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Thursday, July 21, 2011

New test may detect early emphysema

One of the interesting things about obstructive lung diseases like asthma, chronic bronchitis and asthma is that there is no concrete test that says:  that guy has asthma, or that gal has COPD.  Yet that might all change in leu of new research at the University of Iowa.

As of right now the only true method of diagnosing emphysema is by autopsy.  Although signs and symptoms such as increased shortness of breath and barrel chest, and pulmonary function testing, can help a doctor to diagnose this lung disease.

Yet U of I researchers now believe a CT Scan that that measures blood flow in the lungs (you can see an image here) may detect early emphysema.  This is significant, because this test may provide an option for doctors to help them determine if their patient is at an increased risk for further loss of lung tissue if they continue to smoke cigarettes.

I can think of no worse way to die than to suffocate to death.  Emphysema patients gradually become more and more dyspneic (feeling of air hunger) as time goes on, especially if they continue to smoke.  The end stages of this disease can last for several years, resulting in permanent air hunger.  I have seen first hand many patients in this condition.  It's not a pretty sight.

As an asthmatic myself I know what it's like to not be able to breathe, yet the nice thing about asthma is that the airflow obstruction in the lungs is completely reversible.  With emphysema, the lung damage is permanent, and the airflow obstruction is only partially reversible.  This results in permanent dyspnea that -- if you continue to smoke -- progresses over time.

So this test is significant because it could provide doctors with the evidence they need to tell their patients that if they continue to smoke they will continue to destroy lung tissue.  It will also allow physicians to distinguish emphysema with chronic bronchitis. 

Likewise,  according to lead study author Eric Hoffman, Ph.D., UI professor of radiology, internal medicine and biomedical engineering. "Our discovery may also help researchers understand the underlying causes of this disease and help distinguish this type of emphysema from other forms of chronic obstructive pulmonary disease. This type of CT scan could even be a tool to test the effectiveness of new therapies by looking at the changes in lung blood flow."

Scientists also have little knowledge about by what mechanisms obstructive lung diseases such as emphysema develop, although this new research suggests that loss of blood flow occurs before loss of lung tissue. 

Likewise, "although the underlying causes of emphysema are not well understood, smoking increases the risk of developing the disease," Hoffman said. "Our study suggests that some smokers have an abnormal response to inflammation in their lungs; instead of sending more blood to the inflamed areas to help repair the damage, blood flow is turned off and the inflamed areas deteriorate."

Tissue is destroyed because the human body naturally works to optimize gas exchange, so when one area of the lung becomes permanently blocked, the body blocks blood flow to that area of the lung so it can be sent to areas of the lung where gas exchange can occur. 

If blood flow is returned to the inflamed area the damage can be repaired by increased blood flow "that brings oxygen and helpful cellular components to the site of injury," notes the press release. 

Likewise, "This study suggests that the ability to distinguish when to turn off or when to ramp up blood flow is defective in some people -- probably due to genetic differences. If this genetic difference is coupled with smoking, which increases lung inflammation, that could increase the risk of developing emphysema."

This is very interesting research and it will be interesting what happens from here. 

(The above information was obtained from this press release)

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