Elucidation of the mechanism of exacerbation of COPD based on vascular permeability in peripheral airways and establishment of new therapeutic strategies

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K09622
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Respiratory organ internal medicine
• Research Institution: Osaka City University
• Principal Investigator: KANAZAWA HIROSHI 大阪市立大学, 大学院医学研究科, 准教授 (90332957)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 慢性閉塞性肺疾患 / 急性増悪 / 血管透過性 / 末梢気道

Outline of Final Research Achievements

Exacerbation of COPD impairs a patient's quality of life and respiratory function, causing a worse prognosis. Therefore, prevention of exacerbations in the long-term management of COPD, and rapid diagnosis and establishment of appropriate treatment are extremely important clinical issues. In this study, we established the pathogenesis of COPD exacerbation, and identified biomarkers that are effective for high-risk group and early diagnosis. Using this biomarker, we proposed effective treatment strategies for the prevention of exacerbation of COPD, and provided a logical guideline for the selection, dosage, and duration of treatment for the acute phase of exacerbation. In addition, we elucidated the phamacological mechanisms of several drugs that showed preventive effects of exacerbation of COPD in large-scale clinical trials from the viewpoint of microvascular permeability in the peripheral airways, and showed the direction of new therapeutic strategies.

Free Research Field

呼吸器内科学

Academic Significance and Societal Importance of the Research Achievements

COPDの増悪機序を細気道レベルにおける微小循環障害による血管透過性亢進の観点から解明し、現在のCOPD患者の長期管理における主要課題であるCOPDの増悪予防と管理のための論理的基盤を提供するもので学術的意義は高い。そして、増悪を起こしやすいフェノタイプの分別可能性という重要な臨床上の進展が期待できる。今回の研究成果から，増悪を起こしやすい患者を鋭敏なバイオマーカーを用いて簡便に鑑別し，頻回の増悪や入院に至る前に介入を行うことで，COPD の予後が大きく改善されることが期待される。また、COPDの増悪の治療に関して、有効な論理的薬物療法のあり方が示され、医療経済的にも大きな貢献が期待される。