Pathogenesis of COPD 3: Oxidative Stress – Is There a Possibility of Developing New Drugs from the Standpoint of This Pathogenetic Mechanism?

Abstract

Growing evidence suggests that oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, the pathogenetic mechanisms underlying this disease are not fully understood. Although current therapies for COPD, which are mainly bronchodilators, can provide symptomatic relief, no available therapy can reverse or even slow the progression of COPD. A better understanding of the underlying mechanisms by which oxidative stress drives disease pathogenesis is critical for developing novel and more effective therapies. This chapter focuses first on the relationship between cigarette smoking and oxidative stress in COPD. Next, the role of antioxidants in the lung and the antioxidant capacity in COPD is explained. The latest information on genetic predisposition and epigenetic regulation of oxidative stress in COPD is then specifically reviewed, focusing on the role of microRNAs in this disease. Finally, the current state and the future direction of antioxidant therapeutics in COPD are presented. Certain classes of antioxidants are expected to be developed into promising treatments for COPD. However, their current therapeutic potential remains limited due to the complexity of this disease. Hence, multidisciplinary therapeutic approaches are necessary for developing novel strategies of COPD treatment.