Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Clinical Sciences and Community Health University of Milano, Paediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Respir Res. 2017 Dec 19;18(1):211. doi: 10.1186/s12931-017-0691-x.
The role of neutrophil elastase (NE) is poorly understood in bronchiectasis because of the lack of preclinical data and so most of the assumptions made about NE inhibitor potential benefit is based on data from CF. In this context, NE seems to be a predictor of long-term clinical outcomes and a possible target of treatment. In order to better evaluate the role of NE in bronchiectasis, a systematic search of scientific evidence was performed.Two investigators independently performed the search on PubMed and included studies published up to May 15, 2017 according to predefined criteria. A final pool of 31 studies was included in the systematic review, with a total of 2679 patients. For each paper data of interest were extracted and reported in table.In this review sputum NE has proved useful as an inflammatory marker both in stable state bronchiectasis and during exacerbations and local or systemic antibiotic treatment. NE has also been associated with risk of exacerbation, time to next exacerbation and all-cause mortality. This study reviews also the role of NE as a specific target of treatment in bronchiectasis. Inhibition of NE is at a very early stage and future interventional studies should evaluate safety and efficacy for new molecules and formulations.
中性粒细胞弹性蛋白酶 (NE) 在支气管扩张中的作用尚不清楚，因为缺乏临床前数据，因此关于 NE 抑制剂潜在益处的大多数假设都是基于 CF 数据做出的。在这种情况下，NE 似乎是长期临床结果的预测指标，也是治疗的可能靶点。为了更好地评估 NE 在支气管扩张中的作用，我们对科学证据进行了系统搜索。两名研究人员独立在 PubMed 上进行了搜索，并根据预设标准纳入了截至 2017 年 5 月 15 日发表的研究。系统评价共纳入 31 项研究，共有 2679 名患者。对于每篇论文，我们都提取了感兴趣的数据并在表中报告。在本综述中，痰中的 NE 已被证明可作为稳定期支气管扩张和加重期以及局部或全身抗生素治疗时的炎症标志物。NE 还与加重风险、下一次加重时间和全因死亡率相关。本研究还回顾了 NE 作为支气管扩张治疗的特定靶点的作用。NE 的抑制处于非常早期的阶段，未来的干预性研究应评估新分子和制剂的安全性和疗效。
