There is a pressing need to develop new treatments for chronic obstructive pulmonary disease (COPD), as no currently available drug therapy reduces the relentless progression of the diseases, chronic obstructive bronchitis and emphysema, falling under the umbrella of COPD. World-wide, 600 million people suffer from COPD, with some three million dying from the disease each year representing a globally market of US$2.8 billion US. There is a particular need to develop drugs that control the underlying inflammatory and destructive processes that cause COPD. There have been few therapeutic advances in the drug therapy of COPD. This contrasts with the enormous advances made in asthma management reflecting a much better understanding of the underlying disease. Although COPD is commonly treated with drugs developed for asthma, this is often inappropriate as the inflammatory process in COPD differs markedly from that in asthma. Recognition of the global importance and rising prevalence of COPD and the absence of effective therapies has now led to a concerted effort to develop new drugs for this disease. This recently prompted us to collaborate with Professor Peter Barnes (head of Throracic Medicine at the National Heart and Lung Institute, and one of the world's field leaders in COPD) to produce a major dossier "Therapeutic and pharmaceutical approaches to COPD" (click here for access). One of the targets addressed in this dossier was neutrophil elastase. Japanese researchers have recently published data describing the effect of an inhibitor of this enzyme, ONO-6818, on acute lung injury and pulmonary emphysema induced by human neutrophil elastase, one of the few well-accepted models of emphysema. ONO-6818 was reported to attenuate neutrophil elastase-induced increases in lung myeloperoxidase activity, hemoglobin, and neutrophil count in bronchoalveolar lavage fluid. Furthermore, it significantly attenuated pathological changes in lung function. ONO-6818 may represent an effective treatment for COPD although it should be noted that, as discussed in our recent dossier, the role that neutrophil elastase plays in the etiology of this disease is not yet clear.

Entry date October, 2002

Adapted from Kuraki et al, Am J Respir Crit Care Med 2002 Aug 15;166(4):496-500