Perks B, Shute J K
Department of Medical Specialties, Southampton General Hospital, Southampton, United Kingdom.
Am J Respir Crit Care Med. 2000 Nov;162(5):1767-72. doi: 10.1164/ajrccm.162.5.9908107.
Infection of the cystic fibrosis (CF) airways elicits an exaggerated, interleukin-8 (IL-8) mediated, neutrophil inflammatory response. Necrosing neutrophils release DNA and actin into the airways, increasing the viscoelasticity of airway secretions. Mucolytics aim to improve airway clearance by reducing this viscoelasticity. DNase I reduces the viscoelasticity of CF sputum, and a human recombinant form of this enzyme is widely administered to patients with CF. Gelsolin, which cleaves actin polymers, is also known to reduce CF sputum viscosity in vitro, and it has been proposed as a future mucolytic agent. We have shown that the anionic polymers DNA and actin bind and mask immunologic recognition of the basic peptide IL-8 and prevent this chemokine from binding to neutrophil receptors. Reduction of CF sputum viscosity by DNase I or gelsolin in vitro was demonstrated to increase the proportion of free IL-8 and the IL-8-dependent neutrophil chemotactic activity of sputum supernatants. We hypothesize that an electrostatic interaction between polymer and chemokine may limit the inflammatory potential of the latter, but that this interaction may be weakened by polymer cleavage. The potential risk of increased inflammation via this mechanism suggests a caveat should be attendant on treatment of patients with CF with these mucolytic agents.
囊性纤维化(CF)气道感染引发过度的、由白细胞介素8(IL-8)介导的中性粒细胞炎症反应。坏死的中性粒细胞将DNA和肌动蛋白释放到气道中,增加了气道分泌物的粘弹性。粘液溶解剂旨在通过降低这种粘弹性来改善气道清除功能。脱氧核糖核酸酶I(DNase I)可降低CF痰液的粘弹性,这种酶的重组人形式已广泛应用于CF患者。凝溶胶蛋白可切割肌动蛋白聚合物,在体外也已知其可降低CF痰液粘度,有人提议将其作为未来的粘液溶解剂。我们已经表明,阴离子聚合物DNA和肌动蛋白结合并掩盖了碱性肽IL-8的免疫识别,阻止这种趋化因子与中性粒细胞受体结合。体外实验证明,用DNase I或凝溶胶蛋白降低CF痰液粘度可增加游离IL-8的比例以及痰液上清液中依赖IL-8的中性粒细胞趋化活性。我们推测聚合物与趋化因子之间的静电相互作用可能会限制后者的炎症潜能,但这种相互作用可能会因聚合物的切割而减弱。通过这种机制增加炎症的潜在风险表明,在使用这些粘液溶解剂治疗CF患者时应谨慎。