Therapeutic use of heparin and derivatives beyond anticoagulation in patients with bronchial asthma or COPD

[Display omitted] •Heparin is a unique molecule in biology with multiple pharmacological properties.•Heparin therapy has benefits in patients with COPD and asthma.•Inhaled heparin is safe and without adverse events associated with anti-coagulation. In this review, we identify potential targets for the therapeutic effects of heparin in asthma and chronic obstructive pulmonary disease (COPD), consider the safety and delivery modalities of this therapeutic approach. Specifically, we point to the anti-inflammatory, antioxidant and mucolytic effects of unfractionated heparin with potential to modify disease progression in COPD and asthma when administered via the inhaled route. Inhaled heparin may represent an effective add-on therapy in COPD and asthma patient groups, especially when taking into consideration the relative deficiency in endogenous heparin reported in asthma patients.