Fibre is already well known for its benefits in preventing heart attacks, diabetes and some cancers but also recent research has shown that it may also help to ward off lung disease, even if you are still smoking and regardless of BMI.
“While it’s impossible to say if eating more fiber will offset the effect of smoking on your lungs, it does improve lung function, both in smokers and in non-smokers as well,” explains nutrition expert Corrine Hanson.
As the nation ages, the number of people with COPD is projected to grow, creating a major national health problem for which the only preventative strategy is to give up smoking.
“Many people can’t give up smoking, which is one of the reasons why we are so excited about this study,” says Hanson, an associate professor at the University of Nebraska Medical Center.
In the study those who ate a high fibre diet had significantly improved lung function, exhaled more air and had less airway restriction compared to those that did not follow the diet.
Although, at its highest level, the effects of dietary fibre did not quite offset smoking, it still showed benefits equivalent to using an inhaler, Hanson says. He believes this may be due to its anti-inflammatory benefits, which may also explain why it helps to prevent cardiovascular disease, diabetes, and other ailments as well. Fibre has been shown to exhibit both anti-inflammatory and anti-oxidant properties, which have been implicated in both the development and progression of lung disease. Fibre also plays a key role in the formation of beneficial gut bacteria which has increasingly been found to be involved in good overall health.
Here are tips on boosting the fibre content of your diet:
- Wash but don’t peel fruits and vegetables. Eating the skin and membranes ensures that you get every bit of A baked potato with the skin has twice the fibre of a potato without the skin.
- Eat raw vegetables. Cooking them may reduce fibre content by breaking fibre down into its carbohydrate components. To avoid this effect, cook, microwave, or steam vegetables only until they are ‘al dente’ – tender, but still firm to the bite.
- Choose whole fruits, vegetables. Juice does not contain as much fibre from the skin and membranes of whole fruits and veggies, and can also contain added sugar.
- Add bran or wheat germ to casseroles, meatloaf, and cooked cereal. Each tablespoon of bran adds more than 1 gram of fibre and can barely be detected when blended with some cereal or a casserole.
- Add vegetables to casseroles, soups, salads, sandwiches, pasta, and rice dishes. For example, simply add a cup of broccoli to a pasta dish for an extra 2 grams of
Hansen also says “there are very few interventional strategies for the prevention of COPD, with the exception of smoking cessation. This is a non-invasive, very inexpensive strategy that may be good for your lungs.”
If you do decide to alter your diet and increase your fibre intake then ensure you consult your doctor and ensure you maintain your usage of medication and oxygen therapy.
References: http://www.newsmax.com and http://www.medpagetoday.com
PH or Pulmonary Hypertension is a disease that causes high blood pressure in the lungs due to narrowing in the pulmonary arteries by thickening of the vessel walls. It results in the heart having to work harder to pump the blood and the organ can become enlarged and weakened leading to heart failure. It can be caused by an underlying disease such as Lupus.
Lupus is a less common disease that many people haven’t heard of. It is an autoimmune disease that occurs when the immune system attacks healthy tissues resulting in inflammation, swelling, pain and cell tissue damage. There are different types of Lupus but the most severe is systemic lupus erythematosus (SLE). Symptoms range from mild to severe, and many people will have long periods with few or no symptoms before experiencing a sudden flare-up, where their symptoms are particularly severe. Even mild cases can be distressing and have a considerable impact on a person’s quality of life. Lupus is a complicated condition and common symptoms are fatigue, joint pain and swelling and rashes, however the disease can cause systemic damage and can effect organs like the kidney, heart and lungs.
They are both very separate diseases and PH does not cause Lupus however Lupus can cause PH. Patients suffer from shortness of breath, fatigue and fluid retention; symptoms also seen in patients with PH. The development of lupus-associated PH is not completely understood and “it is not yet known, for example, whether lupus itself can directly cause PH, or whether lupus is simply a trigger for the development of [PH] in susceptible individuals,” the report explains.
It is more common in female patients to develop lupus and PH at a younger age (15-50 years) than those that traditionally develop PH alone. PH can worsen the symptoms of Lupus and it is important to diagnose it early. Individuals should be aware of swelling in the feet, ankles, legs and abdomen, difficulty in breathing, chest pain, light-headedness and fainting.
There is currently no cure for either PH or Lupus but there are treatments that can help to ease the symptoms. Medications to help with inflammation, swelling and to ease blood pressure as well as measures to deal with fluid balance and supplemental oxygen to help with breathlessness and oxygen levels in the blood. Oxygen therapy helps with both diseases simultaneously; by helping to reduce inflammation and increasing blood oxygen levels which helps in tissue repair to reducing breathlessness, easing the hypertension and decreasing blood pressure among many other benefits. If Lupus is in association with the PH then immuno-suppressive medications can sometimes be administered which help with the inflammation and irritation in the body however they can also cause damage in the blood vessels in the lungs which can be counterproductive. Lupus is still very much an unknown disease and with time and understanding of its processes there will hopefully be more effective treatments in the future that could ease Lupus symptoms as well as PH symptoms if the patient suffers with both conditions.
References: http://pulmonaryhypertensionnews.com and http://www.nhs.uk
A research team at the Wyss Institute for Biologically Inspired Engineering at Harvard University have used their new ‘organ-on-a-chip’ technology to develop a model of the human airway so that diseases such as COPD can be studied outside of the human body to allow researchers to gain new insights into the disease mechanisms, identify biomarkers and test new drugs.
Diseases such as COPD and asthma are inflammatory reactions in the lungs whether to smoking, inhaled particles or bacterial/viral infections. It is already known that many of the disease processes occur in the alveoli however much less is known about how inflammation starts off these reactions and why these processes react in the way that they do. For example the reason why the body recruits white blood cells and the build-up of mucus, both of which compromises the patient’s lungs or the cause and reasoning behind exacerbations.
A new microfluidic model of the lung has been created of the lung’s small airways made with chips lined with cells from both normal donors and diseased patients. This model is like looking inside an actual patient and “recapitulates critical features of asthma and COPD with unprecedented fidelity and detail” explains Donald Ingber. Now with this micro-engineered human lung small airway lung inflammatory diseases over several weeks can be studied in order to gain better insight into disease mechanisms, as well as screen for new therapeutic drugs.
This device closely mimics the 3D cellular architecture of an actual human small airway and contains fully matured human small airway epithelium with different cell types and channels containing all the components that you have in your lungs including white blood cells and nutrients. The device can keep itself ‘alive’ for a few weeks before starting to deteriorate. Inflammatory situations such as asthma and COPD can be simulated by adding an asthma-inducing immune factor or by setting up the system with lung epithelial cells from a COPD patient and then researchers can observe the different ways that the airways react in different situations. In both cases, the team was not only able to observe highly disease- and cell type-specific changes but could also exacerbate them with agents simulating viral or bacterial infection.
Demand for such a device is high due to the fact that the inflammatory response is so complex and internalised that it cannot be adequately studied in humans or animals and there are no known drugs that can stop and start the inflammation processes so that you could potentially get a snap-shot of what was going on.
This new organ-on-a-chip technology has provided researchers with a window on a molecular scale to be able to observe the activities of living human tissue and allows them to break down the processes and interactions of specific cell types and immune system components so as to understand why the diseases progress in the way they do and ideas on how this could be prevented based on the interactions between the lung tissue and the immune system, whether this be by manipulating the immune system response or by developing new drugs to counteract the effects.
“This novel ability to build small airway chips with cells from individual patients with diseases like COPD positions us and others now to investigate the effects of genetic variability, specific immune cell populations, pharmaceutical candidates and even pandemic viruses in an entirely new and more personalized way; one that will hopefully increase the likelihood of success of future therapeutics,” said Ingber.
A recent trial has shown that the use of lung coils has produced significant lung function improvements for emphysema patients.
In advanced emphysema parts of the lung become hyperinflated when patients breathe in and these can press down on and impair the healthy lung tissue as well as pushing down on the diaphragm making breathing extremely difficult. Patients would normally undergo surgery and have a lung-reduction procedure, however this is risky and very invasive. The new lung coil may offer a less invasive and effective alternative treatment to reduce lung volume.
The coils are shaped in a simple loop around 10-15cm in length when stretched out. They are made from Nitinol which is a metallic ‘memory’ material that returns to its intended shape even after long-term repeated stretches and compressions.
They are inserted into the lungs using a bronchoscope and placed in areas with diseased lung tissue where they immediately resume their looped form. The coils grab lung tissue and pull it inwards to reduce the lung volume in these sections to allow other sections with healthy lung tissue to inflate more normally. It has been shown that a minimum of 10 coils are needed in order for there to be significant clinical benefits but 12 per lung is the current practice.
Coil treatment has shown to provide significant improvements in the 6 min walking distance test and forced expiratory volume and also less dependence on supplemental oxygen. These results are from 3 months post coil insertion and the trial is still continuing for another 9 months to see if the good results continue long-term. If the results continue to show an improvement in lung function and breathing ability long-term then the coil treatment will be an effective new treatment for COPD patients and other patients with diseases where damaged lung sections cause difficulty in breathing. It is far less drastic and invasive than lung reduction surgery and results show that it is more effective.
A recent study has shown that if you suffer from a lung condition such as COPD then you are at a much higher risk to suffer from falls, especially if have other medical conditions, have already taken a tumble or have a long history of smoking.
Past research has already linked COPD to an increased risk of imbalance, muscle weakness, thinning bones and blackouts. COPD alone accounts for 5% deaths globally and falls are also a major public health problem, accounting for more unintended deaths and injuries each year than any other cause (except traffic accidents).
Most falls in the study occurred indoors, often when people were standing and using their upper body at the same time, with loss of balance the most commonly reported cause. It was found that people had more than twice the risk of falling if they suffered from additional medical problems and more than triple if they already had a fall in the previous year. The findings add to growing body of evidence highlighting the increased fall risk faced by COPD patients.
In another study it was also noted that those patients who used supplemental oxygen regularly were at a reduced risk of falls. This is probably due to the fact that oxygen levels are increased in the blood stream due to the use of supplemental oxygen and that the problems such as weakness and imbalance are reduced.
Just one fall especially in the more elderly of patients can result in anything from a bruise to a hip replacement and from an unnecessary trip to the GP or a long-term stay in hospital. Having an injury when you have difficulty breathing only adds to the severity of the injury and the recovery process and could hamper your progress and increase the severity of your condition and lessen your quality of life. COPD patients need to be aware of their increased risk of falling and injuring themselves and take precautions. If you are prescribed oxygen then ensure you use it as regularly as required and as prescribed. There are workouts designed to help improve balance and stability which can help to minimize the risk. Adjust your home and activities to reduce the likelihood of a fall; not using stairs as often, moving objects to lower heights etc.
Bronchitis is one of the diseases that falls under the COPD umbrella. It is where the main airways become inflamed and irritated leading to shortness of breath, mucus build-up and severe coughing. The new treatment being tested on patients with chronic bronchitis targets the thickened airway tissue by freezing it via a technique known as cryotherapy.
The theory behind it is that the cycle of freezing and thawing destroys the damaged tissue in the lungs allowing healthy cells to develop in its place and helps to repair the lungs and improve breathing. This has already been used to successfully treat oesophageal cancer.
A catheter is inserted into the airway and navigated to where the airways are thickened via an MRI scan and then liquid nitrogen at -200C is sprayed onto that section. The section of lung tissue is then allowed to naturally thaw for a few minutes and then the area is repeatedly blasted until the target tissue has been destroyed. The flash-freeze and slow thaw of the tissue has been shown to destroy the targeted cells but does not affect the collagen, which provides the scaffold for healthy tissue to regrow into.
This is currently being trialled in several British Hospitals and appears to be successful. The treatment can be adapted according top the patients needs and the number of treatments will depend upon the severity of their condition and how much tissue needs to be frozen. Hopefully these trials are the start of a journey towards a new successful treatment for COPD.
The medical potential is vast as it could mean that damaged tissue anywhere in the body could be treated by cryotherapy in the same way and allow new tissue growth to come through, thereby allowing aided self-healing of a huge number of conditions.
PAM stands for pulmonary alveolar microlithiasis, which is a rare lung disease. It is where small stones accumulate in the alveolar air sacs in the lungs and therefore makes it increasingly difficult to breathe. The cause has been found to be due to a DNA mutation which results in the loss of a cellular pump which would normally remove excess phosphate from the air sacs. As a result there is a build-up of calcium and phosphate which leads to the formation of microliths or stones. These cause chronic inflammation, lung tissue damage and scarring and respiratory failure and patients require a continuous oxygen supply of a high oxygen concentration in order for patients to be able to get enough oxygen into their bodies to function.
New research has identified biomarkers, which may hold the key to being able to treat this rare and debilitating disease. It seems that the condition causes elevations of certain proteins (cytokines and surfactant) in the blood. By monitoring these levels doctors will be able to follow disease progression and treatment response in patients.
Another finding was that the stones dissolve in EDTA which is used currently as a treatment for heavy metal poisoning. If the lungs can be washed in a solution containing EDTA then the stones could be dissolved and reduce the burden being placed on the air spaces and relieve respiratory symptoms. As long as there are no toxic side-effects then this could become a new therapy for patients with PAM.
As the stones are caused by excess phosphate it has been surmised that a low phosphate diet may be able to prevent the formation of the stones, however a phosphate-restricted diet brings with it other medical problems such as rickets. Another possible idea is to restore the function of the pump in the cells by inserting a phosphate pump gene into the DNA of the cells using viral vectors.
“This study demonstrates how discovering the causes of these rare lung diseases not only can inform us how the lung normally functions, but can also lead us to potential therapeutic interventions for these rare and often lethal lung diseases,” says James Kiley, PhD, Director of the Division of Lung Diseases at NHLBI.
Rare disease research can reveal insights into the fundamental biology of the lung and this study for PAM has revealed a potential role for phosphate in the regulation of surfactant balance in the lung and have attracted the interest of cystic fibrosis scientists who may be able to use the findings to help treat CF.
References: http://healthnews.uc.edu and http://medicalxpress.com
Chronic Pulmonary Disease is a leading cause of death around the world. However mortality rates for women are higher than for men, who’s mortality rate has actually dropped between 1999 and 2006. The mortality rate for women however did not change and by 2000 women exceeded male mortality rates. This has prompted a shift in the perception that was once held that COPD was a ‘male disease’ and to look into why women are at a significant risk of death from COPD compared to men.
The primary risk factor for CPD is tobacco smoking. There is new evidence suggesting that the two genders differ in their susceptibility to the effects of smoking.
There may be a gender-specific genetic predisposition for lung damage, also women have smaller airways and therefore smoking the same amount of tobacco as men can result in proportionally more lung damage. Exposure to second-hand smoke, choice of cigarette brands and inhalation methods all may contribute to these gender differences. The number of women smoking also has increased dramatically over the last few decades.
These gender differences may start early in life and may be influenced by sex hormones. A study showed that young girls exposed to pollution and tobacco smoke showed greater lung reduction than the boys.
Smoking women are typically younger when they receive their COPD diagnosis and also the annual progression of COPD is more rapid in female smokers than in male smokers, even if they smoked for fewer years and smoked less than their male counterparts.
However 15% COPD diagnoses are non-smokers and of this group 80% are non-smokers suggesting that it is not just tobacco but other risk factors that contributes to a higher prevalence of COPD in women compared to men. Occupational exposures to dusts, coal and metallic fumes in the agricultural and industrial workplaces are a huge risk factor and over the last few decades more women have entered into these traditionally male occupations. In less-developed countries women are more likely to be employed in the textile, brass-ware, ceramics and glassware industries where there is a risk of exposure to damaging agents.
There is also a difference in the clinical symptoms experienced between the genders. Men report more sputum production and quality of life is lower for women who tend to suffer with higher rates of anxiety and depression and suffer more from shortness of breath. Men demonstrate higher rates of diabetes, sleep apnoea and cardiovascular disease whereas women tend to develop osteoporosis and bowel disease. Women also tend to suffer more with decreased BMI and higher airway obstruction readings and a poorer resulting prognosis. Women are also more likely than men to be diagnosed late, which also impacts upon their health and outlook if treatment is started later after more lung damage has occurred.
Upon diagnosis women tend to be younger than men and examination of their lung tissue shows that women in fact had more airway problems at that point, than men. This may explain why women experience more breathlessness and more of a decreased capacity to exercise than men.
These findings suggest that gender must be considered in future COPD studies and that gender is highly important in the treatment of COPD in the future. Gender-specific treatments may need to be developed as well as trying to diagnose women at an earlier point in their lung deterioration to increase survival rates for women.
References: http://www.webmd.com and http://www.medpagetoday.com
A team led by UC San Francisco professor of medicine John Fahy, MD, has discovered why mucus in the lungs of people with cystic fibrosis (CF) is thick, sticky and difficult to cough up, leaving these patients more vulnerable to lung infection.
They found that inflammation causes new molecular bonds to form within mucus which transforms it from a liquid to a sludge.
This research has implications for other lung conditions characterized by thickened mucus, such as chronic obstructive pulmonary disorder (COPD) and asthma.
The scientists also made headway in the lab in exploring a potential new therapeutic approach to dissolve those bonds and return the mucus to a liquid that is easier for the lungs to clear.
Polymers – naturally-occurring molecules in mucus that form long chains – are the key to the discovery. Originally it was thought that there was just an increased concentration of these polymers with CF sufferers but now they know that more bonds form they just need to develop a drug that will break down and dissolve these extra bonds safely.
Fahy likened the polymers to logs floating down a river. “The logs can float down the river as long as they are floating independently,” he said. “But if you bolt them together side to side, they will clog the river.”
The researchers found that inflammation causes the extra disulphide bonds to form, when mucin polymers are exposed to highly reactive oxygen molecules released by inflammatory cells in a process called oxidative stress. Patients who are treated with pure oxygen have long been known to develop sticky mucus and this could be an unfavourable side-effect of the oxygen that’s used to treat them.
A new drug called TDG has been developed to target these mucin polymer bonds to re-liquefy a patient’s mucus but it is still going through the testing stages at present and will be at least 5 years away.
This new finding that explains the reason behind mucus thickening will not only help CF sufferers but other patients with lung diseases such as COPD and asthma. This potential new treatment in the pipeline could help millions of patients enjoy an easier more comfortable life if this drug can eliminate the problems of thickened mucus. It not only clogs up the lungs and makes breathing difficult and coughing it up distressing but also increases the risk of harmful infections taking hold, which could also be reduced with this new treatment.
COPD is often misunderstood as the symptoms can be caused by different types of lung diseases. Separating the fact from the fiction will help you to understand your condition and help you to liver better and manage your COPD.
COPD is an umbrella term for Emphysema, Chronic Bronchitis and Chronic Asthmatic Bronchitis but all three result in obstructed air flow through the lungs.
Common misunderstandings include that it only occurs in older smokers and that nothing can be done about it. Here are four common misconceptions and the truth about them:
Myth or Truth: Only Smokers Get COPD
Long-term smokers do commonly suffer from COPD symptoms such as cough, shortness of breath and frequent lung infections. Whilst COPD is normally caused by smoking, this isn’t true for everyone and in different parts of the world it may be more commonly caused by wood smoke from cooking fires. Other causes include:
• Progressive forms of asthma
• Being born without a protein called alpa-1 antitrypsin
• Workplace exposure to gases and fumes
• Heavy exposure to second-hand smoke or air pollution
Myth or Truth: COPD Only Occurs in Older People
COPD is more common in older people who have smoked for many years. However younger people can develop COPD and a lung test can detect early changes and provide early detection. Even before COPD symptoms develop, the early changes of emphysema or bronchitis may be present and COPD can be diagnosed in people as young as 30.
Myth or Truth: People With COPD Need to Slow Down
COPD symptoms may make some types of activity difficult, but slowing down is not good for those with COPD. Physical therapy, including breathing exercises and exercises to strengthen the arms and shoulders, can be an important part of treatment. Regular exercise along with a healthy diet helps muscles stay strong, and that reduces the demand placed on the lungs.
People with COPD should also try to stay active socially. Isolating yourself at home can lead to depression, which can make symptoms worse. It is important to stay in touch with friends and family and maintain a good support network. Many people with COPD also benefit from participating in support groups.
The correct use of supplemental oxygen at home can make life a lot easier, especially with the use of portable concentrators so that you can still go out and exercise and do daily activities whilst still using oxygen. There are different types of equipment and accessories that the oxygen supplier can provide to help improve your quality of life so that you don’t have to slow down.
Myth or Truth: There Is No Treatment for COPD
This is the biggest myth about COPD – that you can’t do anything about it. Although there is no cure for COPD, it can be treated and managed in many people. It does depend upon how advanced the disease is and whether you are suffering from any other possibly complicating diseases such as hypertension, heart disease or diabetes. You can slow down the progression of COPD by:
• Taking medication as directed
• Getting pulmonary rehabilitation
• Using oxygen as needed
• Stopping smoking
With these changes, many people are able to manage their COPD symptoms well. If you smoke, even if you are still in your 30s, ask your doctor to check your lung capacity. It’s never too late to quit as when you do, your lung capacity immediately begins to improve, however there may have been some irreversible changes to your lungs already if early stages of COPD have already set in. Many of the irreversible effects of chronic bronchitis, emphysema, and chronic asthmatic bronchitis can be avoided with early diagnosis and treatment.