Protease Inhibitors

a1-Antitrypsin (or a1-proteinase inhibitor) and secretory leukoprotease inhibitor (SLPI) are proteins generated by the body that protect the connective tissue of the lungs from degradation by neutrophil elastase. A genetic deficiency or defect in aj-antitrypsin leads to alveolar destruction and emphysema [113], and intravenous administration of exogenous a1-antitrypsin can be used to halt these pathological processes. Progressive lung damage can similarly occur in patients with cystic fibrosis through the action of elastase released from infiltrating neutrophils. For a given intravenous dose of aj-antitrypsin, only 2% has been estimated to reach the lungs [114]. As a result, aerosol administration is viewed as a more efficient means of achieving therapeutic repression of elastase-induced lung damage. Inhaled aj-antitrypsin and recombinant human SLP1 have been shown to be well tolerated [115,116]. Currently, phase II human trials investigating the efficacy of inhaled a1-antitrypsin are being completed by Bayer®/PPL Therapeutics. With the discovery of the matrix metalloproteinases (MMPs) in the lung and as a clearer understanding of their role in lung disease is made [117], it is possible that we may see MMP inhibitors delivered by inhalation for therapeutic benefit in the future.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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