COPD World News         Week of December 30, 2007

Combo Therapy Surpasses Single Drug for Severe COPD

LONDON, UK -- Combination drug therapy with salmeterol (Serevent), a long-acting inhaled bronchodilator, and fluticasone (Flovent) improved survival and led to fewer treatment withdrawals compared with single-drug therapy in severe COPD.

A multicenter head-to-head study found a 52% reduction in the risk of all-cause mortality at any time during the study for the combo treatment compared with single-drug treatment, Jadwiga A. Wedzicha, M.D., of Royal Free & University College Medical School here, and colleagues reported in the first January issue of the American Journal of Critical Care Medicine.

Significantly, however, exacerbations, which are key drivers of morbidity and mortality, were similar for the two regimens, the researchers reported.

The study, Investigating New Standards for Prophylaxis in Reducing Exacerbations (INSPIRE), compared the relative efficacy of the combination treatment with monotherapy with the long-acting bronchodilator tiotropium (Spiriva).

Mortality was significantly lower for the combination treatment patients: 21 (3%) patients in this group died compared with 38 (6%) in the tiotropium group.

The exacerbation rates between the two groups were statistically indistinguishable, the researchers said. Although exacerbation rates were similar, there were differences in the treatment required. Oral corticosteroids were used more often to treat the tiotropium patients, whereas the combination patients required antibiotics more frequently, the researchers said.

For more information:

http://www.medpagetoday.com/Pulmonary/SmokingCOPD/dh/7815

COPD World News         Week of December 23, 2007

Menopause Linked to Decreased Lung Function

BERGEN, Norway -- For perimenopausal women, neither too thin nor too fat may be the route to avoiding decreased lung function, allergies, and asthma, according to investigators here.

Women not menstruating for the previous six months had about an 80% increase in respiratory symptoms compared with those menstruating regularly, Francisco Gómez Real, M.D., of the University of Bergen, and colleagues reported in the December issue of the Journal of Allergy and Clinical Immunology.

In addition, the researchers found the association of amenorrhea with lower lung function was particularly strong and significant for the thinnest women, and was also linked to poorer lung function in the heaviest women, whereas there was no association for normal-weight women.

The literature on menopause and lung health is scarce, the researchers wrote, although reports have suggested that asthma in some women starts to worsen around menopause.

The authors speculated that as women undergo menopause, insulin resistance, a proinflammatory condition, could explain their poorer lung function. Smoking, related to earlier menopause and worsening respiratory health, was another limitation, although the analyses were adjusted for pack-years of smoking. Clinicians should be aware of an increased asthma risk and lower lung function in perimenopausal women, especially those who are thin, they added.

For more information:

http://www.medpagetoday.com/OBGYN/Menopause/dh/7771

COPD World News         Week of December 16, 2007

New Technique Reveals Insights Into Lung Disease

Leicester, UK - Universities of Leicester and Nottingham are collaborating to use a magnetic resonance technique to image and quantify the air spaces inside the lungs. The results of their research may lead to a link between childhood disease and later degenerative lung disease (COPD).

There are relatively few centres around the world which have access to this particular magnetic resonance technique, which is based in Nottingham University. Researchers at the University of Leicester have recruited cohorts of some 10,000 children – the largest to focus on respiratory illnesses in childhood. The two groups have combined forces, with a joint grant from the Wellcome Trust.

The method relies on the fact that certain noble gases (which are relatively rare in the atmosphere and are very un-reactive), when hyper-polarized in a very strong laser beam, can be detected by magnetic resonance methods.
Tests involve individuals inhaling a very small quantity (in this case 10ml or two teaspoons) of the hyper-polarized helium-3 gas. This technique provides the key to unlock a whole new area of research in the field of lung development.

This is quite different from the magnetic resonance scans are now commonplace in British hospitals. However, all magnetic resonance techniques function without the use of radioactive substances or ionising radiation (as is the case with x-ray techniques). They are thus very safe, and have no known side effects and are ideal for research into childhood illness.
The pulmonary alveolus is the most peripheral structure within the air spaces of the lung, in which the gases carbon dioxide and oxygen move between the air and the blood.

There are said to be about 500 million alveoli in the adult lung, and they have a combined surface area equivalent to about one tennis court. All the alveoli are formed by the age of 3 years, so early illnesses and exposures may leave children at risk of later lung disease.

Professor Silverman added: “The outcome that we are seeking is evidence that in young people and teenagers, there are differences in alveolar structure and number in association with disorders of fetal prenatal development and early childhood disease.

“We anticipate that there is an additional impact of teenage smoking on alveolar structure and function. If these observations are confirmed, they would provide for the first time evidence of impaired alveolar (as opposed to airway) development in childhood.

“This could be the link between childhood disease and later degenerative lung disease (COPD). We will then seek the specific factors (genetic or environmental) which lead to defective lung development, and will propose further research to ameliorate these factors.”

For more information:

http://www.healthnewsdigest.com/news/Disease_420/Insights_Into_Lung_Disease.shtml

COPD World News         Week of December 9, 2007

HAT inhibitors combat Asthma and COPD

Nottingham, UK - Two University of Nottingham studies exploring the causes and treatment of asthma and COPD could lead to the development of drugs to battle these debilitating conditions.

Researchers will explore histone acetyl transferase (HAT) inhibitors in asthma and COPD. This study will investigate a bank of plant extracts at the University of Strathclyde, seeking compounds that could combat the intercellular processes that result in the symptoms of asthma and COPD — inflammation of the airways which can lead to coughing, breathlessness and increased chest infections. Though they are different diseases, asthma and COPD affect the human body in a similar way. In asthma, allergens irritate the lungs, in COPD, this is done by cigarette smoke. This irritation inflames the sufferer’s airways, which the muscles then close, creating a narrowing effect.

Research done at the University over the past 15 years has found that the muscle layer in the airway is more complex than has traditionally been thought. As well as going into spasm during asthma and COPD attacks the muscle layer produces a wide range of mediators and cytokines — proteins that act as chemical signalers when it comes into contact with allergens or cigarette smoke.

In asthma and COPD sufferers, these proteins are produced by stimulation of airway muscle cell walls in the lungs, releasing intracellular signaling proteins called ‘transcription factors’ which alter the DNA of the cell and activate messenger RNA. It is these ‘transcription factors’ which activate the inflammation by causing release of mediators and cytokines. By exploring plant extracts that may reduce the activation of HATs within airway cells, the researchers may isolate compounds that could be used to suppress inflammation in respiratory disease.

Any drug successfully synthesised from such compounds could potentially revolutionise the treatment of respiratory disease. There is also the potential to treat other inflammatory diseases, such as rheumatoid arthritis and Inflammatory Bowel Disease.

For more information: 

http://www.physorg.com/news115984431.html

COPD World News     Week of December 2, 2007

Lung-on-a-chip leads to new insights on Pulmonary Diseases

Ann Arbor, MI - A new "lung-on-a-chip" developed at the University of Michigan mimics the fluid mechanics of the real thing on a plastic wafer just bigger than a quarter. It allows researchers to grow lung airway cells that act more like they're in a human body instead of a Petri dish.

Biomedical engineers used the device to show that the respiratory crackles stethoscopes pick up in patients with lung diseases aren't just symptoms, but may actually cause lung damage. "Our lung-on-a-chip causes the cells to really become lung-like in terms of function and protein secretion. They form the tight tissue connections that they do in the human lung. That doesn't happen in a dish. This device gives you the convenience and control of a dish but in physical conditions that are more like the body," said Shuichi Takayama, associate professor of biomedical engineering and principal investigator on this study.

A paper on the findings is published in Proceedings of the National Academy of Sciences and was adapted from materials provided by the University of Michigan.

For more information:

http://www.sciencedaily.com/releases/2007/11/071119143651.htm

COPD World News         Week of November 25, 2007