Cool Developments in COPD Medicine

At the beginning of the 20^th century, refrigeration technology was in a poor state.^[1] The chemicals used in early refrigerators were inefficient and toxic, leading to numerous deaths.^[1] To solve this, Frigidaire tasked Thomas Midgley, Jr., Albert Henne, and Robert McNary with finding the perfect refrigerant, a goal they seemingly achieved in 1928.^[1] The refrigerants they invented, chlorofluorocarbons (CFCs), solved the immediate problems and paved the way for widespread food refrigeration, air conditioning, and a hole in the ozone layer.^[1]  This unexpected and unfortunate backfiring is oddly similar to how immune cells can inadvertently cause tissue damage in chronic obstructive pulmonary disease (COPD).

COPD is a common condition with multiple causes. It is responsible for 3.5 million deaths each year worldwide and affects roughly one in every twenty people.^[2,3] This makes it a leading cause of death in the U.S. and is associated with significant declines in quality of life for those affected.^[4] COPD has not-cool symptoms like difficulty breathing and chronic cough.^[2,3] Just like CFCs break down the ozone layer, dangerous particles in the air (like from smoking) cause lung problems that lead to COPD.^[1,2,3] In people with COPD, the body overreacts to airborne particles, causing the airways to narrow and/or lung tissue to break down.^[2] 

Eosinophils are a type of white blood immune cell whose job is to destroy invaders.^[5] They are one of the major types of immune cells implicated in the overreactions associated with COPD and are involved in up to 40% of cases.^[2] In Eosinophilic COPD, the number of eosinophils increases in the airway and around the body, changing the nature of the disease from an adaptive immune response to a more difficult-to-manage innate response.^[2]

Let’s decompress some information about eosinophils. These immune cells follow chemical signals carrying destructive chemicals that can grind through everything from DNA to fats and proteins.^[2,5] Normally, when bacteria or other bad actors invade the body, a danger signal called interleukin-5 (IL-5) flips the switch to attract, activate, and initiate the production of more eosinophils.^[2] Some researchers hope new treatments may be able to put IL-5 and the excessive eosinophilic overreactions on ice. New medications, including one approved in 2025, use monoclonal antibodies to target IL-5 and cool the inflammatory cascade. These new therapies in development may help reduce the number of eosinophils in individuals with eosinophilic COPD, hopefully lowering symptoms.

Though exciting, anti-IL-5 medications are intended to be add-on therapies to be used on top of normal COPD treatment regimens. People with COPD should discuss with their doctor the available support options, including smoking cessation tools, vaccines against common lung infections (such as flu and COVID), oxygen therapy, pulmonary rehabilitation, and standard-of-care medications. If these haven’t produced enough relief, enrolling in a clinical trial may help lower the temperature for COPD and close a hole in the COPD treatment layer around the world.

Creative Director Benton Lowey-Ball, BS, BFA

References:

[1] Bhatti, M. S. (1999). A historical look at chlorofluorocarbon refrigerants. ASHRAE Transactions, 105, 1186. https://www.osti.gov/biblio/20002388

[3] World Health Organization. (6 November, 2024). Chronic obstructive pulmonary disease (COPD). [Website, accessed 4 November, 2025]. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

[4] Barnes, P. J. (2019). Inflammatory endotypes in COPD. Allergy, 74(7), 1249-1256. https://onlinelibrary.wiley.com/doi/full/10.1111/all.13760

[5] Dixon F. J. (Ed.). (1987). Advances in immunology (Vol. 39). Academic Press. https://www.google.com/books/edition/Advances_in_Immunology/GXpByqkfZNcC