Joselyn Rojas-Quintero, MD, is a Venezuelan scientist and physician with multiple master’s degrees in immunometabolism, the study of the dynamic interactions between the immune system and metabolic processes. Her extensive expertise led to her being recruited by Harvard University and Brigham and Women’s Hospital in 2015. Though her private practice had focused on asthma and autoimmune diseases, for the next seven years, Dr. Rojas-Quintero’s work focused on early onset emphysema mediated by enzymes. “My background allows me to move back and forth to study any organ as long as the focus is on immunology and metabolism,” Dr. Rojas-Quintero explained.
During her time at Harvard, Francesca Polverino, MD, PhD, of Baylor College of Medicine took notice of her work and in 2022 asked Dr. Rojas-Quintero to join her research team. The goal of Dr. Polverino’s research was to understand the benefits of metformin; a medication currently used to treat type 2 diabetes and determine if it could be used for other diseases. Her initial findings, published in a medical journal in 2021, concluded that the use of metformin could protect the lungs from damage from smoking, including fibrosis that leads to emphysema. By adding Dr. Rojas-Quintero to the team at Baylor, Dr. Polverino hoped to further understand how the medicine affected metabolism and how that could in turn be used to protect the lungs from damage.
To help fund these experiments, the researchers turned to ACRC’s awards and grants program. “We hope the data we are compiling can help us identify what we could be using this {medication} for,” said Dr. Rojas-Quintero. “I don’t think it is going to be a drug for every person, but our hope and my goal is to find if we can use this in early stages of COPD so that we can slow or reverse the damage before the disease progresses to the point where they need a lung transplant.”
The Benefits of Metformin
Metformin has been used for over 35 years for people with type 2 diabetes. It lowers sugar levels in a different way than insulin does. Insulin enters the cells and induces the metabolism of sugars whereas metformin goes into the liver, muscles, kidney, gut and lungs and has three methods of action. First, it repurposes fatty acids into energy, saving the cells from dying. Second, it works as a scavenger to bind to free radicals, so it helps with oxidative stress. Third, it reduces aging because it can affect the process of how you switch genes on and off.
“Imagine you have a neighborhood, and every house has an antenna,” Dr. Rojas-Quintero explained. “Some houses have one, some have two, some have three, and some have none. The number of antennas you have determines if a gene is on or off. Metformin can change that whole landscape because it can change how many antennas you have.”
Because of this ability, metformin has recently been used to treat some cancers because it can remove “junk cells” and get the body ready for chemotherapy. Dr. Rojas-Quintero and her team are interested in how metformin may be used to treat and reverse the damage of chronic lung diseases, specifically COPD.
Can Metformin Treat COPD?
Dr. Rojas-Quintero and her team are about halfway through their research, and the results are promising. So far, they have discovered that metformin has a strong effect on a type of lung cell called the AT2 cell. AT2 cells are important because, when they are healthy, they help repair the lungs and they make surfactant, a substance that coats the inner surface of the alveoli (air sacs), keeping the lungs working well. But for them to work, their metabolism must be “reset.”
Dr. Rojas-Quintero’s research shows that metformin helps AT2 cells, and even the whole lung, in three big ways:
- Boosts surfactant production: Metformin increases surfactant proteins A and D. These not only help with surfactant secretion but also fight off infections.
- Repairs cell structures: It helps rebuild the “laminar bodies” or storage particles composed of surfactant phospholipids and proteins, that AT2 cells use to make surfactant.
- Reduces harmful molecules: Metformin lowers certain chemicals linked to the ceramide pathway. These chemicals are tied to lung inflammation, COPD flare-ups, and even higher risk of death. By reducing them, metformin may lower those risks.
More recent data also show that metformin increases healthy types of fats in the lungs. These fats support better cell energy and metabolism.
“What makes this exciting is that patients with COPD who take metformin show slower disease progression. No other treatment has been proven to stop lung damage like this. If we can stop the loss of lung function, we can prevent early death from COPD,” Dr. Rojas-Quintero said.
They are still collecting data to map the full extent of how metformin changes both AT2 and AT1 lung cells. This is important for moving toward clinical trials. “Metformin has been used safely worldwide for over 35 years. The main risk people ask about is lactic acidosis, but that’s very rare (about 1 in 100,000 patients) and depends mostly on dosage. With proper screening and careful dosing, the benefits far outweigh the risks,” Dr. Rojas-Quintero continued.
Overall, the evidence shows that metformin could be a safe, powerful new way to treat COPD by protecting lung cells and slowing down disease progression. “I believe thinking out-of-the-box is going to be the key to how we can change the game for our COPD patients.”
Learn more about the research that is revolutionizing lung health at: Lung.org/research.
Blog last updated: October 1, 2025
