Table 2.

Immunological effects of Roflumilast.

Mediator	Action of mediator	Effect of roflumilast	reference
Interleukin-6	Activates monocytes, fibroblasts and B cell.	↓	[15], [16], [17]
Interleukin-8	Enhances neutrophil chemotaxis	↓	[15], [16], [17]
Tumour Necrosis factor α	From leucocytes and activates inflammatory cells + increases e-selectin on vascular endothelium	↓↓	15
E-Selectin	Increases movement of leucocytes into endothelium	↓	18
Transforming factor β1	Cell growth + proliferation + apoptosis	↓	15
Eosinophil cationic protein	Cytotoxic + promotes fibrosis	↓	9
Neutrophil elastase	Stimulates mucus secretion + degrades connective tissue	↓↓	19
Fibroblast growth factor	Regulates cell proliferation + wound repair	↓	15