De Volder Joyceline, Vereecke Lars, Joos Guy, Maes Tania
Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
VIB Inflammation Research Center, Ghent, Belgium; Ghent Gut Inflammation Group (GGIG), Ghent University, Belgium; Department of Rheumatology, Ghent University Hospital, Belgium.
Biochem Pharmacol. 2020 Dec;182:114292. doi: 10.1016/j.bcp.2020.114292. Epub 2020 Oct 17.
Suppression of airway inflammation with inhaled corticosteroids has been the key therapeutic approach for asthma for many years. Identification of inflammatory phenotypes in asthma has moreover led to important breakthroughs, e.g. with specific targeting of the IL-5 pathway as add-on treatment in difficult-to-treat eosinophilic asthma. However, the impact of interfering with the neutrophilic component in asthma is less documented and understood. This review provides an overview of established and recent insights with regard to the role of neutrophils in asthma, focusing on research in humans. We will describe the main drivers of neutrophilic responses in asthma, the heterogeneity in neutrophils and how they could contribute to asthma pathogenesis. Moreover we will describe findings from clinical trials, in which neutrophilic inflammation was targeted. It is clear that neutrophils are important actors in asthma development and play a role in exacerbations. However, more research is required to fully understand how modulation of neutrophil activity could lead to a significant benefit in asthma patients with airway neutrophilia.
多年来，吸入性糖皮质激素抑制气道炎症一直是哮喘的关键治疗方法。此外，哮喘炎症表型的鉴定带来了重要突破，例如在难治性嗜酸性粒细胞性哮喘的附加治疗中特异性靶向白细胞介素-5途径。然而，关于干扰哮喘中性粒细胞成分的影响，相关记录和了解较少。本综述概述了关于中性粒细胞在哮喘中作用的既定观点和最新见解，重点关注人类研究。我们将描述哮喘中性粒细胞反应的主要驱动因素、中性粒细胞的异质性以及它们如何促进哮喘发病机制。此外，我们将描述针对中性粒细胞炎症的临床试验结果。很明显，中性粒细胞是哮喘发展中的重要因素，并在病情加重中起作用。然而，需要更多研究来充分了解调节中性粒细胞活性如何能给气道中性粒细胞增多的哮喘患者带来显著益处。
