Chen Zi, Bai Fang-Fang, Han Lu, Zhu Jin, Zheng Tao, Zhu Zhou, Zhou Lin-Fu
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Int Arch Allergy Immunol. 2018;175(1-2):5-15. doi: 10.1159/000484873. Epub 2018 Jan 6.
Severe asthma comprises only 5% of patients with asthma, but the burden it brings to the social health system accounts for more than half of all asthmatics. Clinical evidence shows that severe asthma is often linked to the recruitment and activation of neutrophils in the airways. However, the underlying molecular and immunological mechanisms of neutrophilia in severe asthma are not clear and currently available drugs exert only limited effects on neutrophilic inflammation. Great efforts are underway to address the mystery of neutrophilic inflammation in chronic respiratory disorders. Sialic acid-binding immunoglobulin-like lectins (Siglecs) are members of the immunoglobulin gene family. Of note, Siglec-9 is uniquely expressed by human neutrophils and monocytes, as well as a minor population of natural killer cells. Engaging this structure with antibodies or glycan ligands results in programmed cell death in human neutrophils. Intriguingly, the administration of Siglec-E antibody abolished the recruitment of neutrophils in mouse models of neutrophilic pulmonary inflammation in vivo. Given that neutrophils are probably a major culprit in the generation and perpetuation of inflammation, targeting Siglec-9 could be beneficial for the treatment of severe asthma, chronic obstructive pulmonary disease, and related pulmonary disorders characteristic of neutrophilia.
重度哮喘仅占哮喘患者的5%,但其给社会卫生系统带来的负担却占所有哮喘患者的一半以上。临床证据表明,重度哮喘通常与气道中嗜中性粒细胞的募集和活化有关。然而,重度哮喘中嗜中性粒细胞增多的潜在分子和免疫机制尚不清楚,目前可用的药物对嗜中性粒细胞炎症的作用有限。人们正在努力解开慢性呼吸系统疾病中嗜中性粒细胞炎症之谜。唾液酸结合免疫球蛋白样凝集素(Siglecs)是免疫球蛋白基因家族的成员。值得注意的是,Siglec-9仅在人类嗜中性粒细胞、单核细胞以及一小部分自然杀伤细胞中独特表达。用抗体或聚糖配体与这种结构结合会导致人类嗜中性粒细胞程序性细胞死亡。有趣的是,在体内嗜中性粒细胞性肺部炎症小鼠模型中,给予Siglec-E抗体可消除嗜中性粒细胞的募集。鉴于嗜中性粒细胞可能是炎症产生和持续存在的主要罪魁祸首,靶向Siglec-9可能对治疗重度哮喘、慢性阻塞性肺疾病以及具有嗜中性粒细胞增多特征的相关肺部疾病有益。