Pharmaceutical Department, Faculty of Pharmacy, University of Parma, Parma, Italy.
Expert Opin Drug Deliv. 2011 Sep;8(9):1205-20. doi: 10.1517/17425247.2011.588697. Epub 2011 May 26.
Chronic Obstructive Pulmonary Disease (COPD) is a severe disease that leads to a non-reversible obstruction of the small airways. The prevalence of this disease is rapidly increasing in developed countries, and in 2020 it has been predicted that this disease will reach the third cause of mortality worldwide. COPD patients do not respond well to current treatment modalities, such as bronchodilators and corticosteroids.
This review article focuses on the patho-physiology of COPD, explores current approaches to alleviate and treat the disease, and discusses the potential use of statins for treatment. Specifically, the mechanism of action and metabolism of simvastatin, the most known and studied molecule among the statin family, are critically reviewed.
Various cellular pathways have been implicated in COPD, with alveolar macrophages emerging as pivotal inflammatory mediators in the COPD patho-physiology. Recently, emerging anti-cytokine therapies, such as PDE4 inhibitors and ACE inhibitors, have shown good anti-inflammatory properties that can be useful in COPD treatment. Recently, statins as a drug class have gained much interest with respect to COPD management, following studies which show simvastatin to exert effective anti-inflammatory effects, via inhibition of the mevalonic acid cascade in alveolar macrophages.
慢性阻塞性肺疾病（COPD）是一种严重的疾病，会导致小气道的不可逆阻塞。这种疾病在发达国家的发病率迅速上升，据预测，到 2020 年，它将成为全球第三大致死原因。COPD 患者对目前的治疗方法如支气管扩张剂和皮质类固醇反应不佳。
本文综述了 COPD 的病理生理学，探讨了缓解和治疗该疾病的现有方法，并讨论了他汀类药物治疗的潜在用途。具体而言，重点评述了他汀类家族中最知名和研究最多的分子辛伐他汀的作用机制和代谢。
各种细胞途径都与 COPD 有关，肺泡巨噬细胞作为 COPD 病理生理学中的关键炎症介质。最近，新兴的抗细胞因子疗法，如 PDE4 抑制剂和 ACE 抑制剂，已显示出良好的抗炎特性，可用于 COPD 治疗。最近，他汀类药物作为一种药物类别，在 COPD 管理方面引起了极大的关注，研究表明辛伐他汀通过抑制肺泡巨噬细胞中的甲羟戊酸途径发挥有效的抗炎作用。
