Right Ventricular Hypertrophy: Causes, Symptoms, Treatment
Gum Disease Could Be Horrifying Warning Sign Of Fatal Lung Disease, Study Warns
More than half of UK adults suffer from gum disease - new research shows it may be linked to a non-curable lung condition that is one of the world's biggest killers
COPD is the sixth-leading cause of death worldwide, according to the World Health Organisation (WHO), it is not curable (Image: University College London (UCL)/)
More than half of UK adults suffer from gum disease, but it can have a far more serious impact on your health than just bleeding gums and bad breath, new research shows.
Poor oral hygiene makes a potentially fatal lung condition worse, according to the results of a new study. Gum disease - also known as periodontitis - has now been found to aggravate chronic obstructive pulmonary disease (COPD), say scientists. COPD is the sixth-leading cause of death worldwide, according to the World Health Organisation (WHO). It is not curable and smoking is the leading cause in higher-income countries including the UK and US. However non-smokers also regularly suffer from COPD.
Periodontitis results from the untreated build-up of plaque, a sticky film made primarily of bacteria. Over time plaque can harden into tartar and cause inflammation in gums. If left it can produce deep gaps between the teeth and gums where bacteria flourish and may lead to bone loss. Previous studies have shown that periodontitis is a risk factor for numerous diseases, including diabetes, high blood pressure and some cancers. This latest study shows that periodontitis activates immune cells associated with aggravated progression of COPD.
The findings, published in the journal mSystems (corr), suggest that periodontitis and COPD together worsen COPD. But it is not all bad news, researchers say that this knowledge means that gum disease management could be a potential treatment for COPD.
Some level of irreversible periodontitis affects almost half of UK adults, according to NHS figures (Image:
Getty Images)The research team from West China Hospital of Stomatology at Sichuan University showed that bacteria associated with gum disease activated two types of cells - gamma-delta T cells and M2 macrophages - which are important to the immune system but also promote COPD. By enhancing periodontal therapy and targeting the inhibition of gamma-delta T cells and M2 macrophages we may be able to help control the progression of COPD," said Microbiologist Dr Boyu Tang, who led the study with microbiologist Dr Yan Li.
An oral bacteria called Porphyromonas gingivalis plays an important role in gum disease, according to previous studies. In this latest trial the Chinese research team used mice to show how those bacteria could aggravate progression of COPD.
In one experiment, they showed that mice infected with both periodontitis and COPD had worse progression of COPD than mice infected with just COPD. And in experiments using mouse lung tissue, the team showed that P. Gingivalis could activate the immune cells, promoting their ability to produce cytokines associated with worsening COPD.
The team said they intend to continue their research. "We'll further carry out additional studies on human subjects to confirm the mechanism," Dr Li said. The team plan to recruit patients with both conditions and offer periodontitis treatment, then compare lung function and immune cell counts before and after. Dr Li added: "Our finding could lead to a potential new strategy for treating COPD."
How Altitude Sickness Affects Your Lungs
It is climbing season, and many climbers must think about altitude sickness before taking on the next great challenge. Known also as acute mountain sickness, hypobaropathy, Acosta disease, puna, or soroche, altitude illness happens when your body struggles to adjust to lower oxygen levels which happen as you climb higher into the atmosphere. For most, the condition only occurs at 8,000 feet (2,500 meters) or higher, but it really varies from person to person.
Though the condition can become severe quickly, if caught before it becomes life-threatening, it can be treated. However, you will need to recognize the symptoms to avoid complications. "The best and safest way to enjoy the climb or visit to higher altitudes is to be prepared which includes knowledge about the signs and symptoms of altitude sickness and understanding what your health care provider told you to do before the climb and during if symptoms develop," explained Dr. Albert Rizzo, American Lung Association's Chief Medical Officer.
Here's what you should know about altitude sickness to keep you and your loved ones safe.
Who is most at risk?Altitude sickness occurs because the higher you climb, the thinner the atmosphere gets. This makes breathing in the same amount of air much harder, so you get less oxygen than you would at lower altitudes. If your body is unable to take the time and adjust to the difference in oxygen, altitude sickness occurs.
A person who is not accustomed to high altitudes is more likely to experience symptoms. You are also more likely to develop symptoms if you ascend quickly or stay at a high altitude for a long time. In fact, almost everyone who ascends to 11,000 feet or higher will develop altitude sickness.
The age, weight, blood pressure and respiratory capacity of an individual may also make you more susceptible to developing symptoms. Smoking, alcohol usage and the use of sedatives can also greatly increase the chances of getting altitude sickness. Having a medical diagnosis that affects your breathing can put you at greater risk as well.
What are the symptoms of altitude sickness?Altitude sickness can cause a variety of symptoms which vary depending upon the severity. The symptoms of acute mountain sickness usually appear within the first day or so of reaching a high altitude. They usually include:
Morphine Shows Potential As Effective Cough Therapy For Pulmonary Fibrosis, Study Finds
In a recent study published in The Lancet Respiratory Medicine, a team of researchers compared the efficacy of the controlled release of low-dose morphine as an antitussive treatment against that of a placebo in idiopathic pulmonary fibrosis patients.
Study: Morphine for treatment of cough in idiopathic pulmonary fibrosis (PACIFY COUGH): a prospective, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trial. Image Credit: luchschenF/Shutterstock.Com
Idiopathic pulmonary fibrosis is a lung disease consisting of progressive fibrosis of the lungs, with cough being the most commonly reported symptom.
The cause of this disease remains unknown, and currently, there are no cures for this condition, making it invariably fatal.
The available treatments only address the symptoms and slow the progression of the disease. Cough, which is linked to a rapid progression of the disease, also has significant impacts on the physical, psychological, and social aspects of life.
Chronic cough has often been treated with opioids, and morphine is believed to not only lower the cough reflex but also act on the neural pathways directly in the brain.
Furthermore, lower doses of morphine can be used as an antitussive or palliatively for treating dyspnea, as opposed to its use as an analgesic, which requires higher doses.
Studies investigating the use of low doses of morphine to treat interstitial lung disease and refractory cough have also reported high safety and tolerability.
About the studyIn the present study, the researchers evaluated the safety and efficacy of the controlled release of low-dose morphine as an antitussive agent in treating patients with idiopathic pulmonary fibrosis using a placebo-controlled method.
Furthermore, since this study was to establish a proof-of-concept, a two-way crossover trial model was adopted to reduce patient variation and increase statistical power.
This double-blind, randomized, multicenter study was called PACIFY COUGH and was conducted across three centers in the United Kingdom specializing in interstitial lung disease.
Participants between the ages of 40 and 90 years who had been diagnosed with idiopathic pulmonary fibrosis in the last five years and experienced chronic and severe cough lasting more than eight weeks were included in the study.
The cough severity was assessed on the visual analog scale, and a value of 30 mm or more was used as the cut-off for inclusion in the study since previous studies have reported that patients with cough of this severity or higher have significantly lower quality of life.
Lung function tests such as forced vital capacity and diffusion capacity of carbon monoxide were also performed for participant screening.
Other criteria for inclusion in the study consisted of no evidence of being current smokers and high-resolution computer tomography images indicating that the fibroid changes were greater than the level of emphysema.
Comorbidities such as significant renal or hepatic impairment, coronary artery disease, requirement of prolonged oxygen therapy, less than six months of predicted life expectancy, and a history of alcohol or drug use were grounds for exclusion from the study, as was an existing intolerance to morphine.
Patients were randomly assigned to two groups, with one group receiving a controlled release of low-dose morphine. The others received the placebo in period one, and the treatments switched in period two.
The primary outcome was the percentage change in how frequent the coughs were during the daytime or when the patients were awake compared to the baseline measurements.
Patient-reported responses on changes in cough, dyspnea, depression, and interstitial lung disease were the secondary outcomes.
ResultsThe results showed that the administration of low-dose morphine through controlled release significantly lowered the objective cough counts as compared to the placebo over a period of two weeks.
A 39.4% reduction in objective cough counts was observed after the administration of morphine as compared to that of the placebo.
Furthermore, compared to baseline measurements of 21.6 coughs per hour, the mean frequency of daytime cough decreased to 12.8 coughs per hour after morphine administration, and no similar changes were observed after administering the placebo.
Additionally, 40% of the participants experienced adverse reactions after morphine administration, while only 14% experienced adverse reactions after the administration of the placebo.
However, the major side effects of morphine were constipation and nausea, while the placebo group had one case of death.
Given that the study only administered low-dose morphine for two weeks, the researchers believe that more randomized controlled trials are required to assess the long-term safety profiles of morphine use for idiopathic pulmonary fibrosis.
However, the substantial impact of severe and chronic cough on all aspects of life merits the clinical use of low-dose morphine to reduce these symptoms in the short term in patients with idiopathic pulmonary fibrosis.
ConclusionsOverall, the findings indicated that a treatment option consisting of a controlled release of low-dose morphine can significantly lower the objective cough counts in patients with idiopathic pulmonary fibrosis.
However, more trials are required to understand the long-term safety profile of this treatment.
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