[ad_1]
Chronic obstructive pulmonary disease (COPD), an inflammatory disease of the small airways in the lungs, affects 16 million Americans and is the fourth leading cause of death in the United States, according to the NHLBI (National Heart Lung and Blood Institute). ). Identifying small airways diseases at an early stage, when it is the easiest to treat, could potentially lead to new pharmacotherapies for people with COPD, according to researchers.
However, physicians had difficulty identifying non-invasive small airways abnormalities; the tiny bronchioles with COPD, whose internal diameter is less than 2 mm, are simply too small to be visualized in CT and are not well reflected in pulmonary function tests.
In a landmark study funded by the NHLBI, an international team of researchers led by Michigan Medicine confirmed the ability of a non-invasive imaging biomarker to identify small airway damage in COPD.
in the American Journal of Respiratory and Critical Care Medicine, researchers report the ability of a relatively new technique, called parametric response mapping (MPR), to identify a small airway abnormality in COPD. Invented at Michigan Medicine, University Medical Center of the University of Michigan, by Brian Ross, Ph.D., Professor of Radiology and Biological Chemistry and Craig Galban, Ph.D., Associate Professor of Radiology, the PRM is a noninvasive technique that measures lung density during inhalation and exhalation.
The team examined lung tissue from COPD patients undergoing lung transplantation, as well as those who received healthy tissue. The researchers then matched these samples with CT scans performed prior to surgery.
They confirmed that the PRM was able to non-invasively identify the losses, narrowing and obstructions of the small airways. This technical feat required the collaboration of large multidisciplinary teams of radiologists, pulmonologists, thoracic surgeons and pathologists spread over several sites in two countries, all of them activated at all times due to the unpredictable nature of transplant surgery.
MeiLan Han, MD, Lead Author and Lung Specialist and Professor of Internal Medicine at the University of Michigan, says, "We now have confidence in our ability to identify airway disease when imaging patients with COPD . PRM is already clinically available and used by the University of Canada. Michigan clinical teams are evaluating patients with COPD. This is what we mean by laboratory medicine at the bedside of the patient. "
Although these studies were conducted in patients with severe disease, COPDGene, another NHLBI-funded study, detected MPR-defined airways abnormalities on CT scans of patients with severe disease. less severe, which predicts the risk of loss of lung function. However, Han notes, "we still need to validate the type of airway disease identified by the MRP technique in patients with less severe disease.This type of lung tissue is more difficult to obtain, but we are working on techniques that would allow us to use smaller proteins, quantities of lung tissue to perform such studies. "
At the present time, there is no way to cure or reverse COPD. Lifestyle changes, such as quitting, and treatment with bronchodilators and inhaled steroids can help dilate the airways and reduce inflammation. Surgery to remove damaged lung tissue and lung transplantation are options for some patients with serious illness. By helping to identify patients at risk for disease progression, RPMs can be used as a non-invasive measure to facilitate clinical trials of new treatments, the researchers concluded.
"These results illustrate the importance of developing non-invasive techniques to improve diagnostic capabilities and advance new treatments needed to combat this devastating disease," said James Kiley, Ph.D., Division Director. lung diseases at the national level. and Institute of the blood. "The refinement of this approach and other similar approaches could also advance the study of COPD in its early stages of development."
###
Other authors: Vasilescu DM, Ph.D., University of British Columbia, Vancouver, Canada; Martinez FJ, MD, Weill Cornell Medical College, New York, NY; Marchetti N, DO, Lewis Katz School of Medicine, Temple University, Philadelphia, PA; CJ Galban, PhD, University of Michigan, Ann Arbor, MI; Hatt, C, PhD, University of Michigan, Ann Arbor, MI and Imbio, Minneapolis, MN; Meldrum C, PhD, University of Michigan, Ann Arbor, MI; Dbad Chandra, MD, Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Tanabe N, MD, Kyoto University, Kyoto, Japan; Reddy R, MD, University of Michigan, Ann Arbor, MI; Lagstein A, MD, University of Michigan, Ann Arbor, MI; Ross BD, PhD, University of Michigan, Ann Arbor, MI; Labaki WW, MD, University of Michigan, Ann Arbor, MI; Murray S, ScD, University of Michigan, Ann Arbor, MI; Meng X, University of Michigan, Ann Arbor, MI; Curtis JL, MD, University of Michigan, Ann Arbor, MI and VA Ann Arbor Healthcare System, Ann Arbor, MI; Hackett TL, PhD, University of British Columbia, Vancouver, Canada; Kazerooni E, MD, University of Michigan, Ann Arbor, MI; Criner GJ, MD, Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Hogg JC, MD, University of British Columbia, Vancouver, Canada.
Funding: Han: NIH RO1 HL122328, NIH K24 HL138188; Vasilescu: Canadian Thoracic Society and Alpha-1 Foundation; Hackett: Canadian Institutes of Health Research and Michael Smith Foundation for Health Research; Curtis: Department of Veterans Affairs Merit Review I01 CX000911, NIH RO1 AI120526 and NIH R21 AI 117371; Ross: NIH R35, CA197701.
Source link
