Ferri Sebastian, Paoletti Giovanni, Pelaia Corrado, Heffler Enrico, Canonica Giorgio Walter, Puggioni Francesca
IRCCS Humanitas Research Hospital, Rozzano.
Humanitas University, Pieve Emanuele, Italy.
Curr Opin Allergy Clin Immunol. 2023 Aug 1;23(4):309-318. doi: 10.1097/ACI.0000000000000920. Epub 2023 Jun 20.
Chronic Obstructive Pulmonary Disease (COPD) is a common, heterogeneous disease associated with abnormal inflammatory response of the lung to noxious particles and gases. The progression of disease leads to respiratory failure, disability and premature death. Although recent progress in reducing the global burden of many chronic disease, such as heart disease and cancer, mortality and morbidity due to COPD continue to increase despite of cigarette smoking worldwide policy. Additionally, diagnostic and therapeutic options have not changed in decades. While patients affected by other respiratory disease may benefit with a personalized precision medicine, thanks to the new biological treatment, to date, there is no biological treatment available for COPD. COPD is generally a neutrophils-predominant disease but approximately 40% of patients with COPD had also an eosinophilic airway inflammation.
different Phase III trials have been recently performed to evaluate the efficacy and safety of several biological treatments, mostly against eosinophilic inflammation and, to date, some of this trial, still ongoing have promising results.
This review resumes the rationale, the attempts of biological treatment in COPD and latest promising results.
慢性阻塞性肺疾病(COPD)是一种常见的异质性疾病,与肺部对有害颗粒和气体的异常炎症反应相关。疾病进展会导致呼吸衰竭、残疾和过早死亡。尽管近期在减轻许多慢性疾病(如心脏病和癌症)的全球负担方面取得了进展,但尽管全球推行控烟政策,COPD导致的死亡率和发病率仍在持续上升。此外,几十年来诊断和治疗选择并未改变。虽然受其他呼吸系统疾病影响的患者可能受益于个性化精准医学,得益于新的生物治疗,但迄今为止,尚无针对COPD的生物治疗方法。COPD通常是以中性粒细胞为主的疾病,但约40%的COPD患者也存在嗜酸性气道炎症。
最近进行了不同的III期试验,以评估几种生物治疗的疗效和安全性,主要针对嗜酸性炎症,迄今为止,一些仍在进行的试验取得了有前景的结果。
本综述概述了COPD生物治疗的基本原理、尝试以及最新的有前景的结果。