Institutes of Integrative Medicine, Heilongjiang Provincial Hospital of Traditional Chinese Medicine, Heilongjiang, China.
Medicine (Baltimore). 2024 Aug 23;103(34):e39342. doi: 10.1097/MD.0000000000039342.
Asthma is a highly prevalent chronic inflammatory disease characterized by variable airflow obstruction and airway hyperresponsiveness. Neutrophilic asthma (NA) is classified as "type 2 low" asthma, defined as 65% or more neutrophils in the total cell count. There is no clear consensus on the pathogenesis of NA, and the accumulation of neutrophils and release of neutrophil extracellular traps (NETs) may be responsible for its development. A NET is a large extracellular meshwork comprising cell membrane and granule proteins. It is a powerful antimicrobial defence system that traps, neutralizes, and kills bacteria, fungi, viruses, and parasites and prevents the spread of microorganisms. However, dysregulation of NETs may lead to chronic airway inflammation, is associated with worsening of asthma, and has been the subject of major research advances in chronic lung diseases in recent years. NA is insensitive to steroids, and there is a need to find effective biomarkers as targets for the treatment of NA to replace steroids. This review analyses the mechanisms of action between asthmatic neutrophil recruitment and NET formation and their impact on NA development. It also discusses their possible therapeutic significance in NA, summarizing the advances made in NA agents and providing strategies for the treatment of NA, provide a theoretical basis for the development of new therapeutic drugs, thereby improving the level of diagnosis and treatment, and promoting the research progress in the field of asthma.
哮喘是一种高度流行的慢性炎症性疾病，其特征是气流阻塞和气道高反应性的可变性。中性粒细胞性哮喘（NA）被归类为“2 型低”哮喘，定义为总细胞计数中 65%或更多的中性粒细胞。NA 的发病机制尚无明确共识，中性粒细胞的积累和中性粒细胞细胞外陷阱（NETs）的释放可能是其发展的原因。NET 是由细胞膜和颗粒蛋白组成的大型细胞外网状物。它是一种强大的抗菌防御系统，可捕获、中和和杀死细菌、真菌、病毒和寄生虫，并防止微生物的传播。然而，NETs 的失调可能导致慢性气道炎症，与哮喘的恶化有关，并且近年来一直是慢性肺部疾病研究的主要进展领域。NA 对类固醇不敏感，需要寻找有效的生物标志物作为治疗 NA 的靶点来替代类固醇。这篇综述分析了哮喘中性粒细胞募集和 NET 形成之间的作用机制及其对 NA 发展的影响。它还讨论了它们在 NA 中的可能治疗意义，总结了 NA 制剂的进展，并为 NA 的治疗提供了策略，为开发新的治疗药物提供了理论基础，从而提高了诊断和治疗水平，并促进了哮喘领域的研究进展。
