COPD Drug Trial Flashcards
What is the difference in the affected site between asthma and COPD?
Asthma - Small and large airways
COPD - Airways and Lungs
Which respiratory condition would you expect to see airways hyper-responsiveness?
Asthma
Which inflammatory cells would be raised in a patient with asthma?
Eosinophils, mast cells and Th2 Lymphocytes
Which inflammatory cells would be raised in a patient with COPD?
Neutrophils, macrophages and Th1 lymphocytes
What treatments can be used for asthma, but not for COPD?
bronchodilators and corticosteroids
What are the mediators of Asthma?
IL-4, IL-5 and cysLTs
what are the mediators in COPD?
TNF-Alpha, IL-8 and LTB4
What are typical changes seen in the airways of asthma patients?
Mucus plugs and epithelium in folds dur to airway constriction
Which are the most commonly affected airways with asthma?
bronchi and bronchioles
which part of the airways becomes most inflamed in asthma?
The conducting zone
What happens to the smooth muscle of the airways during an asthma attack?
It contracts resulting in a narrow airway and thus limited airflow
Which layer of the airways becomes thickened in asthma?
reticularis lamina
What happens to the number of mucus glands in asthma patients?
They increase therefore more mucus is secreted
What are the three pathological features seen in COPD?
Chronic bronchitis - mucus hypersecretion
Small Airway disease
Emphysema
What is a small airway classified as?
Less than 2nm
What happens to goblet cells in COPD/
They undergo hyperplasia so more mucus is secreted
What is chronic bronchiolitis known as?
Small Airway Disease
How does smoking affect decline the lung function?
Lung function decline is much faster is smokers, and does not return to a normal point upon smoking cessation
What is emphysema?
A breakdown of lung parenchyma
What happens o alveolar attachments in COPD?
They breakdown
Why do bronchoconstrictors have no effect on COPD?
The constriction is caused by fibrosis not smooth muscle contraction
How does smoking effect COPD?
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
What drug is in development for COPD?
protease inhibitors
What is a requirement for patients of a drug trial for COPD?
they only have COPD, no other co-morbidities
What makes trialling COPD drugs challenging?
They require long time periods as decline over many years has to be watched
