Research Pinpoints Role of Biomarker In COPD

A report suggests that people with chronic obstructive pulmonary disease (COPD) and asthma have a protein in their lungs that leaks a small molecule into their bloodstream which restricts their breathing instead of relaxing their airways.

Published in the American Journal of Respiratory Cell and Molecular Biology, the report says this discovery may help clinicians diagnose and determine the severity of chronic lung diseases and make current treatments more effective. A protein in the cell membranes of the lungs can leak cyclic adenosine monophosphate (cAMP), causing the airways to become constricted.

These cells control constriction of the airways in asthma. By losing cAMP, the cells are more apt to constrict and worsen asthma, researchers said. They defined cAMP in the bloodstream as a biomarker by analyzing blood samples from a well-defined cohort of asthma patients. They determined that cAMP blood levels are higher in asthma patients. 

The knowledge gained from this research allows for better diagnostics of the illness and forms the basis for new therapeutics that will plug the leak of cAMP into the protein.

Additional insights from Dr. Nair:  There is a certain “back to the future element” to cAMP and lung disease. Theophylline was used for asthma and COPD many years ago, but it fell out of favor due to side effects that would occur (high pulse, nausea, vomiting, insomnia, irritability) if it was not maintained at a certain level or therapeutic window. That level got thrown off easily by drug interactions, sometimes with common medications such as antibiotics and common conditions such as liver disease. At very high levels, cardiac rhythm abnormalities and seizures could occur. Also, it was not as effective as regular treatment. It is very rarely used anymore, except for people who have been on it a long time. 

There has been a search for a “cleaner version” of Theophylline. The closest we have come to is a medication called Daliresp (Roflumalast). It is more of an add on medication – sometimes it helps and sometimes it doesn’t. It is also limited by GI side effects.

To read more about the study, please visit AJMC.