New anti-inflammatory targets for chronic obstructive pulmonary disease

Key Points Chronic obstructive pulmonary disease (COPD) is a major and increasing global health problem that results in progressive airway obstruction. Although effective bronchodilators have been developed, there is no safe and effective treatment for the underlying chronic inflammation, which is resistant to corticosteroids. There is an urgent need for the development of safe and effective anti-inflammatory therapies to reduce disease progression, exacerbations and comorbidities of COPD. The discovery of anti-inflammatory treatments has been hampered by the difficulties of undertaking clinical trials in patients with COPD. Promising new approaches include novel antioxidants, multi-kinase inhibitors as well as drugs that target cellular senescence and abnormal repair. Drugs that reverse corticosteroid resistance are also showing promise. Current treatments for chronic obstructive pulmonary disease (COPD) do not reduce disease progression or suppress chronic inflammation. This Review highlights new therapeutic targets that have been discovered through a better understanding of the underlying inflammation in COPD and provides an update on the development of anti-inflammatory drugs for this disorder. Chronic obstructive pulmonary disease (COPD) is associated with chronic inflammation of the peripheral airways and lung parenchyma, which leads to progressive obstruction of the airways. Current management with long-acting bronchodilators does not reduce disease progression, and there are no treatments that effectively suppress chronic inflammation in COPD. An increased understanding of the inflammatory processes that are involved in the pathophysiology of COPD has identified several new therapeutic targets. This Review discusses some of the most promising of these targets, including new antioxidants, kinase inhibitors and drugs that target cellular senescence, microbial colonization, epigenetic regulation of inflammatory gene expression and corticosteroid resistance.