1 Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR) 1087, l'Institut du Thorax, Nantes, France.
Am J Respir Crit Care Med. 2014 Nov 15;190(10):1094-101. doi: 10.1164/rccm.201405-0859PP.
Asthma is a major chronic disease ranging from mild to severe refractory disease and is classified into various clinical phenotypes. Severe asthma is difficult to treat and frequently requires high doses of systemic steroids. In some cases, severe asthma even responds poorly to steroids. Several studies have suggested a central role of IL-17 (also called IL-17A) in severe asthma. Indeed, high levels of IL-17 are found in induced sputum and bronchial biopsies obtained from patients with severe asthma. The recent identification of a steroid-insensitive pathogenic Th17 pathway is therefore of major interest. In addition, IL-17A has been described in multiple aspects of asthma pathogenesis, including structural alterations of epithelial cells and smooth muscle contraction. In this perspective article, we frame the topic of IL-17A effects in severe asthma by reviewing updated information from human studies. We summarize and discuss the implications of IL-17 in the induction of neutrophilic airway inflammation, steroid insensitivity, the epithelial cell profile, and airway remodeling.
哮喘是一种主要的慢性疾病,从轻到重不等,包括各种临床表型。重度哮喘难以治疗,经常需要大剂量的全身类固醇。在某些情况下,重度哮喘甚至对类固醇反应不佳。几项研究表明白细胞介素-17(也称为白细胞介素-17A)在重度哮喘中起核心作用。事实上,在重度哮喘患者的诱导痰和支气管活检中发现高水平的白细胞介素-17。因此,最近发现的类固醇不敏感的致病性 Th17 途径引起了广泛关注。此外,白细胞介素-17A 已在哮喘发病机制的多个方面得到描述,包括上皮细胞的结构改变和平滑肌收缩。在这篇观点文章中,我们通过回顾来自人类研究的最新信息,来阐述白细胞介素-17A 在重度哮喘中的作用。我们总结并讨论了白细胞介素-17 在诱导中性粒细胞性气道炎症、类固醇不敏感性、上皮细胞特征和气道重塑中的作用。
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