Antibiotics have transformed healthcare – but they don’t always work for people with chronic obstructive pulmonary disease (known as COPD).
As the Florey Research Fellow for Thoracic Medicine at the Royal Adelaide Hospital, Dr Eugene Roscioli is developing the next generation of medications to ensure more effective treatments are available for COPD patients.
More than 600,000 Australians live with COPD every day.
Through conducting research to interrupt disease exacerbations linked with bacterial infection, Dr Roscioli has a goal of preventing COPD before it becomes incurable.
Preventing the snowball effect
Affecting the lungs, COPD incorporates bronchitis, asthma and emphysema. It is linked with significant ill health, early death and substantial costs for treatment and management in the healthcare system.
All current treatments only provide symptom relief and focus on preventing flare-ups, including exacerbations caused by bacterial infection in the airways.
“Exacerbations are a nightmare for people with COPD, and may knock years off their lives,” says Dr Roscioli.
“Preventing exacerbations will allow people with COPD to live longer with a better quality of life.”
“It’s a snowball effect. The more exacerbations you have, the more you get and the more permanent the damage is to your lungs.”
Antibiotics do not kill all bacteria
Azithromycin is a common antibiotic used to manage COPD exacerbations, and acts by killing bacteria and reducing inflammation.
The problem is that Azithromycin doesn’t kill all bacteria.
“Surviving bacteria acclimatise to their surroundings and become stronger, making COPD exacerbations worse,” Dr Roscioli says.
Azithromycin also blocks autophagy, an essential natural bacteria removal process in our cells.
“Our recent work shows for the first time in the world that autophagy is decreased in COPD patients,” he says.
“This work has wider implications for patient health, and we are now working towards developing a new diagnostic procedure to measure autophagy in lung clinics.”
Dr Roscioli is also working to engineer a version of Azithromycin that works to eliminate bacteria that cause COPD exacerbations, but does not interfere with autophagy.
“This would allow the natural autophagy processes to eliminate bacteria themselves – rather than making it worse,” he says.
“If we can cut off the leading causes of exacerbations, we’d be hopeful that people with COPD could have less hospital admissions and have a similar length and quality of life as everyone else.”
Read the research
Dr Roscioli’s recent papers were published in collaboration with colleagues at The University of Adelaide, University of South Australia, the Department of Premier and Cabinet, Centre of Cancer Biology and institutions in Sweden, and the USA.
Modification of azithromycin to counter its arrest of autophagy is available via the European Respiratory Journal.
Autophagy is suppressed in peripheral blood mononuclear cells during chronic obstructive pulmonary disease is published on the Biology pre-print server.
