White blood cells (WBCs) are a major component of immunity in response to pathogen invasion. Neutrophils are the most abundant WBCs in humans, playing a central role in acute inflammation induced by pathogens. Adhesion to vasculature and tissue infiltration of neutrophils are key processes in acute inflammation. Many inflammatory/autoimmune disorders and cancer therapies have been found to be involved in activation and tissue infiltration of neutrophils. A promising strategy to develop novel targeted drug delivery systems is the targeting and exploitation of activated neutrophils. Herein, a new drug delivery platform based on neutrophils is reviewed. There are two types of drug delivery systems: neutrophils as carriers and neutrophil-membrane-derived nanovesicles. It is discussed how nanoparticles hijack neutrophils in vivo to deliver therapeutics across blood vessel barriers and how neutrophil-membrane-derived nanovesicles target inflamed vasculature. Finally, the potential applications of neutrophil-based drug delivery systems in treating inflammation and cancers are presented.

Neutrophil-Based Drug Delivery Systems

Innate immunity normally provides excellent defence against invading microorganisms. Acute inflammation is a form of innate immune defence and represents one of the primary responses to injury, infection and irritation, largely mediated by granulocyte effector cells such as neutrophils and eosinophils. Failure to remove an inflammatory stimulus (often resulting in failed resolution of inflammation) can lead to chronic inflammation resulting in tissue injury caused by high numbers of infiltrating activated granulocytes. Successful resolution of inflammation is dependent upon the removal of these cells. Under normal physiological conditions, apoptosis (programmed cell death) precedes phagocytic recognition and clearance of these cells by, for example, macrophages, dendritic and epithelial cells (a process known as efferocytosis). Inflammation contributes to immune defence within the respiratory mucosa (responsible for gas exchange) because lung epithelia are continuously exposed to a multiplicity of airborne pathogens, allergens and foreign particles. Failure to resolve inflammation within the respiratory mucosa is a major contributor of numerous lung diseases. This review will summarise the major mechanisms regulating lung inflammation, including key cellular interplays such as apoptotic cell clearance by alveolar macrophages and macrophage/neutrophil/epithelial cell interactions. The different acute and chronic inflammatory disease states caused by dysregulated/impaired resolution of lung inflammation will be discussed. Furthermore, the resolution of lung inflammation during neutrophil/eosinophil-dominant lung injury or enhanced resolution driven via pharmacological manipulation will also be considered.

/pdf/key-mechanisms-governing-resolution-of-lung-inflammation-3ljslnfexy.pdf

Key mechanisms governing resolution of lung inflammation

Understanding the roles of cytokines and neutrophil activity and neutrophil apoptosis in the protective versus deleterious inflammatory response in pneumonia

In Reply :

We thank Dr Gusmao-Flores for the interest in our recent article “Corticosteroid therapy for severe community-acquired pneumonia: a meta-analysis.”[1][1] We appreciate the opportunity to respond to the concerns raised with regard to our article.

According to Cochrane recommendations

http://rc.rcjournal.com/content/respcare/59/4/557.full.pdf

Corticosteroid Therapy for Severe Community-Acquired Pneumonia: A Meta-Analysis-Reply

Incidence and Mortality of Adults Hospitalized With Community-Acquired Pneumonia According to Clinical Course

Neutrophil activation state and its relationship with an inflammatory environment in community-acquired pneumonia (CAP) remain insufficiently elucidated. We aimed to evaluate the neutrophil apoptosis and cytokine pattern in CAP patients after 72 h of treatment, and their impact on infection resolution. Apoptosis of blood and bronchoalveolar lavage (BAL) neutrophils was measured in nonresponding CAP (NCAP), in responding CAP (blood only) and in patients without infection (control). Pro-inflammatory (interleukin (IL)-6, IL-8) and anti-inflammatory (IL-10) cytokines were measured. Main outcomes were clinical stability and days of hospitalisation. Basal neutrophil apoptosis was higher in the BAL and blood of NCAP, whereas spontaneous apoptosis (after 24 h culture) was lower. Cytokines in NCAP were higher than in responding CAP and control: IL-6 was increased in BAL and blood, IL-8 in BAL and IL-10 in blood. An increased basal apoptosis (≥20%) in BAL of NCAP was associated with lower systemic IL-10 (p After 72 h of treatment, an increased basal alveolar neutrophil apoptosis might contribute to downregulation of inflammation and to faster clinical stability.

https://erj.ersjournals.com/content/erj/38/5/1158.full.pdf

Increased lung neutrophil apoptosis and inflammation resolution in nonresponding pneumonia.

From the authors:

We would like to thank C.G.A. Persson and L. Uller for their interesting observations and suggestions concerning our recently published article [1]. Also, we would like to comment the issues they have raised.

As they point out, we performed our study in patients (and controls), using blood and bronchoalveolar lavage (BAL) neutrophils for in vivo / ex vivo experiments. We did not include tissue samples due to the difficulty of obtaining them, just as C.G.A. Persson and L. Uller acknowledge. We analysed neutrophils from BAL fluid from non-responding community-acquired pneumonia (NCAP) patients to whom bronchoscopy was indicated and had signed informed consent. Bronchoscopy has the advantage of being a technique that is able to sample around 106 alveoli and, in addition, it is indicated for patients with NCAP [2]. All this could give relevant …

https://erj.ersjournals.com/content/erj/39/3/790.full.pdf

Increased lung neutrophil apoptosis and inflammation resolution

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Increased lung neutrophil apoptosis and inflammation resolution in nonresponding pneumonia.

Increased lung neutrophil apoptosis and inflammation resolution