PT  - JOURNAL ARTICLE
AU  - Korkmaz, Brice
AU  - Lesner, Adam
AU  - Guarino, Carla
AU  - Wysocka, Magdalena
AU  - Kellenberger, Christine
AU  - Watier, Hervé
AU  - Specks, Ulrich
AU  - Gauthier, Francis
AU  - Jenne, Dieter E.
ED  - Sibley, David R.
TI  - Inhibitors and Antibody Fragments as Potential Anti-Inflammatory Therapeutics Targeting Neutrophil Proteinase 3 in Human Disease
AID  - 10.1124/pr.115.012104
DP  - 2016 Jul 01
TA  - Pharmacological Reviews
PG  - 603--630
VI  - 68
IP  - 3
4099  - http://pharmrev.aspetjournals.org/content/68/3/603.short
4100  - http://pharmrev.aspetjournals.org/content/68/3/603.full
SO  - Pharmacol Rev2016 Jul 01; 68
AB  - Proteinase 3 (PR3) has received great scientific attention after its identification as the essential antigenic target of antineutrophil cytoplasm antibodies in Wegener’s granulomatosis (now called granulomatosis with polyangiitis). Despite many structural and functional similarities between neutrophil elastase (NE) and PR3 during biosynthesis, storage, and extracellular release, unique properties and pathobiological functions have emerged from detailed studies in recent years. The development of highly sensitive substrates and inhibitors of human PR3 and the creation of PR3-selective single knockout mice led to the identification of nonredundant roles of PR3 in cell death induction via procaspase-3 activation in cell cultures and in mouse models. According to a study in knockout mice, PR3 shortens the lifespan of infiltrating neutrophils in tissues and accelerates the clearance of aged neutrophils in mice. Membrane exposure of active human PR3 on apoptotic neutrophils reprograms the response of macrophages to phagocytosed neutrophils, triggers secretion of proinflammatory cytokines, and undermines immune silencing and tissue regeneration. PR3-induced disruption of the anti-inflammatory effect of efferocytosis may be relevant for not only granulomatosis with polyangiitis but also for other autoimmune diseases with high neutrophil turnover. Inhibition of membrane-bound PR3 by endogenous inhibitors such as the α-1-protease inhibitor is comparatively weaker than that of NE, suggesting that the adverse effects of unopposed PR3 activity resurface earlier than those of NE in individuals with α-1-protease inhibitor deficiency. Effective coverage of PR3 by anti-inflammatory tools and simultaneous inhibition of both PR3 and NE should be most promising in the future.