Second University of Naples, Unit of Pharmacology, Department of Experimental Medicine, Naples, Italy.
Expert Opin Emerg Drugs. 2012 Mar;17(1):61-82. doi: 10.1517/14728214.2012.660917. Epub 2012 Feb 16.
Chronic obstructive pulmonary disease (COPD) is a major public health problem with increasing morbidity and mortality. It is characterized by airflow obstruction that is usually progressive, not fully reversible and does not change markedly over several months. It is associated with an enhanced inflammatory response in the airways and the lung to noxious particles or gases. Therefore, bronchial relaxation and inflammatory response suppression represent a mechanistic approach to the treatment of COPD.
This review article is focused on emerging treatment for COPD that is mainly based on new bronchodilators and anti-inflammatory drugs. We also mention new pharmacologic agents whose mechanisms of action target protease activity at the enzymatic level and the potential regenerative therapy for COPD.
New drugs for the treatment of COPD are greatly needed, but development of novel drugs for COPD has proved to be very difficult. Nevertheless, in these last years, several new potential targets have been identified and novel agents for these new targets, as well for known targets, have been developed. Rational therapy depends on elucidating the cellular and molecular mechanisms that are involved in bronchodilation and inflammation in COPD patients, and the structural changes and aberrant repair mechanisms that characterize the pathophysiology of COPD.
慢性阻塞性肺疾病(COPD)是一个主要的公共卫生问题,发病率和死亡率不断上升。它的特征是气流阻塞,通常是进行性的,不完全可逆的,并且在几个月内不会明显改变。它与气道和肺部对有害颗粒或气体的增强炎症反应有关。因此,支气管舒张和炎症反应抑制代表了治疗 COPD 的一种机制方法。
本文重点介绍了 COPD 的新兴治疗方法,主要基于新型支气管扩张剂和抗炎药物。我们还提到了新的药理制剂,其作用机制靶向酶水平的蛋白酶活性,以及 COPD 的潜在再生治疗。
非常需要治疗 COPD 的新药,但 COPD 新药的开发已被证明非常困难。然而,在过去几年中,已经确定了几个新的潜在靶点,并且已经开发出针对这些新靶点以及已知靶点的新型药物。合理的治疗取决于阐明参与 COPD 患者支气管扩张和炎症的细胞和分子机制,以及表征 COPD 病理生理学的结构变化和异常修复机制。