Bronchiectasis is making a come-back

This lung disease from the 1800’s has begun to reappear again, especially among the elderly. Historically cases were due to untreated chest infections where antibiotics weren’t readily available and the poorer part of the community suffered with it more.
Research data from the NHS shows that of the 12000 patients admitted with Bronchiectasis in 2013-2014 most of them were over 60 years of age. Cases have doubled in the last decade among those aged 70 and over and now more than 1 in every 100 in this category will be affected.
Bronchiectasis occurs when the airways of the lungs become abnormally widened, which results in chronic inflammation due to the inability to clear mucus secretions in the airway passages leading to a build-up of mucus. The excess mucus also harbours bacteria which can lead to worsening of the condition due to frequent infections. Symptoms typically include a chronic cough, shortness of breath, wheezing, fatigue, coughing up blood, and chest pain, along with worsening respiratory function. Inhaled antibiotics, bronchodilators, physical methods of dislodging mucus and oxygen therapy are all part of the treatment for this disease.
Experts agree that bronchiectasis may occur in people who suffered an infection in childhood such as pneumonia or whooping cough, which damage the lung. Underlying problems with the immune system and allergies are also thought to play a role. This is a main factor as to why the elderly are susceptible as with age comes a compromised immune system.
Bronchiectasis tends to occur as an after-effect of a chest infection such as whooping cough, tuberculosis, pneumonia or measles – particularly if the infection was not treated with antibiotics. Damage to the bronchi takes years to build up and symptoms don’t tend to start until middle age, even if the original infection was years earlier.
‘Antibiotics only really came in on a regular basis in the Sixties and Seventies,’ says Professor Brown.’But we also see people who had antibiotics and despite that have bronchiectasis. Even if you treat it, the infection can still cause scarring, it’s just less likely.’
The disease is incurable and although infections can be treated with antibiotics, there are concerns that the bacteria is becoming resistant to drugs.
Surprisingly more women are affected than men for no known reason other than for the fact that rheumatoid arthritis is a high risk factor for developing Bronchiectasis and this condition is more common in women. Also patients tend to be more affluent. ‘We found the disease has had a resurgence in recent years, particularly among more well-off members of society,’ says Jeremy Brown, a professor of respiratory infection at University College London. ‘It could be partly down to improved diagnosis in these groups, but whatever the reason we need better treatment options.’
The study found that 42% of people with bronchiectasis also had asthma and 36% had chronic obstructive pulmonary disease (COPD). This is an important finding and can help with long-term management of these conditions. A study has found that COPD can be predictive of developing Bronchiectasis but that also this then makes the outcome for the COPD patient a lot graver.
The reasons for this disease increasing in certain groups is being investigated but it could be that it is running alongside the fact that diagnosis for other predictive diseases like COPD has improved in recent years but as to the reason why it is more prevalent in middle-class patients is unknown. With this rise of cases in recent years more research is now underway to improve treatment and to investigate the disease’s coexistence with other diseases such as COPD.
References: and and

Stem cells and nanoparticles could be the future treatment for lung disease

Malaysian scientists are joining forces with Harvard University experts to help in seeking a safe, more effective way of tackling lung problems including chronic obstructive pulmonary disease (COPD), the progressive, irreversible obstruction of airways causing almost 1 in 10 deaths today and to revolutionize the treatment of lung diseases through the delivery of ‘nanomedicine.’
Treatment of COPD and lung cancer commonly involves chemotherapeutics and corticosteroids which are misted into a fine spray and inhaled, enabling direct delivery to the lungs and a quick and effective medicinal effect. However, because the particles produced by today’s inhalers are large, most of the medicine is deposited in the upper respiratory tract and does not reach down to lower parts of the airways and lungs.
The Harvard team is working on “smart” nanoparticles, which are tiny particles that deliver the appropriate levels of a medication to the deepest, tiniest sacs of the lung and ensures an even distribution, through the use of magnetic fields.
Malaysia’s role is to help ensure the safety and improve the effectiveness of nanomedicine and in assessing how nanomedicine particles behave in the body, what attaches to them to form a coating, where the drug accumulates and how it interacts with different cells.
Inhaled nanomedicine holds the promise of helping doctors prevent and treat such problems in future, reaching the target area more swiftly than if administered orally or even intravenously. This is particularly true for COPD and lung cancer, says Dr. Brain. “Experiments have demonstrated that a drug dose administered directly to the respiratory tract achieves much higher local drug concentrations at the target site.”
“Nanotechnology is making a significant impact on health care by delivering improvements in disease diagnosis and monitoring, as well as enabling new approaches to regenerative medicine and drug delivery,” says Prof. Zakri Abdul Hamid, Science Advisor to the Prime Minister of Malaysia.
Lung regeneration is another key focal point as scientists have found that regardless of their stage in life, lung cells are able to regenerate themselves in order to repair missing or damaged tissue. The team behind the discovery hopes that they will one day be able to replicate this natural behavior in order to help repair tissue damage in patients with conditions such as COPD.
There are two main types of lung cells: type 1 cells, where oxygen and carbon dioxide are exchanged during breathing and type 2, which secrete surfactants, a type of lubricant essential to the breathing process. Type 2 cells have been previously observed to regenerate into type 1 cells in the presence of cell damage, but a team of scientists from the University of Pennsylvania School of Medicine and Duke University have shown that the opposite also occurs.
“We saw new cells growing back into these new areas of the lung. It’s as if the lung knows it has to grow back and can call into action some type 1 cells to help in that process,” explained cardiologist Rajan Jain and the observation suggests that there is much more flexibility in the pulmonary system than previously thought.
Understanding how and why these mature cells are regenerating into different types of lung tissue may be the key to treating certain types of lung damage caused by conditions such as chronic obstructive pulmonary disease. Although patients may somewhat control the condition, there is currently no cure. The ability to regrow damaged lung tissue on demand, then, could completely change treatment options and possibly offer a cure for COPD patients.
References: and www.medicaldaily


For those suffering from respiratory diseases, sleep apnoea is often an accompanying condition. Sleep apnoea is a common and chronic condition in which breathing stops or becomes shallow during sleep. Breathing pauses can last from a few seconds to minutes and can occur 30 or more times an hour. Disrupted sleep and a reduction in the level of oxygen reaching the brain can increase blood pressure (leading to heart disease), reduce mental ability and leave you feeling tired and fatigued, in addition to your daily respiratory symptoms.

There are two common treatments for sleep apnoea; continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs). A recent study has shown that both treatments not only are effective in reducing sleepiness and increasing oxygen levels while you sleep but also result in a lowering of both systolic and diastolic blood pressure rates.

MADs work by pushing the jaw and tongue forward to keep the airway open during sleep and are shaped similar to a gum shield. With CPAP the patient wears a mask connected to a device that produces mild air pressure and provides oxygen which helps to keep the airway open.
Some patients find it difficult to adapt to CPAP with problems wearing the face mask or being unable to sleep due to the noise of the compressor and find MADs a more suitable treatment but it does depend on what type of sleep apnoea you suffer from as to which treatment is more suitable.
In the study of 5000 patients both treatments were tested as to their effectiveness and ability to decrease blood pressure. There was no significant difference between CPAP and MADs in lowering blood pressure, they both were equally effective however CPAP was more likely to lower systolic blood pressure compared to MADs and would be slightly more effective in patients who are able to enjoy more hours of sleep.
Even though CPAP appears slightly more effective and are effective across the whole severity range, MADs are equally good as an alternative treatment for some patients who suffer mild to moderate sleep apnoea. The lowering of blood pressure achieved by the two treatments is modest so if you suffer from very high blood pressure you should get it checked regularly and take your medication to help to combat this.
Many patients find that by combating their sleep problems they feel much more able to face the day with their respiratory condition and in combination with oxygen therapy during the day or night they feel able to being able to carry out all their daily activities and feel near normal again.


Respiratory Breakthrough!?!

monkey with breathing mask on
respiratory breakthrough

Scientists claim to have found the root cause of asthma which could also aid in the treatment of other respiratory diseases like COPD. This breakthrough could mean that there could be a new treatment within 5 years.
They have found a protein within the airways which they believe triggers an asthma attack. Asthmatics seem to have higher levels of this protein and when they breathe in a trigger such as dust or pollen these protein molecules cause a rapid increase of calcium within lung tissue cells. High levels of calcium within these cells make them contract and cause the airway spasms which trigger an asthma attack.
The presence of this protein makes cells more sensitive to any asthma triggers, which then makes an attack much more likely.
A drug already exists which can deactivate the protein and clinical trials could start within 2 years, raising hope that a treatment could be available within 5 years.
It is hoped that a few courses of treatment would be enough to stop asthma attacks. Not only this but there is hope that it may have a role in tackling COPD and chronic bronchitis for which there is currently no treatment. Hopefully at a minimum it may prevent flare-ups for these patients and make them less susceptible to the triggers such as dust, smoke and pollen, which can stimulate a severe respiratory event. This could help COPD sufferers enjoy fewer flare-ups and less respiratory distress improving their ability to lead more normal lives.