Weeds in Your Yard Help Lungs and Adrenals, et al

The following information came in my daily newsletter from Annie over at Care2. It's all about living green. The following has some good information on weeds in your yard and what they "treat." Enjoy and remember to always check with your pharmacist and physician prior to implementing new things into your healing process. Better safe.
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The Healing Weeds in Your Yard
posted by Annie B. Bond Jun 27, 2008 7:00 am

By the Care2 Staff, with thanks to Wise Woman Herbalist Susun Weed.

Many of the lawn-and-garden weeds that people kill with toxic herbicides actually contain health-giving properties and vital nutrients often missing from foods grown in depleted soil.

A weedy lawn is often a goldmine of healing and health! Find out what four of the most common weeds growing in your yard may offer you:

Chickweed:
Rich in nutrients, chickweed makes a great addition to the salad bowl, nourishing to the lymph and glandular systems, and offering healing for those with cysts, fevers, and inflammations. A good neutralizer for those with over-acid systems, and beneficial for those with yeast overgrowth and fatty deposits.

Dandelion:
All parts, from root to flower, are beneficial. Good for the liver, urinary tract, and female reproductive system, dandelion has cancer- and virus-fighting properties, and is a great beautifier. Dandelion is also beneficial for insomnia, arthritis, hypoglycemia and diabetes. Sap from a cut stem may be used to treat blemishes, corns, stings, warts and other skin problems.

Nettle:
Yes, they can sting you but if you gather them carefully and tincture or cook them, nettles are a fabulous source of calcium–a must to prevent osteoporosis–and a great ally for regrowing thinning hair. They are a tonic for the kidneys and adrenals (if you’ve been stressed or fatigued, nettle is the ally for you) and for the respiratory system, offering healing for asthmatics and those with other bronchial and lung complaints.

Red Clover:
Herbalist Susun Weed says red clover offers menopausal women many of the benefits of soy without any of the drawbacks. It is one ingredient of traditional spring tonics to purify and revitalize the entire system, high in calcium and compounds that are useful in treating bronchitis and other respiratory conditions.

CAUTION: Before you eat your weeds, be sure that you’ve picked them in an area free of animal waste, pollution from motor vehicles, and chemical herbicide or pesticide treatments.
Please consult a health professional before treating health conditions with herbs. We are not recommending that you discontinue conventional medical practices.

What Is COPD and What is the Treatment?

Chronic Obstructive Pulmonary Disease (COPD)

What Is It?
Chronic obstructive pulmonary disease (COPD) refers to a group of disorders that damage the lungs and make breathing increasingly more difficult over time. The two most common forms of COPD are chronic bronchitis and emphysema. Both are chronic (long-term) illnesses that impair airflow in the lungs. Currently, COPD affects at least millions of people in the United States, causing more than 100,000 deaths each year. In more than 80% of cases, the illness is related to cigarette smoking.


Chronic Bronchitis

In this respiratory disorder, the air passages in the lungs are inflamed, and the mucus-producing glands in the larger air passages of the lungs (bronchi) are enlarged. These enlarged glands produce too much mucus, which triggers a cough. In chronic bronchitis, this cough lasts for at least three months of the year for two consecutive years.
Chronic bronchitis affects about 3% of the people in the United States, most commonly men older than 40. You are more likely to develop chronic bronchitis if you:


Smoke tobacco
Are exposed to air pollution
Are exposed in the workplace to airborne organic dusts or toxic gases, especially in cotton mills and plastic manufacturing plants
Have a history of frequent respiratory illnesses
Live with a smoker
Have an identical twin with chronic bronchitis


Chronic bronchitis may have different symptoms in different people. In milder cases, a cough produces only a small amount of thin, clear mucus. In other people, the mucus is thick and discolored. Symptoms similar to asthma may develop, including wheezing and shortness of breath. Eventually, the airways become narrowed, limiting the amount of oxygen that gets to the air sacs. Blood vessels constrict in an attempt to divert the blood to better-oxygenated areas of the lung. This increases blood pressure in the arteries that feed the lungs, and strains the right side of the heart. Eventually, if blood pressure remains high enough in the lungs, heart failure develops, and blood backs up in the liver, abdomen and legs.


Emphysema

In this disorder, the tiny air sacs in the lungs, called alveoli, are destroyed. The lungs are unable to contract fully and gradually lose elasticity. Holes develop in the lung tissue, reducing the lungs' ability to exchange oxygen for carbon dioxide. As a result, breathing may become labored and inefficient, and you may feel breathless most of the time.
You are more likely to develop emphysema if you:


Smoke
Are exposed to passive ("secondhand") smoke
Are exposed to airborne irritants or noxious chemicals (lead, mercury, coal dust, hydrogen sulfide)
Live in an area with significant air pollution (high levels of sulfur dioxide and particulates)
An estimated 100,000 people in the United States have an inherited form of emphysema in which the lungs lack a protective protein called alpha-1-antitrypsin. In people with this form of the disease, lung damage can appear as early as age 30, decades sooner than smoking-related emphysema usually starts.


Symptoms


People with COPD commonly have symptoms of both chronic bronchitis and emphysema.


Chronic Bronchitis

Your first symptom may be a morning cough that brings up mucus and that occurs at first only during the winter months. As the illness progresses, the cough begins to last throughout the day and throughout the year, and produces more mucus. Eventually, about 15% of people with chronic bronchitis develop a continuous cough, breathlessness, rapid breathing, or a bluish tint to the skin from lack of oxygen.


Chronic bronchitis also makes you prone to frequent respiratory infections and to potentially life-threatening flare-ups of severe breathing difficulties that often require hospitalization. If heart failure develops, there may be swelling in the ankles, legs, and sometimes the abdomen.


Emphysema

If you have emphysema, you may first feel short of breath during activities such as walking or vacuuming. Because lung function decreases slowly in emphysema, you may hardly notice as breathing becomes more and more difficult. With time, you may develop increased shortness of breath, wheezing, coughing, a tight feeling in the chest, a barrel-like distended chest, constant fatigue, difficulty sleeping, and weight loss.


Diagnosis
Your doctor will examine you, looking for evidence of COPD by checking for rapid breathing; a bluish tint to your skin, lips or fingernails; a distended, barrel-shaped chest; use of neck muscles to breathe; abnormal breath sounds; and signs of heart failure, especially swelling in the ankle and legs.
To confirm the diagnosis, he or she may order the following tests:


Pulmonary function test — In this test, you will breathe into a special mouthpiece, and a machine will take measurements to test how much your airways are blocked and how much your lungs inflate.


Blood tests — Blood tests measure the different types of blood cells or the amount of oxygen and carbon dioxide in the blood. Others are used to check for low alpha-1-antitrypsin levels, especially in a nonsmoker who shows symptoms of emphysema.



Chest X-rays — These help to rule out pneumonia and lung cancer, and they also show heart size. If you have emphysema, chest X-rays can pinpoint areas where lung tissue has been destroyed.



Electrocardiogram — This test measures the electric activity of the heart and usually is done to make sure your symptoms are not caused by a heart problem.


Sputum analysis — A small amount of mucus is collected and tested for respiratory infection

.
Exercise stress test — In this test, you walk on a treadmill while a specialist monitors the intensity of your exercise. This test looks for any signs of coronary artery disease.


If you are diagnosed with the inherited form of emphysema, family members, including children, also should be tested to determine if they have a deficiency of alpha-1-antitrypsin.


Expected Duration
Symptoms of chronic bronchitis tend to begin in smokers after age 50. These symptoms persist and gradually worsen for the rest of the smoker's life unless he or she quits smoking.
Most cases of emphysema are diagnosed in smokers in their 50s or 60s. People with the inherited form of emphysema can show symptoms as early as age 30. Regardless of the cause, emphysema has no cure and lasts a lifetime.


Prevention
Because the majority of cases of COPD are related to smoking, you can drastically reduce your risk of this illness by avoiding cigarettes. If you smoke, get the help you need to stop. If you don't smoke, don't start. You also may reduce your risk of COPD by limiting your exposure to secondhand smoke and by avoiding outdoor activities when air pollution levels are high.


If you have been diagnosed with chronic bronchitis, avoid contact with anyone with symptoms of an upper respiratory tract infection, because even a mild cold can trigger a flare-up of bronchitis symptoms. Wash your hands frequently and avoid touching your face with your hands during the cold and flu season. Also, anyone with COPD should be vaccinated against influenza and pneumococcal pneumonia.


Treatment
No treatment can fully reverse or stop COPD, but steps can be taken to relieve symptoms, treat complications, and minimize disability. First, your doctor will tell you to quit smoking, the most critical factor for maintaining healthy lungs. Although quitting smoking is most effective during the early stages of COPD and can reverse some early changes, it can also slow down the rate of decline of lung function in later stages. Other COPD treatments may include:


Environmental changes — If your doctor believes that your COPD is caused by work-related exposure to dusts or chemicals, he or she will recommend that you ask your employer to find an alternative work environment. In general, people with COPD also should avoid exposure to outdoor air pollution, secondhand smoke, and airborne toxins (deodorants, hair sprays, insecticides) in the home.


Medications — Doctors generally prescribe medications that open up the airways, called bronchodilators, taken as a spray that is inhaled or in pill form. Antibiotics also may be necessary to treat acute respiratory infections, such as bacterial pneumonia. Daily inhaled corticosteroids may be given to reduce airway inflammation. For flare-ups, an oral corticosteroid called prednisone often is prescribed.


Exercise programs — Regular exercise builds stamina and will improve your quality of life, even if it does not directly improve lung function. Pulmonary rehabilitation programs have been shown to lower the need for hospitalization.


Good nutrition — A balanced diet can help maintain stamina and improve resistance against infection. Also, getting enough water and other fluids can help to keep mucus watery and easy to drain.


Supplemental oxygen — If your lungs are not getting enough oxygen into your blood, oxygen therapy can improve your quality of life, increase your ability to exercise, help to relieve heart failure, prolong life, improve mental function, and lift your spirits.


Lung volume-reduction surgery — In carefully selected patients, surgery to remove the most severely diseased portions of the lungs allows the less damaged areas of the lungs to expand better. The long-term value of this procedure is unknown.


Lung transplants or heart-lung transplants — Transplants are rarely an option, except in very selected cases of early onset, severe COPD

When To Call a Professional
If you smoke or if you work in a job that carries a high risk of COPD, you should see your doctor once a year to be checked for early signs of lung disease. If you have family members with alpha-1-antitrypsin deficiency, tell your doctor so that you can be tested for the problem, too. If you already know that you have alpha-1-antitrypsin deficiency, your doctor can monitor your breathing regularly for early signs of emphysema.
Call your doctor whenever you have shortness of breath, a chronic cough with or without phlegm, or a significant decrease in your usual ability to exercise.


Prognosis
There is no cure for COPD, but quitting smoking, sticking to your treatment program, and exercising daily can significantly improve your function and sense of well-being.


People with COPD who continue to smoke can expect progressive deterioration of lung function. Quitting completely is the best chance of stopping or at least slowing down the process. It is never too late to quit. Even with severe chronic bronchitis, symptoms can improve. The lung damage from emphysema cannot be reversed. However, quitting smoking can decrease the risk of additional harm to the lungs.


http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20740.html#treat

This is for informational purposes only and is not to be construed as medical advise. Always check with your personal physician prior to making any changes in your medical treatments.

Why Not Just Suck on a Tailpipe?

Doctors: Stay off Peachtree while prepping for race

Those of us with Emphysema, Asthma, COPD, lung and heart dis-ease are all too familiar with the affects of poor air quality. We have come to recognize and respect that the pollutants can and will shut us down quickly. In this article, pulmonologists from Emory University Medical explain the pollution and how it can affect us. They also give us informational direction on where to get our outdoor exercise. Oh! The O-Zone, the particulates, the pollen, the mold! Someone pass the bong~I get sob just typing those things here! :)

On a side note ~ Best of success to all you Peachtree Road Racers and Possum Trotters! You totally Rock!!!
Hugs,
Luna
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Runners take in more bad air while training along major roads


By STACY SHELTON


The Atlanta Journal-ConstitutionPublished on: 06/18/08



With the 39th annual Peachtree Road Race fast approaching, a lot of runners are tuning up by running the course. But if you're hitting Peachtree Road during rush-hour for a jog, says an Emory pulmonologist, why not just suck on the tailpipe of a passing car instead?



That's about the equivalent of what you're doing to your heart and lungs, says Dr. W. Gerald Teague, professor of pediatrics at Emory University and director of the Emory Pediatrics Asthma Clinical Research Center.



"When you are running near a busy thoroughfare you not only are exposed to the pollution already in the air, you are also going to be exposed to particles, tire debris and exhaust emissions at the source, so you could get much more exposure versus exercising in a park," Teague says in a Q & A published by the Clean Air Campaign, a public-private partnership to reduce traffic congestion and improve air quality in metro Atlanta. Teague is a member of the Campaign's board of directors.



Instead of exercising along a busy road, Teague suggests jogging, bicycling or walking in a park, or on side streets. And when a rare red alert is issued for smog, either work out in a gym or exercise in the morning or late evening. (Go to www.cleanaircampaign.com to sign up for e-mail alerts).



On Wednesday, forecasters issued an orange alert for the third day in a row, meaning that Thursday's air is expected to violate federal smog limits. That's particularly bad for children and people with heart and lung disease, no matter where they are in metro Atlanta. Public health experts advise them to limit prolonged outdoor exercise to the morning and late evening.
The threats to public health come from the generalized ground-level ozone, an ingredient in smog formed when man made pollution mixes with heat, and the localized tiny particles from vehicle exhaust.



Dr. David Schulman, chief of pulmonary critical care at Emory University Hospital, said Wednesday that long-term exposure to traffic pollution can decrease lung function, but it can also lead to heart problems — and even heart attacks. A study out of Scotland showed "during exercise, people who inhaled diesel exhaust increased the stress on their hearts three-fold as opposed to exercising in clean air," Schulman said.



Rich Heidal, a 29-year-old auditor who lives near Lenox Square mall and plans to run the Peachtree Road Race, said he's noticed a big difference between running Peachtree and bicycling in the North Georgia mountains, where the air is cleaner. On Peachtree, "the buses will knock you over. The heat from the pipes makes it more difficult to breathe. You definitely want to get off the [main] road."



The exception, of course, is running or walking in the July 4 race with 55,000 other people. The mass body odor can get downright nasty, but with only foot traffic, Atlanta's busy artery is far less hazardous to your health.



Joggers are not the only ones gagging in metro Atlanta's fumes. Study after study has shown a link between vehicle traffic and asthma in the general population, including an oft-quoted study from the 1996 Atlanta Olympics. When metro Atlantans cleared the roads during the games, hospital visits for asthma attacks plunged between 11 percent and 44 percent, according to various health data.



It may not look like it, especially on days when Atlanta's skyline is blurred by a gauze of brown air, but the region's air quality has markedly improved in the last 30 years as power plants, industries, vehicle engines and fuels have gotten cleaner.



Still, asthma rates among children and adults are on the rise, a dichotomy that's often explained in academic studies as increased exposure: More people breathing in traffic pollution. The latest Georgia data from the state Division of Public Health estimates 10 percent of children have asthma and 7 percent of adults.



The problem is, we can't get away from our own pollution. Even in the enclosed environment of a car, we're still breathing in the toxins spewed by the vehicles in front of us, said Roby Greenwald, a post-doctoral researcher in Emory's Department of Pediatrics who is studying the effects of urban air pollution on asthma in children.



And the absolute worst thing you could do for your heart and lungs is live within about 100 yards of an interstate highway. As metro Atlanta grew, more residences — with balconies — were built next to major thoroughfares.
"I wouldn't live in those," Greenwald said. "A condo right on Peachtree is going to be much, much better than an apartment overlooking the Connector."



In an interview last year, Teague said just growing up near a major freeway can limit lung growth. Particle pollution has also been linked to emphysema, stroke, lung cancer and heart disease, he said.




But living on a cul-de-sac in the suburbs doesn't necessarily make you immune. Harmful pollutants have been measured all over metro Atlanta.


"Really, you can't move away from it," said Sonya Lunder, a senior analyst for the Environmental Working Group, a Washington-based advocacy group for public health and the environment. "It's hard for policy makers or the public to know what to do about it."
Some of the solutions, Lunder said, include better public transportation, anti-idling laws, and building schools, parks and residential developments away from major thoroughfares.





http://www.ajc.com/sports/content/sports/peachtree/stories/2008/06/18/avoid_peachtree_while_training_for_race_0619.html

Stem Cell Success in Lung Disease

Canadian Scientists Deliver On Promise Of Stem Cell Therapy For Lung Disease

MONTREAL, June 19 /CNW Telbec/ -

Two Quebecers suffering from pulmonary hypertension, a rare but debilitating lung disease, were treated in Montreal with their own gene-modified stem cells. This experimental treatment was administered at the Jewish General Hospital's Centre for Pulmonary Vascular
Disease.

"Our present therapies for pulmonary hypertension may control the disease
for a few years, but often fail and do not represent a cure," said Dr. David
Langleben, Director of the Centre for Pulmonary Vascular Disease and the local
Principle Investigator for this study. "We need new approaches such as this
cell-based therapy."

The therapy, developed by Dr. Duncan Stewart, CEO of the Ottawa Health
Research Institute, and founding scientist of Northern Therapeutics Inc., is
unique in the world as it is the only clinical study employing patient stem
cells genetically modified for clinical use in lung disease.

A team of scientists at the JGH led by Dr. Jacques Galipeau, Hematologist
and stem cell researcher, genetically engineered the stem cells with synthetic
DNA in an ultra specialized laboratory to produce nitric oxide, a critical
molecule involved in the repair and protection of blood vessels. With the
sponsorship of the Stem Cell Network, the study has moved forward and the
highest cell dose ever given to a human subject was administered to one of the
patients.

"These enhanced stem cells are given in a heart catheterization suite,
and lodge in the lung where it is hoped they will stimulate the repair and
regeneration of blood vessels in the lung," explained Dr. Galipeau, Associate
Professor of Medicine and Oncology at McGill University.

This procedure has cured laboratory rats with pulmonary hypertension, and
this study in Canadian volunteers afflicted with pulmonary hypertension seeks
to assess the safety of this type of stem cell treatment. This study, which
includes a site in Toronto as well as in Montreal, is the only one of its kind
in Canada, and rests at the cutting edge of stem cell therapies worldwide.

Two patients, enrolled in Toronto, were treated but received a lower dose
of cells. This research team is also planning to use a very similar enhanced
stem cell treatment in the near future to treat patients suffering from heart
attacks. These new therapies offer hope for better patient outcomes.

About the JGH
Since 1934, the Sir Mortimer B. Davis - Jewish General Hospital, a McGill
University teaching hospital, has provided "Care for All," serving patients
from diverse religious, linguistic and cultural backgrounds in Montreal,
throughout Quebec and beyond. As one of the province's largest acute-care
hospitals, the JGH has achieved a reputation for excellence in key medical
specialties by continually expanding and upgrading its facilities for clinical
treatment and teaching, as well as research at the Lady Davis Institute for
Medical Research. For more, please visit JGH.ca.

The Stem Cell Network, established in 2001, brings together more than
70 leading scientists, clinicians, engineers, and ethicists from universities
and hospitals across Canada with a mandate to investigate the immense
therapeutic potential of stem cells for the treatment of diseases currently
incurable by conventional approaches. Headquartered at the University of
Ottawa, the Stem Cell Network is one of Canada's Networks of Centres of
Excellence funded through Industry Canada and its three granting councils.
(www.stemcellnetwork.ca)

Networks of Centres of Excellence are unique partnerships among
universities, industry, government and not-for-profit organizations aimed at
turning Canadian research and entrepreneurial talent into economic and social
benefits for all Canadians. The NCE program is managed jointly by the three
federal granting agencies- Natural Sciences and Engineering Research Council,
the Canadian Institutes of Health Research, and the Social Sciences and
Humanities Research Council.

For further information: Glenn J. Nashen, Director; Reena Kudhail,
Communications Specialist, Public Affairs & Communications, Jewish General
Hospital, (514) 340-8222 x 4120, rkudhail@jgh.mcgill.ca,
communications@jgh.mcgill.ca; JGH.ca

http://www.newswire.ca/en/releases/archive/June2008/19/c5874.html

COPD Patient-to-Patient Tips on Living Well

PATIENT TO PATIENT TIPS

For many people, the toughest challenge is not controlling symptoms such as coughing and shortness of breath, but rather coping with the relentless march of the disease as it slowly encroaches on daily activities. Knowledgeable as your doctor and other health professionals are, they can't advise you on the many small but significant ways that COPD can impair your ability to function. This is the sort of advice you can get only from resourceful patients who have faced the same problems you have and found ways around them. The following are tips gleaned from COPD patients.

Bathing
If you find a shower or bathtub difficult, try using a bath stool. For bathing, use a hand sprayer, which may be attached to the tub faucet or shower head. When excess humidity bothers you while bathing, leave the bathroom door open and use your bathroom exhaust fan. If you feel weak, don't take a bath or shower when you are alone. People who use oxygen may find that bathing is easier if they wear the apparatus during their bath or shower. The tubing can be draped over your shower curtain rod.

Grooming
Shaving and putting on makeup is much easier if you have a low mirror so that you can sit down. Women should avoid elaborate hairdos that require tiresome setting and extended use of dryers. Try to avoid toiletries that are heavily perfumed; many patients find them irritating.

Dressing
It's a bad idea to restrict chest and abdominal expansion; avoid belts, bras, and girdles that are tight. Men may find that suspenders are more comfortable than belts. Most women find that slacks and socks are much easier to put on than pantyhose. You can place your underwear inside your pants and put them on together. Wear slip-on shoes. Putting on any kind of shoe is much easier if you use a long shoehorn (12–28 inches). You may find that cotton underclothing is more comfortable than synthetic in both warm and cold climates.

Household gadgets
One of the handiest gadgets is a pair of pickup tongs (these look like giant scissors) for retrieving things from hard-to-reach places. Most medical supply houses stock these. Another pickup device is a magnet on a short string. It's great for getting thumbtacks, hairpins, etc., that have fallen on the floor. If you must vacuum, use a machine with a disposable bag or a filtering method to keep dust from escaping. A small hand vacuum is easy to use for spot cleaning.

Emergency planning
A matter of concern to those who live alone is how to get help quickly when needed. Make arrangements to have a relative or friend call at the same time every day to make sure you are okay. Consider buying a cordless phone and carrying it around with you. This way, if you run into trouble, you can call for help. Many companies offer monitoring services. They provide a panic button, worn on a chain around the neck, that can summon emergency help.

Traveling with oxygen
People who use oxygen can travel to most places, but it requires some advance planning.
Call your local oxygen supplier one to two weeks in advance to arrange for your oxygen supply while you are traveling. Your needs will vary according to your mode of transportation (see "Using oxygen on an airplane") and length of stay at your destination.

If traveling by air, book far in advance because airlines allow only a limited number of people traveling with oxygen per flight.

Take antiseptic hand-washing packets or gel to help avoid picking up bacterial or viral infections. Also wash hands with soap and water frequently.

If you are traveling to an area of high altitude, plan ahead for an oxygen supply at your location.


Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
This information is not intended to replace the advice of a doctor.

http://www.aolhealth.com/respiratory-health/learn-about-it/living-well-with-lung-disease/patient-to-patient-tips

Finger Clubbing Puzzle Solved - Lung Disease

UK Medics Solve Ancient Riddle Of 'Finger Clubbing'

ScienceDaily (Jun. 5, 2008) —


A puzzling medical condition, identified more than 2,000 years ago by Hippocrates, has finally been explained by researchers at the University of Leeds.

The phenomenon of "finger clubbing", a deformity of the fingers and fingernails, has been known for thousands of years, and has long been recognized to be a sign of a wide range of serious diseases – especially lung cancer.

"It's one of the first things they teach you at medical school," explained Professor David Bonthron of the Leeds Institute of Molecular Medicine. "You shake the patient by the hand, and take a good look at their fingers in the process."

Lung cancer, heart disease, hyperthyroidism, various gastrointestinal diseases and many other conditions all result in finger clubbing. But exactly why swollen, reddened fingers should be an indicator of serious illness has remained a mystery – until now.

"There are benign cases of clubbing, where it isn't associated with other illnesses, but particularly because of the link to lung cancer, it is generally regarded as rather sinister," said Bonthron. "You look at the range of conditions connected to finger clubbing and wonder what on earth they could have in common."

The researchers found clues in the medical literature, detailing past cases and previous research. "We knew that in cystic fibrosis patients who have undergone a lung transplant, their finger clubbing goes away. The same goes for empyema patients who have had their lungs drained. It suggested that impaired lung function was somehow crucial to finger clubbing – but we didn't understand how."

Prof Bonthron, Dr Chris Bennett of the Yorkshire Regional Genetics Service and their colleagues studied a group of patients suffering from inherited primary hypertrophic osteoarthropathy (PHO), a genetic disorder in which the finger clubbing is accompanied by painful joint enlargement and a thickening of the bone.

Their findings implicated a fatty compound called PGE2, which is produced naturally by the body to mediate the effects of internal inflammation. Crucially, once it has done its work, PGE2 is broken down by an enzyme 15-HPGD, produced in the lungs. The patients followed by the Leeds study were found to have a genetic mutation which prevented the production of 15-HPGD, resulting in up to ten times as much of the PGE2 in their systems.

"If you don't have this enzyme the PGE2 isn't broken down normally and simply builds up," said Bonthron, whose findings are published online this week in Nature Genetics.
In lung cancer patients, it is most likely overproduction of PGE2 by the tumour that causes the clubbing. In congenital heart disease, blood bypasses the lungs, where PGE2 is normally broken down by 15-HPGD.

The researchers have suggested that a straightforward urine test for levels of PGE2 may be a useful first step in the diagnosis of individuals with unexplained clubbing, and to understanding whether it is the symptom of something far more serious. The results also suggest that existing drugs such as aspirin, which are already used to prevent PGE2 production, may be effective in reducing the painful symptoms of finger clubbing.

It has taken 2,000 years to make the connection, but Bonthron adds: "Actually, when you look back, it's rather obvious. When we found this gene, everything else fell neatly into place – it was like a smack on the forehead."

Journal reference:
Uppal S, Diggle CP, Carr IM, Fishwick CWG, Ahmed M, Ibrahim GH, Helliwell PS, Latos-Bielenska A, Phillips SEV, Markham AF, Bennett CP, Bonthron DT. Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy. Nature Genetics, 2008; 40 (6): 789 DOI: 10.1038/ng.153
Adapted from materials provided by University of Leeds.

http://www.sciencedaily.com/releases/2008/05/080529163120.htm

VIDEO CONFERENCING REHAB SUCCESS FOR COPD'ers

Video-Conferencing Program Helps Patients Breathe Easy

Allows staff to provide direction, support to chronic respiratory sufferers outside Edmonton
Sara Ditta, The Edmonton JournalPublished: 1:28 pm

Seventy-five-year-old Carmen Tien-kamp is buying a treadmill this week.
After completing half of an eight-week program to help her manage her chronic lung disease, she's more mobile than she has been in years.

The Breathe Easy program, provided by the Caritas Centre for Lung Health at the Edmonton General Hospital, is designed to help patients manage chronic lung disease through exercise and education. Fitness keeps the rest of the body healthy and takes the load off of the diseased lungs.

Tienkamp was diagnosed seven years ago with chronic obstructive pulmonary disease, also known as COPD. Last August, she was put on supplementary oxygen.

"I had no energy," she said of her life before starting the Caritas program. "I was like a couch potato."

Patients across central and northern Alberta can also participate in the same program via live video through Capital Health's Telehealth network.

Art Measor, who lives in Wainwright, has taken the program twice. The first time, about 10 years ago, he drove 21/2 hours, twice a week, to participate.
"It was worth it," he said.

In 2006, he needed it again after being treated for lung cancer and found the trip was no longer necessary. He only needed to travel five blocks to the Wainwright Health Centre.
Measor, who was part of a two-year pilot project, consulted with a pulmonologist, listened to lectures and followed-up with doctors via live video. Exercise was overseen by rural therapists trained by Caritas staff.

After completing both versions of the course, he said there was little difference.
"The video one is fabulous. It's exactly the same thing," Measor said. "I received a similar amount of attention and the same followup."

Dr. Fred MacDonald, who created and runs the program, tried to reach rural patients with his rehabilitation program for years. Technology finally provided him the opportunity in 2005. Since then, it has reached about 120 rural patients in Peace Country, Aspen, David Thompson and East Central regions.

"Country patients have done very, very well," said MacDonald. "We have the patients now telling us what a joy it is that they don't have to go into Edmonton and can exercise in their own community."

Reaching more regions is key because only 1.2 per cent of Canadians have access to a rehabilitation program to deal with COPD.
"Most patients are given an inhaler and a lecture on COPD and told to deal with it," MacDonald said. "And that's it."
A Canadian dies every hour from complications related to COPD. To keep chronic patients healthy, it's necessary to provide more direction, he said.

"It has to become a way of life," he said. "The only way you can achieve that is to physically bring them into a program and coerce or encourage, browbeat or whatever it takes, to get them to do the things that are necessary to improve their health."

This is believed to be the only rehabilitation program available through video-conferencing in Canada.

MacDonald says patients also wait less time to see a pulmonologist by using the program. Without it, many patients must wait about six months.

The program's exercise component includes stationary bicycling, treadmill, step-ups and simple breathing exercises. The lectures include topics on eating right, goals, relaxation, travel and homecare.

Myron Peterson took the program 10 years ago and still regularly visits the gym at Caritas to lift weights. He said he would probably be in "bad shape" now if he had never met MacDonald.
"If it wasn't for him, a lot of us would be dead. I'm sure of that."

It's not unusual for patients to become more fit and active very quickly, said Tina Jourdain, a program respiratory therapist.

"Some of them put us to shame," she said. "It's embarrassing when an 80-year-old can do more on a treadmill than you and they have lung disease."

sditta@thejournal.canwest.com
http://www.canada.com/edmontonjournal/news/story.html?id=002a84e0-b6f8-40f6-9612-90fb1c318b65

EXAM FOR COPD, OTHERS

Exam Overview
Your medical history provides important clues that can help your health professional diagnose chronic obstructive pulmonary disease (COPD).

In taking your medical history, your health professional will ask questions about:

Shortness of breath.
When were you first short of breath (at exercise or at rest)?
How often are you short of breath?
How long have you been short of breath? Is it getting worse?
How far can you walk and how many steps can you climb before having to stop because of shortness of breath?
Coughing.
How often and when do you cough?
How long have you been coughing? Is it getting worse?
Do you cough up mucus (sputum)? What color is it?
Have you ever coughed up blood?
Your and your spouse's or housemate's use of tobacco: whether any of you smoke, how long you've smoked, how many cigarettes a day you smoke, how long ago you quit smoking, whether you feel you can quit smoking, and more.
Exposure to airborne irritants, such as dust or chemicals, on the job.
Childhood respiratory illnesses.
Family history of respiratory disease.
Other medical conditions you may have and their treatment.
How your condition is affecting your quality of life: missed work, disrupted routines, and depression, for example.
What type of family and social support you have.

During the physical examination, your health professional will examine your body for other clues that may explain the cause of your symptoms. A physical exam involves:

Taking your temperature, weight, and body mass index (BMI), which measures weight for height and provides a way to estimate the effect of weight on health.
Examining your ears, eyes, nose, and throat for signs of infection.
Listening to your heart and lungs with a stethoscope.
Checking for signs that blood is backing up in your neck veins, which may indicate a heart problem such as cor pulmonale.
Pressing or tapping on your abdomen (abdominal palpation).
Examining your fingers and lips to see whether the skin has a blue tint (cyanosis).
Checking your fingers to see if their ends swell and the nails bulge outward (clubbing).
Evaluating your legs and feet for swelling (edema).
A physical examination is not painful, but parts of it (such as abdominal palpation) may feel slightly uncomfortable.

Why It Is Done

A history and physical exam help your health professional make a diagnosis. They are a routine and important part of any visit to a health professional.

Results

Your history may reveal risk factors that suggest you have COPD or an increased risk for developing COPD, such as:

Cigarette smoking.
Family history of emphysema.
Work-related hazards.
Frequent, severe respiratory illnesses.
Long-term (chronic) cough with or without mucus.
Progressive shortness of breath.
Your physical examination may also suggest COPD. Findings indicating COPD include:
An expanded chest (barrel chest).
Wheezing during normal breathing.
Taking longer to exhale fully.
Decreased breath sounds or abnormal breath sounds such as crackles or wheezes.

Certain physical exam findings will help your health professional assess the severity of your condition. These include:

The use of "accessory" muscles, such as the neck muscles, during quiet breathing.
Breathing through pursed lips.
The inability to complete full sentences without stopping to take a breath.
Bluish discoloration of the fingertips or nailbeds (cyanosis).
Swelling in the legs or abdomen.

Any or all of these findings may suggest severe impairment.

A careful history and examination of your heart should also be done to exclude heart disease that can either be associated with or cause symptoms similar to those of COPD. This is especially important because smoking is an important risk for heart disease as well as COPD. The heart exam may reveal a rapid heart rate or show signs of heart failure.

The liver may be increased in size, which sometimes can occur because of right-sided heart failure (cor pulmonale).

The result of the physical exam varies. Not every person will have all the possible symptoms or signs of COPD.

What To Think About

There are no special considerations for the history and physical examination.
Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.

For More Information: http://body.aol.com/procedures/history-and-physical-examination-for-copd

LUNGS, COPD & SMOKING ~ 40 YRS LATER, RK'S WORDS STILL LOUDLY RING OUT

While a century ago lung cancer was so rare that medical residents were called into the operating room to "see a condition you'll probably never see again," thanks to tobacco companies it has reached epidemic proportions, said Eriksen. The famous 1964 US Surgeon General's report commissioned by President John F. Kennedy - which concluded that smoking is a serious health hazard and requires urgent remedial action - was released on a Saturday because the government feared the news would crash the stock market due to the power of tobacco companies.

"WE IN the US still have not taken appropriate action," Eriksen declared, "and neither have you in Israel." In the US alone, over 160,000 deaths from lung cancer occur each year - more than the next four leading cancers (colon, breast, pancreas and prostate) combined. "This is unacceptable. It is a man-made form of cancer and preventible. "

The cumulative number of deaths by smoking around the world has reached 70 million. This figure is projected to reach 520 million by 2050 if nothing significant is done, Eriksen concluded.

A short time before New York senator Robert Kennedy was assassinated in 1968, the former US attorney-general stated: "The cigarette industry is peddling a deadly weapon. It is dealing in people's lives for financial gain. The industry we seek to regulate is powerful and resourceful. Each new effort to regulate will bring new ways to evade. Still, we must be equal to the task, for the stakes involved are nothing less than the lives and health of millions all over the world.

"But this is a battle [that] can be won. I know it is a battle [that] must be won."

Indeed, 40 years later, it still must.

Full article: http://www.jpost.com/servlet/Satellite?apage=2&cid=1212659681334&pagename=JPost%2FJPArticle%2FShowFull

Deep Breathing Exerciser Spirometer for COPD/Emphysema

Hudson TriFlo II Incentive Deep Breathing Exerciser Spirometer

Hudson RCITriFlo II Incentive Deep Breathing Exerciser

The TriFlo II Incentive Spirometer is ideal for developing, improving, and maintaining respiratory fitness.

The TriFlo II Incentive Deep Breathing Exerciser has been scientifically constructed as a means of encouraging you to take a slow Sustained Maximal Inspiration (SMI).

A Sustained Maximal Inspiration is vitally important to your general well-being. Deep breaths expand the small air sacs of your lungs and help clear the air passages of mucus. This, in turn, can help prevent the build up of fluid in your lungs.

Normally, you take many deep breaths each hour--usually without being aware of it. They are spontaneous and automatic, and occur in the form of sighs and yawns.

In certain instances, however, your normal breathing pattern can change. When you are experiencing pain following chest or abdominal surgery, for example, breathing tends to become shallow, and deep breaths are suppressed in an effort to minimize pain. In these instances, it is important that you strive to resume your normal breathing pattern--despite any discomfort you may have. Taking the deep breaths that you might ordinarily suppress will help prevent the possibility of respiratory complications.

By carefully following your physician's instructions and the directions provided with your TriFlo II Spirometer, you should be well on your way toward better breathing.

Features:
Manufacturer: Hudson RCI
Product: TriFlo II Incentive Deep Breathing Exerciser
Product Number: 8884717301

Instructions for Use:

With the unit in an upright position, exhale normally and place your lips tightly around the mouthpiece.
To achieve a Slow Sustained Maximal Inspiration (SMI), inhale at a sufficient rate to raise only the ball in the first chamber, while the ball in the second chamber remains at rest.
For a higher flow rate, inhale at a rate sufficient to raise the first and second balls, while the ball in the third chamber remains at rest.
Exhale after performing the exercise, remove the mouthpiece from your lips and exhale normally.
Relax following each prolonged deep breath, take a moment to rest, and breathe normally. Then, repeat the exercise as directed by your physician.

http://www.metromedicalonline.com/8884717301.html

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Please note that I have no relationship whatsoever with the manufacturer(s) and/or distributors of this product. This is informational use only for those with COPD, Emphysema and other breathing issues. Remember to check with your doctor before implementing any form of exercise into your routine.

We Must Help To Heal Our Selves

I want to share this with you. Since the COPD and asthmatic bronchitis diagnosis, I have realized that we are all responsible for the self healing part of body, mind, spirit healing. Without the self healing, the conventional treatments can only go so far. We must dig in, make and keep the commitment to self heal in partnership with our medical team. It is My body and no one knows it better than I.

I am healing and recreating myself day by day.

*********************************

Many of us go through life seeking healing from other people when really the only person who can heal us is ourselves. We run to doctors or healers to have them "heal" us. Yet, the body is the one which heals itself with the assistance of whatever remedies or assistance it receives.

The body is the one which knows what to do with the calcium, the vitamins, the enzymes, the healing energy... If it didn't have its own innate intelligence, it would not know how to utilize these healing substances that we ingest and accept into our being.

The medicines or the medical staff are not the healers... the body itself is the healer.

You can do "hands-on" healing on yourself. All you need is the willingness to accept that this is indeed possible and give permission to have Divine energy flow through you.

Thus, the responsibility for healing oneself returns to its only true home, yourself.

EXCERPTED FROM: Increase Your Healing Ability
by Marie T. Russell

REMOTE LUNG REHAB HELPS COPD'ers

This is a very good indicator, imo, that ALL pulmonary rehab, whether via internet, teleconference or in person, is a definite and paramount ingredient to those of us who want to improve our physical abilities, thus, quality of life.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Program Provides Lung Rehab Remotely

NEW YORK (Reuters Health) - A program that uses video-teleconferencing, the internet and other technologies to deliver lung rehabilitation remotely to people with the chronic lung disease COPD who live in rural areas helps them breathe more easily and get more out of life, researchers have found.

The Telehealth program shows similar results to standard in-person lung rehabilitation, Tina Jourdain, a respiratory therapist who is involved with the program, told the American Thoracic Society's 2008 international conference in Toronto.

The Telehealth program is an extension of the Breathe Easy Pulmonary Rehabilitation program based in Edmonton, Canada. According to Jourdain, referrals to the program have increased over the years, but many rural patients live too far from respiratory centers to benefit from it. To expand access, the Telehealth Pulmonary Rehabilitation program was launched in 2005, she explained in a statement.

With the Telehealth program, people with chronic lung disease "see" lung specialists and therapists and engage in a guided exercise program remotely. Two days per week patients attend educational sessions led by Telehealth at their local healthcare center and perform appropriate exercises supervised by a respiratory therapist or physical therapist at any community center with exercise space.

Jourdain and colleagues compared results achieved in the in-person program with those achieved by 113 rural patients who used the Telehealth program for 8 weeks.

The 86 patients who completed the 8-week program experienced significant improvements in the distance they could walk in 12 minutes and in quality of life, Jourdain reported.

"The results were similar between local programs and the Telehealth program," she said.
"Many patients are hesitant to exercise without supervision out of the fear of 'doing more harm than good' when they experience shortness of breath," she explained. "This results in the patient becoming more sedentary and deconditioned."

With the Telehealth program, "the patient is monitored and builds knowledge and self-confidence to do exercise regularly, which in turn improves their physical condition and their quality of life as well," Jourdain said.

According to the Canadian Thoracic Society, only 98 pulmonary rehabilitation facilities exist in Canada, with the capacity to serve just 1.2 percent of Canadians with COPD. Because many Canadian COPD patients live in rural areas, expanding the reach of such programs is important, researchers note.

http://www.reuters.com/article/healthNews/idUSCOL84724320080528

In Memory of Our Military Veterans, Our Heroes

Vietnam Veterans Memorial

Annual visitors: 3,538,479
History: The V-shaped granite wall inscribed with American soldiers who died in the war was designed in 1981 by Maya Lin, an undergraduate student at Yale.

We Thank You for keeping us safe and free. We honor you for your sacrifice of your very life. May we be worthy of all you have done.

Rest in peace and glory, dear warriors. You are not forgotten.

Puppy Mills - Let's Help Those Poor Animals!

I am going to break away from COPD articles today to bring a VITAL message from the ASPCA.
I ask you to help by following these guidelines and protecting our animals. They are so worthy of love and a good home, food, water, health care. Until a few months ago, I was owned by 2 Siberian Huskies for 13 years. They are gone now and I miss them each and every day. When I got to the point that I had trouble breathing with this COPD, these 2 wonderful babies tried their very best to breath for me. Words are inadequate to express my appreciate to them and to our Creator for entrusting those 2 beautiful souls to me for 13 wonderful years. So there is NO WAY I will ever believe that these beautiful animals God/dess has created do not have souls and feelings. And they just want to be loved and love you back so please help. Please. They deserve and count on our help and love. They have no other voice or hope than us.

Rest in peace, babies. I love you and have you tucked here in my heart.

Thank you and sweetest blessings,
Kasey/Luna
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FIGHT ANIMAL CRUELTY
10 Ways You Can Help Fight Puppy Mills

1. Do Not Buy Your Puppy From a Pet Store
That puppy who charmed you through the pet shop window has most likely come from a large-scale, substandard commercial breeding facility, commonly known as a puppy mill. In these facilities, parent dogs are caged and bred as often as possible, and give birth to puppies who could have costly medical problems you might not become aware of until after you bring your new pet home.

2. Make Adoption Your First Option
If you’re looking to make a puppy part of your family, check your local shelters first. Not only will you be saving a life, but you will ensure that your money is not going to support a puppy mill. There are many dogs waiting for homes in shelters all across the country―and an estimated one in four is a purebred! Your second option is breed rescue. If your heart is set on a specific breed you haven’t been able to find in a shelter, you can do an Internet search for a breed-specific rescue organization.

3. Know How to Recognize a Responsible Breeder
If you’ve exhausted your options for adopting and are choosing to buy from a breeder, remember that responsible breeders have their dogs’ interests in mind. They are not simply interested in making a sale, but in placing their pups in good homes. A responsible breeder should screen you as thoroughly as you screen them! Read the ASPCA’s responsible breeding statement to find out more about how a responsible breeder behaves.

4. See Where Your Puppy Was Born and Bred
One sign that you are speaking to an unscrupulous breeder is that they will not let you see the facility in which your puppy was born. Always ask to see the breeding premises and to meet both parents (or at least the mother) of the puppy you want to take home. You should also ask for an adoption contract that explains―in terms you understand―the breeder’s responsibilities, health guarantee and return policy.

5. Internet Buyers, Beware!
Buying a puppy from the Internet is as risky as buying from a pet store. If you buy a puppy based on a picture and a phone call, you have no way of seeing the puppy’s breeding premises or meeting his parents. And those who sell animals on the Internet are not held to the Animal Welfare Act regulations―and so are not inspected by the USDA.

6. Share Your Puppy Mill Story with the ASPCA
If you have—or think you have—purchased a puppy-mill puppy, please tell us your story. Every bit of evidence gives us more power to get legislation passed that will ban puppy mills.

7. Speak Out!
Inform your state and federal legislators that you are disturbed by the inhumane treatment of dogs in puppy mills, and would like to see legislation passed that ensures that all animals bred to be pets are raised in healthy conditions. You can keep up-to-date about current legislation to ban puppy mills by joining the ASPCA Advocacy Brigade.

8. Tell Your Friends
If someone you know is planning on buying a puppy, please direct them to our puppy mill information at ASPCA.org. Let them know that there are perfectly healthy dogs in shelters waiting to be adopted.

9. Think Globally
Have a webpage, a MySpace page or a blog? Use these powerful tools to inform people about puppy mill cruelty by adding a link to our puppy mill information at ASPCA.org.

10. Act Locally!
When people are looking to buy or adopt a pet, they will often ask the advice of their veterinarian, groomer or pet supply store. Download and print our flyers and ask to leave them in the offices of your local practitioners.
http://www.aspca.org/site/PageServer?pagename=cruelty_puppymills_topten

COPD/EMPHYSEMA: CONTROLLED COUGHING

CONTROLLED COUGHING

COPD can cause your lungs to produce excess mucus, leading to frequent coughing. Not all coughs are effective in clearing excess mucus from the lungs. Explosive or uncontrolled coughing causes airways to collapse and spasm, trapping mucus.

The effective, or controlled, cough comes from deep within the lungs and has just enough force to loosen and carry mucus through the airways without causing them to narrow and collapse. Controlled coughing saves energy and therefore, oxygen.

Controlled coughing techniqueTo cough effectively:

1. Sit on a chair or on the edge of your bed, with both feet on the floor. Lean slightly forward. Relax.
2. Fold your arms across your abdomen and breathe in slowly through your nose. (The power of the cough comes from moving air.)
3. To exhale: lean forward, pressing your arms against your abdomen. Cough 2-3* times through a slightly open mouth. Coughs should be short and sharp.
* The first cough loosens the mucus and moves it through the airways. The second and third cough enables you to cough the mucus up and out.
4. Breathe in again by "sniffing" slowly and gently through your nose. This gentle breath helps prevent mucus from moving back down your airways.
5. Rest
6. Perform again if needed.

Tips
Avoid breathing in quickly and deeply through your mouth after coughing. Quick breaths can interfere with the movement of mucus up and out of the lungs and can cause uncontrolled coughing.

Drink 6-8 glasses of fluid per day unless your doctor has told you to limit your fluid intake. When mucus is thin, coughing is easier.

Use the controlled coughing technique after you use your bronchodilator medication or any time you feel mucus (congestion).

Mucus clearing devices

If you have trouble coughing up secretions, your physician may prescribe a mucus clearing device, such as the Flutter device or the Positive Expiratory Pressure (PEP) valve. There are other mucus clearing devices on the market that may be prescribed by your doctor.

A mucus clearing device (such as the Flutter) helps loosen mucus in the airways so you can cough it up more easily. The Flutter consists of:

A mouthpiece
Protective cover
High-density stainless steel ball
A circular cone

When you exhale, your breath moves the steel ball inside, causing vibrations in your lungs. These vibrations loosen the mucus so it can move up and out of the airways.

The PEP valve generates variable resistance to the air you breathe out (called positive expiratory pressure). The PEP setting best for you is determined by your physician or therapist.

To use the PEP valve, place the mouthpiece in your mouth, seal your lips around it, take a deep breath using your diaphragm and breathe out slowly with a moderate force through the one-way valve for as long as you can. The increased pressure in the airways will give you the feeling to cough. When you feel the urge to cough, take a deep breath in, hold for 1-3 seconds and cough to loosen the mucus.

For more health information content, go to Cleveland Clinic Health Information Center

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/.

Personalized Asthma & COPD Therapy News

Personalized therapy for asthma and COPD

Scientists at Washington University School of Medicine in St. Louis have defined a new type of immune response that is activated in patients with severe asthma and COPD (chronic obstructive pulmonary disease). Their discovery could dramatically improve diagnosis and therapy of patients with chronic inflammatory lung disease.

"We've cracked the first part of the molecular code that links a viral infection to the later development of chronic inflammatory diseases like asthma and COPD," says senior author Michael Holtzman, M.D., the Selma and Herman Seldin Professor of Medicine, director of the Division of Pulmonary and Critical Care Medicine and a pulmonary specialist at Barnes-Jewish Hospital. "With this information, we can more precisely diagnose and monitor these types of diseases and then better target our therapy to specific abnormalities. That's a big step forward from simply monitoring breathing status".

The findings, published online May 18, 2008, in Nature Medicine, promise a way to determine whether a patient's asthma or COPD is the result of a chronic immune response that can be turned on by a respiratory viral infection. Guided by these new findings, this type of immune response could be detected by monitoring specific types of inflammatory cells or molecules in the lung or potentially in the bloodstream, giving physicians a more precise approach to diagnosis and therapy of lung disease.

This type of testing could eventually tell physicians whether a patient's condition is mild, moderate or severe, as well as track the effectiveness of therapy. It could also lead to the development of new types of drugs that target the underlying cause of inflammatory lung disease.

"With our results, we can now work on developing more rational ways to diagnose and monitor lung conditions such as asthma and COPD," Holtzman says.

"As it stands now, the diagnosis of chronic lung disease generally depends on clinical judgment and standardized tests of lung function, but we have little that tells us what's going on in the patient's lungs at the cellular and molecular level".

Asthma and COPD are both serious lung diseases that cause shortness of breath, wheezing, coughing and fatigue. In the United States, about 20 million people have been diagnosed with asthma and about 12 million with COPD, which includes emphysema and chronic bronchitis. Holtzman's research aims to find therapies for these disorders that modify the underlying causes of the disease instead of simply suppressing symptoms as most present-day therapys do.

In this study, Holtzman and his colleagues observed that a common type of viral infection of the lung can leave behind a persistent trace of the virus. This viral remnant likely becomes an ongoing stimulus for a chronic immune response, which could last for long periods, even a lifetime. This response causes the cells in the lung passages to overproduce mucus and become hyper-reactive to irritants.

The research team uncovered the details of this immune process by studying mice that are infected with a respiratory virus that is very close to the type of viruses that cause similar infections in humans. When the mice got over their infection, they were left with chronic airway disease characterized by mucus production and increased airway reactivity to an inhaled irritant.

A key molecular feature of this chronic disease was the production of a powerful natural inflammatory substance, interleukin-13 (IL-13). Investigating the source of IL-13, the scientists tracked down a previously undescribed type of immune pathway. This pathway is part of the immune system that is supposed to be activated for only short periods of time. However, the researchers observed that the pathway can also be persistently activated after viral infection, likely due to the pathways ability to respond to viral remnants.

Under these conditions, they also observed that the pathway is set up to amplify its own activity. This combination of persistent activity and positive feedback leads to the long-term production of IL-13 as well as other substances that then cause continuous inflammation in the lung tissue and the development of chronic lung disease.

The team of researchers confirmed that the same immune process could also be detected in the lungs of people with severe asthma and COPD. This type of immune response is typically linked to parasitic infections and allergic disease, but here it appears to be associated with viral infection and chronic inflammatory disease. Importantly, the response produces a specific array of compounds that can be detected in the lung and likely in the blood to serve as diagnostic markers of disease. The research team is now working to verify that the profile of biomarkers for this immune response can be used to diagnose patients with asthma and COPD.

In another recent article, Holtzman and his colleagues "Now, identified another new type of immune mechanism that developed after respiratory viral infection and led to inflammatory lung disease. In this case, the virus triggered an allergic-type antibody response to cause the later development of disease. This pathway did not stay active quite as long but it still caused changes in the airways of the lungs that were similar to the disease found in humans with chronic asthma. The new findings show that patients with severe asthma and COPD may also share some mechanisms that cause their disease.

Now we have identified two new immune pathways that lead to chronic lung disease, and we already have evidence for additional pathways," Holtzman says. "Our goal is to find distinct biological markers for each pathway. This will tell us how to diagnose and what to treat. Then, we must develop therapeutics that are directed to each type of response so that physicians can deliver a therapy that is tailored to the specific type of asthma or COPD found in that patient".

Deciphering these unique immune pathways also can identify new targets for drugs that could block the harmful immune responses, as per Holtzman. He says the findings could also make drug development much more accurate.

"There appear to be a number of distinct ways to cause asthma or COPD. If an experimental drug works on only one of these causes, it is likely to fail in drug trials that include a broad range of patients," he explains. "But if we can set up trials so the test drug is targeting a specific immune response and is given only to those who have that type of response, then we can more accurately determine whether the drug is beneficial".

http://medicineworld.org/cancer/lead/5-2008/personalized-therapy-for-asthma-and-copd.html