it has been discovered that certain flavonoids will inhibit the production and secretion of il - 6 from human mast cells and macrophages , and that this effect provides a potential treatment of those inflammatory conditions that are mediated by or involve elevated levels of that messenger cytokine ( see background section above for a discussion of such diseases ). flavonoids have previously been reported to inhibit mast cell secretion ( middleton , e et al , biochemical pharmacology 43 : 1167 ( 1992 ) and other inflammatory processes ( see middleton et al ., 2000 above ), but there was no awareness of an effect of these compounds on il - 6 . certain plant flavones ( in citrus fruit pulp , seeds , sea weed ) are being touted as anti - allergic , anti - inflammatory , anti - oxidant and cytoprotective with possible anti - cancer properties . i report here that only some flavones , such as quercetin , myrisetin , genistein , and kaempherol inhibit mast cell secretion of il - 6 , and reverse or relieve inflammatory conditions , such as coronary artery disease , asthma , atopic dermatitis , inflammatory bowel disease , interstitial cystitis , migraines , multiple sclerosis , and rheumatoid arthritis ( see expanded list above ). quercetin inhibits secretion from human mast cells ( kimata et al . allergy 30 : 501 ( 2000 )), and has also been used effectively for the treatment of chronic prostatitis ( shoskes et al ., urology 54 : 960 ( 1999 )). other flavonoids may have opposite effects . use of the term “ bioflavonoids ” or “ citrus flavonoids ” listed in certain commercial products , therefore , provides little information , and may include molecules that have detrimental effects . for instance , pycnogenol , marketed as an anti - inflammatory compound , actually promotes the secretion of inflammatory molecules in vitro . the present discovery of an inhibitory effect of certain flavonoids on the production and secretion of il - 6 from human mast cells and macrophages was unexpected , as such flavonoids had previously been shown to inhibit degranulation of mast cells , and , as discussed below , i have now observed that il - 6 is not stored in mast cell granules , but rather in small ( 20 - 70 um ) vesicles . nor is it obvious to the art , as no other compound was known to inhibit il - 6 secretion from mast cells or macrophages . it will be shown below that il - 1 induces selective secretion of il - 6 , but not granule - stored tryptase , from hcbmc or hhmc - 1 cells . stimulation of hmc - l cells with il - 1 and tnf - α lead to a 10 - fold synergistic increase in il - 6 production , still without tryptase arising only from degranulation that in this case does not occur . ultrastructural immunogold localization indicates that il - 6 is compartmentalized in 20 - 70 nm - size vesicles and is excluded from the secretory granules . these findings indicate that il - 1 induces selective secretion of il - 6 through a mechanism distinct from degranulation . the compositions of the invention may be formulated in any standard means of introducing pharmaceuticals orally or parenterally into a patient , e . g ., by means of tablets or capsules , or administering topically by means of creams , ointments and transdermal formulations in the case of skin disease . standard excipients and carriers for the active ingredients of the inventive compositions are described in remington &# 39 ; s pharmaceutical sciences , mack publishing co ., easton , pa . the preferred flavonoid compounds for inhibiting the release of il - 6 from mast cell vesicles are quercetin , myrisetin , genistein and kaempferol ; quercetin is highly preferred . in order to increase absorption , these flavonoids may be administered as their glycoside derivatives . these compounds may be obtained from kaden biochemicals , hillsborough , n . j . the preferred concentration range of the flavonoid components of oral formulations are 10 - 3 , 000 mg per tablet or capsule . the number of capsules or tablets to be taken per day is determined by the nature and severity of the medical condition , and is readily determinable by the patient &# 39 ; s physician . other representative formulations are described in the examples below . human cord blood - derived mast cells ( hcbmc ) were grown from cd34 + progenitor mononuclear umbilical cells isolated from umbilical cord blood by positive selection of ac133 ( cd 133 +/ cd34 + high ) cells by magnetic cell sorting ( miltenyi biotec , auburn , calif .). cd34 + cells were then cultured in isocove &# 39 ; s modified dulbecco &# 39 ; s medium ( 1mdm ) containing 100 ng / ml stem cell factor ( from amgen , thousand oaks , calif .) plus test components in 10 % fbs at 37 ° c . in 5 % co 2 balanced air . by 10 weeks , 95 % of the cells in culture could be identified as mast cells by immuno - staining for tryptase . hcbmc were washed three times in pbs and resuspended in culture medium ( 1 × 10 5 cells / 200 ul sample ). test substances , e . g ., il - 1 were added and cells were incubated at 37 ° c . in 5 % co 2 for six hours for dose - response experiments or for the indicated times in time - course experiments . il - 6 and tryptase were measured in cell - free supernatant fluids by elisa ( r & amp ; d systems , minneapolis , minn .) and fluoroenzymeimmunoassay ( pharmacia , uppsala , sweden ), respectively . human leukemic mast cells ( hmc - 1 ) was obtained from dr . butterfield ( mayo clinic , rochester , minn . ), and cultured in imdm medium supplemented with 10 % fbs , pbs and 2 μm alpha . thioglycerol . hcbmc or hmc - i cells 2 × 10 5 / 200 μl sample were stimulated in full culture medium as indicated . dose - response of il - 6 and tryptase secretion from hcbmc and hmc - 1 cells were tested after stimulation for six hours with indicated concentrations of il - 1 or other stimuli . time - course of il . 6 production induced by 50 ng / ml of il - 1 a from cbmc or by 10 ng / ml il - 1 from hmc - 1 cells could be tested . the data in general represent means +/− standard error of the mean from 3 to 4 experiments done in duplicate for each cell type used . this technique was employed to localize il - 6 . hcbmc or hmc - 1 cells were fixed with 5 % acrolein and embedded in lr white . microthin sections were cut and these were mounted on grids . for il - 6 localization , grids were incubated with 6 . 3 μg / ml ( cbmc ) or 20 μg / ml ( hmc - 1 ) polyclonal rabbit antihuman il - 6 antibody ( biologicals ) overnight , followed by goat anti - rabbit igg conjugated with 10 nm gold particles ( 1 : 30 , polyscience , warrington , pa .). monoclonal mouse anti - human tryptase antibody ( chemicon , tenecula , calif .) at 40 μg / ml ), followed by goat anti - mouse igg conjugated with 10 nm gold particles , was used to localize tryptase . processed grids were stained with uranylacetate and lead citrate and viewed with a cm20 transmission electron microscope . 11 - 6 was localized in microvesicles ( 20 - 70 nm ) and tryptase in mast cell granules . negative controls were processed similarly , but without the primary antibody . magnification was 17 , 800 ×. the results are shown in fig1 . curved arrows indicate vescicles ( about 50 nm ) containing il - 6 shown by bound electron - dense gold particles . note the clusters of gold particles ( dark dots ) inside ( white curved arrows ) and outside ( dark curved arrows ) of the cell ( bar = 50 nm ). in this experiment , the effect of quercetin on the production of il - 6 and tnf - a from rat peritoneal macrophages and human mast cells that are involved in inflammation was studied . the results are shown in table 1 . the results indicated that quercetin almost completely inhibited the production of il - 6 from both cell types , and also greatly inhibited the production of tnf - a from both cell types . in this experiment , the inhibition of il - 6 secretion by quercetin from hcbmc was studied in the presence of anti - ige , an inhibitor of the stimulating effect of ige on production of il - 6 . the results are shown in table 2 . the controls showed that anti - ige antibody itself had no effect on the production and release of il - 6 . however , quercetin had a profound inhibitory effect on il - 6 production and release in the presence of antibody . s another experiment examining the inhibition of the release of il - 6 from hcbmc by quercetin , with the results set forth graphically in fig3 . in the graph , column 1 shows the spontaneous release of il - 6 from the cultured mast cells . column 2 shows the increase in il - 6 secretion after incubation of cells with anti - ige alone . column 3 shows incubation of the cells with 0 . 1 mm quercetin for 30 mins ., followed by incubation of the cells for 6 hrs . with amti - ige . the experiment was replicated 6 times per variable . the results , which are statistically significant , show that quercetin profoundly inhibited the secretion of il - 6 from mast cells whose production of il - 6 had been stimulated by anti - ige antibodies . the effects of anti - ige , alone and or after with the flavonoid n on the secretion of il - 6 from hcbmc . the compositions of fig3 are shown below . bar # drug and concentration 1 spontaneous 2 anti - ige * 3 quercetin , 100 μm 4 ″ 10 μm 5 ″ 1 μm 6 ″ 0 . 1 μm 7 ″ 0 . 01 μm 8 morin 100 μm 9 ″ 10 μm 10 ″ 1 μm 11 ″ 0 . 1 μm 12 ″ 0 . 01 μm 13 cromolyn 100 μm as anticipated , anti - ige more than doubled the secretion of il - 6 over the spontaneous control . the two highest concentrations of quercetin greatly reduced the secretion of il - 6 compared to either the spontaneous control or the anti - ige value alone ; the three lower concentration of the flavonoid only slightly reduced the secretion of the cytokine compared to ige alone . the two concentrations of the flavonoid morin had only a small effect on il - 6 secretion in the presence of anti - ige ; so did a high concentration of cromolyn , but this effect was not statistically significant . these results demonstrate the specificity of the flavonoid effect that is quercetin , but not morin , inhibited the anti - ige - mediated increase in the secretion of il - 6 from human mast cells . in this experiment , the selective secretion of il - 6 from hcbmc in the absence and presence of crh , il - 1 or anti - ige antibody was studied . in parallel incubations , the effect of each of these agents on the secretion of tryptase from mast cell granules was also examined . the results are shown in table 3 . low concentrations of crh , il - 1 and anti - ige antibody profoundly increased the production and secretion of il - 6 . neither crh nor il - 1 increased the secretion of the marker tryptase , suggesting that neither of these agents stimulated degranulation of the cells . in contrast , anti - ige antibody greatly increased the secretion of this marker protein . in this experiment , the effects of quercetin , alone or together with il - 1 , on the production and secretion of il - 6 from human mast cells was studied . the results are shown in table 4 . the results indicate that neither quercetin alone northe solvent ( dmso ) in which it was dissolved had a significant effect on il - 6 secretion , even though the highest concentration slightly decreased the spontaneous formation of il - 6 . il - 1 alone caused a great increase in il - 6 . this effect of il - 1 on il - 6 was greatly inhibited by quercetin in a dose - dependent fashion . it is known ( marshall et al . j . clin . invest . 97 : 1122 ( 1996 )) that interleukin - 10 ( il - 10 ) can inhibit il - 6 production from rat peritoneal mast cells stimulated by lipopolysaccharide ( lps ) and anti - ige antibody , even though il - 10 did not influence histamine release . no one has examined this phenomenon in human mast cells . the effect of il - 10 on hmc - 1 leukemic cells producing il - 6 , especially cells stimulated by il - 1 that induces selective release of il - 6 , was studied alone or together with a flavonoid compound . the results are shown in table 5 . the results of these experiments indicate that a combination of low doses of il - 10 and quercetin had a synergistic inhibitory effect on il - 6 secretion from hmc - 1 cells . this combination may , therefore , be effective in the treatment of inflammatory diseases presenting with high il - 6 , especially systemic mastocytosis . certain histamine - i receptor antagonists have been shown to inhibit cytokine secretion from human leukemic mast cells ( lippert et al , exp . dermatol . 2 : 118 ( 2000 ). azelastine , like olopatadine , is a histamine - 1 receptor antagonist , and has been reported to inhibit tryptase secretion ( lytinas et al ., allergy asthma proc . 23 : ( 2002 )). here we show ( fig4 ) that azelastine is a potent inhibitor of il - 6 secretion from hcbmc ; this inhibition was dose - dependent and , at 60 μm , this compound reduced il - 6 secretion to below control levels . azelastine . hcl may be obtained from wallace laboratories , cranbury , n . j . it may also be obtained from the same company as astelin , a nasal spray containing 0 . 1 % azelastine . hcl in aqueous solution . in vivo , azelastine may be administered at a dosage of about 2 to 100 mg per 70 kg body weight per day . at concentrations below 1 μm azelastine was ineffective ; however , when added together with 10 μm quercetin , the combination inhibited il - 6 secretion from hcbmc ( table 6 ). these results , taken together , demonstrate that certain flavonoid compounds inhibit the production and secretion of il - 6 from human mast cells that are stimulated by different inflammatory stimuli .
the invention is a method of treating il - 6 - mediated inflammatory diseases with flavonoid inhibitors of the production and secretion of il - 6 from human or animal mast or macrophage cells . the most effective flavonoid compounds include quercetin , kaempferol , myricetin and genistein , and these can be administered alone or in combination with s - adenosylmethionine , folic acid , interleukin - 10 or a histamine - 1 receptor antagonist such as azelastine .