Th17 profile in COPD exacerbations

Ponce-Gallegos, Marco Antonio; Ramírez-Venegas, Alejandra; Falfán-Valencia, Ramcés

COPD is characterized by a continuous inflammatory process of the airways, leading to obstruction or limitation of airflow, which is mainly associated with exposure to cigarette smoke. 1, 2 However, only 10%-20% of smokers will develop the disease at some day in their life. These data lead to the belief that this disease is due to multiple factors that interact with each other. Among the most prominent are genetic factors that can condition patients to have a certain susceptibility to COPD. For example, deficiency of alpha1-antitrypsin (AAT) (responsible for inhibiting proteases, whose function is to deplete the extracellular matrix) is present in at least 1% of the carriers of the disease in Europe and the United States and other regions around the world such as Africa and Australia. 3 Many cells participate in the pathophysiology of COPD, the most important are neutrophils, macrophages, CD4+ and CD8+ T lymphocytes and the chemical mediators they produce (cytokines, chemokines, enzymes, growth factors, etc.). For example, neutrophil elastase (NE) is an enzyme that degrades the extracellular matrix to facilitate the migration of the neutrophil through the lung parenchyma to the inflammation area. People harboring AAT deficiency alleles have a greater susceptibility to presenting the disease or presenting it at an earlier age. 1, 4 On the other hand, cytokines such as TNF-α, IL-1β, IL-6, CXCL8 (also called IL-8), IL-22, IL-23, IL-17A, IL-17F and TGF-β among others are increased in samples from patients with COPD, suggesting an important role in its pathophysiology and in the exacerbations that may occur due Epidemiology COPD is now considered a serious public health problem, reaching the fourth place in mortality worldwide and in Mexico as well. 6, 7 Globally, this disease is present in ~600 million of people, especially in low-and middle-income countries. It is estimated that in 2020, it will rank among the first three causes of death worldwide. 8 COPD and asthma are the airway obstructive pathologies more prevalent. 9