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Table of Contents
Vol. 19, No. 5, 2010
Issue release date: July 2010
Section title: Review

Open Access Gateway

Med Princ Pract 2010;19:330–338

New Therapies for Chronic Obstructive Pulmonary Disease

Barnes P.J.
National Heart and Lung Institute, Imperial College London, London, UK
email Corresponding Author

Prof. Peter J. Barnes

National Heart and Lung Institute

Imperial College School of Medicine

Dovehouse Street, London SW3 6LY (UK)

Tel. +44 207 351 8174, Fax +44 207 351 5675, E-Mail p.j.barnes@imperial.ac.uk

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Chronic obstructive pulmonary disease (COPD) is a major global health problem which is increasing throughout the world and a major cause of death. However, current therapies fail to prevent disease progression or mortality. The mainstay of current drug therapy are long-acting bronchodilators; several longer-acting inhaled β2-agonists and muscarinic antagonists (and combinations) are now in development. No treatments have so far been shown to suppress chronic inflammation in COPD lungs. With better understanding of the inflammatory and destructive process in the pathophysiology of COPD, several new targets have been identified. Several mediator antagonists tested in COPD have so far been disappointing, but CXCR2 antagonists that block pulmonary neutrophil and monocyte recruitment may be more promising. Broad-spectrum anti-inflammatory drugs may be more effective, and include inhibitors of the enzymes phosphodiesterase-4, p38 mitogen-activated protein kinase, NF-ĸB kinase and phosphoinositide 3 kinase-γ and -δ, but side effects will be a major limitation so that inhaled delivery may be necessary. Perhaps the most promising approach is reversal of corticosteroid resistance through increasing histone deacetylase-2 activity. This might be achieved by theophylline-like drugs, phosphoinositide 3 kinase-δ inhibitors, more effective antioxidants and non-antibiotic macrolides.

© 2010 S. Karger AG, Basel

Article / Publication Details

First-Page Preview
Abstract of Review

Received: August 02, 2009
Accepted: November 30, 2009
Published online: July 14, 2010
Issue release date: July 2010

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 1

ISSN: 1011-7571 (Print)
eISSN: 1423-0151 (Online)

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