Pitt Physicians Confirm Autoimmunity as Factor in Chronic Obstructive Pulmonary Disease

Pulmonary specialists at the University of Pittsburgh School of Medicine are reporting solid evidence that chronic obstructive pulmonary disease (COPD) is an autoimmune disease in many patients. Previous speculation that COPD may have an autoimmune component has remained unproven until now. The finding, reported recently in the American Journal of Respiratory and Critical Care Medicine, holds particular relevance regarding possible future treatments, including a clinical trial of inhaled cyclosporine now enrolling patients at the University of Pittsburgh. This approach also is scheduled for discussion on Friday, Feb. 29, at the Pittsburgh International Lung Conference being held at the Omni William Penn Hotel Downtown.

The fourth-leading cause of death and second-leading cause of disability in the United States, COPD is a lung disease commonly related to smoking that diminishes breathing capacity over time and includes conditions such as chronic bronchitis and emphysema. The National Institutes of Health estimates that 12 million adults have a current diagnosis of COPD, with an additional 12 million unaware that they have the disorder.

“COPD damages the lung tissue, expanding and breaking down the walls of air sacs, which hinders air flow out of the lungs and the transfer of oxygen into the blood,” said Steven R. Duncan, M.D., a senior author of the study and professor of medicine at the University of Pittsburgh School of Medicine. “This new work shows that in some patients with COPD, immune system antibodies attack the cells that line the airways and air sacs of the lungs called epithelial cells.”

The Pitt researchers tracked immune system antibodies in 55 smokers or former smokers (47 with COPD) compared to 21 healthy people who had never smoked. Abnormal antibodies were found in 68 percent of smokers and former smokers with COPD but in only 13 percent of former smokers without COPD and 10 percent of those who had never smoked.

“COPD is responsible for 120,000 deaths a year,” said Frank C. Sciurba, M.D., a study senior co-author, associate professor of medicine and director of Pitt’s Emphysema Research Center. “Available treatments, including inhaled bronchodilators, have little effect on disease progression. New information learned may help us to develop better treatments and perhaps even halt disease progression.”

Investigators at the Emphysema Research Center are conducting a clinical trial of an inhaled form of cyclosporine, long used to suppress the immune system in transplant patients. “We are working every day to increase awareness of the disease and find new ways to help our patients,” added Dr. Sciurba.

Symptoms of COPD include a recurring cough, sometimes underestimated as “smoker’s cough,” wheezing, shortness of breath, overproduction of sputum and inability to breathe deeply. The most important step patients can take to reduce the risk of developing COPD or slow progression of the disease is to quit smoking.

“We expect to see increasing numbers of patients with COPD in the Pittsburgh area since our smoking rates – some 25 percent – are higher than elsewhere in the United States,” said Dr. Sciurba.

Patients with more severe COPD interested in additional information on these research findings and the inhaled cyclosporine trial may call the Emphysema Research Center at 412-692-4800. For a copy of the paper, call Michele Baum at 412-647-3555.

For information on the Pittsburgh International Lung Conference, follow this link: https://ccehs.upmc.edu/courses/brochure_1248.pdf.