COPD drug trial

Question 1

What is the affected site in asthma vs COPD?

Answer 1

Asthma: large and small airways. Airway hyper-responsiveness. Mucus

COPD: airways and lungs. Mucus

Question 2

What inflammatory cells are in asthma vs COPD?

Answer 2

Asthma: eosinophils, mast cells, Th2 lymphocytes
COPD: neutrophils, macrophages, Tc1 lymphocytes

Question 3

What are mediators in asthma vs COPD?

Answer 3

Asthma: IL4, cysLTs

COPD: TFN-alpha, IL8, LTB4

Question 4

What is treatment for asthma vs COPD?

Answer 4

Asthma: bronchodilators and corticosteroids

COPD: bronchodilators and corticosteroids don’t work

Question 5

What causes mucus hyper secretion in COPD?

Answer 5

Goblet cell hyperplasia and goblet cell hypertrophy

Desynchronisation of epithelial cells- don’t push mucus properly

Question 6

What causes small airways to become obstructed?

Answer 6

Increased mucus secretion
Loss of alveolar attachments
Lots of fibrosis- hard to hold alveoli open

Question 7

What are the 2 types of emphysema?

Answer 7

Panlobular emphysema: affects entire lung lobe

Centrilobular emphysema: mainly affects top of lobe

Question 8

What are the 3 main types of COPD and what areas do they affect?

Answer 8

Chronic bronchitis- bronchi
Emphysema- distal respiratory tract
Small airway disease- bronchioles

Question 9

When testing a new COPD drug what tests should be carried out?

Answer 9

Lung function- to see if drug leads to a reduced decline in lung function over age

Bronchoalveolar lavage- to detect an increase in anti-proteases/ decrease in proteases

High resolution CT scan- to see if theres a slowing in presence of emphysema (new holes/ larger holes?)

Question 10

What might prevent a COPD drug from working and how can this we solved?

Answer 10

mucus might prevent drug from getting to its target area

We can give patient a mucolytic which breaks down mucins