Neutrophil elastase (NE) and NE inhibitors: canonical and noncanonical functions in lung chronic inflammatory diseases (cystic fibrosis and chronic obstructive pulmonary disease)

J Aerosol Med Pulm Drug Deliv. 2008 Mar;21(1):125-44. doi: 10.1089/jamp.2007.0653.


Proteases and antiproteases have multiple important roles both in normal homeostasis and during inflammation. Antiprotease molecules may have developed in a parallel network, consisting of "alarm" and "systemic" inhibitors. Their primary function was thought until recently to mainly prevent the potential injurious effects of excess release of proteolytic enzymes, such as neutrophil elastase (NE), from inflammatory cells. However, recently, new potential roles have been ascribed to these antiproteases. We will review "canonical" and new "noncanonical" functions for these molecules, and more particularly, those pertaining to their role in innate and adaptive immunity (antibacterial activity and biasing of the adaptive immune response).

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cystic Fibrosis / enzymology*
  • Cystic Fibrosis / immunology
  • Humans
  • Immunity
  • Immunity, Innate
  • Leukocyte Elastase / antagonists & inhibitors
  • Leukocyte Elastase / immunology*
  • Leukocyte Elastase / metabolism
  • Lung / immunology
  • Lung / pathology
  • Protease Inhibitors / metabolism*
  • Pulmonary Disease, Chronic Obstructive / enzymology*
  • Pulmonary Disease, Chronic Obstructive / immunology


  • Protease Inhibitors
  • Leukocyte Elastase