Research Advances in COPD Drugs and Novel Targets

Chronic obstructive pulmonary disease (COPD) is the third-most deadly disease in the world and will be a major healthcare problem for decades to come. Its etiology is mainly related to the exposure to cigarette smoke and poisonous gases, and the infections of viruses including COVID-19 induce acute exacerbation of COPD, which may cause death in patients. Few advances have been made in COPD pathological mechanism, and the current clinical treatment strategies focus on both bronchodilator and anti-inflammatory interventions; but with limited clinical therapeutic agents, COPD therapies still lack more drugs especially those that antagonize COPD-specific inflammatory responses. We review the COPD clinically applied drugs, and the progress of research on new drugs and related novel targets, including [Formula: see text] agonists and anti-muscarinic drugs for airway diastole, glucocorticoids and phosphodiesterase-4 inhibitors for anti-inflammatory, protease inhibitors, emerging antioxidants, adhesion factor inhibitors, growth factor antagonists, adenylate cyclase agonists, chemokine antagonists, etc. We thus provide insights on the COPD new drugs research and development.

Small Molecule Drugs in Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBDs), mainly represented by Crohn’s disease (CD) and Ulcerative Colitis (UC), are chronic disorders with an unclear pathogenesis. This incurable and iterative intestinal mucosal inflammation requires the life-long use of anti-inflammatory drugs to prevent flares or relapses, which are the major providers of complications, such as small bowel strictures and intestinal perforations. The introduction of tumor necrosis factor (TNF)-alpha inhibitors and other compounds, such as anti-IL12/23 and anti-alpha4/beta7 integrin monoclonal antibodies, has considerably improved the clinical management of IBDs. They are now the standard of care, being the first-line therapy in patients with aggressive disease and in patients with moderate to severe disease with an inadequate response to conventional therapy. However, for approximately one third of all patients, their efficacy remains insufficient by a lack or loss of response due to the formation of anti-drug antibodies or compliance difficulties with parenteral formulations. To address these issues, orally administered Small Molecules Drugs (SMDs) that use a broad range of novel pharmacological pathways, such as JAK inhibitors, sphingosine-1-phosphate receptor modulators, and phosphodiesterase 4 inhibitors, have been developed for CD and UC. This article provides an updated and complete review of the most recently authorized SMDs and SMDs in phase II/III development.

New coronavirus infection (COVID-19): from the dermatologist’s view

Recently published data on the pathogenesis and cutaneous manifestations of a new coronavirus infection (COVID-19) are presented. The most described lesions are urticarial, papulo-vesicular, erythematous rash, purpura, livedo-angiitis, as well as chilblains. Eruptions mainly appear together with main COVID-19 symptoms or a few days later. The treatment of new coronavirus infection may lead to a quick regression of skin lesions along with improvement of the general state of the patient. The review also provides data on the fact that COVID-19 patients with severe psoriasis and atopic dermatitis receiving biologic therapy (guselkumab, ustekinumab, adalimumab, secukinumab, ixekizumab, etanercept, dupilumab) and phosphodiesterase-4 inhibitors experience mild or asymptomatic COVID-19. Moreover, such patients do not develop cutaneous manifestations of COVID-19. The specific COVID-19 treatment has not been developed yet. We think that these findings might provide better understanding of mechanisms of action of biologic drugs in COVID-19.