College of Medicine, University of Sharjah , Sharjah , United Arab Emirates.
Sharjah Institute for Medical Research, University of Sharjah , Sharjah , United Arab Emirates.
Expert Rev Respir Med. 2019 Nov;13(11):1057-1068. doi: 10.1080/17476348.2019.1666002. Epub 2019 Sep 17.
: Asthma is a respiratory disorder typically characterized by T-helper type 2 (Th2) inflammation that is mediated by cytokines, including IL-4, IL-5, and IL-13. Pathophysiologically, airway inflammation involving prominent eosinophilia, elevated IgE synthesis, airway hyperresponsiveness, mucus hypersecretion, and airway remodeling manifest clinically in patients as wheezing, breathlessness, chest tightness and episodic coughing. However, the Th2 paradigm falls short in interpreting the full spectrum of asthma severity. : Severe asthmatics represent a distinct phenotype with their mixed pattern of neutrophilic-eosinophilic infiltration and glucocorticoid insensitivity making them refractory to currently available therapies. Th17 cells and their signature cytokine, IL-17, have been implicated in the development of severe asthma. Here, we review the contribution of IL-17 in the pathological features of asthma, gathered from both human and animal studies published in during the past 10 years, and briefly discuss the clinical implications of targeting IL-17 imbalance in asthmatic patients. : With advancement in our understanding of the role of IL-17 in asthma pathology, it is clear that IL-17 is a targetable pathway which may lead to improvement in clinical symptoms of asthma. However, further elucidation of the complex interactions unfurled by IL-17 is essential in the empirical development of effective therapeutic options for refractory asthmatics.
哮喘是一种呼吸系统疾病,通常以 Th2 炎症为特征,由细胞因子介导,包括 IL-4、IL-5 和 IL-13。从病理生理学角度来看,气道炎症涉及明显的嗜酸性粒细胞增多、IgE 合成升高、气道高反应性、黏液过度分泌和气道重塑,在临床上表现为喘息、呼吸困难、胸闷和阵发性咳嗽。然而,Th2 范式在解释哮喘严重程度的全貌方面存在不足。
严重哮喘患者表现出一种独特的表型,其中性粒细胞-嗜酸性粒细胞浸润的混合模式和糖皮质激素不敏感使他们对目前可用的治疗方法产生抵抗。Th17 细胞及其特征性细胞因子 IL-17 被认为与严重哮喘的发生有关。在这里,我们回顾了过去 10 年在人类和动物研究中发表的关于 IL-17 在哮喘病理特征中的作用的研究,简要讨论了靶向哮喘患者 IL-17 失衡的临床意义。
随着我们对 IL-17 在哮喘病理中的作用的理解的提高,很明显,IL-17 是一个可靶向的途径,这可能会改善哮喘的临床症状。然而,进一步阐明 IL-17 展开的复杂相互作用对于开发有效的治疗选择对于难治性哮喘患者至关重要。
Expert Rev Respir Med. 2019-9-17
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