Novel Anti-Inflammatory Approaches to COPD

Mario Cazzola,1 Nicola A Hanania,2 Clive P Page,3 Maria Gabriella Matera4 1Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy; 2Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA; 3Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King’s College London, London, UK; 4Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, ItalyCorrespondence: Mario Cazzola, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy, Email mario.cazzola@uniroma2.itAbstract: Airway inflammation, driven by different types of inflammatory cells and mediators, plays a fundamental role in COPD and its progression. Neutrophils, eosinophils, macrophages, and CD4+ and CD8+ T lymphocytes are key players in this process, although the extent of their participation varies according to the patient’s endotype. Anti-inflammatory medications may modify the natural history and progression of COPD. However, since airway inflammation in COPD is relatively resistant to corticosteroid therapy, innovative pharmacological anti-inflammatory approaches are required. The heterogeneity of inflammatory cells and mediators in annethe different COPD endo-phenotypes requires the development of specific pharmacologic agents. Indeed, over the past two decades, several mechanisms that influence the influx and/or activity of inflammatory cells in the airways and lung parenchyma have been identified. Several of these molecules have been tested in vitro models and in vivo in laboratory animals, but only a few have been studied in humans. Although early studies have not been encouraging, useful information emerged suggesting that some of these agents may need to be further tested in specific subgroups of patients, hopefully leading to a more personalized approach to treating COPD.Keywords: anti-inflammatory drugs, COPD, inflammation, treatment