International Journal of Molecular Sciences Review Proteases, Mucus, and Mucosal Immunity in Chronic Lung Disease Michael C. McKelvey 1 , Ryan Brown 1, Sinéad Ryan 1, Marcus A. Mall 2,3,4 , Sinéad Weldon 1 and Clifford C. Taggart 1,* 1 Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast BT9 7BL, UK;
[email protected] (M.C.M.);
[email protected] (R.B.);
[email protected] (S.R.);
[email protected] (S.W.) 2 Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany;
[email protected] 3 Berlin Institute of Health (BIH), 10178 Berlin, Germany 4 German Center for Lung Research (DZL), 35392 Gießen, Germany * Correspondence:
[email protected]; Tel.: +44-289097-6383 Abstract: Dysregulated protease activity has long been implicated in the pathogenesis of chronic lung diseases and especially in conditions that display mucus obstruction, such as chronic obstructive pulmonary disease, cystic fibrosis, and non-cystic fibrosis bronchiectasis. However, our appreciation of the roles of proteases in various aspects of such diseases continues to grow. Patients with muco- obstructive lung disease experience progressive spirals of inflammation, mucostasis, airway infection and lung function decline. Some therapies exist for the treatment of these symptoms, but they are unable to halt disease progression and patients may benefit from novel adjunct therapies. In this review, we highlight how proteases act as multifunctional enzymes that are vital for normal Citation: McKelvey, M.C.; Brown, R.; airway homeostasis but, when their activity becomes immoderate, also directly contribute to airway Ryan, S.; Mall, M.A.; Weldon, S.; dysfunction, and impair the processes that could resolve disease.