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Repurposing Medications for the Treatment of Patients with COPD
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Joselyn Rojas-Quintero, MD, speaks about her team's current research into COPD treatment on this issue of The Respiratory Report.
The multifactorial nature of chronic obstructive pulmonary disease (COPD) is apparent to pulmonologists. Given the essential role of the stem-like alveolar epithelial type 2 (AT2) cells in repairing the lungs’ injured alveoli and maintaining alveoli number and lumen size, treatments designed to treat COPD should ideally either address AT2 cell biology and/or lead to AT2 cells number increases.
Joselyn Rojas-Quintero, MD, an instructor in medicine at Baylor College of Medicine, maintains a focus in her research to improve the world’s understanding of the pathophysiology of diseases such as COPD. In the second issue of The Respiratory Report, a quarterly newsletter from HCPLive powered by the American Lung Association Research Institute, Rojas-Quintero spoke on her team’s current research in the COPD treatment space.
“Metformin has been known for over 55 years,” Rojas-Quintero said. “It's one of the safest drugs we have. It has all the pharmacovigilance you can find, and…has a multifactorial aspect of its mechanism of action. It can impact not just the liver, but the gut, the muscles, and the brain. It's not just the metabolic aspect, but also the aging aspect. So back in 2019, I was talking to my PI, back in Harvard and we started talking about how we can reverse the aging effect that we see in COPD…We thought, what if metformin really helps just to prevent the aging aspect of of the alveolar epithelial cells we see.”
Rojas-Quintero highlighted that metformin, a biguanide which can inhibit mitochondrial-complex-I, is a pleiotropic drug which has the capability to improve patients’ mitochondrial health. It does this through the use of AMPK activation, reducing oxidative stress and exerting anti-aging and anti-cancer results among patients.
Given the array of such effects, Rojas-Quintero and her team began by testing their theory that metformin may protect mice from cigarette smoke-induced emphysema through a pilot study.
“Quite impressively, we found that the telomeres of lungs were actually prevented from losing their length,” Rojas-Quintero said. “We thought there is more to this than just the metabolic aspect of it. We chose to analyze the kidneys and and the muscles of these mice, and we found the same thing. Then we thought ‘If this is in the animals, how can we translate that into humans? Is there anything we can try to map out from patients who have COPD and happen to have diabetes and are taking this medication?’...So we did a quantification of emphysema progression and patients who have COPD and also take metformin for their diabetes, they have slower emphysema progression. In fact, there is data out there now that says that patients who take this drug and have COPD, they actually do better.”
To learn more about Rojas-Quintero's research, view the interview above or read her contribution to the second issue of The Respiratory Report here:
