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Regenerative pharmacology for COPD: breathing new life into old lungs
  1. John-Poul Ng-Blichfeldt1,2,
  2. Reinoud Gosens2,
  3. Charlotte Dean3,
  4. Mark Griffiths3,4,
  5. Matthew Hind3,5
  1. 1 MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, UK
  2. 2 Department of Molecular Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, Netherlands
  3. 3 National Heart and Lung Institute, Imperial College London, London, UK
  4. 4 Barts Heart Centre, St Bartholomews Hospital, London, UK
  5. 5 Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  1. Correspondence to Dr John-Poul Ng-Blichfeldt, MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge CB2 0QH, UK; jpblich{at}


Chronic obstructive pulmonary disease (COPD) is a major global health concern with few effective treatments. Widespread destruction of alveolar tissue contributes to impaired gas exchange in severe COPD, and recent radiological evidence suggests that destruction of small airways is a major contributor to increased peripheral airway resistance in disease. This important finding might in part explain the failure of conventional anti-inflammatory treatments to restore lung function even in patients with mild disease. There is a clear need for alternative pharmacological strategies for patients with COPD/emphysema. Proposed regenerative strategies such as cell therapy and tissue engineering are hampered by poor availability of exogenous stem cells, discouraging trial results, and risks and cost associated with surgery. An alternative therapeutic approach is augmentation of lung regeneration and/or repair by biologically active factors, which have potential to be employed on a large scale. In favour of this strategy, the healthy adult lung is known to possess a remarkable endogenous regenerative capacity. Numerous preclinical studies have shown induction of regeneration in animal models of COPD/emphysema. Here, we argue that given the widespread and irreversible nature of COPD, serious consideration of regenerative pharmacology is necessary. However, for this approach to be feasible, a better understanding of the cell-specific molecular control of regeneration, the regenerative potential of the human lung and regenerative competencies of patients with COPD are required.

  • lung repair
  • regeneration
  • regenerative pharmacology
  • adult stem cells
  • retinoic acid

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  • Contributors All authors: conception and design, manuscript writing, critical reading and revision, final approval of manuscript.

  • Funding This work was supported by the Lung Foundation Netherlands (Longfonds) under grant no. and by the NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.