Catching up with the burden of COPD

COPD still is an incurable disease and progresses rapidly. 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.

In their aim to catch up, scientists around Prof. Mareike Lehmann and the director of the LHI, Prof. Ali Önder Yildirim, have summarized their current research results in an article for the renowned 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. The scientists 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.

In their article first author Theodore Kapellos, corresponding author Mareike Lehmann, Thomas Conlon and Ali Önder Yildirim define four key drivers of COPD pathogenesis:

• 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
• The effects of innate and adaptive immune cell signaling on alveolar epithelial proliferation and differentiation

In their vision there are two major strategies for future COPD treatments:

• The manipulation of the degrading and anti-regenerative immune cell functions
• The re-activation of pro-regenerative mechanisms to enable the lung to heal itself

Their 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.

Original publication

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