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CD44 mimics as candidates for the treatment of asthma Asthma is now thought to affect 155 million people worldwide. In the United States alone there has been a two-fold increase in the number of cases of asthma driving market values up as high as $8 billion worldwide. Despite a large number of drugs available to clinicians, up to 15% of patients suffer from uncontrollable disease symptoms, increasing the demand for novel therapies that possess new modes of action. While asthma is an inflammatory disorder of the airways involving mediator release from mast cells and eosinophils and orchestrated by T cells, inflammation alone is insufficient to explain the chronic nature of the disease and its progression. Defective airway repair has been proposed to represent an additional pathophysiological feature of asthma. Epidermal growth factor (EGF) appears to be a key factor in bronchial epithelial repair; it stimulates epithelial cell proliferation and migration. The 3v isoform of the cell-surface adhesion molecule and hyaluronan receptor CD44 is overexpressed in damaged epithelium and seems to regulate the repair response by presenting EGF more efficiently to its receptor. With this in mind, Yale researchers have examined whether CD44 plays a role in resolving lung inflammation. CD44-deficient mice succumb to unremitting inflammation following noninfectious lung injury, characterized by impaired clearance of apoptotic neutrophils, persistent accumulation of hyaluronan fragments at the site of tissue injury, and impaired activation of transforming growth factor-beta1. This phenotype was partially reversed by reconstitution with CD44+ cells, thus demonstrating a critical role for this receptor in resolving lung inflammation. A number of CD44 antagonists are currently in development, mostly for the treatment of cancer (see "Focus on Metastasis" section of this edition of TherapeuticAdvances), however few CD44 mimics have appeared despite their potential in stimulating the repair of damaged airway. This therapeutic area deserves further industrial attention. Link to journal abstract:
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