Onoue Satomi, Misaka Shingen, Kawabata Yohei, Yamada Shizuo
University of Shizuoka, School of Pharmaceutical Sciences, Department of Pharmacokinetics and Pharmacodynamics, Global Center of Excellence (COE) Program, 52 - 1 Yada, Suruga-ku, Shizuoka 422 - 8526, Japan.
Expert Opin Drug Deliv. 2009 Aug;6(8):793-811. doi: 10.1517/17425240903089310.
Chronic obstructive pulmonary disease (COPD) is an increasingly important cause of morbidity and mortality, pathological features of which are pulmonary inflammation and irreversible airflow obstruction. Current therapies for COPD are aimed at improvement of clinical symptoms and reduction of inflammation in the respiratory systems. There is a pressing need for the development of new COPD medication, particularly as no existing treatment has been shown to reduce disease progression. In spite of a better understanding of the underlying disease process, there have been limited advances in the drug therapy of COPD, in contrast to the enormous advances in asthma management. Several new therapeutic targets and strategies have been proposed, and new drug candidates, including bronchodilators, protease inhibitors anti-inflammatory drugs and mediator antagonists, are now in clinical development for COPD treatment. New dry powder inhaler (DPI) systems for inhaled COPD therapy have also been developed to maximize drug concentrations in the airway systems, while minimizing systemic exposure and associated toxicity. This article aims to review recent developments in COPD drugs and the delivery systems for inhalation therapy, with particular emphasis on device options and formulations of DPI systems.
慢性阻塞性肺疾病（COPD）是发病率和死亡率日益重要的原因，其病理特征为肺部炎症和不可逆的气流阻塞。目前COPD的治疗旨在改善临床症状并减轻呼吸系统炎症。迫切需要开发新的COPD药物，特别是因为尚无现有治疗方法被证明可减少疾病进展。尽管对潜在疾病过程有了更好的理解，但与哮喘管理方面的巨大进展相比，COPD药物治疗的进展有限。已经提出了几种新的治疗靶点和策略，包括支气管扩张剂、蛋白酶抑制剂、抗炎药物和介质拮抗剂在内的新候选药物目前正在进行COPD治疗的临床开发。还开发了用于吸入COPD治疗的新型干粉吸入器（DPI）系统，以在气道系统中使药物浓度最大化，同时将全身暴露和相关毒性降至最低。本文旨在综述COPD药物和吸入治疗给药系统的最新进展，特别强调DPI系统的设备选择和制剂。
