Scientists solve COPD puzzle

UK researchers have discovered why patients with Chronic Obstructive Pulmonary Disease (COPD) fail to respond to steroid treatment.

Scientists from Imperial College, London have also been able to combat this resistance and have started clinical trials for a potential therapy.

The researchers found that although other inflammatory diseases are usually easily treated with steroids, these steroids fail to `switch off' activated inflammatory genes in patients with COPD.

`Switching off' inflammatory genes requires an enzyme called Histone Deacetylase 2 (HDAC2) but the researchers found that in COPD patients, levels of HDAC2 were very low compared to normal cells.

However, studies in rats found that low doses of the drug theophylline successfully raised the levels of HDAC2 and broke steroid resistance.

Speaking at the British Endocrine Society's annual meeting, lead researcher Professor Peter Barnes said: “COPD kills tens of thousands of people in the UK every year and currently we can only treat the symptoms, not the underlying problem of inflammation in the lungs.”

“Our work has finally provided an explanation for steroid resistance in COPD, and has allowed us to identify ways to combat this.”

Barnes revealed that the first stages of clinical trials to test low doses of theophylline in COPD patients are now under way. If the trials are successful, it is hoped that they may lead to a change in the treatment of COPD and other severe inflammatory diseases that do not respond to steroid treatment.

Barnes added: “We hope that the clinical trials of theophylline will be successful so that we can finally offer an effective therapy to COPD sufferers - a staggering 6 per cent of the population.”

In 2004 the European Respiratory Society reported that COPD kills over 30,000 people each year in the UK and that by 2020 is likely to account for over six million deaths worldwide. It is currently the fourth most common cause of death in the UK.