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Essential Science: How implanted coils help to fight lung disease

By Tim Sandle     Jan 18, 2016 in Science
London - A new method to treat severe breathing problems caused by lung disease has shown success in a small French clinical study. The new technique's advantage? It is only moderately invasive.
The novel technique consists of inserting coils, made of a metal alloy, via a scope into a person's lungs. The coils function to tighten diseased tissue and open up healthy airways. The scientists behind the method hope it will avoid certain types of major surgery where the outcomes are that the size of the lungs are reduced. The primary application will be for those suffering with chronic bronchitis and severe emphysema, which is a type of chronic obstructive pulmonary disease (COPD.)
COPD causes normally elastic airways to stiffen and sometimes swell-up, making breathing difficult and limiting mobility. Treatment includes inhaled medicine (containing steroids); breathing class training; the use of portable oxygen tanks; and sometimes major lung surgery to extract diseased tissue. It is the avoidance, or at least delay, of surgery that what medical device coil aims to achieve.
COPD is a common condition in many countries and, although there are several causes, it is associated with smoking or industrial exposure (a hazard of working in factories with lax health and safety procedures.)
The high incidence affects the lives of many patients through invalidity and it comes with an associated morbidity in a high proportion of cases. There is also an association with bacterial infection. Here bacteria from the upper airways can spread and find their way to the lung parenchyma. Once there, a combination of factors (including virulence of the infecting organism, status of the local defenses, and overall health of the patient) can cause bacterial pneumonia. Patients with COPD are often more susceptible to infection because of an overall impairment of their immune response.
Evaluation of respiratory function in COPD is undertaken by routine spirometry, together with bronchodilator test substances. A spirometry test involves taking a deep breath and then blowing it out as quickly as possible into a machine called a spirometer. The device measures lung function. The device measures how much air you can blow out of your lungs and how fast you can blow it out. The resultant spirograms provide an assessment of the type of airflow limitation. X-rays also assist with the assessment of the condition.
The new coil is branded PneumRx and it is described as a "endobronchial coil implant." The coil is only a few centimeters in length, but when it is implanted in the lungs it springs open, forming a circular shape. The coil was manufactured in the U.K., put together by a company in London called BTG PLC. BTG is an international specialist healthcare company focused on developing and commercializing products targeting critical care, cancer and other disorders. The video below shows the basic operation of the device:
Trials of the new treatment, performed in France, showed it helped patients to walk further and reduced symptoms, such as low rates of coughing and breathlessness. The results of the French study matches earlier tests carried out in the U.S.
An Oxygen Catalyst
A snapshot showing the new, efficient oxygen catalyst in action in Dan Nocera's laboratory at MIT.
Photo courtesy MIT/NSF
In the U.S. randomized controlled clinical trial, in a six-minute walk test, patients fitted with the coil were able to walk several meters further and experienced less difficulty in breathing. The study consisted of 315 subjects.
With the study in France, 100 patients randomly assigned to receive usual care or coil treatment at 10 hospitals in France. Although only 18 patients achieved a pre-set target in the walk test, this was twice the number in the control group. This number improved, with practice, over time.
The French study was sponsored by the French government and the results have been published in the Journal of the American Medical Association. The research paper is titled "Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema The REVOLENS Randomized Clinical Trial."
With the French study, the results showed success with some patients. Although the increase in steps taken and slight reduction in breathing problems does not necessarily sound like much to someone who does not suffer with COPD, Dr. Ravi Kalhan, a Northwestern University lung specialist who has been involved with the studies, told the science site Biotechnology that "every little increment of something that could work in COPD is significant. There are a lot of people with this disease."
Further studies are required to determine long-term outcomes with the medical device.
In related COPD news, researchers based at the Louis Armstrong Center of Music and Medicine, based at Mount Sinai Beth Israel, have conducted research to see if trying to create music can help to alleviate the symptoms of COPD. Here it was found less fatigue and dyspnea (shortness of breath) was experienced with certain types of instruments. The findings are published in the journal Respiratory Medicine. The research paper is titled “AIR: Advances in Respiration – Music therapy in the treatment of chronic pulmonary disease.”
This article is part of Digital Journal's Essential Science series. Other articles in the series are:
"Space-food for astronauts made from bacteria";
"Health effects of antibiotic use";
"Graphene makes improved night vision tech";
"Personalized medicines, the health innovation”;
Power paper can store electricity”;
"Why some rainbows are completely red";
"Bright white light affects animal reproduction";
"Low cost device restores speech to patients";
"Learn about the new field of neurogastronomy."
More about Lung disease, coils, Lungs, Copd, chronic obstructive pulmonary disease
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