# The Role of Serine Proteases and Antiproteases in the Cystic Fibrosis Lung

**Authors:** Matthew S. Twigg, Simon Brockbank, Philip Lowry, S. Peter FitzGerald, Clifford Taggart, Sinéad Weldon

PMC · DOI: 10.1155/2015/293053 · 2015-06-21

## TL;DR

This paper explores how imbalanced protease and antiprotease levels in cystic fibrosis patients contribute to lung disease and inflammation.

## Contribution

The study highlights the role of antiproteases as potential therapeutic targets for cystic fibrosis lung disease.

## Key findings

- CF lungs have elevated neutrophil serine proteases that disrupt homeostasis.
- Protease/antiprotease imbalance leads to impaired mucus clearance and inflammation.
- Antiproteases are being explored as possible treatments for CF lung disease.

## Abstract

Cystic fibrosis (CF) lung disease is an inherited condition with an incidence rate of approximately 1 in 2500 new born babies. CF is characterized as chronic infection of the lung which leads to inflammation of the airway. Sputum from CF patients contains elevated levels of neutrophils and subsequently elevated levels of neutrophil serine proteases. In a healthy individual these proteases aid in the phagocytic process by degrading microbial peptides and are kept in homeostatic balance by cognate antiproteases. Due to the heavy neutrophil burden associated with CF the high concentration of neutrophil derived proteases overwhelms cognate antiproteases. The general effects of this protease/antiprotease imbalance are impaired mucus clearance, increased and self-perpetuating inflammation, and impaired immune responses and tissue. To restore this balance antiproteases have been suggested as potential therapeutics or therapeutic targets. As such a number of both endogenous and synthetic antiproteases have been trialed with mixed success as therapeutics for CF lung disease.

## Linked entities

- **Diseases:** cystic fibrosis (MONDO:0009061)

## Full-text entities

- **Genes:** PRTN3 (proteinase 3) [NCBI Gene 5657] {aka ACPA, AGP7, C-ANCA, CANCA, MBN, MBT}, Irak1 (interleukin-1 receptor-associated kinase 1) [NCBI Gene 363520] {aka RGD1563841}, ADAM17 (ADAM metallopeptidase domain 17) [NCBI Gene 6868] {aka ADAM18, CD156B, CSVP, HYPT16, NISBD, NISBD1}, MUC1 (mucin 1, cell surface associated) [NCBI Gene 4582] {aka ADMCKD, ADMCKD1, ADTKD2, CA 15-3, CD227, Ca15-3}, NFKBIA (NFKB inhibitor alpha) [NCBI Gene 4792] {aka EDAID2, IKBA, MAD-3, NFKBI}, PI3 (peptidase inhibitor 3) [NCBI Gene 5266] {aka ESI, SKALP, WAP3, WFDC14, cementoin}, CSF2 (colony stimulating factor 2) [NCBI Gene 1437] {aka CSF, GMCSF}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, ELN (elastin) [NCBI Gene 2006] {aka ADCL1, SVAS, WBS, WS}, ILF3 (interleukin enhancer binding factor 3) [NCBI Gene 3609] {aka CBTF, DRBF, DRBP76, MMP4, MPHOSPH4, MPP4}, MUC4 (mucin 4, cell surface associated) [NCBI Gene 4585] {aka ASGP, HSA276359, MUC-4}, CD14 (CD14 molecule) [NCBI Gene 929], IRAK1 (interleukin 1 receptor associated kinase 1) [NCBI Gene 3654] {aka IRAK, pelle}, CFTR (CF transmembrane conductance regulator) [NCBI Gene 1080] {aka ABC35, ABCC7, CF, CFTR/MRP, MRP7, TNR-CFTR}, Mpo (myeloperoxidase) [NCBI Gene 303413], CD2 (CD2 molecule) [NCBI Gene 914] {aka LFA-2, SRBC, T11}, PLG (plasminogen) [NCBI Gene 5340] {aka HAE4}, CTSG (cathepsin G) [NCBI Gene 1511] {aka CATG, CG}, MMP12 (matrix metallopeptidase 12) [NCBI Gene 4321] {aka HME, ME, MME, MMP-12}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, MMP9 (matrix metallopeptidase 9) [NCBI Gene 4318] {aka CLG4B, GELB, MANDP2, MMP-9}, SLPI (secretory leukocyte peptidase inhibitor) [NCBI Gene 6590] {aka ALK1, ALP, BLPI, HUSI, HUSI-1, HUSI-I}, Wfdc15b (WAP four-disulfide core domain 15B) [NCBI Gene 408230] {aka Pi3, Serpina1c, Skalp, Wfdc14}, SERPINA1 (serpin family A member 1) [NCBI Gene 5265] {aka A1A, A1AT, AAT, PI, PI1, PRO2275}, MUC2 (mucin 2, oligomeric mucus/gel-forming) [NCBI Gene 4583] {aka MLP, MUC-2, SMUC}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, Syt1 (synaptotagmin 1) [NCBI Gene 25716] {aka P65}, TIMP1 (TIMP metallopeptidase inhibitor 1) [NCBI Gene 7076] {aka CLGI, EPA, EPO, HCI, TIMP, TIMP-1}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, MUC5AC (mucin 5AC, oligomeric mucus/gel-forming) [NCBI Gene 4586] {aka MUC5, TBM, leB, mucin}, CXCR1 (C-X-C motif chemokine receptor 1) [NCBI Gene 3577] {aka C-C, C-C-CKR-1, CD128, CD181, CDw128a, CKR-1}, FN1 (fibronectin 1) [NCBI Gene 2335] {aka CIG, ED-B, FINC, FN, FNZ, GFND}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, MUC5B (mucin 5B, oligomeric mucus/gel-forming) [NCBI Gene 727897] {aka MG1, MUC-5B, MUC5, MUC9}, CTSC (cathepsin C) [NCBI Gene 1075] {aka CPPI, DPP-I, DPP1, DPPI, HMS, JP}, Cr1l (complement C3b/C4b receptor 1 like) [NCBI Gene 54243] {aka Cr1, Crry}, SFTPA1 (surfactant protein A1) [NCBI Gene 653509] {aka COLEC4, ILD1, PSP-A, PSPA, SFTP1, SFTPA1B}, ELANE (elastase, neutrophil expressed) [NCBI Gene 1991] {aka ELA2, GE, HLE, HNE, NE, PMN-E}, CXCL2 (C-X-C motif chemokine ligand 2) [NCBI Gene 2920] {aka CINC-2a, GRO2, GROb, MGSA-b, MIP-2a, MIP2}, F2 (coagulation factor II, thrombin) [NCBI Gene 2147] {aka PT, RPRGL2, THPH1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, TLR2 (toll like receptor 2) [NCBI Gene 7097] {aka CD282, TIL4}, MPO (myeloperoxidase) [NCBI Gene 4353], TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}
- **Diseases:** damage (MESH:D020263), inflammatory tissue damage (MESH:D017695), Inflammation (MESH:D007249), CF lung disease (MESH:C563237), NE (MESH:C564275), infection (MESH:D007239), NETs (MESH:C536657), pulmonary arterial hypertension (MESH:D000081029), pulmonary inflammation (MESH:D011014), bronchiectasis (MESH:D001987), CF (MESH:D003550), autosomal recessive genetic disorder (MESH:D030342), bacterial infection (MESH:D001424), P. aeruginosa infection (MESH:D011552), Klebsiella pneumonia infection (MESH:D007710), inflammatory damage (MESH:D018746), infection of the lung (MESH:D012141)
- **Chemicals:** sodium (MESH:D012964), reactive oxygen species (MESH:D017382), histidine (MESH:D006639), chloride (MESH:D002712), AZD9668 (MESH:C568080), LPS (MESH:D008070), DX-890 (MESH:C512995), serine (MESH:D012694), bacterial pathogen-associated molecular pattern (-), LTA (MESH:C009900), oligonucleotides (MESH:D009841), aspartate (MESH:D001224),  (MESH:D053481),  (MESH:D011480),  (MESH:D053492),  (MESH:D000515),  (MESH:C506814)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Pseudomonas aeruginosa (species) [taxon 287], Staphylococcus aureus (species) [taxon 1280], Homo sapiens (human, species) [taxon 9606], Rattus norvegicus (brown rat, species) [taxon 10116]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC4491392/full.md

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Source: https://tomesphere.com/paper/PMC4491392