What You Ought to Know About Combating Asthma and COPD

A recent event in London, the Asthma & COPD conference, has again raised awareness of the issues facing the medical industry and sufferers of these conditions, whilst outlining the positive progress being made in preventing and treating them. The event covered important topics, including comparing exacerbation of asthma with potential options for treatment, an examination of inhalation devices and combination therapies, combating resistance to steroids and establishing phenotyping to tailor therapeutic options to patients and enhance outcomes. Events like these are crucial for gathering professionals together to discuss developments and difficulties in the research of asthma and COPD, and how to formulate new strategies in order to gain the most positive and effective results from a range of therapies.

 

Asthma affects around 5.4 million people in the UK, which equates to 1 in every 11 adults, and 1 in every 11 children. The condition is more common in adult women than in adult men, and is a long-term condition which affects a person’s ability to breathe easily and normally. It is caused by inflammation in the airways of the lung, specifically the bronchi which transport air in and out of the lungs. People with asthma have bronchi which are more sensitive than normal people. When irritants come in to contact with the lungs coughing and tightness of the chest is common, but in asthmatics this occurs much more often and more intensely. When this reaction is severe, it is known as an asthma attack, which can sometimes be life threatening. Asthma can be hereditary, and triggers and severity of symptoms differ between individuals. Common triggers include animal fur, cold air or pollen. Asthma lacks a cure, but a range of treatments and therapies are available to help prevent and relieve symptoms. Medication, inhalers and lifestyle improvements, such as avoiding triggers, eating healthy and exercising, are often advised to help asthmatics live a more normal lifestyle.

 

COPD, or chronic obstructive pulmonary disease, is a term used to describe a range of lung diseases. Like asthmatics, the weakness of COPD sufferers lungs may cause airway obstruction, leading to frequent chest infections, breathlessness, and a repetitive cough with phlegm. Its main cause has been identified as smoking, with long-term regular smokers being at the highest risk of developing COPD. It is one of the most common respiratory diseases in the UK, and it is believed that there are over 3 million people in the UK living with it. Unlike asthma, more men are affected by COPD than women. Like asthma, there is no cure and damage to the lungs from it is irreversible. Usually an inhaler or medication is given to improve ease of breathing, as well as tuition in breathing techniques. The single best thing to do to tackle COPD is to stop smoking and become more active, which can help improve overall wellbeing.

Categories: Asthma, COPD, lung diseases, Smoking

Study Discovers New Method for Detecting COPD Damage

There’s a new, non-invasive way to see if smoking has affected your wellbeing. This is according to research published in the April issue of The Journal of Nuclear Medicine, which found that in vivo ventilation/perfusion (V/Q) imaging can detect early changes to the lung caused by cigarette smoke exposure. The study, “Detection of Lung Dysfunction Using Ventilation and Perfusion SPECT in a Mouse Model of Chronic Cigarette Smoke Exposure”, also found that VQ imaging provides a non-invasive method for studying lung dysfunction in preclinical models.

So what does this mean for your wellness? According to the study’s researchers, the findings have the potential to be applied clinically to study and diagnose the early stages of chronic obstructive pulmonary disease (COPD). Cigarette smoking is the common culprit for COPD, which a slow-progressing, debilitating lung disease. COPD is defined by certain characteristics, such as chronic inflammation, increased mucus production, small-airway fibrosis and airspace enlargement. Yet often if you have COPD, you can go undiagnosed for years as symptoms take a while to present themselves, by which time you may have incurred irreversible damage.

According to N. Renee Labiris, PhD, one of the authors of the study, ‘Better diagnostic tools are needed to detect early changes in smokers to prevent further lung dysfunction and provide patients with individualized treatment regimens. Our preclinical study suggests that not only can V/Q imaging detect early and small changes in lung pathology, the type of V/Q mismatching could provide insight into the underlying pathologies, which current measures of lung function are unable to do.’

For the study, the researchers performed /Q single photon emission computed tomography (SPECT) and a computed tomography (CT) scan on mice who had been were exposed to cigarette smoke for 50 minutes twice daily, five days a week, for either eight or 24 weeks. When the researchers analysed the different tests, they found that the SPECT V/Q imaging was able to identify COPD characteristics before CT was able to detect structural changes in the lungs.

Labiris noted, ‘V/Q imaging is a common nuclear medicine technique, and SPECT/CT systems are increasingly used in clinical practice. As such, the technology examined in this study can be carried out in both preclinical and clinical settings, enabling researchers to translate preclinical investigations of disease, associated functional abnormalities and future drug targets into an improved understanding and management of the disease in patients.’

Study Discovers New Method for Detecting COPD Damage

Categories: COPD, Research, V/Q Imaging

Is COPD Inflammation Responsible for Your Depression?

Chronic obstructive pulmonary disease (COPD) affects more than your physical wellness, it can also take its toll on your emotional wellbeing. This is according to a new press release issued by the American Thoracic Society, which states, for the first time, that there’s a link between the systemic inflammation associated with COPD and depression.

According to researcher Hilary Strollo, MS, a graduate of the University of Pittsburgh School of Health and Rehabilitation Sciences, ‘Systemic inflammation is thought to be an important mediator of comorbidities in COPD, but the relationship between inflammation and depression has not been explored. In our study, we found a strong association between depressive symptoms and levels of the inflammatory biomarker interleukin-6 (IL-6) which was independent of the severity of airflow obstruction.’

For the study, the researchers recruited 450 tobacco-exposed people, 237 of whom were men and 215 were women. 37 (16%) males and 49 (23%) females were found to suffer from depression. This is a common health concern fro people who have COPD, and depression has previously found to be strongly associated with how severe the disease is, as well as a reduced quality of life. The study found the most significant biological variables associated with depressive symptoms were lower FEV1 (most strongly associated with depression), being female, increased IL-6 levels and being a current smoker.

To gather their data, the researchers used results from the Beck Depression Inventory (BDI), the Saint George Respiratory Questionnaire (SGRQ), and the UCSD Shortness of Breath Questionnaire (SOBQ). The study participants also underwent spirometry and computed tomography (CT) of the chest. Strollo explained, ‘Depression has been linked with a number of symptoms and comorbidities in COPD patients. Our findings add evidence of a strong relationship between depression and one of the hallmarks of COPD, systemic inflammation, independent of the severity of disease.’

Based on the results of this study, it is strongly suggested that, if you have COPD, you should be evaluated for depression and then treated accordingly. You should pay a visit to your health care provider for a thorough assessment if you often experience feeling sad or empty, crying, irritability, decreased pleasure in things you normally enjoy doing, weight changes, sleep disturbances or fatigue, poor concentration or an inability to make decisions.

Categories: COPD, depression, Research

Toxic Combination: Tobacco and Wood Smoke Raises COPD Risk

If you’re consistently exposed to both wood smoke and tobacco smoke, your wellbeing is at a greater risk for developing chronic obstructive pulmonary disease (COPD). This is according to a new Colombian study, scheduled to be presented at the American Thoracic Society (ATS) 2013 International Conference, which also found that those exposed to both kinds of smoke are also at risk to experiencing more frequent and severe symptoms of the disease, as well as more severe airflow obstruction, than those who are exposed to only one type of smoke.

According to study lead author Carlos Torres-Duque, MD, director of research at the Fundacion Neumologica Colombiana in Bogota, ‘Although previous studies have shown a definite link between wood smoke exposure and the development of COPD, those studies were case-controls and case series of patients with similar disease or health profiles. This new data derives from a population-based study that looked at wood smoke exposure and the overall prevalence of COPD, as well as the characteristics of the disease and those who suffer from it.’

Using data from the PREPOCOL (Prevalencia de la Enfermedad Pulmonar Obstructiva Crónica en Colombia) study – which evaluated the prevalence of COPD among the adult residents of five Colombian cities – the researchers investigated 5,539 subjects, 8.9% of whom were diagnosed with COPD, and divided them into four groups. 30.9% of participants were exposed to wood smoke and who had never smoked tobacco, 18.7% were exposed to tobacco smoke but had no exposure to wood smoke, 29.8% had been exposed to both types of smoke and 20.6% had exposure to neither type of smoke.

Dr Torres-Duque explained, ‘In the population we studied, exposure to wood smoke was identified as an independent risk factor for developing COPD, both in women and men. In addition, the prevalence of COPD was significantly higher in those who were exposed to both wood and tobacco smoke and those with both exposures had more symptoms and more severe disease than those who were exposed to only one type of smoke.’ Dr Torres-Duque added, ‘It is also possible that the responses of the lungs and airways could vary, based on the pollutants to which they’re exposed.’

Categories: COPD, tobacco smoke, wood smoke

Innovative COPD Drug Produces Positive Results in Trials

A positive batch of late-stage trial data has put Spanish drug manufacturer Almirall and US group Forest Laboratories one step closer to improving COPD wellness. The company has announced the results of their study, which indicates they are close to filling their chronic obstructive pulmonary disease (COPD) inhaler Genuair with regulators which could greatly improve COPD sufferers’ wellbeing.

Genuair delivers a fixed dose of alclidinium bromide and formoterol fumarate, which are two different bronchodilators with different modes of action. The doses of aclidinium/formoterol tested were 400/6mcg and 400/12mcg, taken twice a day. According to the group, both of the bronchodilators made their primary endpoints during the pivotal six-month Phase III clinical trial of Genuair (also known as Pressair).

The study researchers boasted that both doses of the aclidinium/formoterol combination showed statistically significant improvements in lung function. This was measured by change from baseline in morning pre-dose through FEV1, and compared with formoterol 12mcg and in FEV1 at one hour post-dose versus aclidinium 400mcg. The study researchers also noted that both treatment arms were well tolerated in the study, although nasopharyngitis and back pain were the most common side effects experienced.

A second Phase III trial is now underway, the results of which are expected over the coming weeks. If this second trial produces positive results, the groups will have the support they need to file a New Drug Application with regulators on both sides of the pond. According to Bertil Lindmark, Chief Scientific Officer at Almirall, ‘We expect this novel combination of aclidinium/formoterol to offer patients a new option in COPD treatment. In addition to the improved efficacy shown in this study, the safety profile was comparable to placebo.’

The World Health Organisation (WHO) calls COPD as a global epidemic, with an estimated 64 million people suffering from the condition around the world. Chronic obstructive pulmonary disease is common, progressively debilitating your lungs through persistent airflow limitation that makes it hard to breathe. Therefore, a new treatment which could effectively reduce the symptoms of COPD is always welcome, and this study may provide new hope for millions of sufferers worldwide.

Innovative COPD Drug Produces Positive Results in Trials

Categories: aclidinium formoterol, chronic obstructive, COPD, Drug, obstructive pulmonary, phase iii, positive results, produces positive, pulmonary disease, Research, study researchers

Do You Need an Oxygen Concentrator if You Have COPD?

Approximately 21% of the air you breathe is oxygen, which is absolutely essential to your wellbeing. Oxygen is used for the function of every cell in your body, and becomes transported to each and every one of these cells through your airwaves and into your lungs. This is why anything that might prevent the air from going unobstructed into your lungs can cause wellness problems, which may be the case if you suffer from COPD.

For some patients of COPD, enough air is brought to the alveoli but their capillaries don’t allow enough of the oxygen to pass, and the low oxygen levels the low oxygen levels create hypoxemia. Therefore, COPD patients may need to receive small amounts of oxygen can to allow the air to enter at a higher rate than the original 21%. That way, the oxygen will be more able to push through the capillaries.

Not every person with COPD needs oxygen therapy, but your doctor can measure whether or not you need it by finding out the amount of oxygen you already have in your bloodstream. You might find out you need oxygen when walking, eating, or performing another lifestyle activity that requires it in bigger supply, but some patients may require oxygen 24-hours a day. It works just like any other medicine prescribed by a medical professional; oxygen needs to be taken as directed.

Your doctor will explain the rate your oxygen should be set to ensure that your treatment is only at the level that your body needs, often over 89%. You should never stray from your doctor’s prescribed dosage as too much oxygen will slow your breathing, and not enough can lead to brain problems and heart problems from lack of oxygen. Your doctor may tell you that you only need to take oxygen while exercising and sleeping, or you might find you need to use it for as long as possible throughout the day. If your doctor instructs you to use continuous oxygen then you should not go off it. However, if you need to, for whatever reason, make sure you go off your oxygen while not performing any physical activity, which includes sleeping. You should only be sitting and relaxing.

Do You Need an Oxygen Concentrator if You Have COPD?

Categories: COPD, doctor, Oxygen, oxygen levels, Patients, problems, treatment

Researchers Develop Innovative Way to Study COPD

Researchers from Boston University School of Medicine (BUSM) have created a novel way to study COPD and could lead to new treatments and ways to monitor how those treatments affect patient wellness. This discovery has come as a result of a study published in the American Journal of Respiratory and Critical Care Medicine, in which the US researchers harvested airway cells using a minimally invasive procedure, helping them to identify a genetic signature for chronic obstructive pulmonary disease (COPD).

When your wellbeing is affected by COPD, this means that you can experience coughing, wheezing, shortness of breath, chest tightness and other symptoms that make it difficult to breathe. The progressive lung disease leads to a loss of lung function, and is primarily caused by cigarette smoking. Treatments and lifestyle changes can help you cope with COPD, but as it stands there is not cure or effective therapy to reduce your rate of lung function decline.

Katrina Steiling, an assistant professor of medicine at BUSM who served as the study’s first author, explained, ‘There have been limited molecular studies of COPD given the inaccessibility and invasiveness of obtaining lung tissue.’ Therefore, the researchers worked on the hypothesis that COPD might be detectable in relatively accessible tissue throughout the respiratory tract, even though the disease primarily affects the tissue deep within your lungs.

The researchers obtained airway cells through a bronchoscopy, which is a procedure that involves putting a small camera into your airway through your nose or mouth, and using a cytology brush to gently scrape the sides of your airways to collect cells. 87 of the 238 samples collected from current and former smokers were from patients who had been diagnosed with mild to moderate COPD based on their lung function.

When the researchers compared the airway samples from the 87 COPD patients with the others, they found that 98 genes were expressed at different levels in those diagnosed with COPD. According to Avrum Spira, MD, Alexander Graham Bell professor of medicine, chief of the division of computational biomedicine at BUSM, a physician in the pulmonary, critical care and allergy department at Boston Medical Centre and one of the senior co-authors of the study, ‘Our data shows that there are consistent gene-expression changes that occur in both airway and lung tissue cells in individuals with COPD.’

She continued, ‘Studying COPD using the large airway opens up some really exciting new avenues of research that could also improve care for patients with COPD. While we are still at an early stage, I envision being able to examine airway cells from my patients with COPD to determine what is causing the disease and, from that information, recommend a more specific and effective treatment.’

Researchers Develop Innovative Way to Study COPD

Categories: airway, airway cells, COPD, critical care, lung, lung function, lung tissue, Measuring, Research, study copd

Move Over, Heart Attacks: Lung Attacks Can be Just as Deadly

If you’ve read the title of this article, which I’m guessing you have, you’re probably thinking ‘lung attacks? Is that a thing?’ Lung attacks are all too real, and though they are less known than heart attacks, they are, unfortunately, no less dangerous.

A lung attack is a sign that your chronic obstructive pulmonary disease (COPD) has taken a dramatic turn for the worse. However, doctors often mistake this for a less wellbeing-threatening acute infection. Between 5 and 20% of people who have a lung attack die within a year after being hospitalised for it, which is a similar rate to those whose wellness is affected by a heart attack. COPD can occur if you’ve had prolonged exposure to cigarette smoke or other inhaled irritants, and presents with symptoms such as shortness of breath, coughing, wheezing and mucus or phlegm production. When you have a lung attack, these symptoms can worsen in a matter of hours or days.

Therefore, if you do have COPD, you need to take active steps to reduce your risk of a lung attack, which means quitting smoking and taking the appropriate medication. This is according to the Chronic Obstructive Pulmonary Disease Association (Singapore), who presented the message in November last year, in the wake of World COPD Day. Dr Ong Kian Chung, president of the COPD Association (Singapore) and a respiratory physician at Mount Elizabeth Medical Centre, said that 19% of the country’s residents, whose wellness was affected by COPD, died a year after hospitalisation.

So if lung attacks are so deadly, why don’t we know more about them? Up until recently, lung attacks weren’t thought to be as deadly as they actually are. However, Professor Neil Barnes, a consultant respiratory physician at the London Chest Hospital and The Royal London Hospital in Britain, warns that once you have a lung attack, your risk of having another one increases 2.5 times. He adds that an attack is often triggered by a chest infection, common cold or other infections of the respiratory tract, or even for no apparent reason, but it is often mistaken for being an acute infection, rather than a flare-up of a progressive lung condition.

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Move Over, Heart Attacks: Lung Attacks Can be Just as Deadly

Categories: COPD, Hospitalisation, Lung Attacks

COPD: Is this Chronic Lung Disease Under-Diagnosed in Women?

A survey has found that, contrary to popular belief among wellness experts and members of the general public alike, women’s wellbeing may be more susceptible than men’s to a group of chronic lung diseases. Characterised by shortness of breath and coughing, Chronic Obstructive Pulmonary Disease (COPD) could be under-diagnosed by doctors, researchers said.

COPD has historically been thought to occur predominantly in men, even though there is no published local data on gender differences in the chronic disease. With support from pharmaceutical company Boehringer Ingelheim Singapore, the country’s COPD Association conducted a two-year study, which debunked this perception. 949 adults, of whom roughly two-thirds were men, completed a questionnaire to assess their risk of getting COPD, and then underwent spirometry, a breathing test that measures lung function and capacity, as part of the study.

The researchers detected COPD in 9.1% of the men surveyed and 8.4% of the women, though the difference was greater in smokers and ex-smokers (80% and 30%, respectively). According to president of the COPD Association (Singapore) Ong Kian Chung, evidence is increasingly suggesting that COPD in women in Western countries is rising in prevalence and mortality. For example, data from the United States has shown more COPD deaths among women than men.

So why are women potentially more at risk to COPD? Dr Ong, a respiratory physician in private practice, said smoking-related lung damage could be a bigger risk to women as their lungs are smaller and hormonal or genetic differences could also be a factor. He also pointed to under-reporting in smoking rates among women, and the perception that men are more prone to getting COPD, as reasons for why doctors do not diagnose it enough in women.

To tackle COPD, which is Singapore’s seventh most common cause of hospitalisation, and the seventh most common cause of deaths, COPD Association (Singapore) vice-president Tan Tze Lee advised smokers not to accept persistent coughs as normal ‘smoker’s cough’. Further, you should be looking for symptoms of the disease, which includes wheezing and increased mucus or phlegm. The association has also distributed spirometers to more than 300 of the country’s GPs, in order to improve early detection and effective management.

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COPD: Is this Chronic Lung Disease Under-Diagnosed in Women?

Categories: COPD, Research, Women