Is COPD an Autoimmune Disease?

COPD is a chronic respiratory illness that gets worse over time. It is sometimes known as emphysema or chronic bronchitis. Although preventable in most cases, and always treatable initially, it can also lead to disability and death.

Medical experts know that your airways become less functional and damaged with COPD. This is due to inflammation that narrows the airways and decreases the flow of air in and out. Smoking is the biggest risk factor. But many people who smoke do not develop COPD. And many people who have COPD have never smoked.

So, experts still have a lot to learn about who gets COPD and why, and how the disease progresses. However, a study published in June of 2018 in the American Journal of Respiratory Cell and Molecular Biology suggests that COPD may in fact be an autoimmune disease¹.

What is an autoimmune disease?

An autoimmune disease is a condition where the immune system attacks the body’s own organs, tissues, and cells. The National Institutes of Health (NIH for short) classifies 24 diseases as autoimmune, as proven by clinical evidence². However, the American Autoimmune Related Diseases Association (AARDA, for short) believes there are at least 100 autoimmune related diseases affecting people's lives³.

Some common autoimmune diseases include:

• Type 1 diabetes
• Lupus
• Fibromyalgia
• Rheumatoid arthritis
• Inflammatory bowel disease

AARDA believes that 50 million Americans have an autoimmune disease and that the numbers are rising steadily⁴. According to the NIH, "The chronic and debilitating nature of these diseases, which can lead to high medical costs and reduced quality of life, is a burden on patients and also affects their families and communities."² So autoimmune disease is a priority for research.

Is there an autoimmune component of COPD?

For some time, scientists have known that there are diverse genes involved in the development of COPD, and not just those with the AAT deficiency. In an effort to improve diagnostic efforts, researchers from Georgia State University and Vanderbilt University Medical Center endeavored to find a more complete picture of the biological mechanisms behind COPD by looking at genetic variants.

Here are some of the details of the study:

• Analyzed genetic data from people in the Vanderbilt DNA data bank
• Studied 16 known COPD-associated genetic variants
• 18,335 adults' data was included
• 1805 COPD cases were identified that had 2 or more of the genetic codes
• Median age was 64; 54% were female and 67% had no history of smoking

The findings were quite clear. They confirmed that the 16 previously-known genetic factors were, in fact, associated with COPD. Plus, they found that one particular gene was associated not only with COPD, but also with autoimmune diseases like Type 1 diabetes and rheumatoid arthritis.

Because this gene is already linked to other well-known autoimmune diseases, the researchers suggest this lends credence to the fact that COPD may also be an autoimmune disease.

Previous research has suggested that the immune system may be, in effect, attacking the lungs of people with COPD¹. Apparently, people who have COPD have higher than normal levels of T- and B- immune cells in their lungs. There are also antibodies that target the lining of the respiratory tract in people with COPD.

In summary

The authors of this study acknowledge that there were a number of limitations in their study, so their findings are not absolute. And there is much to still learn about the underlying factors with COPD But if future research can further clarify the COPD autoimmune connection, it could lead to exciting advances in the prevention, diagnosis, and treatment of this debilitating disease.