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COPD/Emphysema ResearchAuthor: Robert W. Rubin, PhD For the past 50 years very little productive research on the development of treatments for COPD/emphysema has been undertaken. Even as the numbers of patients increased into the multimillions, the interest within the research community concerning this disease has been very small. This is due to the belief that little can be done and the very poor federal and private funding environment for COPD research. This attitude has changed significantly in the past 5 years. Although the funding situation in terms of the amount of research money available from the National Institutes of Health and private foundations for COPD research has not improved, certain advances in our understanding of the disease and findings concerning possible new treatments has sparked a lot of interest amongst scientists. Recent studies have pinpointed a class of proteins that are present in the lungs of COPD patients as being strongly linked to the disease. These are certain classes of enzymes that break down proteins (especially the proteins that make up the actual structure of the tissue of the lungs). COPD victims appear to have a higher level of these "proteases" than others do. Certain cellular types and cell activities appear to be linked to the development of the disease especially a cell called a macrophage and a cell called the neutrophil that may be overly active in COPD patients. Another stumbling block to studying this disease has been the absence of an appropriate animal model of the disease. Such models have been developed within the past three years. The pharmaceutical industry has recently taken special aim at this disease and there are 3 to 6 drugs that are in or entering clinical trials right now designed to reduce symptoms and prolong life. Much research has gone into the development of new therapeutics designed to reduce inflammation of the airways in asthma and other allergic diseases and there is now reason to believe that they have some efficacy in the treatment of COPD as well. In addition to the development of new therapies, recently, genetic markers (this has been done at LRRI) have been identified that seem to predict the development of COPD. It is very possible that people are genetically predisposed (or not ) to getting the disease if exposed to toxicants and that we can do a simple blood test and tell them their risk profile. This also would be a breakthrough in the handling of the complexity of options for this disease. Knowing that you were going to for sure develop emphysema unless you stopped smoking, for example, might have a larger effect on behavior than a general warning. In general, protease inhibitors, corticosteroids, retinoids, and cytokine inhibitors are classes of drugs now being investigated as possible new treatments for COPD. There is now some animal model evidence that some of these are significantly helpful and some very recent retrospective evidence for prolongation of life in people. Many avenues are now being pursued and there is much hope of finding new methods of treating the disease in such a way as to arrest its further development and or reduce or eliminate its symptoms. We need much higher levels of federal funding for COPD which receives a tiny fraction of the research dollars expended on other much less prevalent diseases. With as many as 30 million afflicted Americans, this is one of the most serious public health problems this country faces but the political will to cure the disease has not been evident. |
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