Untangling the complexity of COPD

The complexity of chronic obstructive pulmonary disease (COPD) is what makes it a challenging and critical health concern that needs urgent attention. COPD is complex on many different levels; the various risk factors involved, the complexity of the immune response and inflammation pathways in the lungs, and in how it affects different groups of people depending on who they are and where they live.

Key risk factors for COPD are exposure to pollutants, such as tobacco smoke or indoor wood fires, or infections by bacteria or viruses, that enter the lungs and trigger an immune response in the lining of the lungs. This immune response leads to progressive inflammation that damages the lungs, obstructing airflow, making it difficult to breathe.  People living with COPD experience progressive shortness of breath, leading to symptoms like cough, wheeze, and fatigue,  limiting their ability to function day-to-day and reducing their quality of life.  People with COPD often suffer from a sudden worsening of their symptoms, often called a flare or exacerbation, that can be life threatening and can lead to a person having to go to hospital for emergency care. Delays in receiving a diagnosis is often a problem for people with COPD, with many people remaining undiagnosed for a number of years, which is likely to increase a person’s risk of having an exacerbation compared to those diagnosed earlier.

COPD is a complex disease, where the immune response in the lung involves several pathways, leading to the activation of a broad range of immune cells, including neutrophils and eosinophils,  which then cause different types of inflammation. If we are to improve the treatment for as many patients as possible, we need to look at the whole picture of the inflammatory response, not just one pathway at any one time. Addressing the most common inflammatory pathways, with treatments that act ‘upstream’ in the inflammatory cascade, could have a broader impact on the control of COPD, and potentially offer hope to many more patients.

Traditional therapies for COPD mainly focus on relieving symptoms and do little to address the underlying biology. The treatment landscape for COPD is seeing significant change. The use of emerging biological drugs, initially approved for asthma, is encouraging, although only in sub-groups of people with COPD. Further research is ongoing, looking at many other pathways, to see if broader patient groups will also be able to benefit. 

By applying scientific rigour to target our research efforts on untangling the complexities of the immune system, we hope to bring our expertise from pioneering monoclonals in oncology, neuroscience, ophthalmology and other areas, to advance treatment for immune-mediated respiratory and other diseases.