Researchers may have found a new target in chronic obstructive pulmonary disease (COPD) symptoms that could potentially save more lives.

The study focused on mucus plugs, which clog airways in the lungs of many patients with the respiratory disease.

“As a chronic disease, COPD can’t be cured, but our findings suggest that using therapies to break up these mucus plugs could help improve outcomes for COPD patients, which is the next best thing,” said corresponding author Dr. Alejandro Diaz, an associate scientist in the Division of Pulmonary and Critical Care Medicine at Brigham and Women’s Hospital in Boston.

“Mucus is something that we already know a lot about from a basic science standpoint, and there are also a lot of mucus-targeting therapies that either already exist or are in development for other diseases, so it’s an extremely promising target,” Diaz said in a hospital news release.

The researchers used data from the Genetic Epidemiology of COPD (COPDGene) study, which included more than 10,000 people recruited between 2007 and 2011. They had COPD at different stages.

Narrowing that to data from more than 4,000 of these patients, researchers analyzed chest CT scans taken at their first clinic visit in search of mucus plugs.

“Creating mucus is a normal part of the body’s immune response, but usually we cough it up as we’re getting better,” Diaz said. “COPD causes the body to produce too much mucus and makes it harder to clear out, so you end up with these mucus plugs that aren’t strongly correlated with any specific symptoms and can go undetected.”

Researchers found that the death rate for COPD patients with no detectable mucus plugs was 34%. For those with mucus plugs in up to two lung segments, the death rate jumped to 46.7%. Patients with plugs in three or more lung segments had a death rate of 54.1%.

“The data show a compelling association between the accumulation of these mucus plugs and overall mortality, but we don’t know anything about what’s driving it yet,” Diaz said.

COPD is the fourth-leading cause of death in the United States. It affects 15.9 million Americans.

It can be the result of cigarette smoking or long-term exposure to air pollutants. Although reducing exposure to these pollutants can slow its progression, COPD is incurable.

“For the last four decades we’ve had only two targets for COPD therapies — either promoting bronchial dilation, which means making the airways themselves wider, or reducing bronchial inflammation,” Diaz said. “This is telling us that there may be more we can do about this disease than we realized before.”

Mucus is a therapeutic target for other diseases. Researchers now plan to test existing therapies in people with COPD to see if treating the mucus plugs could affect outcomes.

They noted that much about factors affecting COPD deaths remains unknown and not all appear as symptoms for the patient.

Study results were published May 22 in Journal of the American Medical Association and presented simultaneously at the American Thoracic Society 2023 International Conference, in Washington, D.C.

More information

The U.S. Centers for Disease Control and Prevention has more on COPD.

SOURCE: Brigham and Women’s Hospital, news release, May 21, 2023

Source: HealthDay