Neutrophils and Emerging Targets for Treatment in Chronic Obstructive Pulmonary Disease

Mariska Meijer; Ger T Rijkers; Frans J van Overveld


Expert Rev Clin Immunol. 2013;9(11):1055-1068. 

In This Article

Expert Commentary & five-year View

Over the past years, many details of the molecular pathogenesis of COPD have been revealed. This has offered new points of possible interventions, many of which are currently under investigation. This means that in 5 years, we will have a lot more information regarding the intervention of COPD and hopefully, some of these results will be promising and continue into more advanced clinical trials. To further advance the development of targeted intervention, two lines of study, besides the clinical trials, should receive specific attention. First of all, it has become clear that the regulation of neutrophils in COPD follows different routes than the regulation of healthy neutrophils. Identifying the pathways that are altered and the causes of these alterations may allow for treatment at the root of the problem. The development of ectoine is a good example of such an approach. Furthermore, it is necessary to start differentiating the various types of COPD. As long as all the different types are seen as one single condition, it will be very hard to determine whether or not a given drug is effective. For example, eosinophilic COPD is often responsive to corticosteroids, whereas neutrophilic COPD is not. Therefore, the time may have come to define these diseases not solely by their clinical symptoms, but also by the main cell types involved in their pathogenesis, so that treatment may be tailored to the actual causes of the disease.