Is COPD Curable?

Medical Breakthroughs for Chronic Obstructive Pulmonary Disease

In This Article


Many people wonder if there is a cure for chronic obstructive pulmonary disease (COPD). It is the fourth most prevalent cause of death in the world, and the third leading cause of death and disability in the U.S.

Unfortunately, COPD is not curable now, but that may soon change. There are many medical breakthroughs and improvement in outcomes on the horizon and when it comes to COPD. The future looks bright.

Mid adult woman using inhaler
Science Photo Library / Getty Images

Anatomy and Function of the Lungs

To understand the recent breakthroughs in COPD treatment, it’s important to be familiar with some of the basic structures of the respiratory system and their functions.

Inspired air travels into the windpipe (trachea) which allows for air to travel from the mouth, into the lungs, through its tubular branches, called bronchi. As the bronchi descend further downward, they branch off into smaller and smaller branches, called bronchioles.

Finally, the bronchioles form small, thin-walled air sacs or bubbles called alveoli. The alveoli are where the exchange of gases (oxygen and carbon dioxide) takes place between the air that you breathe and your bloodstream. 

Breakthroughs in COPD Treatment

The use of an endobronchial valve for emphysema and combination medications are two current breakthroughs in the treatment of COPD.

Endobronchial Valve for Emphysema

Emphysema is a progressive lung disease that is considered a severe form of COPD. It occurs when the alveoli become damaged (most commonly from smoking). When the alveoli become damaged, air gets trapped inside of them; this results in an increase in pressure on the diaphragm and in the healthy portions of the lungs.

Emphysema causes shortness of breath, making it difficult for a person to do simple tasks, like walking across the room, getting dressed, or taking a bath.

There is currently no cure for emphysema and treatment is primarily comprised of medications (such as bronchodilators to open the airways and improve breathing), steroids (to lower inflammation in the lungs) and antibiotics (to treat respiratory infections that often accompany COPD).

As a last resort, surgery may be performed to remove damaged lung tissue, or a lung transplant may be performed. However, donor lungs are limited and not everyone who needs a transplant will have access to the procedure.

Endobronchial Valve

A new treatment may help to take the place of lung surgery for some people with COPD. The procedure is called an endobronchial valve. It has been approved by the U.S. Food and Drug Administration (FDA).

This procedure can be performed in lieu of surgery to remove diseased lung tissue. The valve can easily be inserted via a minimally invasive procedure, but it’s intended to be used along with breathing medications.

The procedure involves a 30- to 60-minute bronchoscopy using a narrow tube with a camera, inserted into the mouth, trachea, and finally, to the diseased area of the lungs. A one-way silicone duckbill valve is then placed to block off areas of the lung where the alveoli have collapsed (preventing air from entering those areas and becoming trapped).

The result is that the healthier parts of the lungs can function more efficiently, and the diaphragm is able to expand without the pressure from trapped air. This allows a person with emphysema to take deeper breaths and helps alleviate some of the shortness of breath that is associated with emphysema.

It’s important to note that the valve will not cure emphysema, but rather, it is a palliative (improving symptoms of discomfort) treatment, that may function as an alternative to lung surgery. The effects of the surgery—relief from breathlessness—is said to be immediate.

The endobronchial valve procedure is not for everyone, good candidates for the procedure include:

  • Those who have little or no collateral ventilation in the area of the lung (lobe) where the valve will be placed. Collateral ventilation is the passage of air that bypasses diseased/obstructed airways.
  • Those with emphysema who experience breathlessness, even when taking medications for COPD or emphysema.
  • Others

Combination Medications/Inhalers

Another new breakthrough in COPD treatment is a type of medication that is touted as being more effective than standard inhalers, called combination inhalers.

Normally, COPD medications include short- and long-acting inhalers that work to help open the airways to make breathing easier; they work at different speeds, examples include:

Combination medications for COPD may include long-acting bronchodilators combined with a steroid inhaler; the bronchodilator opens the airways while the steroid inhaler works to lower inflammation in the lungs.

Note, the type of steroids, called corticosteroids, used to treat chronic lung diseases are not the same as anabolic steroids, used illegally by some athletes for bodybuilding. Corticosteroids do not have the same dangerous side effects as anabolic steroids, such as liver damage or sterility.

Here is a list of combination inhalers:

Short-acting beta2-agonist and short-acting anticholinergic bronchodilators include Combivent Respimat (ipratropium bromide/albuterol)

Long-acting beta2-agonist and corticosteroids include:

Long-acting beta2-agonist and long-acting anticholinergic bronchodilators include:

  • Anoro Ellipta (umeclidinium and vilanterol inhalation powder)
  • Duaklir Genuair (aclidinium/formoterol fumarate)
  • Inspiolto Respimat (tiotropium bromide monohydrate and olodaterol hydrochloride)
  • Ultibro Breezhaler (glycopyrronium and indacaterol)

Long-acting beta2-agonist, long-acting anticholinergic and a corticosteroid include Trelegy Ellipta (fluticasone furoate, umeclidinium, and vilanterol)

Some types of combination medications do not begin working right away (such as those with corticosteroids), rather, it may take time for the level of medication to build up in the body and begin to be effective in helping to prevent COPD flareups or lessening the severity of symptoms during flareups.

For quick relief of COPD symptoms, it’s still important to take the type of fast-acting bronchodilator prescribed by your healthcare provider, even when a person is taking combination inhalers.

Improved Outcomes in COPD

Health outcomes are changes in health as a result of interventions. In COPD an example of an improved outcome is an intervention (treatment or medication) aimed at preventing death after a period of severe exacerbation (flareup).

According to a 2018 study published in the Journal of American Medical Association (JAMA), “The need to improve outcomes and control healthcare costs in patients with chronic obstructive pulmonary disease (COPD) has never been greater.”

Intervention and Pulmonary Rehabilitation

Transitional care is the continuity of care from one facility or healthcare setting to another (such as from an outpatient care setting, to a hospital admission or from a hospital setting to a long-term care facility (nursing home).

Transitional care is also applicable to a home setting, once a person is discharged from a healthcare facility. This continuity in care includes family care and discharge planning for the patient and family members after admission to a hospital or other healthcare setting.

A self-management education program for people with COPD addresses the disease while educating people in skills used to manage the disease. These skills could include emotional coping skills, breathing techniques, exercise training, education on how to implement a healthy diet, and more.

Study on Outcomes

A randomized controlled trial is a study that aims to lower bias when testing the effectiveness of a new medication or treatment by allocating study subjects randomly to two or more groups. The groups will either receive the medication/intervention or a placebo, alternate treatment, or no intervention.

The group that receives the alternative treatment or no intervention is called the control group. The two groups are then compared to each other to evaluate the effectiveness of the intervention. 

In a 2018 randomized controlled trial, the intervention included people with COPD receiving patient education sessions, a self-management plan for exacerbations (flareups), and a monthly intervention (phone call) from a case manager.

These patients who received the aforementioned interventions were linked with a lower incidence of hospitalization and fewer visits to the emergency room for treatment of their COPD. The 3-month study provided transitional care, support, and chronic (long-term) disease self-management compared those who received standard care, with those who received the aforementioned intervention.

Those who received the intervention were said to have a “robust reduction in subsequent COPD-related acute care events (hospitalization and emergency department visits),” compared to those who did not receive the intervention.

Pulmonary Rehabilitation
Pulmonary rehabilitation is an educational and support service that involves education on the disease process, how to manage symptoms, how to exercise with less shortness of breath, healthy diet principles, and more.

The educational classes are offered in a group setting to allow people with COPD to meet and interact with others who also have COPD. The group participants are able to give and receive support from each other, and learn about how other people with COPD manage their symptoms and emotions.

The skills that are learned in the classes help people with COPD learn how to manage their illness and become stronger by increasing their fitness level, learning breathing exercises, and improving their diet.

Exercising the lungs and muscles by working out and doing breathing exercises can help a person with COPD to live a more active lifestyle. This enables those who may not have felt strong enough to engage in activities and interact with people,to improve the overall quality of their lives.

Pulmonary rehabilitation has been shown to improve outcomes as it may lower the need for hospital stays. Livebetter.org has a directory of pulmonary rehab centers.

The Future

The future of COPD treatment looks very bright. Because this disease is a world-wide leading cause of death, there have been great strides involved in finding innovative, effective treatment modalities, such as stem cell therapy and other types of advanced technology  In the future, medical science may find that one such new treatment, currently being studied, may even lead to the cure for COPD.

Stem Cell Therapy

Stem cells are the rudimentary cells in the body—formed in the bone marrow—that give rise to (create) every type of cell. Stem cells can be used to give rise to new alveolar cells in the future.

There are several big clinical research studies underway right now that are in the final evaluation stages. Although, currently, there are some clinics offering stem cell transplant, therapy for COPD, some experts advise people with COPD to steer clear of them for now until the final results are in from the research studies.

Regenerative Medicine

In the lungs, there are two primary types of cells, including:

  • Type 1 cells: Involved in the exchange of oxygen and carbon dioxide during breathing
  • Type 2 cells: Cells that secrete substances called “surfactants.” Surfactant lines the alveoli to prevent them from collapsing; surfactant reduces the workload involved in breathing.

Recent medical breakthroughs in the treatment of COPD have gone beyond stem cell therapy. In fact, according to the National Emphysema Foundation, researchers are exploring options to manipulate lung cells, enabling mature lung cells to help to repair damaged lung tissue.

In nature, every species—including humans—is capable of regeneration, which is the process of renewal, restoration, and growth, that enables cells or organisms to have resilience against damage or disease. Regenerative medicine is the process of regenerating human cells, tissues, or organs to restore normal function.

A study, published in the journal Nature Communications, discovered type 1 cells, giving rise to type 2 cells in different regeneration models. According to study author and cardiologist Rajan Jain, new cells were observed growing back into new areas of the lung. “It's as if the lung knows it has to grow back and can call into action some type 1 cells to help in that process."

According to Dr. Jon Epstein, also of the University of Pennsylvania, “observation suggested that there is much more flexibility in the pulmonary system than previously believed.”

How Regenerative Medicine May Impact COPD

The groundbreaking research may prove that damaged lung tissue could have the ability to regrow on demand. In standard stem cell therapy studies, stem cells are grown by researchers in a lab, then the stem cells are manipulated to develop or “specialize” into specific types of cells, such as lung cells. The specialized cells are then implanted into a person.

Regenerative medicine, however, involves a way to force damaged, mature lung cells to revert back into a stem cell, specializing themselves. Currently, stem cell therapy focuses on attempting to specialize stem cells, but that would not be the case with regenerative medicine.

This could potentially be very instrumental in changing how COPD is treated, creating new and effective treatment options for people with COPD.

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