COPD Drug Trial

Question 1

What is the difference in the affected site between asthma and COPD?

Answer 1

Asthma - Small and large airways

COPD - Airways and Lungs

Question 2

Which respiratory condition would you expect to see airways hyper-responsiveness?

Answer 2

Asthma

Question 3

Which inflammatory cells would be raised in a patient with asthma?

Answer 3

Eosinophils, mast cells and Th2 Lymphocytes

Question 4

Which inflammatory cells would be raised in a patient with COPD?

Answer 4

Neutrophils, macrophages and Th1 lymphocytes

Question 5

What treatments can be used for asthma, but not for COPD?

Answer 5

bronchodilators and corticosteroids

Question 6

What are the mediators of Asthma?

Answer 6

IL-4, IL-5 and cysLTs

Question 7

what are the mediators in COPD?

Answer 7

TNF-Alpha, IL-8 and LTB4

Question 8

What are typical changes seen in the airways of asthma patients?

Answer 8

Mucus plugs and epithelium in folds dur to airway constriction

Question 9

Which are the most commonly affected airways with asthma?

Answer 9

bronchi and bronchioles

Question 10

which part of the airways becomes most inflamed in asthma?

Answer 10

The conducting zone

Question 11

What happens to the smooth muscle of the airways during an asthma attack?

Answer 11

It contracts resulting in a narrow airway and thus limited airflow

Question 12

Which layer of the airways becomes thickened in asthma?

Answer 12

reticularis lamina

Question 13

What happens to the number of mucus glands in asthma patients?

Answer 13

They increase therefore more mucus is secreted

Question 14

What are the three pathological features seen in COPD?

Answer 14

Chronic bronchitis - mucus hypersecretion
Small Airway disease
Emphysema

Question 15

What is a small airway classified as?

Answer 15

Less than 2nm

Question 16

What happens to goblet cells in COPD/

Answer 16

They undergo hyperplasia so more mucus is secreted

Question 17

What is chronic bronchiolitis known as?

Answer 17

Small Airway Disease

Question 18

How does smoking affect decline the lung function?

Answer 18

Lung function decline is much faster is smokers, and does not return to a normal point upon smoking cessation

Question 19

What is emphysema?

Answer 19

A breakdown of lung parenchyma

Question 20

What happens o alveolar attachments in COPD?

Answer 20

They breakdown

Question 21

Why do bronchoconstrictors have no effect on COPD?

Answer 21

The constriction is caused by fibrosis not smooth muscle contraction

Question 22

How does smoking effect COPD?

Answer 22

Cigarette smoke triggers the release of alveolar macrophages
These release neutrophils which produce oxidants
This results in the production of proteases like neutrophil elastase and matrix metallo proteinases which result in alveolar destruction and mucus hypersecretion

Question 23

What drug is in development for COPD?

Answer 23

protease inhibitors

Question 24

What is a requirement for patients of a drug trial for COPD?

Answer 24

they only have COPD, no other co-morbidities

Question 25

What makes trialling COPD drugs challenging?

Answer 25

They require long time periods as decline over many years has to be watched