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. References: http://medicalxpress.com
In the past patients diagnosed with respiratory conditions requiring oxygen therapy faced the problems associated with traditional canister oxygen technology. Bulky heavy equipment that resulted in many losing their mobility and independence. Now with portable oxygen concentrators this is becoming a thing of the past as these light weight pieces of equipment mean that patients can maintain their lifestyles and still keep active. There are still aspects of having to wear and use oxygen for long periods of time that can make patients feel conspicuous, uncomfortable, restricted or cause secondary health ailments. Technology is moving quickly and devices are becoming smaller, lighter and customisable. There are now products available to aid with the smaller inconveniences to help improve patient’s quality of life even more. These may not be available from your normal supplier via the NHS but are worth the small purchase cost if it aids in improving your mobility, sleep quality and health. Many private oxygen supply companies stock these or other accessories that may suit your own personal needs or many customers purchase online. Oximeters:
You can purchase finger pulse oximeters that are small units that check your heart rate and oxygen saturation at any time, at your own convenience. This way you can check that your oxygen levels are correct and discover early if there is a problem and seek to resolve it before it causes any major health problems. There are also ones specifically designed for children and carry cases are available for them. Drops in oxygen saturation could be an indication of faulty equipment or of a worsening health condition. Being able to monitor and record your changing oxygen saturation levels is not only more convenient than having to wait for a GP appointment to check your levels but it could also help your GP from understanding your oxygen requirements more specifically. Sleep Face Pads:
Many find sleeping at night with masks and tubes very difficult with the tubes rubbing their skin and the feeling of discomfort preventing them from getting a good night’s sleep. There are Sleep Comfort Pads available that are clear in colour so as not to make you feel conspicuous. They are designed to act as a comfort barrier between the mask and your skin to decrease air leaks, improve the comfort of the mask or nasal cannula and are hypoallergenic to reduce irritation. Oxygen Carry Bags:
In order to aid with your mobility and getting out and about with your oxygen equipment there are bags specifically designed for carrying oxygen equipment and supplies. They allow easy, hands free transport of your oxygen tank or concentrator with a padded single shoulder strap for easy on and off. It carries the equipment on the centre of your back for comfort and is padded and insulated to protect your equipment. They can also come with a padded support waistband that can be converted for you to be able to go walking, golfing, biking, gardening or any hands free activity to keep you active and mobile. With mesh to allow the tank to breathe or the concentrator to have air flow around the equipment and some have a vehicle headrest carrier strap to ensure it remains upright whilst you drive. Medical Oxygen Glasses:
Wearing a nasal cannula can feel odd and uncomfortable enough without the additional hassle of wearing prescription glasses. Many people feel self conscious and feel like there are too many things on their face. With the tubing normally going from the nose and out over the ears many patients find it awkward to do their hair or long hair becomes tangled with the tubing or the tubing can become caught on things. Some patients find it too much hassle and either stay at home or remove the tubing when they go out which can have a detrimental effect on your health if you’re not using your oxygen supply when you should be.
These glasses are specially designed for oxygen therapy users and the tubing runs from the nose up to the glasses and is virtually invisible and also out of the way. You can choose the frames that suit you and either have clear or prescription lenses. The tubing follows the frame of the glasses and the tubing is near invisible and doesn’t go across your face making wearing your cannula more comfortable and less conspicuous.
These are just a few of the accessories that are out there, as well as different tubing and prongs that may suit you better. They’re designed to improve oxygen therapy users’ quality of life as if the user feels more comfortable, suffers from less irritation, feels more able to have an active social life and do more activities whilst still using their oxygen then their overall health, well-being and quality of life will be much improved.
References: http://oxyview.com.dnnmax.com and http://www.gbukhealthcare.com and http://www.oxygenconcentratorstore.com
20 years ago the exhibitions were filled with oxygen cylinders and now business is bigger and has progressed a lot. Most people know very little about the oxygen marketplace but it’s very much part of the ‘home-care’ marketplace although opportunities are emerging for retailers too.
In America oxygen is big business and millions of them use oxygen, but it has high pressures on it due to the ‘competitive bidding’ programme, as Americans have the private healthcare system so there are many companies competing for low cost products. In the UK it isn’t as prominent but it’s definitely there and has grown. It’s a business that has gone from nothing to millions in just a few years. Over here the market is about delivering oxygen to patients at home. 70% of them are COPD patients and the numbers involved and the growth rate is huge and is thought to be the second biggest disability in the USA.
The two main products are either static oxygen; which is produced from oxygen concentrators plugged into the mains, or ambulatory oxygen; necessary for patients who want to use oxygen outside of the home. This is achieved by the use of portable oxygen concentrators, transportable oxygen concentrators or devices such as home-filling, where the patient can fill gas cylinders from their static concentrator. A patient is diagnosed with a respiratory disease and either via a doctor or an oxygen assessment clinic their oxygen needs are assessed for a prescription. This prescription is sent to the contracted oxygen provider for that area of the country, of which there are 11 in England and Wales. At the moment the provision is mostly dominated by gas providers which is similar across Europe. This is due to the fact that traditionally the delivery model involved producing liquid oxygen, putting the gas into cylinders and transporting these and therefore gas companies were better equipped to deal with this process.
However oxygen concentrator technology has really taken off over the last few years in the US and has allowed healthcare companies to come into the marketplace and lower the price of the service considerably, as the need for delivery of cylinders and refilling these cylinders is being eradicated as now you can just buy a one-off product. Europe and the UK are slowly catching up with the idea.
There are millions of people diagnosed with COPD around the world and 15% of these are prescribed oxygen. The number of COPD patients coming into the market is increasing and is expected to continue to increase for many more years. COPD patients are also increasingly being prescribed oxygen until the end of their life expectancy combined with the fact that COPD is being diagnosed earlier in life due to an increased awareness of the condition means that many more people will be requiring oxygen for longer periods of time. The demand for oxygen in the UK is being driven by the high levels of smoking. If you smoke for more than 30 years then it is likely that your lungs will become damaged. According to the UK government the number of people diagnosed with COPD is just the tip of the iceberg compared to people who actually have the disease. The NHS needs there to be more competition in order to bring down costs and invest in bringing the newest technology into the UK market. There are private companies coming through though such as Virgin Care who are involved in COPD management and pulmonary rehab management and their next logical step would be to also get involved in oxygen delivery as well. In Scotland the model has already evolved, which although was time-consuming and expensive in the short-term will help the NHS in Scotland long-term and there will be a £2 million saving on the pharmacy oxygen budget for them. They managed to link a manufacturer to a contractor and to the Scottish NHS in a three-way relationship via competitive quotes. Hopefully in the near future this will also happen in the NHS in England and Wales.
It is hoped that there will also be opportunities for retailers too. There are already a small number of specialist retailers in the marketplace. OxygenWorldwide and it’s services can give expert advice and arrangement when travelling with oxygen. Your local provider cannot allow you to take your oxygen equipment abroad on a plane. As demand increases the pressure to produce equipment to hire or buy in order to travel abroad will also increase, as what happened in the US. It was the main driving force in the US for manufacturers to produce portable concentrators that were cheaper and lighter. Cylinders were too awkward to take abroad and airlines charge a fortune. This increasing demand and expectation will help to improve and cheapen the market over here as well.
Consumers increasingly want lighter, longer-lasting, smaller oxygen concentrators and this will be the way forward for the marketplace. The main problem is battery life which is what happened with laptops and mobile phones. As the products become lighter and smaller then the marketplace will grow for retailers to sell them to their customers who want to get out and about more easily and to go abroad. The internet has also opened up the market and has encouraged transatlantic sales which has opened-up the eyes of the UK market to what else there is out there and in combination with an increase in private sales the Department of Health has responded positively. In the future it is expected that the marketplace will continue to open up and will take advantage of the new technology and delivery methods. Patients will still have static oxygen in their homes but will have an ambulatory device tailored to suit their needs. It is envisioned that in the future there could be oxygen monitors positioned on a patient’s ear or finger being programmed back through blue tooth technology, with a device on the hip which will then deliver the amount of oxygen they need at any point in time. Data can be fed and analysed to confirm that the patient is using it efficiently and that the oxygen purity is at the right levels.
As with other markets, the private companies drive the technological advancements and increased demand helps to bring down costs and then these cheaper better products filter down into the public domain. In the meantime before the future gets here, if you are unhappy or feel restricted by the equipment that is currently available via your local supplier then take a look at a private company like OxygenWorldwide for portable oxygen concentrator hire across the world and not just for travelling abroad, costs have come down a lot recently and the technology available is more advanced. It’s worth a look and it’s an investment into your health and quality of life.
Portable oxygen concentrators have started a revolution in the medical oxygen industry, with their use having sky-rocketed over the last five-10 years. Industry experts are optimistic about the future of portable oxygen and that patients will be able to get hold of even better equipment in the future to make their lives as close to normal as technology can allow.
Portable oxygen technology is ever-evolving and improving, with POCs at the heart of it. This is driven by the increasing demand for these devices which in turn has been driven by an increase in diagnosed sufferers requiring oxygen therapy, improved availability and increased affordability. These factors are constantly driving down costs for the industry, allowing them to reinvest to improve devices whose demand then continues to help grow the industry and improve it. However it seems these advancements will come with a little give and take.
Patients and doctors want smaller, lighter, quieter devices that also have a higher oxygen output and a longer battery life. The providers also want in addition more durability, reliability and all at a lower cost.
As with other technologies if you move in one direction to improve a singular feature it often has an negative impact on another and getting the balance is difficult.
The patient is the final target audience and their requirement for freedom will be the ultimate guidance for the future of oxygen technology. They require the freedom to easily fly, drive or boat and do daily activities without worrying about running out of oxygen. Freedom also comes from not waiting on deliveries from the oxygen supplier and all this provides patients with the chance to feel normal again.
A main inhibiting factor on their advancement is the highly competitive nature that the industry has evolved into. This has led to providers dramatically lowering prices in order to maintain market share, which is highly beneficial to the patient however it leaves less money available for re-investment into research to drive improvements. With the steep increasing trend of COPD diagnosis around the world it seems there will be an ever-increasing amount of patients and therefore providers seeking to purchase POC’s which will then still allow for re-investment.
It is hoped that the units will become smaller and lighter with increased battery life which is very important as the current units are not as portal as they could be for end-stage COPD patients.
It is agreed that ‘POCs are still in their genesis’ but the ultimate goal is so that the POC is also the primary oxygen concentrator, so you would only need the one unit.
Making something increasingly portable also brings along other problems and the unit then needs to be made increasingly durable and resistant to banging and dropping and other associated hazards. Replacing a bolt or armrest on a wheelchair is a lot easier and less of an inconvenience to the user than replacing a part in a POC.
Future oxygen technologies will continue to be focused on medically accurate and improved oxygen therapy and delivery/recycling methods but also incorporate much more software and intelligence in the design and lighter weight models. In order for companies to drive down costs more of a focus may also be put on patient maintenance and repair so that parts can be cleaned or replaced easily by the patient and not having to send the unit back and forth to the manufacturer.