Chronic Obstructive Pulmonary Disease (COPD) Quiz

Welcome to the NHLBI Diseases and Conditions Index (DCI) COPD Quiz. Check your knowledge about COPD with the following questions. For each question, select the answer you think is correct.

Take The Quiz >>

Gene Therapy May Stall Inherited Emphysema

A new type of gene therapy may help stop the progression of emphysema in young people who have an inherited form of the deadly disease.

Researchers say previous attempts to correct the gene mutation that predisposes young people to emphysema have failed to achieve lasting results.

But a new study shows a different approach that targets cells known as alveolar macrophages to deliver the gene therapy to the lungs of mice with this form of inherited emphysema was successful in treating the condition for two years.

Emphysema is a progressive lung disease that causes severe shortness of breath. There is no cure for the disease.

People born with a genetic mutation that causes a deficiency in alpha-1 antitrypsin are predisposed to an early form of emphysema as well as cirrhosis of the liver.

Researchers say this single gene defect makes the condition an ideal candidate for gene therapy, which would replace the defective gene with a normal one. But the problem until now has been finding the right cell in which to transfer the gene and deliver it to the lung.

more…

FDA Approves SPIRIVA® HandiHaler® for the Reduction of COPD Exacerbations

Boehringer Ingelheim Pharmaceuticals, Inc. and Pfizer Inc. announced today that the U.S. Food and Drug Administration (FDA) has approved SPIRIVA® HandiHaler® (tiotropium bromide inhalation powder) for the reduction of exacerbations in patients with chronic obstructive pulmonary disease (COPD). SPIRIVA HandiHaler is already FDA-approved as a once-daily maintenance treatment for breathing problems associated with COPD, which includes chronic bronchitis, emphysema, or both.

Reducing exacerbations is a key goal of COPD disease management, according to treatment guidelines. In the clinical trials that served as the basis for this approval, COPD exacerbations were defined as a new onset or increase of symptoms (including cough, sputum, wheezing or difficulty breathing) lasting for at least three days and which required a change in treatment (antibiotics or steroids), which could include hospitalization. COPD exacerbations may be caused by viral or bacterial infections, as well as environmental irritants.

“Exacerbations of COPD are serious events that can negatively impact the lives of patients,” said Dr. Donald P. Tashkin, emeritus professor of medicine, David Geffen School of Medicine at UCLA, Los Angeles. “People with COPD now have a once-daily treatment option that not only helps them manage the debilitating symptoms of COPD, but also can help them reduce the chance of an exacerbation.”

The new indication is supported by data from two clinical trials: the landmark UPLIFT (Understanding the Potential Long-term Impacts on Function with Tiotropium) study and a six-month study conducted in the Veterans Affairs setting, which together involved nearly 8,000 people with COPD. While the UPLIFT trial did not meet its primary endpoint (slowing the rate of decline in lung function versus placebo), it provided relevant and important clinical information regarding the effect of SPIRIVA HandiHaler on COPD exacerbations.

“With today’s approval, SPIRIVA HandiHaler is now the first steroid-free maintenance treatment that has been shown to reduce COPD exacerbations,” said Dr. Christopher Corsico, vice president, drug regulatory affairs, Boehringer Ingelheim Pharmaceuticals, Inc. “We also are pleased that the product label will now include data from the landmark UPLIFT trial, which provides important information for physicians to consider when making treatment decisions.”

Along with the new indication, the SPIRIVA HandiHaler product label now includes clinical trial data from the UPLIFT study. In this trial, COPD patients in both treatment groups were allowed to use all of their respiratory medications with the exception of inhaled anticholinergics in order to simulate a real-world environment. The clinical data demonstrated that SPIRIVA HandiHaler sustained improved lung function over four years when compared with placebo and reduced COPD exacerbations, even with the use of these medications. Additionally, the inclusion of the safety data reaffirmed the established safety profile of SPIRIVA HandiHaler.

The safety profile of SPIRIVA HandiHaler has been well-established in clinical studies involving more than 17,000 COPD patients, 11,000 of whom were treated with SPIRIVA HandiHaler, and in post-marketing experience involving more than 16 million patient-years of exposure since its European approval in 2002. SPIRIVA HandiHaler was approved in the United States in 2004.

more…

Study Unveils Potential Genetic Links to Lung Disease Risk

A new study involving data from more than 20,000 individuals has uncovered several DNA sequences linked to impaired pulmonary function. The research, an analysis that combined the results of several smaller studies, provides insight into the mechanisms involved in reaching full lung capacity. The findings may ultimately lead to better understanding of lung function and diseases like asthma and chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States.

“We have known for a while that genetic factors put some people at risk for lower lung function —a factor in COPD and a risk for early mortality. But, we did not know which specific genetic regions were involved,” said Stephanie London, M.D., Dr.P.H., senior investigator at the National Institute of Environmental Health Sciences (NIEHS), part of National Institutes of Health (NIH), and a senior author on the paper. “These findings point to specific gene regions.”

Impaired lung function is a hallmark of COPD and other lung diseases. But it is also linked to mortality from a wide range of other diseases, including cardiovascular disease and cancer. So knowing some of the genes involved is a first step toward understanding the relationship between lung function and mortality, as well as developing new interventions to manage lung diseases.

more…

Do You Lie to your Doc?

I feel great. I’m taking care of myself. I’m eating all my fruits and veggies. Have you ever told one of these fibs before? If you’ve told one to your doctor, you’re in good company. A new survey shows lying to your doctor is a common habit. But, you might want to be honest at your next visit.

I feel great. I’m taking care of myself. I’m eating all my fruits and veggies. Have you ever told one of these fibs before? If you’ve told one to your doctor, you’re in good company. A new survey shows lying to your doctor is a common habit. But, you might want to be honest at your next visit.

A recent survey shows 52 percent of women reported that they routinely lie to their doctors. And a quarter didn’t think it was a big deal. Doctor Michael Weaver, M.D., internal medicine and addiction medicine specialist, says that’s a common misconception.

“Something that a doctor would consider important, a patient may not recognize a connection to,” Weaver explained to Ivanhoe.

Some of the top lies: I don’t smoke, I don’t drink, I floss all the time, I’ve never had an STD, I exercise regularly, I always use sunscreen, I’m monogamous — and I’m not taking any other meds. Many patients said they lie out of fear, embarrassment or because they want approval from their doctor.

“It’s much more important to be honest and try to be accurate,” Weaver says.

more…

U.S. cancer rates continue their decline: report

By Maggie Fox >>

Fewer people are getting cancer and death rates continue to fall, according to the latest report on cancer in the United States, released on Monday.

New diagnoses for all types of cancer fell by almost 1 percent per year on average from 1999 to 2006 and deaths fell 1.6 percent per year from 2001 to 2006, the National Cancer Institute, Centers for Disease Control and Prevention, American Cancer Society and the North American Association of Central Cancer Registries reported.

Declines in rates of new cases and rates of death for the most common types of cancer — lung, breast, prostate and colorectal cancers — are mostly responsible, they reported in the journal Cancer.

“The continued decline in overall cancer rates documents the success we have had with our aggressive efforts to reduce risk in large populations, to provide for early detection, and to develop new therapies that have been successfully applied in this past decade,” NCI Director Dr John Niederhuber said in a statement.

more…

10 Tips for Managing COPD

If you have COPD, you can improve your life with good management of the disease. Always make sure you talk with your health care provider about questions and concerns.

Try these tips for managing COPD:

1. Give up smoking

2. Eat right and exercise

3. Get rest

4. Take your medications correctly

5. Use oxygen appropriately

6. Retrain your breathing

7. Avoid infections

8. Learn techniques to bring up mucus

9. Make and use an action plan

10. Learn more about COPD

Read More At National Jewish

Genetic Pattern Indicates Early-Stage Lung Cancer

Wistar Institute researchers and collaborators from the University of Pennsylvania and New York University have identified immune system markers in the blood which indicate early-stage lung tumors in people at high risk for developing lung cancer. The findings, published online December 1 in Cancer Research, a journal of the American Association for Cancer Research, could lead to a simple blood test to detect lung cancer in its earliest phases, when it can be most successfully treated.

Wistar investigators Louise C. Showe, Ph.D., and Michael K. Showe Ph.D., and colleagues examined gene expression profiles in blood samples from more than 200 patients with lung cancer or other, non-malignant, lung diseases. Focusing on non-small cell lung cancer (NSCLC), and the large at-risk population of smokers and ex-smokers, the researchers sought to determine whether lung tumors—even at the earliest stages—leave a gene expression signature in circulating blood cells. Recent studies have shown that in some late-stage cancers, an immune system response can be detected in the blood which can contain information on responsiveness to therapy or identify markers associated with prognosis.

more…

Detergent exposure hard on workers’ lungs: studies

People who work in detergent factories are at increased risk of developing respiratory problems, including asthma, probably from exposure to chemicals contained in detergent, two new studies hint.

But a spokesman for the detergent industry argues that the findings from these studies don’t apply to the US and European detergent industries at large. “Over the years, the detergent industry has developed successful product stewardship programs to promote the safe use of enzymes, using appropriate risk assessment and risk management strategies to avoid unacceptable risks in the workplace,” Richard Sedlak, vice president of technical and internal affairs for The Soap and Detergent Association (SDA), said in a prepared statement.

While the author of one of the new studies agrees that the industry overall has done a good job protecting workers, he said regulatory agencies’ current exposure standards are too high.

Exposure to chemicals found in powdered detergent was first recognized in 1969 to cause job-related asthma. Since then, the industry has introduced measures for limiting workers’ exposure, although outbreaks of occupational asthma still occur.

In the latest issue of the journal Occupational and Environmental Medicine, Dr. Frits van Rooy of the Institute for Risk Assessment Sciences in Utrecht, The Netherlands, and colleagues note that workers exposed to detergents in liquid form are not considered to be at risk of these lung problems. But their findings suggest that they should be.

In a related paper, Dr. Paul Cullinan of Imperial College in London and his colleagues report evidence suggesting that current standards for workplace exposure to powdered detergent chemicals are too high to protect workers from respiratory problems.

 

more…

Quantitative CT useful in predicting lung function decline in smokers

by Megan Brooks

In smokers with normal lung function, quantitative CT evidence of lung parenchymal overinflation independently predicts a rapid decline in lung function over the next 2 years, a new study has shown.

“This study shows that imaging of the lung is a crucial component to understanding the development of the emphysema and its effect on lung health,” Dr. Harvey O. Coxson from Vancouver General Hospital, Canada told Reuters Health by email.

Imaging studies have shown that subjects with normal lung function may have emphysematous destruction in their lungs, he and his colleagues point out in the November issue of the journal Thorax. This fueled their hypothesis that early emphysematous destruction might be associated with a subsequent rapid decline in FEV1 that leads to COPD.

more…