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Autoimmunity and COPD: clinical implications.
Caramori, Gaetano Ruggeri, Paolo Di Stefano, Antonino Mumby, Sharon Girbino, Giuseppe Adcock, Ian Kirkham, Paul
Caramori, Gaetano
Ruggeri, Paolo
Di Stefano, Antonino
Mumby, Sharon
Girbino, Giuseppe
Adcock, Ian
Kirkham, Paul
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Epub Date
Issue Date
2017-11-08
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Alternative
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Long term cigarette smoking is the cause of more than 90% of COPD in Westernized countries. However, only a fraction of chronic heavy smokers develop symptomatic COPD by the age of 80 years. COPD is characterized by an abnormal immune response in the lower airways and its progression is associated with infiltration of the lung by innate and adaptive inflammatory immune cells that form lymphoid follicles. There is growing evidence that both cellular- and antibody-mediated autoimmunity has a fundamental role in the pathogenesis of stable COPD. In particular, carbonyl-modified proteins may help to drive autoimmunity in COPD and to cause the characteristic small airways abnormalities and even contribute to the pathogenesis of pulmonary emphysema. Although direct, indirect, and circumstantial evidence of a role for autoimmunity in stable COPD patients has been identified, no cause-and-effect relationship between autoimmunity and the mechanisms of COPD has been firmly established in man. As such the potential contribution of an autoimmune response to the pathogenesis of COPD exacerbation is still being investigated and represents an area of active research. Many drugs targeting autoimmune responses are already available and the results of controlled clinical trials are awaited with great interest. The potential for measuring specific serum autoantibodies as biomarkers to predict clinical phenotypes or progression of stable COPD is promising.
Citation
Caramori G., Ruggeri P., Di Stefano A., Mumby S., et al (2017) 'Autoimmunity and COPD: clinical implications', Chest, 153(6), pp. 1424-1431
doi: 10.1016/j.chest.2017.10.033
Publisher
Journal
Research Unit
PubMed ID
29126842
PubMed Central ID
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Journal article
Language
en
Description
This is an accepted manuscript of an article published by American College of Chest Physicians in Chest Journal on 07/11/2017, available online: https://doi.org/10.1016/j.chest.2017.10.033
The accepted version of the publication may differ from the final published version.
Series/Report no.
ISSN
0012-3692