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Dr. Tillie-Louise Hackett in her laboratory at the Center for Pulmonary Innovation at St. Paul's Hospital
PNG
Chronic obstructive pulmonary disease (COPD) is an insidious disease that damages the lungs long before that the symptoms do not manifest themselves. shown in a study that could lead to profound changes in research, diagnostic and treatment approaches.
About 140,000 BC residents were diagnosed with the incurable and progressive condition that affects breathing. COPD is one of the leading causes of death and hospitalizations in British Columbia. and across Canada.
In the study, published in a journal called Lancet Respiratory Medicine, researchers from the University of British Columbia. based at the Center for Pulmonary Innovation of the Heart of St. Paul's Hospital (HLI) used a new micro-CT imaging technology capable of resolution 1000 times to examine entire lungs or lobes who had been removed from patients (with and without COPD) who received surgery to treat lung cancer tumors several years ago.
Whole lungs and lobes were donated by patients (almost all in their sixties) after organ removal. Patients consented to the use of their resected lungs for research purposes and donated organs were kept at the HLI Tissue Bank in Vancouver, one of the largest deposits of lung tissue biobanks in Canada. world. The research team developed new methods for badyzing archived lung samples using one of the only CT scanners in Canada
Of the lungs or lung segments examined in 34 patients, some came from smokers with normal lung function. a diagnosis of cancer), and the rest came from patients with mild, moderate or severe COPD (formerly known as emphysema). Research collaborators from the University of Southampton, England, and the University of Pennsylvania also collaborated on this study funded by a grant from the Canadian Institutes of Health Research
. a sample of lung tissue in a CT scanner
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Lead author Tillie-Louise Hackett, HLI scientist and badociate professor at the University of British Columbia, said in an interview that this study is the first to demonstrate a substantial loss small airways. function in patients with mild COPD or those whose lungs appear normal on the surface. The researchers drew an badogy with kidney disease in which there is significant damage to the organ before the symptoms appear. Even the small airways in the lungs are sick at the time of the diagnosis of mild or moderate COPD.
"These data strongly support the concept that small airways are the main and the first site of airflow limitation in COPD." State, noting that an earlier study had proposed a hypothesis – now confirmed in this study – that small airways in the lungs "could represent a calm zone in the lung where the disease could accumulate for many years without being noticed. "
is an important finding because, according to current clinical guidelines, patients will not even receive medication to relieve symptoms, such as bronchial dilators or inhaled steroids, until they have a more advanced disease
. Spirometry tests, "said Hackett, adding that the study showed that, since damage occurs to vital structures of the lungs much earlier, experts should consider starting treatment earlier. She said that the study only involved 34 patients and should therefore be considered preliminary, so it may be time to consider whether people at high risk for COPD, such as smokers (of which 40 percent develop COPD ), Smoke, should be offered screening with respiratory tests.
Hackett said that the reason clinical trials in new COPD treatments have failed to show beneficial effects is that there was already too much lung damage in patients enrolled in such tests. Patients with mild illness should now be included in such trials, she said. "If the same drugs were tested on patients with milder forms of the disease, and less tissue damage, the results could be very different," she said.
"We are awaiting the results of this research for policies to improve the early diagnosis and effective management of patients with mild and moderate COPD," the study concludes. "Future clinical trials need to be conducted in cohorts of patients with mild and moderate COPD if we want to have a chance to change the outcome of the disease. "
