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Towards a vaccine for chronic obstructive pulmonary disease
1Department of Immunology, Hunter Area Pathology Service and Hunter Immunology Limited, Newcastle, New South Wales, Australia. robert.clancy@newcastle.edu.au
Internal Medicine Journal
|March 1, 2012
Summary
Chronic obstructive pulmonary disease (COPD) involves toxins and bacterial colonization. An oral vaccine targeting Haemophilus influenzae reduces exacerbations by modulating the immune response to bacteria.
Area of Science:
- Pulmonary Medicine
- Immunology
- Microbiology
Background:
- Chronic obstructive pulmonary disease (COPD) arises from toxins and bacterial colonization.
- Previous studies on bacterial roles in COPD exacerbations were limited by data quality.
- Intrabronchial inflammation in COPD may stem from an exaggerated immune response to colonizing bacteria.
Purpose of the Study:
- To review pathogenic pathways in COPD.
- To support the hypothesis that intrabronchial inflammation is a hypersensitivity reaction to colonizing bacteria.
- To evaluate the therapeutic potential of oral immunotherapy for COPD.
Main Methods:
- Review of existing data on COPD pathogenesis.
- Analysis of the role of colonizing bacteria in COPD exacerbations.
- Evaluation of clinical trial results for an oral vaccine against non-typeable Haemophilus influenzae (NTHi).
Main Results:
- Bacterial colonization is a significant pathogenic pathway in COPD.
- Viral and bacterial infections may share a common inflammatory pathway involving colonizing bacteria.
- An oral NTHi vaccine reduced COPD exacerbation severity and hospital admissions.
Conclusions:
- Colonizing bacteria contribute significantly to COPD pathogenesis.
- Oral immunotherapy with NTHi shows therapeutic promise for COPD.
- Modulating the bacterial load through oral vaccination can limit COPD progression.
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