Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK.
Int J Chron Obstruct Pulmon Dis. 2021 Jul 30;16:2227-2242. doi: 10.2147/COPD.S266394. eCollection 2021.
Chronic obstructive pulmonary disease (COPD) is a progressive lung condition affecting 10% of the global population over 45 years. Currently, there are no disease-modifying treatments, with current therapies treating only the symptoms of the disease. COPD is an inflammatory disease, with a high infiltration of leukocytes being found within the lung of COPD patients. These leukocytes, if not kept in check, damage the lung, leading to the pathophysiology associated with the disease. In this review, we focus on the main leukocytes found within the COPD lung, describing how the release of chemokines from the damaged epithelial lining recruits these cells into the lung. Once present, these cells become active and may be driven towards a more pro-inflammatory phenotype. These cells release their own subtypes of inflammatory mediators, growth factors and proteases which can all lead to airway remodeling, mucus hypersecretion and emphysema. Finally, we describe some of the current therapies and potential new targets that could be utilized to target aberrant leukocyte function in the COPD lung. Here, we focus on old therapies such as statins and corticosteroids, but also look at the emerging field of biologics describing those which have been tested in COPD already and potential new monoclonal antibodies which are under review.
慢性阻塞性肺疾病（COPD）是一种影响全球 45 岁以上人群 10%的进行性肺部疾病。目前，尚无疾病修饰治疗方法，目前的治疗方法仅针对疾病的症状。COPD 是一种炎症性疾病，COPD 患者的肺部有大量白细胞浸润。如果这些白细胞不受控制，就会损害肺部，导致与疾病相关的病理生理学变化。在这篇综述中，我们重点介绍了 COPD 肺部中发现的主要白细胞，描述了受损的上皮衬里释放趋化因子如何招募这些细胞进入肺部。一旦存在，这些细胞就会变得活跃，并可能向更具促炎表型发展。这些细胞释放自己的炎症介质、生长因子和蛋白酶亚型，所有这些都可能导致气道重塑、黏液分泌过多和肺气肿。最后，我们描述了一些目前的治疗方法和潜在的新靶点，这些靶点可以用于靶向 COPD 肺部中异常的白细胞功能。在这里，我们重点介绍了他汀类药物和皮质类固醇等旧疗法，同时也关注了生物制剂这一新兴领域，描述了已经在 COPD 中进行测试的生物制剂和正在审查的潜在新单克隆抗体。
