In the industrialized countries, chronic obstructive pulmonary disease (COPD) is the fourth cause of death. Current therapy does not change prognosis and health related cost. New therapeutic options are therefore needed. Recent evidence shows that COPD pathogenesis is associated with an early pulmonary senescence process, which may explain the insufficient regenerative response to apoptosis and reduced extracellular matrix synthesis which characterize emphysema. Longo et al. have demonstrated bone marrow activation and reduction of cardiovascular and neoplastic risk factors, which can extend lifespan, in mice treated with fasting mimicking diet (FMD).Similar results were shown in humans. Longo et al. have recently demonstrated a correlation between regenerative effect and inhibition of the mTOR dependent nutrient sensing pathways. The demonstration of an up regulation of mTOR in lung homogenate and peripheral blood monocytes of COPD patients, suggests a possible benefit of FMD in COPD. The aim of the study is to evaluate the effects of FMD on bone marrow response and pulmonary function in COPD patients. Patients in GOLD II class will be enrolled and they will be divided into two groups.The FMD group will receive standard of care therapy + 3 FMD cycles (one per month), while the control group will only receive standard of care therapy. Patients will undergo cardiopulmonary exercise test (CPET) and respiratory function tests at the beginning and at the end of the study. Sytoslic blood pressure,diastolic blood pressure, heart rate, circulating stem cell, IGF-1 and GDF11/15, C-reactive protein, insulin, glucose, total and HDL Cholesterol and tryglicerides will be dosed at the beginning and at the end of the study.
