Classes of drugs that target the cellular components of inflammation under clinical development for COPD

ABSTRACT

Introduction

The persistent inflammation that characterizes COPD and affects its natural course also impacting on symptoms has prompted research to find molecules that can regulate the inflammatory process but still available anti-inflammatory therapies provide little or no benefit in COPD patients. Consequently, numerous anti-inflammatory molecules that are effective in animal models of COPD have been or are being evaluated in humans.

Areas covered

In this article we describe several classes of drugs that target the cellular components of inflammation under clinical development for COPD.

Expert opinion

Although the results of many clinical trials with new molecules have often been disappointing, several studies are underway to investigate whether some of these molecules may be effective in treating specific subgroups of COPD patients. Indeed, the current perspective is to apply a more personalized treatment to the patient. This means being able to better define the patient’s inflammatory state and treat it in a targeted manner. Unfortunately, the difficulty in translating encouraging experimental data into human clinical trials, the redundancy in the effects induced by signal-transmitting substances and the nonspecific effects of many classes that are undergoing clinical trials, do not yet allow specific inflammatory cell types to be targeted.

KEYWORDS:

• COPD
• inflammation
• macrophages
• neutrophils
• eosinophils
• therapies

Article highlights

• COPD is characterized by a persistent inflammation that leads to progressive and irreversible airflow obstruction and recurrent acute episodes of worsening.

• Different types of inflammatory cells are involved. Neutrophils, eosinophils, macrophages, and CD4⁺ and CD8⁺ T lymphocytes participate in the inflammatory process of COPD, although the extent of their participation varies according to the patient’s endotype.

• Up to now treating the inflammatory process of COPD has not been really effective.

• The urgent need to develop new therapies for COPD has led to the evaluation in humans of several molecules that have appeared effective in animal models of COPD.

• Although the new therapies are aimed at treating better defined inflammatory conditions, the results so far have been quite disappointing, but useful information is emerging that suggests the use of these molecules in specific subgroups of COPD patients.

Declaration of interest

No potential conflict of interest was reported by the author(s).