Defining Possible Future Therapies for COPD
Chronic obstructive pulmonary disease (COPD) was in 2019 the primary cause of deaths from chronic respiratory diseases, accounting for 3.3 million deaths worldwide. In Germany, according to the “European Lung White Book”, the number of COPD patients increased by 8 % from 2010 to 2019 with more than three and a half million patients in 2019. Still, COPD is incurable and progresses rapidly. Scientists from Helmholtz Munich have now published a Review article about COPD in the European Respiratory Journal.
COPD can be classified based on five leading risk factors: genetic predisposition, early-life events, infections, exposure to tobacco smoke and air pollution. Scientists from the Institute of Lung Health and Immunity (LHI) at Helmholtz Munich define the loss of structural integrity and regenerative capacity of the lung as critical for disease progression and the impaired effectiveness of current COPD therapeutic approaches.
The team of researchers around Prof. Mareike Lehmann and Prof. Ali Önder Yildirim summarized their current research results and defined four key drivers of COPD pathogenesis. These include the mechanisms via which myeloid cells cause alveolar degradation, the consequences of inefficient apoptotic cell removal, the formation of tertiary lymphoid structures and the production of autoreactive antibodies, as well as the effects of innate and adaptive immune cell signaling on alveolar epithelial proliferation and differentiation.
The results led to two major strategies for future COPD treatments including manipulation of the degrading and anti-regenerative immune cell functions and the re-activation of pro-regenerative mechanisms to enable the lung to heal itself.
In conclusion, it will be challenging to induce regeneration in the COPD lung even in end-stage disease. But it is fair to speculate that it will be possible to activate pro-regenerative therapies before the point of no return.
Theodore S. Kapellos, Thomas M. Conlon, Ali Önder Yildirim, Mareike Lehmann (2023): The impact of the immune system on lung injury and regeneration in COPD. European Respiratory Journal. DOI: 10.1183/13993003.00589-2023
More about COPD at the first COPD-iNET symposium on October, 30/31 2023 at Castle Hohenkammer near Munich bringing together members of the COPD-iNET network for scientific exchange and collaborations in the field.