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Endotype-specific biologic and molecular therapies in COPD
| Endotype | Key biomarkers | Primary targeted therapies |
|---|---|---|
| Type-2 | ↑ Eosinophils, ↑ FeNO | Dupilumab, mepolizumab, benralizumab, tezepelumab |
| Neutrophilic | ↑ NETs, ↑ IL-8/CXCR2 | CXCR2 antagonists, anti-NET therapies, macrolide immunomodulation |
| Epithelial injury | CT emphysema score, telomere shortening, senescence markers | Stem-cell/exosome therapy, gene editing, antioxidant therapy |
| Autoimmune | Lymphoid follicles, anti-tissue antibodies | B-cell pathway inhibition (investigational) |
| Corticosteroid-resistant | Low HDAC2, oxidative stress | PI3K inhibitors, Nrf2 activators |