Biomedical Engineering Reference
In-Depth Information
develop COPD (118), and identification of genes that predispose to the
development of COPD may provide novel therapeutic targets, as discussed
in Chapter 16. However, it will be difficult to demonstrate the efficacy of
novel treatments on the rate of decline in lung function, as this requires large
studies over 3 years. Hence, there is a need to develop novel outcome mea-
sures and surrogate biomarkers, such as analysis of sputum parameters
(cells, mediators, enzymes) or exhaled condensates (lipid mediators, reactive
oxygen species) (119). The use of imaging techniques, such as high-
resolution computerized tomography (CT), to measure disease progression
is another promising approach, as scanning resolution increases (120). It
may also be important to more accurately define the presence of emphysema
vs. small airway obstruction using CT scans, as some drugs may be more
useful for preventing emphysema, whereas others may be more effective
against the small airway inflammatory-fibrotic process. More research on
the basic cellular and molecular mechanisms of COPD is urgently needed
to aid the logical development of new therapies for this common and impor-
tant disease, for which no effective preventative treatments currently exist.
Of the drugs currently in development, PDE4 inhibitors, p38 MAP
kinase inhibitors, and CXCR2 antagonists show particular promise as
anti-inflammatory therapies over the next 5-10 years. It is likely that effec-
tive anti-inflammatory therapies would not only reduce exacerbations, but
also improve symptoms and health status. In the long term, these drugs
should slow the decline in lung function and prevent the considerable
morbidity imposed by this common disease.
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