- Bronchoscopic lung volume reduction and lung volume reduction surgery are the only available treatments for patients with advanced stage emphysema.
- Though they improve survival rates and quality of life, they cause disease progression.
- Study focuses on the microscopic origins of emphysema progression before and after lung volume reduction and compares it with newer, non-invasive treatment techniques.
New study provides insights into the microscopic origins underlying emphysema progression before and after lung volume reduction.
This unique engineering perspective of emphysema progression could help to predict patient survival and quality of life following treatment.
‘Mechanical forces involved with invasive surgical procedures for emphysema might play a role in disease progression, and that newer less invasive lung volume reduction techniques are better compared to current surgical approaches.’
Pharmacological treatments have limited benefits for people with emphysema. Currently, the palliative treatment for emphysema includes lung volume reduction surgery (LVRS).
Recently, many non-surgical, less-invasive techniques have emerged for managing emphysema. Among them, bronchoscopic lung volume reduction (bLVR) treatments are widely investigated.
These treatments help to ameliorate advanced stages of disease by removing affected tissue and allowing healthier regions to restore lung function.
Previous work has shown improved survival rates and quality of life associated with these techniques. But how these therapies impact the microscopic mechanisms underlying disease progression, is not well-understood.
Emphysema is a type of chronic obstructive pulmonary disorder that involves thinning and destruction of the alveoli or air sacs of the lungs.
The World Health Organization estimates that there were 3 million deaths caused by COPD in 2015 worldwide, which roughly translates to 5 percent of all deaths that year.
Around 65 million people worldwide are affected by emphysema.
In the United States, as per the National Health Interview Survey from 2007, the prevalence of emphysema is 18 per 1000, and that of chronic bronchitis 34 per 1000.
According to the Centers for Disease Control and Prevention, the number of deaths recorded due to emphysema is around 7455 people in 2014.
Around 3.4 million people (1.4%) in the United States are diagnosed with emphysema. People who generally smoke may have severe emphysema.
Understanding the Molecular Mechanism of Disease Progression
The researchers, Jarred Mondoņedo and Béla Suki of Boston University, established a computational model of emphysema and showed that the emphysema progression depended on specific redistribution of mechanical forces within the lung after intervention.
This study also compares newer, less invasive lung volume reduction techniques, such as novel biomaterial-based lung sealants and coils, with traditional surgical approaches.
The authors add that, "these findings highlight the critical role that mechanical forces might play in emphysema treatment, and suggest how newer and far less invasive lung volume reduction techniques can achieve comparable, if not better, outcomes than current surgical approaches. This could potentially expand treatment options for many with emphysema, while lowering both costs and recovery time for patients."
This research has the potential to shape more individualized, patient-centered treatment strategies.
Future research aims to link this model to routine lung imaging modalities, with the goal of determining the most effective intervention approach to optimize patient outcomes.
The research is published in PLOS Computational Biology
- What is Emphysema? - (http://www.medindia.net/patients/patientinfo/emphysema.htm)
- Jarred R. Mondoņedo et al. Predicting Structure-Function Relations and Survival following Surgical and Bronchoscopic Lung Volume Reduction Treatment of Emphysema. PLOS Computational Biology; (2017) doi:10.1371/journal.pcbi.1005282