Chronic obstructive pulmonary disease (COPD) affects hundreds of millions of people worldwide and is a leading cause of death. Its most destructive feature is emphysema, where the gas-exchange surface of the lung is progressively and permanently lost. No treatment can rebuild the damaged tissue, and in advanced disease, lung transplantation is the only option.

During fetal development, molecular programmes assemble the air sacs (alveoli) and their capillaries in coordination. In the adult lung, these programmes are largely inactive, and decades of cigarette smoke, air pollution and ageing further impair their activation, so the injured lung cannot repair itself. This work has shown that this failure may not be permanent. In preclinical models, reawakening one of these programmes restored air sacs and vessels and reversed established emphysema, indicating that lung destruction may be reversible.

How the two compartments cooperate during this regrowth is unknown, and this interaction could be therapeutically exploited. Using complementary preclinical models, the scientists will address this and aim to create a novel therapeutic landscape to restore lung structure in patients with advanced disease.