Multiple cytokines play a critical role in orchestrating and perpetuating inflammation in asthma and chronic obstructive pulmonary disease (COPD) and several specific cytokine and chemokine inhibitors now in development as future therapy for these diseases. Anti-IL-5 antibody markedly reduces peripheral blood and airway eosinophils, but does not appear to be effective in symptomatic asthma. Inhibition of IL-4 despite promising early results in asthma has been discontinued and blocking IL-13 might be more effective. Inhibitory cytokines, such as IL-10, interferons and IL-12 are less promising, as systemic delivery produces side effects. Inhibition of TNF-alpha may be useful in severe asthma and for treating severe COPD with systemic features. Many chemokines are involved in the inflammatory response of asthma and COPD and several small molecule inhibitors of chemokine receptors (CCR) are in development. CCR3 antagonists (which block eosinophil chemotaxis) and CXCR2 antagonists (which block neutrophil and monocyte chemotaxis) are in clinical development for asthma and COPD, respectively. Because so many cytokines are involved in asthma, drugs that inhibit the synthesis of multiple cytokines may prove to be more useful; several such classes of drug are now in clinical development and any risk of side effects with these non-specific inhibitors may be reduced by the inhaled route.

中文翻译：

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细胞因子定向疗法，用于治疗慢性气道疾病。

多种细胞因子在哮喘和慢性阻塞性肺疾病（COPD）的协调和维持炎症中起着关键作用，目前正在开发几种特定的细胞因子和趋化因子抑制剂作为这些疾病的未来疗法。抗IL-5抗体可显着减少外周血和气道嗜酸性粒细胞，但对症状性哮喘似乎无效。尽管有希望在哮喘中取得早期结果，但IL-4的抑制作用已经中止，而阻断IL-13可能更有效。抑制性细胞因子（例如IL-10，干扰素和IL-12）的前景较差，因为全身递送会产生副作用。TNF-α的抑制作用可用于重度哮喘和具有系统特征的重度COPD治疗。许多趋化因子参与哮喘和COPD的炎症反应，几种趋化因子受体（CCR）的小分子抑制剂正在开发中。CCR3拮抗剂（阻断嗜酸性粒细胞趋化性）和CXCR2拮抗剂（阻断嗜中性粒细胞和单核细胞趋化性）分别在哮喘和COPD的临床开发中。由于哮喘中涉及多种细胞因子，因此抑制多种细胞因子合成的药物可能更有用。几种此类药物目前正在临床开发中，通过吸入途径可以降低这些非特异性抑制剂的任何副作用风险。CCR3拮抗剂（阻断嗜酸性粒细胞趋化性）和CXCR2拮抗剂（阻断嗜中性粒细胞和单核细胞趋化性）分别在哮喘和COPD的临床开发中。由于哮喘中涉及多种细胞因子，因此抑制多种细胞因子合成的药物可能更有用。几种此类药物目前正在临床开发中，通过吸入途径可以降低这些非特异性抑制剂的任何副作用风险。CCR3拮抗剂（阻断嗜酸性粒细胞趋化性）和CXCR2拮抗剂（阻断嗜中性粒细胞和单核细胞趋化性）分别在哮喘和COPD的临床开发中。由于哮喘中涉及多种细胞因子，因此抑制多种细胞因子合成的药物可能更有用。几种此类药物目前正在临床开发中，通过吸入途径可以降低这些非特异性抑制剂的任何副作用风险。