Role of neutrophil elastase in hypersecretion during COPD exacerbations, and proposed therapies.
A common feature of COPD and other chronic lung diseases is hypersecretion of mucus into the airways, causing peripheral airway plugging and further airflow obstruction. The mucus is secreted by goblet cells, which are present in excessive numbers in COPD. This review describes how neutrophils in the airways of COPD patients stimulate the goblet cells to secrete their products. Recent findings on the mechanisms of neutrophil stimulation of goblet cell degranulation are discussed. These implicate the proteolytic enzyme elastase and cell surface adhesion molecules, and provide a basis for the investigation of potential novel therapies.
Nadel
J A
JA
Cardiovascular Research Institute, Departments of Medicine and Physiology, University of California, San Francisco, CA 94143-0130, USA. janadel@itsa.ucsf.edu
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015415:Biomarkers; D002465:Cell Movement / Q000187:drug effects; D002630:Chemotactic Factors / Q000627:therapeutic use*; D020397:Goblet Cells / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007930:Leucine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors / Q000378:metabolism*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D009093:Mucus / Q000201:enzymology; D009504:Neutrophils / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism*; D012008:Recurrence; D012137:Respiratory System / Q000378:metabolism* / Q000473:pathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D002630:Chemotactic Factors; C071244:N-(9H-(2,7-dimethylfluoren-9-ylmethoxy)carbonyl)leucine; D019272:Leukocyte Elastase; D007930:Leucine