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Modulation of airway inflammation to prevent exacerbations of COPD

CORRESPONDENCE: M. Solèr, St. Claraspital, CH-4016 Basel, Switzerland. Fax: 41 616858469. E-mail: markus.soler{at}claraspital.ch

Exacerbations of chronic obstructive pulmonary disease (COPD) are periods in the chronic course of this disease with symptoms of intensified inflammation, induced in part by infections but also by noninfectious irritating mechanisms. Although these exacerbations seem to be linked to accelerated long-term disease progression and impaired quality of life, there are only limited preventive measures available, apart from smoking cessation.

This article compares the effectiveness of different pharmacological treatments for the prevention of COPD exacerbations, including the oral bacterial lysate OM-85.

Given the differences in the mechanism of action of the treatments discussed, this opens some hope for additive or potentiating effects with combined treatments, which will have to be studied in future controlled trials.

KEYWORDS: Chronic obstructive pulmonary disease, exacerbation, OM-85, pharmacotherapy, prevention