Lung Disease Studies could be Key in Coronavirus Battle

Key findings from two separate studies have led scientists from the University of Dundee to believe in possibilities for a new type of treatment for lung conditions, including Covid-19.

Their research(1) indicated that in patients with the severe inflammatory lung condition bronchiectasis, where the lungs become scarred and inflamed, also those patients with asthma, lung conditions were characterised by an excessive type of immune response called neutrophil extracellular trap formation (NETs); the severity of respiratory symptoms and associated risk of death could also be predicted by measuring this immune response and that a commonly used antibiotic, azithromycin, could prevent the immune system from forming NETs. Reduction of NETs in the lungs was also associated with marked improvements in asthma symptoms.

Similar results were found in bronchiectasis, suggesting a treatment target that can work for multiple lung conditions. Several studies have shown that NETs are key in patients suffering severe Covid-19 symptoms.

“The immune system normally tries to clear infections such as viruses or bacteria from the lungs cleanly, quietly and without damaging the lung tissue around them,” explained British Lung Foundation-funded PhD student Holly Keir. “Our research has shown how this goes wrong in lung conditions. When this happens, the key immune cells, called neutrophils, explode, forming NETs that damage the lungs.

In collaboration with biopharmaceutical company Insmed, Professor James Chalmers, School of Medicine and colleagues looked at a new drug called brensocatib, which blocks excessive neutrophil immune response. They demonstrated that brensocatib was associated with a reduction in pulmonary exacerbations in non-cystic fibrosis bronchiectasis patients, potentially leading to a reduction in hospital admissions.

Both brensocatib and azithromycin are now being tested in clinical trials with Covid-19, where researchers believe the same excessive immune response is key to severe disease.

(1)New England Journal of Medicine.