PI3K signalling in chronic obstructive pulmonary disease and opportunities for therapy

• Published in: The Journal of pathology Vol. 254; no. 5; pp. 505 - 518
• Main Authors: Moradi, Sharif, Jarrahi, Esmaeil, Ahmadi, Ali, Salimian, Jafar, Karimi, Mehrdad, Zarei, Azadeh, Azimzadeh Jamalkandi, Sadegh, Ghanei, Mostafa
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.08.2021; Wiley Subscription Services, Inc
• Subjects: 1-Phosphatidylinositol 3-kinase; Animal models; Animals; Bronchodilators; Chronic obstructive pulmonary disease; Clinical trials; cytokine; Drug therapy; Humans; immune response; Inflammation; leukocyte; Lung diseases; microRNA; Obstructive lung disease; Phenotypes; Phosphatidylinositol 3-Kinase - metabolism; Phosphoinositide-3 Kinase Inhibitors - pharmacology; PI3‐kinase; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - metabolism; Respiratory tract diseases; Signal transduction; Signal Transduction - drug effects; Signal Transduction - physiology; Steroid hormones; Toxicity; cytokine; microRNA; PI3-kinase; immune response; leukocyte
• ISSN: 0022-3417; 1096-9896
• DOI: 10.1002/path.5696

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterised by airway inflammation and progressive obstruction of the lung airflow. Current pharmacological treatments include bronchodilators, alone or in combination with steroids, or other anti‐inflammatory agents, which have only partially contributed to the inhibition of disease progression and mortality. Therefore, further research unravelling the underlying mechanisms is necessary to develop new anti‐COPD drugs with both lower toxicity and higher efficacy. Extrinsic signalling pathways play crucial roles in COPD development and exacerbations. In particular, phosphoinositide 3‐kinase (PI3K) signalling has recently been shown to be a major driver of the COPD phenotype. Therefore, several small‐molecule inhibitors have been identified to block the hyperactivation of this signalling pathway in COPD patients, many of them showing promising outcomes in both preclinical animal models of COPD and human clinical trials. In this review, we discuss the critically important roles played by hyperactivated PI3K signalling in the pathogenesis of COPD. We also critically review current therapeutics based on PI3K inhibition, and provide suggestions focusing on PI3K signalling for the further improvement of the COPD phenotype. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.