Blog | Wednesday, October 19, 2011

QD: News Every Day--Novel mechanism may improve steroid response of COPD

Restoring corticosteroid sensitivity in patients with chronic obstructive pulmonary disease (COPD) may holds promise for effectively treating exacerbations of the condition, a team of Johns Hopkins researchers reported.

Physicians know that COPD often doesn't respond to corticosteroids even after patients stop smoking. Corticosteroids do not improve survival or alter the progression of COPD, and may reduce lung symptoms as little as 20% of patients.

But treatment with sulforaphane, a small-molecule activator of the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2), restored sensitivity in alveolar macrophages from patients with COPD. Researchers published their results in the Journal of Clinical Investigation.

The progressive decline in lung function that occurs in COPD is a result of persistent inflammation of the airways and destruction of the lung parenchyma, the researchers wrote in their study. COPD's continuing resistance to corticosteroids is largely caused by inactivation of histone deacetylase 2 (HDAC2). But, treatment with sulforaphane restored HDAC2 activity and corticosteroid sensitivity. Previous studies in 2008 by Johns Hopkins researchers showed sulforaphane activates the Nrf2 pathway (nuclear factor erythroid 2-related factor 2) and it is being tested in clinical trial for patients with COPD.

Broccoli by La Grande Farmers' Market via Flickr and a Creative Commons licenseResearchers said in a press release that sulforaphane, an ingredient of broccoli and other vegetables, can improve the effectiveness of corticosteroids.

An editorialist from 2008 pointed out that sulforaphanes found in vegetables and a related compound found in wasabi offer a more attractive mechanism for improving COPD response to corticosteroids (though not necessarily in the form of food.)