There are some experimental medications that are currently being tested for chronic obstructive pulmonary disease (COPD). These include:

• All-trans-retinoic acid. A derivative of vitamin A, this chemical was found in rat studies to improve the airways of those with emphysema. Researchers are now working to discover whether it will be equally effective in humans.
  
  
• Aerosolized hyaluronic acid. This chemical may have a protective effect against one of the enzymes (elastase) produced by the immune system in response to tobacco smoke.
  
  
• Anabolic steroids. Preliminary study data have suggested that anabolic steroids may help strengthen the lung (bronchial) muscles and promote weight gain in COPD patients. However, physical activity remained severely restricted even while taking these medications.
  
  
• Selective phosphodiesterase-4 inhibitors. In this class of drugs, one appears to be helpful in preventing cells from beginning the inflammation that results in damaged lungs.

To date, surgical treatments for emphysema are only experimental and rarely covered by insurance. However, the following experimental surgeries are being attempted to see if they might be helpful:

• Lung and liver transplantation. Although it is increasingly difficult to find healthy lung donors, lung transplantation seems to greatly improve the condition of emphysema patients. Liver transplantations also appear to be helpful for those with A1AD emphysema, because they trade their protein-deficient (A1AD) liver for a healthy liver with plenty of the protective protein.
  
  
• Lung volume-reduction surgery. This surgery may be either unilateral (involving one lung) or bilateral (involving both lungs). During the surgery, about a third of the damaged lung tissue is removed. The surgeon then sews the rest of the lung(s) back together. By removing some of the expanding lung tissue, the surgeon allows the diaphragm and ribs to shift back toward their original positions before the lung disease. This surgery is showing some promise in promoting weight gain, greater range of activity, better breathing capacity and less reliance on oxygen-replacement therapy. However, only about two-thirds of people show any improvement, and long-term gains are limited. This surgery was approved for payment by Medicare in August 2003.

Finally, some studies suggest that a person’s dietary choices can affect their risk for developing COPD. According to some studies, vitamin C can aid in the prevention of COPD. Other studies suggest that eating mostly meat, refined starches and sodium may increase the likelihood of developing COPD. A recent study has also suggested that omega-3 fatty acids (a healthy fat found in fish and vegetable oils) may improve breathing ability in patients with COPD. More research is needed to better understand the relationship between certain foods and the chronic respiratory symptoms associated with COPD.