Liang Cheng-Cheng, Zhao Ji, Zhang Yan-Qiu, Chen Jian, Wang Yong
Department of Intensive Care Unit, Huaibei Miners General Hospital, China.
J Int Med Res. 2025 Jun;53(6):3000605251352789. doi: 10.1177/03000605251352789. Epub 2025 Jun 28.
Neutrophil elastase is a serine protease secreted by neutrophils that plays a crucial role in the onset and progression of various respiratory diseases. The imbalance between neutrophil elastase and its endogenous inhibitors can contribute to the onset and progression of respiratory diseases such as chronic obstructive pulmonary disease, cystic fibrosis, bronchiectasis, and acute respiratory distress syndrome. The excessive release of neutrophil elastase contributes to multiple pathophysiological processes, such as disruption of the alveolar-capillary barrier, oxidative stress and inflammatory responses, autophagy, and apoptosis. The use of neutrophil elastase as a biomarker in disease assessment and prognosis prediction as well as the potential of neutrophil elastase inhibitors in clinical treatment have shown broad application prospects. Neutrophil elastase inhibitors have certain limitations such as off-target effects, poor lung bioavailability, cost considerations, and variability in patient responses. This article reviews the literature on neutrophil elastase and its inhibitors in the field of respiratory diseases, aiming to provide new insights into the diagnosis and treatment of related respiratory diseases.
中性粒细胞弹性蛋白酶是中性粒细胞分泌的一种丝氨酸蛋白酶，在多种呼吸系统疾病的发生和发展中起关键作用。中性粒细胞弹性蛋白酶与其内源性抑制剂之间的失衡可导致慢性阻塞性肺疾病、囊性纤维化、支气管扩张和急性呼吸窘迫综合征等呼吸系统疾病的发生和发展。中性粒细胞弹性蛋白酶的过度释放会导致多种病理生理过程，如肺泡-毛细血管屏障破坏、氧化应激和炎症反应、自噬和凋亡。将中性粒细胞弹性蛋白酶用作疾病评估和预后预测的生物标志物以及中性粒细胞弹性蛋白酶抑制剂在临床治疗中的潜力已显示出广阔的应用前景。中性粒细胞弹性蛋白酶抑制剂存在一定局限性，如脱靶效应、肺部生物利用度差、成本因素以及患者反应的变异性。本文综述了呼吸系统疾病领域中关于中性粒细胞弹性蛋白酶及其抑制剂的文献，旨在为相关呼吸系统疾病的诊断和治疗提供新的见解。
