Chemokines and inflammation in COPD: implications for targeted therapy

Abstract

A severe global health issue, chronic obstructive pulmonary disease (COPD) is characterised by recurrent respiratory symptoms and restricted breathing because of long-term lung inflammation. A class of minuscule cytokines known as chemokines is essential for immune cell recruitment and activation, which sustains the inflammatory response in COPD. This study thoroughly examines the origins, modes of action and effects of chemokines on developing COPD-related inflammation. We detail the involvement of key chemokines, such as CXCL9, CXCL10, and CXCL11, in COPD pathophysiology. These chemokines are integral in attracting neutrophils, macrophages, and T lymphocytes to the lungs, leading to chronic inflammation, airway remodelling, and emphysema. Increased levels of these chemokines correlate with increased disease severity and frequency of exacerbations. The review additionally examines the possibility of using chemokine pathway targeting as a treatment approach. Current COPD treatments primarily address symptoms without adequately controlling underlying inflammation. By inhibiting chemokine signalling, it may be possible to reduce inflammation, slow disease progression, and improve patient outcomes. We discuss various therapeutic approaches, including developing chemokine receptor inhibitors, biologics such as monoclonal antibodies, drug repurposing, and combination therapies with existing treatments. Furthermore, we review ongoing and completed clinical trials investigating chemokine-targeted therapies in COPD, highlighting their efficacy and safety. This review also emphasises the need for further research to optimise these therapies and identify biomarkers for monitoring treatment response. In conclusion, chemokines are pivotal in the inflammatory processes of COPD. Targeting chemokine pathways presents a promising avenue for developing more effective treatments, which could significantly enhance patient care and disease management.