New treatments for chronic obstructive pulmonary disease.

No currently available treatments reduce the progression of chronic obstructive pulmonary disease (COPD) or suppress the inflammation in small airways and lung parenchyma. However, several new treatments now in development for COPD are targeted at the inflammation process. Antagonists of mediators, such as leukotriene B4, interleukin-8, and tumour necrosis factor-alpha and inhibitors of oxidative and nitrative stress are in clinical development. Phosphodiesterase-4 inhibitors are in clinical trials and drugs that inhibit p38 MAP kinase, nuclear factor-kappaB and phosphoinositide-3 kinase-gamma are now in early development. There is also a search for elastase inhibitors to prevent the development of emphysema and drugs that may even reverse the lung destruction.