Available online 7 January 2023

NE plays a role in several human diseases.

Sivelestat, a selective NE inhibitor, has various clinical applications (particularly in COVID-19).

More studies are needed to identify more diseases associated with NE.

Additional studies to identify more clinical uses of sivelestat are also needed.

Neutrophil elastase (NE), a major protease in the primary granules of neutrophils, is involved in microbicidal activity. NE is an important factor promoting inflammation, has bactericidal effects, and shortens the inflammatory process. NE also regulates tumor growth by promoting metastasis and tumor microenvironment remodeling. However, NE plays a role in killing tumors under certain conditions and promotes other diseases such as pulmonary ventilation dysfunction. NE plays a complex role in various physiological processes and mediates several diseases. Sivelestat, a specific NE inhibitor, has strong potential for clinical application, particularly in the treatment of coronavirus disease 2019. This review discusses the pathophysiological processes associated with NE and the potential clinical applications of sivelestat.

Neutrophil elastase

sivelestat

COVID-19

pathophysiological mechanisms

therapeutic potential

© 2022 Published by Elsevier B.V. on behalf of Xi’an Jiaotong University.