|
September 1998
PEP Pioneers
Second Wind
Torrance, California
Dear Friends:
Improved understandings of the
basic mechanisms that result in COPD are creating a foundation for
new therapeutic approaches, particularly in early or moderate stages
of disease. Certainly
smoking, which is the root cause in most patients must be addressed.
All smoking must be absolutely stopped, if any degree of
airflow limitation, as measured by spirometry, is found.
The rate of decline of FEV1
can be stopped with smoking cessation, but otherwise continues in an
inexorable fashion. New
nicotine replacement products now include gum, patch, spray, and
inhaler, which looks very much like a cigarette. Other drugs, such as bupropion can help curb smoking.
New strategies are being developed which may make smoking
cessation much more successful than ever before.
Beyond smoking cessation, a
search for new antiinflammatory drugs, which are not related to
prednisone or derivatives, is progressing.
Medications which cause the lungs to grow new alveoli are
another exciting avenue of research that may soon lead to
therapeutic intervention. Both
antiinflammatory drugs and the iso-retinins, which stimulate
alveolar growth, are currently under study in humans.
Finally, a naturally occurring
protease inhibitor of the airways has been found to have powerful
antibacterial activity. This
stuff is known as secretory leukoprotease inhibitor (SLPI) or “SLIPPI”. “SLIPPI” can also prevent the development of emphysema in
experimental animals. “SLIPPI”
is now being manufactured through recombinant DNA technology, and
has begun to be studied in Europe.
Thus, it appears that a whole new therapeutic armamentarium
is on the horizon for COPD.
Use of these new therapies
requires identification of the problem.
Here’s where the National Lung Health Education Program
(NLHEP) comes in. NLHEP
intends to find all smokers with early stages of disease so that
they can not only stop smoking, but be candidates for trials of new
therapeutic strategies.
I will be
in touch next month.
Your friend,
Thomas Petty, MD
|
