The pathobiology of asthma and COPD: Targeting new pathways for treatment

MEDI 246

William M. Abraham, abraham@msmc.com, Department of Research, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140-2894
Asthma and chronic obstructive pulmonary disease (COPD) are diseases characterized by airway inflammation. Although there is overlap in symptoms between the two disease entities, the inflammatory processes as defined by the cells, mediators, pulmonary targets, and therapeutic responses suggest that they are distinct. Mast cells, eosinophils, macrophages and Th2 lymphocytes and mediators including histamine, prostaglandin D2, tryptase, cysteinyl leukotrienes (LT), interleukin (IL)-5 and IL-13 characterize asthma pathobiology, whereas neutrophils, macrophages and cytotoxic T lymphocytes and mediators including IL-8, LTB4, elastase and tumor necrosis factor -α are associated with COPD. The difference in the inflammatory components of the two diseases is reflected in the response to therapy. Thus, glucocorticosteroids are effective anti-inflammatory agents in asthmatic patients, but not individuals with COPD. In this presentation, we will describe the inflammatory pathways that contribute to these two airway diseases and identify therapeutic targets that may be potentially useful for prevention and/or treatment.