RT Journal Article
SR Electronic
T1 Targeted therapy in eosinophilic chronic obstructive pulmonary disease
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00437-2020
DO 10.1183/23120541.00437-2020
VO 7
IS 2
A1 Mathieu Fieldes
A1 Chloé Bourguignon
A1 Said Assou
A1 Amel Nasri
A1 Aurélie Fort
A1 Isabelle Vachier
A1 John De Vos
A1 Engi Ahmed
A1 Arnaud Bourdin
YR 2021
UL http://openres.ersjournals.com/content/7/2/00437-2020.abstract
AB Chronic obstructive pulmonary disease (COPD) is a common and preventable airway disease causing significant worldwide mortality and morbidity. Lifetime exposure to tobacco smoking and environmental particles are the two major risk factors. Over recent decades, COPD has become a growing public health problem with an increase in incidence. COPD is defined by airflow limitation due to airway inflammation and small airway remodelling coupled to parenchymal lung destruction. Most patients exhibit neutrophil-predominant airway inflammation combined with an increase in macrophages and CD8+ T-cells. Asthma is a heterogeneous chronic inflammatory airway disease. The most studied subtype is type 2 (T2) high eosinophilic asthma, for which there are an increasing number of biologic agents developed. However, both asthma and COPD are complex and share common pathophysiological mechanisms. They are known as overlapping syndromes as approximately 40% of patients with COPD present an eosinophilic airway inflammation. Several studies suggest a putative role of eosinophilia in lung function decline and COPD exacerbation. Recently, pharmacological agents targeting eosinophilic traits in uncontrolled eosinophilic asthma, especially monoclonal antibodies directed against interleukins (IL-5, IL-4, IL-13) or their receptors, have shown promising results. This review examines data on the rationale for such biological agents and assesses efficacy in T2-endotype COPD patients.Patients with severe COPD and eosinophilic inflammation experience uncontrolled symptoms despite optimal pharmaceutical treatment. The development of new biomarkers is needed for better phenotyping of patients to propose innovative targeted therapy. https://bit.ly/2KzWuNO