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Review
. 2025 Jun;85(6):741-753.
doi: 10.1007/s40265-025-02179-9. Epub 2025 Apr 11.

PI3K Inhibitors as Potential Therapeutic Agents for the Treatment of COPD with Associated Atherosclerosis

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Review

PI3K Inhibitors as Potential Therapeutic Agents for the Treatment of COPD with Associated Atherosclerosis

Mario Cazzola et al. Drugs. 2025 Jun.

Abstract

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) share a complex and multifactorial relationship characterized by overlapping risk factors, systemic inflammation, and intertwined pathophysiological mechanisms, with atherosclerosis emerging as a central inflammatory process connecting COPD and CVD, driven by systemic inflammation, oxidative stress, and endothelial dysfunction. While systemic inflammation is recognized as a critical link between these conditions, the precise pathways through which inflammation arises remain under investigation. There is therefore a need for therapeutic strategies to mitigate cardiovascular risks in patients with COPD. Among the pathways contributing to this interplay, the phosphoinositide 3-kinase (PI3K) signaling pathway has gained significant attention. Dysregulated PI3K signaling contributes to inflammation, oxidative stress, and endothelial dysfunction, which are key drivers of both COPD and CVD. Consequently, PI3K inhibitors have emerged as a promising therapeutic approach to mitigate inflammation and oxidative damage, offering a targeted strategy to address the shared pathological mechanisms underlying these diseases. A comprehensive understanding of the role of PI3K signaling and its inhibitors could facilitate the development of novel interventions to reduce cardiovascular risk in patients with COPD.

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Conflict of interest statement

Declarations. Funding: Open access funding provided by Università degli Studi di Roma Tor Vergata within the CRUI-CARE Agreement. Conflict of interest: The authors have no financial or non-financial relationships or activities concerning this article. Availability of data and material: Not applicable. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Code availability: Not applicable. Author contributions: All authors were involved in the initial conception of the manuscript. M.C. and C.P.P. led the drafting and coordinated the revisions of the manuscript among all authors. P.R, L.C., and M.G.M. critically revised the content on their areas of expertise. All authors approved the final draft.

Figures

Fig. 1
Fig. 1
Summary of the expression and roles of PI3K isoforms in cardiac and lung function. Each bar corresponds to an isoform, with detailed annotations for its expression pattern and role in cardiac or lung function and pathology

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