Novel pharmacological approaches to airway and pulmonary vascular disease

Asthma and chronic obstructive pulmonary disease (COPD) remain major clinical problems with significant unmet needs. This issue of Current Opinion in Pharmacology discusses some of the advances being made in our understanding of the pathogenesis of asthma and COPD, along with providing state-of-the-art reviews on some of the new approaches being taken to combat these conditions. There is an increasing awareness that neuronal pathways may play a role in the airways and, in particular, that sensory nerve pathways may be involved in the pathogenesis of the bronchial hyperresponsiveness that so characterises patients with asthma as reviewed by Spina, and this subject is expanded in the overview of TRPV1 receptors in the airways by Lee. The genetic approaches to the treatment of asthma are reviewed by Ian Hall, and the implication of this research for more patient selective treatment is discussed. The role of Ach, long recognised as an important bronchoconstrictor substance in the airway, is discussed by Trevethick, and other actions of this substance in the airways are reviewed. There is also an excellent overview of the role of purinergic receptors in the airway and the role they play in the regulation of airway epithelial function discussed by Boucher. Finally a major problem in pulmonary pharmacology remains the suitability of animal models, particularly those used in the selection of new drugs. Mary Fitzgerald critically reviews this controversial area and the progress being made to find animal models more representative of the clinical situation