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Pulmonary Rehabilitation Program Effective For Chronic Obstructive Pulmonary Disease

A recent research paper on chronic obstructive pulmonary disease (COPD) said that pulmonary rehabilitation programs are often useful for patients of this disease to have improved daily functions and activities. Chronic obstructive pulmonary disease (COPD) are lung diseases involving restricted airflow and conditions like lung tissue destruction, airway inflammation, air sac enlargement etc. Some common forms of COPD are emphysema and chronic bronchitis.

Pulmonary rehabilitation programs involve exercise training to improve functional capacity of the lungs, taking into consideration the cardiovascular, pulmonary and skeletal muscle limitations. Goals of these programs are to reduce the symptoms of the diseases, increase the physical abilities of the patients and restore the highest level of independence in the attending to the daily functions of the patients.

Researchers had said that by talking the six-minute walk test the patients who had undergone the rehabilitation program could improve on their ability by about 54 meters. The peak work rate of these patients had also improved by about 18% when compared to their physical state before they had undergone the program.

Reference: American Journal of Respiratory and Critical Care Medicine, July 2005

Inhalable Nanoparticles Could Help Treat Chronic Lung Disease

Chronic obstructive pulmonary disease affects the lungs

SEBASTIAN KAULITZKI/SCIENCE PHOTO LIBRARY

Delivering medication to the lungs with inhalable nanoparticles may help treat chronic obstructive pulmonary disease (COPD). In mice with signs of the condition, the treatment improved lung function and reduced inflammation.

COPD causes the lungs' airways to become progressively narrower and more rigid, obstructing airflow and preventing the clearance of mucus. As a result, mucus accumulates in the lungs, attracting bacterial pathogens that further exacerbate the disease.

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This thick mucus layer also traps medications, making it challenging to treat infections. So, Junliang Zhu at Soochow University in China and his colleagues developed inhalable nanoparticles capable of penetrating mucus to deliver medicine deep within the lungs.

The researchers constructed the hollow nanoparticles from porous silica, which they filled with an antibiotic called ceftazidime. A shell of negatively charged compounds surrounding the nanoparticles blocked off pores, preventing antibiotic leakage. This negative charge also helps the nanoparticles penetrate mucus. Then, the slight acidity of the mucus transforms the shells' charge from negative to positive, opening up pores and releasing the medication.

The researchers used an inhalable spray containing the nanoparticles to treat a bacterial lung infection in six mice with signs of COPD. An equal number of animals received only the antibiotic.

On average, mice treated with the nanoparticles had about 98 per cent less pathogenic bacteria inside their lungs than those given just the antibiotic. They also had fewer inflammatory molecules in their lungs and lower carbon dioxide in their blood, indicating better lung function.

These findings suggest the nanoparticles could improve drug delivery in people with COPD or other lung conditions like cystic fibrosis where thick mucus makes it difficult to treat infections, says Vincent Rotello at the University of Massachusetts Amherst, who wasn't involved in the study. However, it is unclear if these nanoparticles are cleared by lungs. "If you have a delivery system that builds up over time, that would be problematic," he says.

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Beyond Smoking: Understanding And Treating Chronic Obstructive Pulmonary Disease

While smoking remains the primary culprit in the development of Chronic Obstructive Pulmonary Disease (COPD), its reach extends far beyond the realm of tobacco. This insidious lung condition, characterised by breathlessness, cough and excessive mucus production, whispers a tale of environmental toxins, genetic predispositions and occupational hazards.

Beyond smoking: Understanding and treating Chronic Obstructive Pulmonary Disease (Photo by Shutterstock)

In an interview with HT Lifestyle, Dr Ashok K Rajput, Senior Consultant, Pulmonology and Sleep Medicine at the CK Birla Hospital in Delhi, shared that the smoke screen obscures a multitude of factors such as -

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Invisible enemies: Microscopic dust particles from industrial processes, air pollution in crowded cities, and even burning biomass fuel within poorly ventilated homes can all silently contribute to the decline of lung function.

Passive smoking: Sharing air with smokers exposes individuals to harmful toxins, increasing their risk for COPD development.

Recurring respiratory infections: Childhood respiratory illnesses and frequent bouts of bronchitis can leave lasting damage to delicate lung tissue, paving the way for future COPD. Long-standing asthma and similar chronic lung diseases can lead to remodelled airways that behave just like COPD.

Indoor pollution: Cooking fumes, chemical cleaning products, and even mold spores within homes can irritate and damage airways, contributing to the progression of COPD.

According to him, by acknowledging the complex tapestry of causes, we can shed light on the true face of COPD. This shift in perspective paves the way for -

Targeted prevention strategies: Public policy changes focused on air quality improvements and indoor pollution control can significantly reduce risk factors.

Early diagnosis and intervention: Increased awareness and screening programs can identify individuals at risk and facilitate timely intervention to prevent irreversible lung damage.

Comprehensive treatment plans: Tailored treatment plans that address the multifactorial nature of COPD can improve symptom management and optimise quality of life.

Dr Ashok K Rajput said, "Our collective effort is essential to create a world where clear lungs are a reality for all. We need to move beyond the smoke screen and commit to promoting clean air initiatives through sustainable practices and advocating for stricter regulations to reduce air pollution. Ensuring everyone has access to comprehensive COPD diagnosis, treatment, and support services. Educating individuals about the diverse causes of COPD and empowering them to take control of their lung health. Together, we can build a future where every individual can breathe freely, unburdened by the silent threats lurking in the air they breathe."

Dr Manoj Kuterri, Medical Director and CEO at Atmantan Wellness Centre, echoed, While smoking remains the primary risk factor for Chronic Obstructive Pulmonary Disease (COPD), extended exposure to environmental toxins, occupational hazards, and genetic predispositions can also contribute to its onset. Beyond conventional treatments like steroids, bronchodilators, and oxygen therapy, effective COPD management involves a holistic approach. This includes addressing comorbidities, adopting lifestyle changes, and enhancing overall quality of life. COPD is characterized by respiratory passage constriction and severe airway inflammation, with causes extending beyond smoking to encompass factors such as exposure to chemicals, dust, environmental pollution, and genetic disorders."

He suggested, "Adopting a healthy and supportive lifestyle is often essential for those with COPD to adequately manage their illness. Quitting smoking is a key component of managing COPD since it greatly aggravates respiratory symptoms and hastens the deterioration of lung function. Regular physical activity that is catered to each person's abilities enhances lung function, endurance, and general well-being. Reducing exposure to respiratory irritants at home can be achieved by creating a COPD-friendly environment with adequate ventilation and air quality. Social Support and emotional health play a crucial role in enhancing the quality of life for people with COPD."

He revealed, "Effective COPD management revolves around sustaining a nutritious, well-balanced diet. Given the potential for muscle wasting in individuals with COPD, maintaining sufficient protein intake is paramount for preserving muscle strength. Optimal dietary choices involve a rich selection of fruits and vegetables, providing essential vitamins, minerals, and antioxidants that contribute to overall health and respiratory well-being. Adopting a pattern of small, frequent meals throughout the day not only aids in maintaining nutritional intake but also facilitates easier breathing, preventing sensations of fullness. Additionally, staying adequately hydrated is crucial as it promotes mucus expulsion, contributing to improved respiratory function. The ancient Yogic practice of Pranayama, or controlled breathing, is an adjunctive method for people with COPD. Partake in Pranayama as it is a useful tool for improving lung capacity, respiratory function, and relaxation for individuals with COPD."

Bringing his expertise to the same, Dr Neel Thakkar, Senior Consultant Pulmonary and Critical Care Physician at Sterling Hospitals in Vadodara, said, "We are all aware that health is not merely the absence of disease, but a dynamic state of complete physical, mental, and social well-being. Understanding and addressing the intricate web of factors influencing health, from lifestyle choices to environmental exposures, is essential for comprehensive care and the effective management of chronic conditions like COPD. Chronic Obstructive Pulmonary Disease (COPD) extends far beyond smoking, becoming a critical health concern globally. Beyond the traditional risk factor of smoking, exposure to high levels of air pollution emerges as a significant contributor to COPD, constituting more than half of the cases in India alone. On the 12th December this year (2023), the air quality index in Maninagar, Ahmedabad was 151, the same as in Mumbai's Bandra Kurla Complex, which is considered poor by air quality standards."

Highlighting the critical need for a broader approach to COPD care, he said, "COPD management entails a variety of strategies, including lifestyle changes, anti-addiction strategies, nutritional considerations, breathing exercises, vaccination, and regular monitoring. Non-pharmacologic therapies are also important. For example, to quit smoking and tobacco, selecting a quit date, informing everyone, anticipating problems, and eliminating the goods from the environment are all beneficial. Individuals with severe COPD, particularly those with pulmonary artery hypertension and low oxygen levels on exertion, require oxygen therapy since it improves both survival and quality of life. Innovative approaches, such as oral vibratory devices, and positive airway pressure devices offer targeted relief and individualised rehabilitation plans for those experiencing persistent symptoms despite standard treatments. Surgical options like lung volume reduction surgery or transplantation become considerations for advanced cases where feasible."

He concluded, "In recent conversations, the interaction of COPD and immunisation has gained importance. Vaccines have been highlighted in research, including the new Global strategy for the prevention, diagnosis, and management of COPD; GOLD 2024 recommendations where the Respiratory Syncytial Virus (RSV) vaccine is suggested for those over the age of 60. This highlights the evolving landscape of COPD care, where preventive measures play a pivotal role in managing the disease and mitigating symptoms. With COPD ranking as the third leading cause of death worldwide, the call to action is clear. 'Breathing is Life. Act Earlier' stresses on the critical need for awareness. Through united efforts, we can strive to mitigate the impact of this pervasive respiratory ailment and enhance the well-being of those affected."

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