title: [Treatment of distal airways involvement in COPD].
abstract: BACKGROUND
  The current pharmacological treatment of COPD provides only partial beneficial effects on symptoms, exercise tolerance, frequency of exacerbations and quality of life. This could be related to poor targeting of the distal airways by current treatments, yet these airways are particularly involved in airflow obstruction and its consequences such as hyperinflation.
  
  
  BACKGROUND
  Many treatments used in COPD could have effects on distal airways, including bronchodilators, corticosteroids, mucolytics and antibiotics. However, these possible effects remain poorly understood.
  
  
  RESULTS
  New treatments targeting more specifically the mechanisms of inflammation, oxidative stress and tissue remodeling that characterize COPD, could prove useful in its management, but most are still only in the early stages of their development. Advances could also come from improvements in inhalation devices, delivering more of the medication to the distal airways.
  
  
  CONCLUSIONS
  Improvement in the management of COPD could come from progress in terms of both molecules and their mode of administration.
authors.affiliation: UPRES EA 220, pôle des maladies respiratoires, hôpital Foch, 11 rue Guillaume-Lenoir, Suresnes, France.
authors.forename: P
authors.initials: P
authors.lastname: Devillier
authors.forename: G
authors.initials: G
authors.lastname: Jebrak
authors.forename: H
authors.initials: H
authors.lastname: Morel
authors.forename: T
authors.initials: T
authors.lastname: Chinet
authors.forename: A
authors.initials: A
authors.lastname: Didier
authors.forename: N
authors.initials: N
authors.lastname: Roche
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D019468:Disease Management; D018450:Disease Progression; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004867:Equipment Design; D005100:Expectorants / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D058988:Phosphodiesterase 4 Inhibitors / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011650:Pulmonary Alveoli / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000209:etiology; D035703:Therapies, Investigational
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D005100:Expectorants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D058988:Phosphodiesterase 4 Inhibitors; D047428:Protein Kinase Inhibitors