UNMC leading national $4.4 million study to test if ibuprofen can reverse lung damage of emphysema

The University of Nebraska Medical Center will lead a clinical research study that will evaluate if a common, over-the-counter drug has potential to reverse the devastating effects of emphysema.

The phase II, three-year study funded for $4.4 million by the National Institutes of Health (NIH) National Heart, Lung and Blood Institute, will look at whether ibuprofen can reduce inflammation in the lungs. Ibuprofen is a non-steroidal, anti-inflammatory drug commonly used to treat pain and swelling.

"Emphysema has been regarded as an irreversible type of chronic obstructive pulmonary disease (COPD) involving damage to the air sacs in the lungs. But, in fact, it may be reversible," said Stephen Rennard, M.D., Larson Professor of Medicine in the Pulmonary and Critical Care Medicine Section of the Department of Internal Medicine."

Dr. Rennard said current treatments, medication, rehabilitation, and sometimes surgery, can help with symptoms and can reduce exacerbations, but nothing yet can reverse the course of the disease.

"Recent studies support the concept that the ability of the lung to repair damage is suppressed. If you can remove the suppression, then maybe lungs can be repaired. This would be important and entirely new," said Dr. Rennard, principal investigator of the study and a recognized expert in COPD.

"Recent evidence indicates lung repair processes are diminished in COPD, partly due to increased levels of prostaglandin E. We know that ibuprofen blocks the production of prostaglandins. We want to know if it can block prostaglandins in the lung," Dr. Rennard said.

Study participants will take 600 milligrams of ibuprofen or a placebo three times a day. Researchers will measure inflammation and use biochemical techniques to determine the extent of lung repair that occurs. They also will compare previous CT scans and pulmonary function tests with results obtained before and after treatment.

If it works, researchers will seek approval to conduct a larger clinical study in patients.

UNMC will coordinate the study and analyze the data. Four other medical centers also are involved in the study. They will recruit 140 patients with emphysema who participated in a previous large NIH emphysema study. The medical centers are National Jewish Health in Denver, Brigham and Women's Hospital in Boston, Temple University in Philadelphia and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.

COPD, also known as emphysema and chronic bronchitis, is the third leading cause of death in the United States, according to the American Lung Association. Emphysema, most often caused by cigarette smoking, leads to destruction of lung tissue. The damage interferes with getting air into and out of the lung and makes it hard to catch your breath.

Other members of the UNMC research team include Kendra Schmid, Ph.D., Amy Nelson, Harlan Sayles, Matt Anderson, Yazen Alnouti, Ph.D. and Tricia LeVan, Ph.D.