Many COPD patients suffer from acute exacerbations where their symptoms suddenly get a lot worse and can result in hospitalisation. 75% of the time it is due to a lung infection whether bacterial or viral. The most common culprits are the influenza virus and Streptociccus pneumoniae, which cause the flu and pneumonia.
Bacteria and viruses cause infections in different parts of the lung and cause bronchitis if it occurs in the larger bronchial tubes or cause bronchiolitis if in the smaller bronchial tubes. An infection in the alveoli or air sacs of the lungs can cause pneumonia. Antibiotics are only effective against bacterial infections and viruses are more difficult to treat. Often a patient will acquire a secondary bacterial infection from having a viral one. This is due to the build up of mucus and inflammation in the lungs which create the perfect breeding ground for bacteria. This is why antibiotics are normally prescribed whether the infection is viral or bacterial as to protect from a secondary bacterial infection from occurring.
The other common causes of exacerbations are sinus infections, air pollution, heat failure and blood clots. It is so important that COPD patients try to avoid any of these triggers and try to prevent picking up any viruses or bacteria in order to prevent exacerbations.
The disease compromises the lung’s ability to defend against bacteria and a new study has shown that even when a patient isn’t experiencing an exacerbation, the bacteria that are colonized in their lungs are causing respiratory symptoms for them. Having bacteria in the lungs increases the inflammation and significantly increases the shortness of breath, cough and sputum in COPD patients. Doctors are aware that most stable patients experience daily fluctuations in respiratory symptoms but the reason why has never been understood until now. These fluctuations can sometimes be fairly intense and often qualify as exacerbations but go unreported to their doctor.
The study shows that medicine needs to alter its approach to treating stable COPD patients and not to focus on just the flare-ups but to understand that COPD is based around a chronic infection and treat accordingly.
“The lungs are constantly being exposed to microbes ‘with every breath you take’ as well as from aspiration of small amounts of secretions from the throat, especially during sleep,” Dr Sethi says. “If the persistence of these bacteria contributes to increased symptoms and inflammation in the lungs in stable COPD, we should regard this as a chronic infection, not innocuous colonization. For that reason, more must be done to reduce chronic infections in COPD.”
However due to resistance, long-term antibiotic treatment is not the way forward and “we need to put more emphasis on developing therapies that can decrease bacterial colonization in COPD.”
At the end of last year a company announced that the drug AB569 had been successful in trials and appears to be able to treat lung infections caused by Pseudomonas aeruginosa, a common culprit of lung infections in COPD and CF patients. This bacteria is common however it is also difficult to treat as it survives without oxygen and it has the ability to develop resistance against antibiotics as it holds a lot of resistant genes. It causes 40% of infections in children with CF and up to 75% of cases in adults with CF as well as a high percentage of COPD infections. If this drug can treat this bacteria and passes human trials then perhaps it can be used to help dramatically cut the number of infections and the resulting exacerbations suffered by COPD and CF patients and also ease their daily fluctuations of respiratory distress.
Here are eight tips that can help you reduce your risk of developing an infection:
- Wash your hands. Regular hand-washing is one of the most important things you can do to reduce your risk of infection.
- Avoid infections. Ask people who are sick not to visit until they are well again, and wear a face mask if you do have to come in contact with someone who has an infection.
- Clear your airways. It is important to keep airways free from mucus. Your doctor can give you devices and teach you manoeuvres to ensure your coughing is productive at shifting the mucus.
- Stay hydrated.
- Clean your equipment. All equipment that you use, including humidifiers, oxygen masks, and flutter valves, should be properly cleaned and maintained to ensure that they don’t harbour infectious organisms.
- Get vaccinated. Talk with your doctor about which vaccines you should get. In general, people with COPD should get a pneumococcal vaccine once, as well as a flu vaccine every year.
- Stay away from crowds. When possible, avoid large crowds, especially during cold and flu season.
- Treat infections as early as possible. Call your doctor at the first sign of infection, so it can be treated before it progresses to a more serious infection of your lungs.
- Breathe clean air if possible. Breathing in air from your supplemental oxygen unit and air that has been filtered in your home will be a lot cleaner and free from irritants such as pollen, dust and germs and will help to reduce the risk of an exacerbation.
References: www.webmd.com and www.buffalo.edu and http://lungdiseasnews.com and www.everydayhealth.com
New studies have found that patients with COPD have a 3 times higher risk of having a certain bacteria within them. The bacteria heliobacter pylori, which is usually linked to the development of stomach ulcers may also be the trigger for lung disease.
Smoking is the main cause of COPD but research suggests that a big role may be played by the bacteria. It mainly colonizes the stomach but evidence suggests that is accumulates in the ears, nose, skin and even the eyes. It has previously been thought to be only involved in stomach ulcers and stomach cancers but recent studies have shown that the bacteria is also linked to other cancers, glaucoma, gall bladder, auto immune disease, iron-deficiency anaemia and other conditions of the eyes, ears, nose and throat.
One theory is that COPD patients may have a high level of this bacteria due to childhood infections that affect lung growth and make them more vulnerable to disease. Early eradication of heliobacter pylori in childhood may enable full lung development and reduce the risk of COPD in later life. The discovery could open the way for new preventative strategies.
- pylori stimulates the release of cytokines, which have an inflammatory effect on the body. When the infection and bacteria are eradicated then cytokine levels return to normal and inflammation decreases.
The findings may point to new ways of tackling COPD, because H. pylori can be detected with a breath test and treated with antibiotics. So it could mean that a simple course of antibiotics could kill off this bacteria, reduce the inflammation and reduce the severity of COPD symptoms immensely or if caught early then prevent COPD from developing.
Asthma is caused by your airways being more sensitive to irritants and becoming inflamed, making it difficult to breathe. Cases are on the increase and one in every 11 children in the UK are now diagnosed with Asthma. One explanation for the rise in Asthma is the ‘Hygiene Hypothesis’, which has been discussed for many years. This suggests that children are no longer exposed to enough bacteria at an early age, which normally would help to build the immune system to be able to tell the difference between friend and foe bacteria. This results in the immune system believing that pollen and other triggers are harmful resulting in the airways becoming inflamed as the immune system attacks.
On the back of these discussions a team analysed the billions of bugs that naturally occur within the human body. Microbes, bacteria and fungi outnumber human cells 10 to one and this ‘microbiome’ is thought to be key to our health. They found that if there were four main groups of bugs missing then the risk of developing asthma was very high. The types of bacteria are faecalibacterium, Lachnospira, Veillonella and Rothia. The team looked for the presence of these bacteria in children aged 3 months and one year and then looked to see if they developed asthma by the age of 3. The lack of these bacteria in both age groups resulted in a high risk of developing asthma by the age of 3.
It appears that the first year of life is crucial and that the ‘right bugs at the right time‘ could be the best way of preventing asthma and other allergies. Exposing children in the first year of life to a wide variety of bacteria could help to ensure that their immune system is calibrated correctly and prevent later development of asthma.
Further experiments, which looked into the ‘passing down of immunity’ from mother to child involved giving a bacterial cocktail to mice who then had offspring with reduced inflammation in their lungs. Other suggestions involve the fact that giving birth by Caesarean section and not breast feeding may both limit the bacteria from being passed from mother to child and hinder immune system development.
Dr Marsland from Switzerland has been researching this area for a number of years and believes that diet, microbes and the first year of life are key in preventing or easing Asthma symptoms. He believes that a high fibre diet is important for keeping the gut healthy, as it is the delicate balance of gut bacteria in our bodies that affects our immune system and may play a role in asthma development.
However this is just a step in the right direction, more research needs to be carried out into these four types of bacteria, their role within the body and their relationship with the immune system and conditions like allergies and Asthma. If there is a direct link then new information could be given to new parents about exposing children to bacteria, a bacteria cocktail could potentially be created to be given to pregnant women or young children, there may also be a way of training the immune system at a later stage of development by introducing these bacteria to patients to try and cure or lessen their Asthma.
Scientists urge people not to run out and buy lots of friendly bacteria yogurt drinks and pro-biotic yogurts, as much more research is needed to ascertain the facts and details of what this discovery actually means for the larger population in real life. Doctors urge Asthma patients to continue with their inhalers, medications and oxygen therapy as prescribed, which all help to ease the symptoms.
References: http://www.nhs.uk and http://www.bbc.co.uk