As researchers continue to examine COPD and emphysema, a recurring theme is the understanding of COPD as a condition in which lung aging is accelerated. For example, the terms “inflammaging” and “senile lung” were created to identify states of inflammation and loss of function linked to the aging process. While knowledge continues to grow, COPD treatment still focuses largely on symptom relief. This article looks at the arc of age-related COPD study, and recent thinking on possible treatment approaches.
Establishing the relationship between aging and COPD
A 2018 publication of the India Chest Society, reported that “COPD and aging share many overlapping hallmarks of aging, which has led to the hypothesis that COPD is a disease of accelerated aging.” The authors noted that “COPD is projected to become the third leading cause of death worldwide in 2030. This coupled with the fact that nearly 25% of the world's population in 2030 is projected to be over the age of 65 provides an urgency to better understand the intersection between aging and lung disease.”
To further the discussion, the study listed 9 “hallmarks of aging,” while acknowledging that aging is influenced by many variables. The hallmarks included genetic instability, telomere attrition, epigenetic alterations, loss of proteostasis, dysregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communications.
“COPD and aging share many overlapping hallmarks…which has led to the hypothesis that COPD is a disease of accelerated aging.”
India Chest Society 2018
In search of treatment strategies
A 2020 study examined age-related mechanisms further in an attempt to move down the path toward two “anti-aging” treatment strategies.
- Repurpose drugs as anti-aging therapies. The International Journal of Molecular Sciences study listed reservatrol, metformin, melatonin, klotho, and receptor blockers as possible candidates for COPD treatment because of their roles in the aging process.
- Explore novel anti-aging treatments. This category of potential COPD treatments included senolytics (to reduce senescent cells), stem cell therapy, and antioxidant therapy.
The research quoted above reminded us that “current treatments for COPD are mainly addressing COPD-associated symptoms, but alternative treatment strategies are needed to evaluate the underlying mechanisms that lead to the development of COPD, especially in the elderly.”
Watching the clock
Similar to the status of COPD biomarkers, which are being researched for their predictive value in forecasting the course of a person’s COPD, the potential of anti-aging treatments has yet to reach fruition.
One thing is certain: there will be no letup in the demand for actionable information, or the number of people eagerly hoping for improved care.
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National Library of Medicine/NIH (2018)
National Library of Medicine/NIH (2019)
National Library of Medicine/NIH (2020)
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