Phosphodiesterase 4B inhibition: a potential novel strategy for treating pulmonary fibrosis
Open accessAbstract
Patients with interstitial lung disease can develop a progressive fibrosing phenotype characterised by an irreversible, progressive decline in lung function despite treatment. Current therapies slow, but do not reverse or stop, disease progression and are associated with side-effects that can cause treatment delay or discontinuation. Most crucially, mortality remains high. There is an unmet need for more efficacious and better-tolerated and -targeted treatments for pulmonary fibrosis. Pan-phosphodiesterase 4 (PDE4) inhibitors have been investigated in respiratory conditions. However, the use of oral inhibitors can be complicated due to class-related systemic adverse events, including diarrhoea and headaches. The PDE4B subtype, which has an important role in inflammation and fibrosis, has been identified in the lungs. Preferentially targeting PDE4B has the potential to drive anti-inflammatory and antifibrotic effects via a subsequent increase in cAMP, but with improved tolerability. Phase I and II trials of a novel PDE4B inhibitor in patients with idiopathic pulmonary fibrosis have shown promising results, stabilising pulmonary function measured by change in forced vital capacity from baseline, while maintaining an acceptable safety profile. Further research into the efficacy and safety of PDE4B inhibitors in larger patient populations and for a longer treatment period is needed.
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- Authors
- Kolb, M., Crestani, B., & Maher, T. M.
- Affiliations
- St. Joseph’s Healthcare Hamilton (CA)
- Inserm (FR)
- University of Southern California (US)
- Corresponding author
- Maher, Toby M.
- Venue
- European Respiratory Review
- Publisher
- European Respiratory Society (ERS)
- Published
- 2023-02-21
- Volume
- 32
- Issue
- 167
- Pages
- 220206
- ISSN
- 0905-9180 (ISSN-L)
- 1600-0617
- PMC
- PMC9949383
- OpenAlex
- W4321499929
- Cited by
- 85
- References
- 124
- Citations by year
- 2026: 28 · 2025: 28 · 2024: 22 · 2023: 7
- FWCI
- 3.96
- Type
- journal article
- Language
- en
- Update notices
- correction (2024-03-27)
- Open access
- diamond
- doi.org
- Licence
- Locations
- European Respiratory Review (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phosphodiesterase function and regulation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Keywords
- PDE4B, PDE4B inhibitors, idiopathic pulmonary fibrosis, interstitial lung disease, cAMP signaling, antifibrotic therapy, anti-inflammatory activity, lung function, drug safety, forced vital capacity
- MeSH terms
- Humans, Lung, Lung Diseases, Interstitial, Disease Progression, Cyclic Nucleotide Phosphodiesterases, Type 4, Idiopathic Pulmonary Fibrosis, Phosphodiesterase 4 Inhibitors
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