <name><surname>Zhang</surname><given-names>M</given-names></name>, <name><surname>Wang</surname><given-names>J</given-names></name>, <name><surname>Gu</surname><given-names>Y</given-names></name>, <name><surname>Wang</surname><given-names>Y</given-names></name>, <name><surname>Zhang</surname><given-names>H</given-names></name>, <name><surname>Liu</surname><given-names>P</given-names></name>, <name><surname>Zhang</surname><given-names>X</given-names></name>, <name><surname>Zhao</surname><given-names>L</given-names></name>. <year>2021</year>. <article-title>Atractylon treatment attenuates pulmonary fibrosis via regulation of the mmu_circ_0000981/mir-211-5p/tgfbr2 axis in an ovalbumin-induced asthma mouse model</article-title>. <source>Inflammation</source>. <volume>44</volume>(<issue>5</issue>):<fpage>1856</fpage>&#x02013;<lpage>1864</lpage>.<pub-id pub-id-type="pmid">33855682</pub-id>
</mixed-citation></ref><ref id="R64"><mixed-citation publication-type="journal"><name><surname>Zhang</surname><given-names>PF</given-names></name>, <name><surname>Pei</surname><given-names>X</given-names></name>, <name><surname>Li</surname><given-names>KS</given-names></name>, <name><surname>Jin</surname><given-names>LN</given-names></name>, <name><surname>Wang</surname><given-names>F</given-names></name>, <name><surname>Wu</surname><given-names>J</given-names></name>, <name><surname>Zhang</surname><given-names>XM</given-names></name>. <year>2019</year>. <article-title>Circular rna circfgfr1 promotes progression and anti-pd-1 resistance by sponging mir-381-3p in non-small cell lung cancer cells</article-title>. <source>Mol Cancer</source>. <volume>18</volume>(<issue>1</issue>):<fpage>179</fpage>.<pub-id pub-id-type="pmid">31815619</pub-id>
</mixed-citation></ref><ref id="R65"><mixed-citation publication-type="journal"><name><surname>Zhou</surname><given-names>M</given-names></name>, <name><surname>Xiao</surname><given-names>MS</given-names></name>, <name><surname>Li</surname><given-names>Z</given-names></name>, <name><surname>Huang</surname><given-names>C</given-names></name>. <year>2021</year>. <article-title>New progresses of circular rna biology: From nuclear export to degradation</article-title>. <source>RNA biology</source>. <volume>18</volume>(<issue>10</issue>):<fpage>1365</fpage>&#x02013;<lpage>1373</lpage>.<pub-id pub-id-type="pmid">33241761</pub-id>
</mixed-citation></ref></ref-list></back><floats-group><fig position="float" id="F1"><label>Figure 1.</label><caption><title>Treatment of MDI-GSH conjugate in differentiated/enhanced THP-1 macrophages induces endogenous circRNA <italic toggle="yes">hsa_circ_0099188</italic> while downregulating endogenous <italic toggle="yes">hsa-miR-381-3p</italic>.</title><p id="P36">Total RNA was extracted from MDI-GSH conjugate-treated THP-1 macrophages using the <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, then reverse transcribed, and analyzed by TaqMan or SyBR green based RT-qPCR. Endogenous miR/circRNA expressions of (A) <italic toggle="yes">hsa-miR-381-3p</italic>, (B) <italic toggle="yes">hsa_circ_0021593</italic>, (C) <italic toggle="yes">hsa_circ_0038467</italic>, (D) <italic toggle="yes">hsa_circ_0084003</italic> and (E) <italic toggle="yes">hsa_circ_0099188</italic> were measured 24 h after MDI-GSH conjugate treatments (<italic toggle="yes">N</italic>=3; bars, SEM). MDI: 4,4&#x02019;-methylene diphenyl diisocyanate. GSH: Glutathione. (**<italic toggle="yes">P</italic>&#x0003c;0.01)</p></caption><graphic xlink:href="nihms-2102340-f0001" position="float"/></fig><fig position="float" id="F2"><label>Figure 2.</label><caption><title>Circular RNA <italic toggle="yes">hsa_circ_0099188</italic> is presented in THP-1 macrophages and MDI-GSH conjugates upregulate endogenous <italic toggle="yes">hsa_circ_0099188</italic> parental host gene transcript <italic toggle="yes">TRHDE</italic>.</title><p id="P37">(A) The information table of <italic toggle="yes">hsa_circ_0099188</italic> obtained from the circBase and Circular RNA Interactome database. (B) A diagram showing the exon numbers and the locations of the convergent and divergent primer sites on the mature <italic toggle="yes">TRHDE</italic> transcripts. The cartoon illustrates the degradation of linear RNA species, including the <italic toggle="yes">TRHDE</italic> transcript, by RNase R. It also shows that <italic toggle="yes">hsa_circ_0099188</italic> is backspliced from intron 2 of the <italic toggle="yes">TRHDE</italic> transcript. (C) Total RNA was isolated from THP-1 macrophages using <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, treated with or without RNAse R, further purified by <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, reverse transcribed, and subjected to RT-PCR using convergent or divergent primers. RT-NTC lane using templates from cDNA synthesis reaction without adding reverse-transcriptase. PCR-NTC lane using only water to replace cDNA templates during PCR reaction. (D) Total RNA was isolated from differentiated/enhanced THP-1 macrophages treated with MDI-GSH at indicated concentration for 24 h, using <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit. The isolated RNA was reverse transcribed and analyzed by TaqMan RT-qPCR assays. Endogenous levels of <italic toggle="yes">TRHDE</italic> were measured at 24 h after MDI-GSH conjugate treatments (<italic toggle="yes">N</italic>=3; bars, SEM). MDI: 4,4&#x02019;-methylene diphenyl diisocyanate. GSH: Glutathione (*<italic toggle="yes">P</italic>&#x0003c;0.05, ***<italic toggle="yes">P</italic>&#x0003c;0.001).</p></caption><graphic xlink:href="nihms-2102340-f0002" position="float"/></fig><fig position="float" id="F3"><label>Figure 3.</label><caption><title>Human circular RNA <italic toggle="yes">hsa_circ_0099188</italic> is a target of <italic toggle="yes">hsa-miR-381-3p</italic>.</title><p id="P38">(A) Alignment of potential <italic toggle="yes">hsa-miR-381-3p</italic> binding sites with the <italic toggle="yes">hsa_circ_0099188</italic> sequence regions. (B) Differentiated/enhanced THP-1 macrophages were transfected with 25 nM of indicated miR-mimics or a non-targeting miR-mimic control (miR-mimic-Ctl) for 24 h. After 24 h, transfected cells were collected, lysed, and immunoprecipitated using either pan-AGO or isotype IgG antibodies. Total RNA was isolated and the fold enrichment of <italic toggle="yes">hsa_circ_0099188</italic> was measured by SYBR Green based RT-qPCR (<italic toggle="yes">N</italic>=3; bars, SEM). (C) Differentiated/enhanced THP-1 macrophages were transfected with 25 nM of either miR-mimic-206-3p, miR-mimic-381-3p, or non-targeting miR-mimic control (miR-mimic-Ctl) for 24 h. Total RNA was isolated using the <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, reverse transcribed, and subjected to SYBR Green RT-qPCR to measure endogenous <italic toggle="yes">hsa_circ_0099188</italic> levels (<italic toggle="yes">N</italic>=3; bars, SEM). (D) Differentiated/enhanced THP-1 macrophages were transfected with 25 nM of miR inhibitors targeting <italic toggle="yes">hsa-miR-206-3p</italic> or <italic toggle="yes">hsa-miR-381-3p</italic> or non-targeting miR inhibitor control for 24 h. Total RNA was isolated and <italic toggle="yes">hsa_circ_0099188</italic> levels were determined using SYBR Green RT-qPCR assays (<italic toggle="yes">N</italic>=3; bars, SEM). (*<italic toggle="yes">P</italic>&#x0003c;0.05, **<italic toggle="yes">P</italic>&#x0003c;0.01).</p></caption><graphic xlink:href="nihms-2102340-f0003" position="float"/></fig><fig position="float" id="F4"><label>Figure 4.</label><caption><title>Transfection of <italic toggle="yes">hsa_circ_0099188</italic> siRNA knocks down endogenous <italic toggle="yes">hsa_circ_0099188</italic> levels while upregulating <italic toggle="yes">hsa-miR-381-3p</italic> in differentiated/enhanced THP-1 macrophages.</title><p id="P39">Differentiated/enhanced THP-1 macrophages were transfected with 25 nM of either si-<italic toggle="yes">hsa_circ_0099188</italic>#1, si-<italic toggle="yes">hsa_circ_0099188</italic>#2 siRNA or nontargeting siRNA control (siCtl). After 24 h, the endogenous levels of (A) <italic toggle="yes">hsa_circ_0099188</italic>, and (B) <italic toggle="yes">hsa-miR-381-3p</italic> were measured by RT-qPCR (<italic toggle="yes">N</italic> = 3; bars, SEM). (*<italic toggle="yes">P</italic> &#x0003c; 0.05, **<italic toggle="yes">P</italic> &#x0003c; 0.01, ***<italic toggle="yes">P</italic> &#x0003c; 0.001).</p></caption><graphic xlink:href="nihms-2102340-f0004" position="float"/></fig><fig position="float" id="F5"><label>Figure 5.</label><caption><title>CircRNA <italic toggle="yes">hsa_circ_0099188</italic> as downstream effector to MDI/MDI-GSH exposure for regulating <italic toggle="yes">hsa-miR-381-3p/PPP3CA/NOS2 and hsa-miR-381-3p/KLF4</italic> and KLF4-mediated M2 macrophage-associated markers and chemokines in macrophages.</title><p id="P40">Differentiated/enhanced THP-1 macrophages were transfected with 25 nM of either si-<italic toggle="yes">hsa_circ_0099188</italic>#1 or nontargeting siRNA control (siCtl) for 24h followed by treating either with or without 10 &#x003bc;M MDI-GSH conjugate for 24h. Total RNA were isolated from macrophages with indicated treatments/transfections by <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, reverse transcribed, and subjected to SYBR green based or TaqMan stem-loop miR RT-qPCR. The endogenous levels of (A) <italic toggle="yes">hsa_circ_0099188</italic> and (B) <italic toggle="yes">hsa-miR-381-3p</italic> as well as the calcineurin catalytic subunit alpha gene (C) <italic toggle="yes">PPP3CA</italic> and calcineurin/NFAT signaling regulated (E) <italic toggle="yes">NOS2</italic>. M2 macrophage-associated transcription factor (D) <italic toggle="yes">KLF4</italic>, markers (F) <italic toggle="yes">CD206</italic>, (G) <italic toggle="yes">TGM2</italic>, (H) <italic toggle="yes">CCL17</italic>, (I) <italic toggle="yes">CCL22</italic>, and (J) <italic toggle="yes">CCL24</italic> mRNA levels were determined in total RNA isolated from macrophages as indicated treatments (<italic toggle="yes">N</italic>=3; bars, SEM). (*<italic toggle="yes">P</italic>&#x0003c;0.05, **<italic toggle="yes">P</italic>&#x0003c;0.01, ***<italic toggle="yes">P</italic>&#x0003c;0.001 when compared to vehicle treated macrophages with transfection of or nontargeting siRNA control (siCtl); <sup>#</sup><italic toggle="yes">P</italic>&#x0003c;0.05, <sup>##</sup><italic toggle="yes">P</italic> &#x0003c; 0.01, <sup>###</sup><italic toggle="yes">P</italic> &#x0003c; 0.001, when compared to macrophages treated with 10 &#x003bc;M MDI-GSH conjugate as well as with transfection of indicated either si-<italic toggle="yes">hsa_circ_0099188</italic>#1 or nontargeting siRNA control (siCtl)).</p></caption><graphic xlink:href="nihms-2102340-f0005" position="float"/></fig><fig position="float" id="F6"><label>Figure 6.</label><caption><title>Overexpression of circular RNA <italic toggle="yes">hsa_circ_0099188</italic> led to the induction of <italic toggle="yes">PPP3CA, NOS2</italic>, as well as M2 macrophage-associated marker and chemokine transcripts in differentiated macrophages.</title><p id="P41">Differentiated/enhanced THP-1 macrophages were transfected with 2.5 &#x003bc;g of either pcDNA3.1<sup>(+)</sup>_Circ_Mini-<italic toggle="yes">hsa_circ_0099188</italic> or pcDNA3.1<sup>(+)</sup>_Circ_Mini vector plasmids for 48 h. Total RNA was isolated from plasmids transfected THP-1 macrophages using <italic toggle="yes">mirVana</italic><sup>&#x02122;</sup> miR isolation kit, reverse transcribed, and analyzed by SYBR green or TaqMan RT-qPCR. The transgene of circRNA (A) <italic toggle="yes">hsa_circ_0099188</italic>, and endogenous miRs (B) <italic toggle="yes">hsa-miR-381-3p</italic> as well as the endogenous (C) <italic toggle="yes">PPP3CA</italic>, (E) <italic toggle="yes">NOS2</italic> and M2 macrophage-associated genes (D) <italic toggle="yes">KLF4</italic>, (F) <italic toggle="yes">CD206</italic>, (G) <italic toggle="yes">TGM2</italic>, (H) <italic toggle="yes">CCL17</italic> (I) <italic toggle="yes">CCL22</italic>, and (J) <italic toggle="yes">CCL24</italic> transcript levels were determined by RT-qPCR (<italic toggle="yes">N</italic>=3; bars, SEM). (*<italic toggle="yes">P</italic>&#x0003c;0.05, **<italic toggle="yes">P</italic>&#x0003c;0.01, ***<italic toggle="yes">P</italic>&#x0003c;0.001).</p></caption><graphic xlink:href="nihms-2102340-f0006" position="float"/></fig><fig position="float" id="F7"><label>Figure 7.</label><caption><title>Role of circRNA <italic toggle="yes">hsa_circ_0099188</italic> in chemokine secretion and regulation of T-cell and eosinophil chemotaxis/migration in macrophages.</title><p id="P42">Cell-free conditioned media were collected from THP-1 macrophages transfected with either <italic toggle="yes">hsa_circ_0099188</italic> overexpression plasmid or the empty vector for 48 h. The levels of secreted proteins (A) CCL17, (B) CCL22, and (C) CCL24 in the conditioned media from <italic toggle="yes">hsa_circ_0099188</italic>-overexpressing or vector-transfected THP-1 macrophages were quantified by ELISA following the manufacturer&#x02019;s instructions. The conditioned media were used as chemoattractant to attract (D) Jurkat T-cells clone E6-1 or differentiated (E) HL-60 C_15 eosinophils. T-cell and eosinophil migration responding to the conditioned media was measured after 6 h. The percentage of cells migrating towards the bottom chamber is shown. (*<italic toggle="yes">P</italic>&#x0003c;0.05, **<italic toggle="yes">P</italic>&#x0003c;0.01, ***<italic toggle="yes">P</italic>&#x0003c;0.001).</p></caption><graphic xlink:href="nihms-2102340-f0007" position="float"/></fig><fig position="float" id="F8"><label>Figure 8.</label><caption><title>Proposed mechanisms by which MDI-GSH conjugate exposure induces <italic toggle="yes">NOS2</italic> and M2 macrophage-associated markers and chemokine <italic toggle="yes">CCL17, CCL22</italic>, and <italic toggle="yes">CCL24</italic>, via <italic toggle="yes">hsa_circ_0099188/hsa-miR-381-3p</italic> regulated PPP3CA and KLF4 activation in macrophages.</title><p id="P43">MDI: 4,4&#x02032;-methylene diphenyl diisocyanate; TFs: transcription factors; CDS: coding sequences; PPP3CA: Protein phosphatase 3 catalytic subunit alpha; KLF4: Kr&#x000fc;ppel-like factor 4. Note. Some illustrated schematics were obtained from motifolio templates (Motifolio Inc., Ellicott City, MD, USA).</p></caption><graphic xlink:href="nihms-2102340-f0008" position="float"/></fig></floats-group></article>