Chiesi is working to develop and manufacture medicinal products for people with respiratory diseases, including asthma and COPD (chronic obstructive pulmonary disease), and to improve their quality of life. Both asthma and COPD are characterized by reduced respiratory flow, even though the underlying pathophysiological causes differ from each other.
According to the WHO’s latest estimates, 235 million people worldwide suffer from asthma. 64 million people have COPD (WHO, 2004), which is anticipated to become the third leading cause of death by 2030. If no actions are taken to reduce the most common risk factor cigarette smoking –the number of estimated COPD-related deaths is expected to increase by 30% over the next 10 years.1
In the search for continued improvement in the health of patients, Chiesi Farmaceutici researches and develops new therapeutic solutions based on the innovative formulation technology Modulite®, which allows the creation of spray solutions (pMDI, pressurised Metered Dose Inhaler) for inhalation able to deliver extra-fine particles. Chiesi Farmaceutici has patented and introduced into the market a dry powder-based medical device for inhalation (DPI, dry powder inhaler), which is also able to deliver extra-fine particles.
ASTHMA AT A GLANCE
Asthma is a chronic inflammatory disease characterized by recurrent respiratory symptoms such as shortness of breath, coughing, wheezing and tightness in the chest. Under normal circumstances, air can flow freely into the lungs. In certain circumstances, and when the asthma is not under control, the airways exhibit heightened sensitivity to inflammation, which can trigger an asthma attack. This leads to several changes: the bronchi contract, the mucous membranes of the airways swell and clog the small bronchi, which in turn then makes it harder to breathe. These clinical manifestations are, in principle, reversible, although this varies considerably over time and among patients. Generally, an asthmatic condition tends to deteriorate during the night and the early hours of the morning. Although asthma cannot be cured, it is possible to control the disease allowing patients to have a satisfactory quality of life.
What causes asthma? An asthma attack is triggered when a sensitive person comes in contact with irritants. Because asthma is a multifactorial disease, the causes of acute asthma attacks will vary. There are predisposing genetic factors (which explain why the incidence is higher among people with asthma in the family), the presence of allergies, female gender, obesity and ethnic origin. At the same time, asthma attacks can be triggered by factors such as respiratory infections, allergens, exposure to pollutants at work, tobacco smoke and environment pollution if inhaled in large quantities. Other trigger factors include physical effort or hypersensitivity to drugs (such as ASA hypersensitivity).
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
COPD is a lung disease characterized by persistent and irreversible bronchial obstruction that is associated with an increase in chronic inflammatory response to noxious particles or gases. The classic symptoms of COPD are shortness of breath, chronic cough and chronic sputum production. Sometimes these symptoms may worsen acutely and trigger an exacerbation. There is a dual-mechanism underlying the bronchial obstruction in COPD patients: on the one hand, the inflammation of the small airways causes the mucous membranes of the bronchial tubes to swell, which results in increased resistance to airflow. On the other hand, the progressive destruction of the lung parenchyma (emphysema) causes a decreased elasticity of the lungs. It is important to emphasise that both mechanisms may coexist and cause a reduced airflow throughout the lungs.
What risk factors are associated with COPD? First and foremost, there are genetic risk factors that may predispose some people to develop the disease. The most important risk factors are cigarette smoke, exposure to pollutants in the home (from cooking or combustion of biofuel) or environmental pollution. Secondary factors include age, gender, socio-economic status, respiratory infections, asthma and chronic bronchitis. COPD patients are generally more likely to develop cardiovascular disease, osteoporosis, diabetes, lung cancer and bronchiectasis, which in turn increases the risk of hospital admission or the risk of dying. Unlike asthma, COPD is a disease that has its onset late because it is associated with a slow and progressive exposure to the risk factors.3