Chemokine receptors in airway disease: which receptors to target?

Many disease states within the airway result in the co-ordinated infiltration of key inflammatory cells. The cellular influx is choreographed through the temporal and spatially-regulated expression of chemokines, which potentiate the migration of cells along gradients of chemotactic ligands. Chemokines act as ligands for the chemokine receptors; a distinct class of G-protein-coupled receptor. Over 40 chemokine ligands and 18 chemokine receptors have been identified on human cells. Chemokine receptors are divided into several classes; the two most prominent of which are the CC- and CXC-chemokine receptors, classified through the spatial arrangement of two conserved cysteine residues. The role of chemokine receptors such as CCR2, CCR3, CCR4, CCR8 and the CXC chemokine receptors; CXCR1 and CXCR2 on cell types of relevance to respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) and chronic bronchitis will be explored in this review. Chemokines have proven to be amenable drug targets for the development of low molecular weight antagonists by the pharmaceutical industry. So far, no chemokine receptor antagonist has entered the clinic in trials for respiratory disease, but over the next few years it is expected that many will do so, at which time the potential of these exciting new targets will be fully realised.