The Potential for Phospholipids in the Treatment of Airway Inflammation: An Unexplored Solution

2021 ◽  
Vol 14 ◽  
Author(s):  
Varsha Komalla ◽  
Meenu Mehta ◽  
Fatima Achi ◽  
Kamal Dua ◽  
Mehra Haghi

: Asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) are major inflammatory respiratory diseases. Current mainstay therapy for asthma, and chronic obstructive pulmonary disease are corticosteroids, which have well-established side effect profiles. Phospholipids (PLs) are ubiquitous, diverse compounds with varying functions such as their structural role incell membrane, energy storage, and cell signaling.Recent advances in understanding PLs role as inflammatory mediators in the body as well as their widespread long-standing use as carrier molecules in drug delivery demonstrate the potential application of phospholipids in modulating inflammatory conditions. This review briefly explains the main mechanisms of inflammation in chronic respiratory diseases, currentanti-inflammatory treatments and areas of unmet need. The structural features, roles of endogenous and exogenous phospholipids, including their use as pharmaceutical excipients are reviewed. Current research on the immunomodulatory properties of PLs and their potentialapplication in inflammatory diseasesis the major section of this review. Considering the roles of PLs as inflammatory mediators and their safety profile established in pharmaceutical formulations, these small molecules demonstrate great potential as candidates in respiratory inflammation. Future studies need to focus on the immunomodulatory properties and the underlying mechanisms of phospholipids in respiratory inflammatory diseases.

2020 ◽  
Vol 73 (8) ◽  
pp. 1668-1670
Author(s):  
Mykola M. Ostrovskyy ◽  
Nadiia V. Korzh

The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). Patients’ quality of life was evaluated with the help of standardized St.George’s Respiratory Questionnaire (SGRQ). Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.


2017 ◽  
Vol 8 (6) ◽  
pp. 38-41 ◽  
Author(s):  
Ivan I. Pavlyuchenko ◽  
Evgenii A. Kokov ◽  
Lyudmila N. Kokova ◽  
Olga S. Okhremenko

Chronic obstructive pulmonary disease (COPD) is a common disease involving the pathological process, of bronchopulmonary and cardiovascular systems. This is a complex disease in which inflammation plays a leading role in the formation of the whole complex of pathological changes. COPD accompanies local deficit of antiproteases, excessive formation of active forms of oxygen, inducing uncontrolled lipid peroxidation and oxidative stress. An increase in the level of proinflammatory cytokines, such as IL-6, IL-8, TNF-α, is particularly significant in the combination of chronic obstructive disease with metabolic syndrome. Determination of a specific phenotype of COPD, and the degree of disruption of protective and adaptive systems in these forms of the disease course allows optimizing the treatment regimens for patients. The purpose of this work was to identify additional biochemical and biophysical markers of phenotyping and monitoring of therapy in patients with COPD of different phenotype and severity level in the acute stage on the basis of studying the main indicators of the system of antioxidant protection of blood and some cytokines. Significant differences in antioxidant system (AOS) indices in patients with COPD of different phenotype and severity were determined. The established differences in the activity of erythrocyte enzymes and the overall antioxidant activity of blood plasma can serve as an important additional link for the phenotyping of COPD. Complex treatment with the use of anticoagulants, normalizing the rheological properties of blood and mucolytics with pronounced antioxidant properties, reduces the level of prooxidant load on the body due to correction of metabolic processes and has the most pronounced effect on AOS blood parameters and cytokine profile.


2021 ◽  
Vol 12 ◽  
Author(s):  
Fabrizio Facchinetti ◽  
Maurizio Civelli ◽  
Dave Singh ◽  
Alberto Papi ◽  
Aida Emirova ◽  
...  

Chronic respiratory diseases are the third leading cause of death, behind cardiovascular diseases and cancer, affecting approximately 550 million of people all over the world. Most of the chronic respiratory diseases are attributable to asthma and chronic obstructive pulmonary disease (COPD) with this latter being the major cause of deaths. Despite differences in etiology and symptoms, a common feature of asthma and COPD is an underlying degree of airways inflammation. The nature and severity of this inflammation might differ between and within different respiratory conditions and pharmacological anti-inflammatory treatments are unlikely to be effective in all patients. A precision medicine approach is needed to selectively target patients to increase the chance of therapeutic success. Inhibitors of the phosphodiesterase 4 (PDE4) enzyme like the oral PDE4 inhibitor roflumilast have shown a potential to reduce inflammatory-mediated processes and the frequency of exacerbations in certain groups of COPD patients with a chronic bronchitis phenotype. However, roflumilast use is dampened by class related side effects as nausea, diarrhea, weight loss and abdominal pain, resulting in both substantial treatment discontinuation in clinical practice and withdrawal from clinical trials. This has prompted the search for PDE4 inhibitors to be given by inhalation to reduce the systemic exposure (and thus optimize the systemic safety) and maximize the therapeutic effect in the lung. Tanimilast (international non-proprietary name of CHF6001) is a novel highly potent and selective inhaled PDE4 inhibitor with proven anti-inflammatory properties in various inflammatory cells, including leukocytes derived from asthma and COPD patients, as well as in experimental rodent models of pulmonary inflammation. Inhaled tanimilast has reached phase III clinical development by showing promising pharmacodynamic results associated with a good tolerability and safety profile, with no evidence of PDE4 inhibitors class-related side effects. In this review we will discuss the main outcomes of preclinical and clinical studies conducted during tanimilast development, with particular emphasis on the characterization of the pharmacodynamic profile that led to the identification of target populations with increased therapeutic potential in inflammatory respiratory diseases.


2020 ◽  
Author(s):  
Jang Ho Lee ◽  
Hyang Yi Lee ◽  
Youngwon Jang ◽  
Jae Seung Lee ◽  
Yeon-Mok Oh ◽  
...  

Abstract Background: Pulmonary rehabilitation (PR) is a well-established treatment for chronic obstructive pulmonary disease (COPD). The standard protocol for PR requires frequent hospital visits, which can be difficult for patients. We performed this study to assess whether unsupervised home-based PR (HBPR) is effective for patients with COPD.Methods: This investigation was a prospective cohort study. After assessing the outcome data, including the results of a COPD assessment test (CAT); the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; a pulmonary function test; the modified Medical Research Council (mMRC) dyspnea scale; and the 6-min walking test (6MWT), specialists imparted education to patients about unsupervised HBPR. Patients who exercised more than three times per week were classified as the compliant group, and the others were categorized as the noncompliant group. Changes in the outcomes were compared between the compliant and noncompliant groups.Results: 41 patients were enrolled in this study. After 8 weeks of unsupervised HBPR, there were significant improvements in CAT scores, BODE index, and forced expiratory volume in 1 s among patients in the compliant group compared with those in the noncompliant group. Moreover, their CAT and mMRC scores improved significantly after 8 weeks compared with those at baseline. On the other hand, patients in the noncompliant group showed no significant improvement in any of the outcomes.Conclusions: Unsupervised HBPR can be effective for compliant patients with COPD. We recommend unsupervised HBPR for patients with COPD even when regular hospital visits for PR are not possible.Trial registration: NCT03754881


2012 ◽  
Vol 2 (1) ◽  
pp. 6 ◽  
Author(s):  
Janice G. Gullick ◽  
M. Colleen Stainton

Chronic obstructive pulmonary disease (COPD) changes family roles and relationship dynamics and the experience of the disease is influenced by family functioning. Merleau- Ponty&rsquo;s existential philosophy of the body provided the framework for this Heideggerian phenomenological inquiry. Fifteen people with COPD and 14 family members engaged in 58 semi-structured interviews either face-to-face or by telephone. This study identified a difference in the essence of the lived experiences between male and female carers, and between spousal and non-spousal carers in relation to severe COPD. Previous reciprocity framed the level of acceptance of the caring role and perception of care burden. The stories highlight the self-perceived need for women carers to be <em>conscious micro-managers</em> of illness. Male family members would care alongside, lending support and caring in a reactive way as specific needs or crises arose. Caring in COPD required a <em>binding vigilance</em>; a constant need of the carer to monitor the physical and emotional well-being of the sick person that bound them emotionally and cognitively to the task of caring. Carers were the managers of crises and families cared from a perspective of possible death. Family was perceived as the best thing in life. Health professionals should consider the influence of gender, family relationships and the impact of reciprocity when planning support for family caregivers. Further research is required to identify the similarities and differences in family caring between COPD and other chronic illnesses, and to further understand the specific needs of male carers.


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