Secretory phospholipase A₂ and airway inflammation and hyperresponsiveness.

Phospholipases mediate the release of arachidonic acid from membrane phospholipids, enabling the subsequent metabolism to potent inflammatory mediator products of cyclooxygenase and lipoxygenase enzymes, such as prostaglandins and leukotrienes. Cytosolic phospholipase A₂ has long been recognized as important, but newly characterized are secreted A₂ isoenzymes. These secretory phospholipases are released into the extracellular compartment on cell activation. Elevated levels have been found in allergic patients after allergen challenge. Earlier investigations in a mouse asthma model utilizing airway challenges with allergen showed an important role for cysteinyl leukotrienes in the airway remodeling process. Utilizing secretory phospholipase knockout mice, group X deficiency significantly diminished the airway goblet cell metaplasia, mucus hypersecretion, increased airway smooth muscle mass, and subepithelial fibrosis observed in wild type mice after allergen challenge. The mechanism is likely through impaired generation of cysteinyl leukotrienes in the knockout mice. Recent human investigation in patients with exercise induced bronchoconstriction is supportive of a role of secretory phospholipase, directing attention to these enzymes as particularly attractive pharmacologic targets in asthma.