Tag: COPD

Unravelling the mystery of smaller lungs in low- and middle-income countries

Andre Amaral

In low- and middle-income countries (LMICs), a notable number of individuals have smaller lungs for their sex, age, and height, especially in South and East Asia, as well as sub-Saharan Africa. The key question: Why does this pattern persist in these regions?

This phenomenon extends beyond physiological concerns, and as indicated by recent studies, reveals a troubling link between smaller lungs and heightened risks of suffering from heart disease and diabetes. Dr André Amaral, an epidemiologist at the National Heart and Lung Institute (NHLI), explores this phenomenon.

The BOLD study

Chronic lung diseases affect millions of people of all ages worldwide. Approximately 20 years ago, the Burden of Obstructive Lung Disease (BOLD) study was set up by Imperial College London to find out more about the prevalence and determinants of chronic obstructive pulmonary disease (COPD), which back then, was already considered a leading cause of disability and death.

The BOLD study was conducted in 41 sites across Africa, Asia, Australia, Europe, the Caribbean and North America, and recruited more than 30,000 adults aged 40 years and over. The large coverage of world regions, and ethnic groups, as well as the large number of participants, all answering the same questions and undergoing the same measurements in a standardised manner, makes the BOLD study unique. Participants in this study provided information on several characteristics of their life. This included whether they had been diagnosed with lung disease, a heart disease, or diabetes, whether they smoke or ever smoked, their weight and height, and their highest level of education. The level of their lung function was measured through a medical test called spirometry, which measures how much air a person can breathe out in one forced breath.

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Professor Sir Peter Barnes knighted for excellence: Reflections on his career in respiratory science

Professor Sir Peter Barnes FRS FMedSci, from the National Heart and Lung Institute (NHLI), was made a Knight Bachelor in this year’s King’s Birthday Honours “for services to respiratory science.” Sir Peter is Professor of Thoracic Medicine at the NHLI and he was Head of Respiratory Medicine at Imperial until 2017. Here he writes about his reaction to his award and describes some of the current research projects in chronic obstructive pulmonary disease (COPD).

A surprise! 

My wife opened the letter “On His Majesty’s Service” as she thought it was a tax demand – I was absolutely shocked to see I had been offered a knighthood. Of course, I was and am delighted with the award. It is very good for respiratory science and medicine, which generally receives little public attention. This is surprising as chronic lung diseases are amongst the most common in the UK, affecting one in seven people and the third ranked cause of death. I would like to dedicate this award to all the brilliant students, post-docs, research fellows, visiting scientists and colleagues that I have worked with at Imperial College London over many decades.  

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COVID and lung health: patient experience and what comes next?

The pandemic has been a huge challenge for people with lung disease – Dr Nick Hopkinson outlines what needs to change to provide them with the required support.

The COVID-19 pandemic has had a double impact on people with lung disease – both the impact of the condition itself as well as measures to avoid it on individuals and the impact on access to healthcare. COVID-19 is a respiratory infection, with people with COPD and severe asthma among those who are the most vulnerable. Many people with these conditions have spent a year shielding to avoid it.

Data from patient surveys by the Asthma UK and British Lung Foundation Partnership early in the pandemic found high levels of anxiety, with four key themes emerging from survey responses:

  • Individuals’ vulnerability to COVID-19,
  • Worrying what the experience of contracting COVID-19 would be like,
  • Uncertainty about the future,
  • The inadequacy of government response.

Many patients reported that their care had been disrupted, with reduced support available and face to face appointments replaced by remote options. (more…)

A week in the life of a Clinical Research Fellow

Dr Francesca Conway takes us through a typical week as a clinical research fellow and how her previous time at Imperial contributed to her developing an interest in a career in clinical academia.

Monday

6am. I’m awakened by the horrifically jolly alarm tone on my phone. It’s still dark, it’s still raining, and it’s still cold. Hedgehogs have the right idea hibernating over winter, I think, as I haul myself out of bed.  Must consider this hibernation proposition in my next supervisor meeting. 1 shower, 1 yoghurt and 3 smoothies later and I’m in the hospital.

Today I have a patient coming to see if she is eligible to be recruited to the clinical trial which forms part of my PhD. Mrs X has travelled from 300 miles away. She greets me with a smile and tells me how pleased she is to be here. I immediately remember why I love my job, and scrap the idea of hibernation. I offer her a coffee, she gratefully accepts and whispers, could I have an extra shot in that? I assume she means coffee. I wonder what time she woke up, but am pretty sure it was before 6am.

I am researching a potential new treatment for Chronic Cbstructive Pulmonary Disease (COPD) for my PhD. Mrs X suffers with COPD, a disease affecting the lungs most commonly caused by smoking. More than 3 million people die from it each year. Targeted Lung Denervation or “TLD”, is a non-surgical procedure where we deliver energy to the airways using a system made by Nuvaira, a US-based company. The idea is that the energy disrupts the nerve supply to the lungs, so the airways relax and open. With initial data looking promising, we hope that this will lead to improvements in health for patients like Mrs X. More information on the Airflow website. (more…)

Do we need to think differently about COPD?

COPD
The internal structure of the lungs by Dave Farnham (CC BY 4.0)

Ann Morgan, a PhD student at the National Heart and Lung Institute, gives us her thoughts on why smoking isn’t the only culprit behind the rise in COPD. 

The traditional view of COPD (chronic obstructive pulmonary disease) is that it is a self-inflicted disease caused by smoking. However, it is increasingly likely that this description is something of an oversimplification. While still very much associated with smoking, clinicians and researchers alike are getting to grips with the reality that COPD is a more complex and heterogeneous disease than previously thought. We are also becoming more aware of the fact that it is a disease which rarely occurs in isolation. The vast majority of people who present with COPD have at least one other co-existing disease or condition, and around 50% have four or more accompanying chronic diseases or ‘comorbidities’. (more…)

How COPD patients can sing their way to better health this Christmas

COPD singing

Carol Singers (CC BY 2.0)

In this post, Dr Nicholas Hopkinson looks at the benefits of singing for people with respiratory conditions such as COPD.

Singing carols is a big part of Christmas cheer, but not many people realise that singing can also be helpful for people with lung disease. COPD is an extremely common condition – there are 1.3 million people with this diagnosis in the UK. Existing treatments help to some extent, but do not reverse the underlying pathology, meaning that even with optimal care many patients remain breathless with activity limitation and poor quality of life. This symptom burden represents a major area of unmet need. Singing for Lung Health (SLH) groups are a potential way for patients to gain skills to improve control of their breathing and posture, reducing symptom burden and enhancing wellbeing. (more…)

Lung volume reduction – new hopes and missed opportunities in COPD


COPD, chronic obstructive pulmonary disease, has traditionally been thought of as an irreversible and somewhat hopeless condition. Many patients with COPD may be missing out on the possibility for a dramatic improvement in their condition. They deserve better.

COPD, is a common and important condition. There are 1.3 million people with a diagnosis of COPD in the UK and it’s now the third leading cause of death worldwide. The main symptoms are breathlessness, cough and sputum production.

The term COPD encompasses a range of pathological processes, usually caused by smoking or inhaling other noxious materials. It includes chronic bronchitis – inflammation and damage to airways as well as emphysema – destruction of the lung tissue itself and damage to the blood vessels in the lung. In emphysema the walls of the alveoli (air sacs) break down. The lung tissue loses its elasticity and becomes baggy, and air gets trapped in the lungs making breathing uncomfortable. In some people the condition is caused by alpha one antitrypsin (A1AT) deficiency; the inherited lack of a defensive enzyme, which makes their lungs much more vulnerable. (more…)

Smoke and the burnout of muscles

Image: Shutterstock - SMOKE & THE BURNOUT OF MUSCLESFor World No Tabaco Day 2017, researchers from Imperial’s Muscle Lab provide an insight into how smoking takes its toll on our lung health. 

Smoking is a leading cause of preventable death and disease in the world. It is estimated that the society costs associated with smoking are approximately ₤12.9 billion a year, including the NHS cost of treating smoking related diseases and loss of productivity.

Chronic obstructive pulmonary disease (COPD) is one of the major diseases caused by smoking. The disease ranks third among the leading causes of death worldwide. Around 1.2 million Britons suffer from the disease (Source: British Lung Foundation). The usual clinical picture is that of a smoker with symptoms that include shortness of breath and chronic cough. (more…)