The immunomodulatory effect of inhaled granulocyte-macrophage colony-stimulating factor in cystic fibrosis. A new treatment paradigm.

Journal of Inflammation Research
Lars HesletSteen Nepper-Christensen

Abstract

Patients with cystic fibrosis (CF) experience recurrent infections and develop chronically infected lungs, which initiates an altered immunological alveolar environment. End-stage pulmonary dysfunction is a result of a long sequence of complex events in CF, progressing to alveolar macrophage dysfunction via a T-helper 2 (T(H)2) dominated alveolar inflammation with CD20 T-cell activation, induced by the chronic infection and showing a poor prognosis. There is great potential for treatment in transforming the T(H)2 into the more favorable T-helper 1 (T(H)1) response. Current literature in the PubMed database and other sources was reviewed in order to evaluate aspects of the innate alveolar host defense mechanisms and the potential impact on the immunoinflammatory response of inhalation of granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients with CF. It seems that the cellular host defense, (ie, the alveolar macrophage and neutrocyte function) and the inhaled GM-CSF interact in such a way that the so-called tolerant alveolar environment dominated by the T(H)2 response may be transformed into an active T(H)1 state with a normal pulmonary host defense. The shift of the T(H)2 to the T(H)1 subset dominated by specific...Continue Reading

Citations

Jul 16, 2014·Journal of Controlled Release : Official Journal of the Controlled Release Society·Seho ParkSangyong Jon
Jul 25, 2019·Pharmaceutics·Brandon Banaschewski, Thomas Hofmann

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bronchoalveolar lavage

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