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Abstract
Structural remodeling is central to the initiation and progression of many chronic
lung diseases, representing an important unmet need. We examine the evidence supporting
bromodomain-containing protein 4 (BRD4) as a validated biological target for treatment
of airway remodeling. In epithelial cells and fibroblasts, BRD4 serves as a scaffold
for chromatin remodeling complexes in active super-enhancers. In response to inflammatory
stimuli, BRD4 is repositioned to innate and mesenchymal genes activating their production.
Proof-of-concept studies show promising benefit of selective BRD4 inhibitors in disrupting
epithelial mesenchymal transition and myofibroblast transition in diverse models of
lung injury. Recent identification of biomarkers of BRD4 provides a basis for further
drug development for application in viral-induced airway inflammation, COPD and interstitial
lung diseases.