College of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia 750004, China.
Ningxia Key Laboratory of Clinical and Pathological Microbiology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, China.
Oxid Med Cell Longev. 2018 Apr 23;2018:6567578. doi: 10.1155/2018/6567578. eCollection 2018.
Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible. Cigarette smoke and oxidative stress are main etiological risks in COPD. Interestingly, recent studies suggest a considerable overlap between chronic bronchitis (CB) phenotypic COPD and cystic fibrosis (CF), a common fatal hereditary lung disease caused by genetic mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Phenotypically, CF and COPD are associated with an impaired mucociliary clearance and mucus hypersecretion, although they are two distinct entities of unrelated origin. Mechanistically, the cigarette smoke-increased oxidative stress-induced CFTR dysfunction is implicated in COPD. This underscores CFTR in understanding and improving therapies for COPD by altering CFTR function with antioxidant agents and CFTR modulators as a great promising strategy for COPD treatments. Indeed, treatments that restore CFTR function, including mucolytic therapy, antioxidant ROS scavenger, CFTR stimulator (roflumilast), and CFTR potentiator (ivacaftor), have been tested in COPD. This review article is aimed at summarizing the molecular, cellular, and clinical evidence of oxidative stress, particularly the cigarette smoke-increased oxidative stress-impaired CFTR function, as well as signaling pathways of CFTR involved in the pathogenesis of COPD, with a highlight on the therapeutic potential of targeting CFTR for COPD treatment.
慢性阻塞性肺疾病(COPD)是一种以气流受限为特征的疾病状态,这种气流受限不能完全逆转。香烟烟雾和氧化应激是 COPD 的主要病因风险。有趣的是,最近的研究表明,慢性支气管炎(CB)表型 COPD 与囊性纤维化(CF)之间存在相当大的重叠,CF 是一种常见的致命遗传性肺部疾病,由囊性纤维化跨膜电导调节因子(CFTR)基因突变引起。表型上,CF 和 COPD 与受损的黏液纤毛清除和黏液过度分泌有关,尽管它们是两个不同的、无关联的实体。从机制上讲,香烟烟雾增加的氧化应激诱导的 CFTR 功能障碍与 COPD 有关。这强调了 CFTR 在理解和改善 COPD 治疗中的作用,通过使用抗氧化剂和 CFTR 调节剂改变 CFTR 功能是 COPD 治疗的一个很有前途的策略。事实上,已经在 COPD 中测试了恢复 CFTR 功能的治疗方法,包括黏液溶解疗法、抗氧化 ROS 清除剂、CFTR 刺激剂(罗氟司特)和 CFTR 增强剂(ivacaftor)。本文旨在总结氧化应激的分子、细胞和临床证据,特别是香烟烟雾增加的氧化应激导致 CFTR 功能障碍,以及 CFTR 参与 COPD 发病机制的信号通路,并强调靶向 CFTR 治疗 COPD 的治疗潜力。