COPD World News Week of January 31, 2010
New York, NY - Heart and lung function appear to be intimately intertwined, so that even mild cases of chronic lung disease affect the heart's ability to pump blood, a new study finds. "It suggests that a larger subset of heart failure may be due to lung disease," said Dr. R. Graham Barr, an assistant professor of medicine and epidemiology at Columbia University Medical Center and lead author of a report in the Jan. 21 issue of the New England Journal of Medicine.
It's long been known that severe chronic obstructive pulmonary disease (COPD) can have damaging effects on the heart, Barr said. But the new report, which covered 2,816 people in a long-running lung study, shows that "even a mild decrease in lung function affects heart function," he said.
Barr and his colleagues used two imaging techniques, computed tomography (CT) scanning and MRI, to measure both heart and lung structure and function. "We observed a linear straight-line relationship," Barr said.
The probable cause of the loss of ability to pump blood, he said, is a reduced blood supply to the heart. COPD is the fourth-leading cause of death in the United States. One form of COPD is emphysema, in which lung tissue is destroyed. Another form is chronic obstructive bronchitis, which causes narrowed airways, a persistent cough and excess mucus production. Lung disease is strongly associated with smoking.
The immediate application of the finding to medical practice would be in diagnosis, Barr said. "Our study was not of possible intervention," he said. "Future studies will show how much treatment of the lung affects the heart and how much treatment of the heart affects the lung.
"Barr has begun such a study, which he said is in an early stage. "These problems take a long time to develop, and so they take a long time to study," he said. The study is expected to last several years.
Meanwhile, physicians seeing people who report such lung problems as shortness of breath might consider testing their heart function, Barr said. The report is an offshoot of a large study, supported by the U.S. National Heart, Lung and Blood Institute, that focused on finding early stages of heart, lung and blood diseases.
"What makes it a novel finding is that just a slight degree of lung disease can have an overall impact on cardiovascular health," said James P. Kiley, director of the institute's lung disease division. "What we are seeing here is the ability to bring the two conditions together.
"There is a distinct benefit in looking at the two conditions together, Kiley explained. "Understanding cardiovascular disease might help understand lung disease and vice versa," he said. "We can put more emphasis on the possibility that these two do have a link and that the link needs to be explored further, even in the clinical assessment of a patient."
For more information:
http://www.nlm.nih.gov/medlineplus/news/fullstory_94330.html
COPD World News Week of January 24, 2010
Tampa, FL - According to William Haley, PhD, of the University of South Florida, in Tampa, and colleagues - the strain of caring for a disabled spouse is associated with an increased risk of stroke.
The risk is greater for men, and especially African-American men. On the other hand, there was no significant association of any level of caregiving stress with the risk of coronary heart disease.
One implication of the study, published by the researchers, is that men looking after disabled partners may need extra support. The issue is important because about 12% of Americans older than 45 report they have what the researchers called "family caregiving responsibilities," they noted. And, high caregiver stress has been found to be a risk factor for depressive symptoms and early mortality.
To see how such stress affects cardiovascular health, the researchers turned to the so-called REGARDS study - Reasons for Geographic and Racial Differences in Stroke. It is a continuing epidemiological look at stroke and coronary heart disease incidence and mortality in a large national sample of adults over age 45.
Of the more than 30,000 participants in the study, the researchers found 767 who lived with and cared for a disabled spouse and had no history of stroke or coronary heart disease. Based on interviews and home visits, the researchers divided the participants into those reporting high, some, or no strain associated with caregiving. They also calculated 10-year stroke and coronary heart disease risk.
In a multivariate regression analysis, high caregiving strain was associated with a 13.62% 10-year risk of stroke for high-strain caregivers, the researchers reported. That was 23% higher than the estimated stroke risk of 11.06% for caregivers reporting no strain.
African-American men with high caregiving stress had an estimated 10-year stroke risk of 26.95%, markedly higher than the risk for any other race or sex group. Among other groups with high caregiving strain, white men had a 10-year risk of about 15%, while white and African-American women had risks estimated to be between 10% and 12%.
The researchers cautioned that the study is cross-sectional, so it could be that people high in some stroke risk factors may simply find caregiving to be more stressful. Other limitations included the fact that there were only a small number of highly stressed African-American men, which could have exaggerated the effect in this group, and the use of risk scores rather than observed stroke and cardiovascular events.
Interestingly, men overall in the study reported lower stress than women, perhaps because they tend to use more paid help and have more assistance from extended family, the researchers said.
For more information:
http://www.medpagetoday.com/Geriatrics/Strokes/tb/17987
COPD World News Week of January 17, 2010
San Diego, CA - Entest BioMedical announced recently the filing of a third patent application relating to the area of chronic obstructive pulmonary disease, a condition that affects more than 5 million patients in the United States, resulting in more than 120,000 deaths per year. The application covers an implantable medical device useful in re-directing the immune system to stop tissue inflammation.
“The importance of the inflammatory process in COPD is exemplified by the use of broad-acting steroids that reduce inflammation. Unfortunately, these drugs do not address the cause of the inflammation, and have a variety of adverse effects” Stated Dr. Stephen Josephs, inventor of the technology.
A recent article “Immunologic aspects of chronic obstructive pulmonary disease” by Cosio et al in the New England Medical Journal suggests that COPD may actually be not just a disease of inflammation but, of active immunological attack. The current technology seeks to induce a process in which immunity towards components of the body is blocked.
“To date Entest has filed two previous patent applications covering use of fat stem cell components in COPD and methods of using photoceuticals to enhance stem cell therapy. The current patent application has a variety of derivative uses outside of COPD including treatment of transplantation rejection, and other disease in which the immune system has gone awry” Stated David Koos, Entest’s CEO.
The essence of the technology is the use of existing implantable devices to deliver chemical/protein signals that specifically stop inflammatory reactions in a manner that is more in tune with biological processes. Instead of us “telling the body” what it should do with a blunt-force approach, as is the standard of care, the current invention uses more natural and slow acting interventions.
Entest BioMedical Inc. is a majority owned subsidiary of Bio-Matrix Scientific Group Inc. The Company is involved with the development of stem cell therapy treatments for Chronic Obstructive Pulmonary Disease (COPD), immuno-cancer therapies, testing procedures for diabetes, stem cell research applications for diabetes and other illnesses. The Company also is involved with medical device
development (including stem cell extraction instrumentation).
For more information:
http://www.entestbio.com/about/about-entest-biomedical-inc.html
COPD World News Week of January 10, 2010
New York, NY - Children who are around smokers face a higher risk of early emphysema when they become nonsmoking adults, perhaps because their lungs never totally recovered from secondhand smoke exposure, new research suggests.
Researchers reached their conclusions after conducting CT scans on 1,781 non-smokers from six communities in the United States. About half of them grew up in homes with at least one smoker.
"We were able to detect a difference on CT scans between the lungs of participants who lived with a smoker as a child and those who did not," Gina Lovasi, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health, said in a university news release.
"Some known harmful effects of tobacco smoke are short-term, and this new research suggests that effects of tobacco smoke on the lungs may also persist for decades.
"The researchers didn't find a link between childhood exposure to tobacco smoke and lung function. "However, emphysema may be a more sensitive measure of damage compared with lung function in this relatively healthy cohort," Lovasi noted.
For more information:
http://www.nlm.nih.gov/medlineplus/news/fullstory_93568.html
COPD World News Week of January 3, 2010
Washington, DC - The FDA has expanded the approved indications for inhaled tiotropium bromide (Spiriva HandiHaler) to include reducing exacerbations of chronic obstructive pulmonary disease, in addition to its previous approval for COPD maintenance.
Tiotropium is a bronchodilator that works by antagonizing acetylcholine receptors in airway tissues. The new indication was based on results of two clinical trials with nearly 8,000 patients combined -- one called UPLIFT and a separate six-month study with patients in a Veterans Affairs setting.
Although the drug failed to meet its primary endpoint in UPLIFT, significantly slowing declines in lung function versus placebo, it did show benefits in reducing exacerbations. These were defined as new onset or increase of symptoms over at least three days and required a change in treatment or hospitalization.
Participants in the UPLIFT trial were permitted to use all nonanticholinergic respiratory medications and were assigned to either tiotropium or placebo. The tiotropium group saw a median 16.7-month delay before the first exacerbation of symptoms.
The drug was also associated with a mean 14% reduction in number of exacerbations, though there was no significant difference between groups in exacerbations leading to hospitalization.
In addition to the new indication, the drug's label now includes some of the UPLIFT study data.In a press release, the two companies that co-market the product, Pfizer and Boehringer Ingelheim, said it was the first steroid-free drug approved for COPD maintenance that is also demonstrated to reduce exacerbations.
For more information:
http://www.medpagetoday.com/Pulmonology/SmokingCOPD/tb/17611
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