Breakthrough discovery from UBC researcher discovers that permanent lung damage caused by chronic obstructive pulmonary disease (COPD) starts before patients even begin showing symptoms.
The discovery was made by Dr. Tillie-Louise Hackett, associate professor in the University of British Columbia’s faculty of medicine, that will drastically change how patients are treated for COPD, and is the leading cause of hospital admissions in B.C. and Canada. The findings were published in The Lancet Respiratory Medicine.
Hackett, who is also a principal investigator at St. Paul’s Hospital Centre for Heart Lung Innovation (HLI), and her research team found that even patients diagnosed with mild COPD have already lost a sizeable portion of their small airways—more than 40 per cent—on average.
Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and a cough creating sputum. COPD is a progressive disease, meaning it typically worsens over time. It eventually makes everyday activities like walking much more difficult to do.
“These patients often have little to no symptoms, so it was believed their lungs were relatively undamaged,” said Hackett. “Now that we know the severity of the damage, we need to look at earlier intervention to ensure the best outcomes for COPD patients,” says Hackett. “If the same drugs were tested on patients with more mild forms of the disease, and less tissue damage, the results could be very different.”
The study collected lung samples from 34 patients that were analyzed using an ultra-high resolution microCT scanner, which is one of only three in the country. This scanner was fundamental to Hackett’s research and was funded by the Canada Foundation for Innovation and St. Paul’s Foundation. Although the HLI Lung Tissue Registry Biobank at St. Paul’s has been collecting specimens for more than 30 years, the recent addition of the microCT scanner made it possible to image samples that are embedded in paraffin in extreme detail.
The new findings also suggest previous large clinical trials testing new COPD treatments may have failed because patients already had substantial lung damage.
It is estimated approximately one in 10 people over the age of 40 may suffer from COPD. Martin Mannette has been living with the disease for eight years. He is managing well with a careful combination of medication, but the 68-year-old is excited about how this research could impact future patients.
“I worry about COPD taking over as the number one killer,” says Mannette, “so anything we can do for the next generation so they can avoid COPD is so important.”
With COPD on the rise and expected to be the third leading killer, Dr. Don Sin, the Canada Research Chair in COPD and a St. Paul’s respirologist, says the findings have significant implications.
“This breakthrough finding will allow us to develop new drugs to treat patients with COPD at the earliest stages of their disease when the disease is reversible,” says Sin. “This will prevent disease progression in thousands of patients and help them stay out of the hospital and remain healthy in their own homes.”