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Lung Disease
Increasing level of pollution has made breathing in urban areas very difficult, raising the incidence of respiratory problems. Out of the world's top 20 cities with polluted air, 13 belong to India and according to the World health Organisation (WHO) report published in 2011, lung diseases rank 2ndin the list of top 20 causes of death. Naturally, lung disease is a big health issue that needs to be addressed. Here are some facts about lung disease you should know about.
To understand the condition of your lungs, you need to first understand how the lungs function. Lungs are soft organs present on both right and left side of the chest. They are protected by a had covering called the ribcage. Each lung is made of sections called lobes. The main function of the lungs is to make oxygen available for purifying blood and to and eliminate carbondioxide from impure blood or deoxygenated blood. So when you breathe, air travels down your windpipe (trachea). The windpipe bifurcates with each branch entering each of the lungs. Into the lungs, the windpipe is further branched to tubes called bronchioles that end in small sacs called alveoli, where the inhaled air reaches for delivering oxygen.
A lung disease or disorder occurs in the various structures of lungs and disrupts its functioning. It can vary from a mild common cold to life-threatening conditions like pneumonia and cancer. Lung disease can be caused by infections, inflammation, obstruction of airways, decreased lung function, problems related to pulmonary circulation, etc. Smoking, infections, air pollution, genetics, exposure to asbestos, etc. Can cause various lung diseases.
TypesThe common as well as rare types of lung disease include -
Causes'In any form of lung disease mainly the breathing gets affected,' says Dr Animesh Arya, Senior Consultant, Respiratory Medicine, Delhi based Sri Balaji Action Medical Institute. Here are some common forms of lung diseases he explains.
1. Asthma:It is the most common lung disease triggered by allergies, infections and pollutants that harm the airways and cause inflammation.
2. Acute bronchitis: Bronchitis is the inflammation of the air passage. Acute bronchitis is caused by viral or bacterial respiratory infections.
3. Chronic Obstructive Pulmonary Disease (COPD): It a group of diseases that causes breathing difficulties and interfere with the exhalation process of breathing.
4. Chronic bronchitis: It is a type of COPD caused mainly due to smoking.
5. Emphysema: It is a COPD caused by environmental factors and may also be triggered by allergens or organisms that cause diseases like pneumonia and tuberculosis.
Apart from these common forms of lung diseases, other rare lung diseases include:
6. Cystic fibrosis: It is rare lung disease caused by genetic mutation that results in excess mucus production causing blockage of airways.
7. Acute respiratory distress syndrome (ARDS): It is a medical emergency caused as a result of lung injury due to a severe illness.
8. Lung cancer: It can affect any part of the lung. It is mainly caused due to smoking. Here are 10 common symptoms of lung cancer you need to know.
9. Interstitial lung disease: This is a group of diseases affecting the interstitium, a thin lining separating the air sacs.
Symptoms'Bronchitis, asthma, COPD, lung infections and pulmonary fibrosis have similar symptoms even though they are very different in nature,' says Dr Arya. He lists a few common symptoms of lung diseases:
In most cases, chronic cough, chest pain and breathing difficulties necessitate a lung function test. But your doctor might first take a look at the results of your blood test that may indicate whether you have any kind of lung infection. Otherwise, based on your symptoms your doctor might recommend the following lung function tests for you, as explained by Dr Arya.
'If any of the above mentioned symptoms persist for a long time, it is better to consult a doctor immediately for diagnosis,' says Dr Arya. The management of lung disease depends on the type of lung disease you're diagnosed with but largely medication is the main treatment option for lung disease patients.
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Lung Scarring Symptoms And Causes
Scars on the lung tissue cause it to thicken and lose elasticity. Doctors refer to lung scarring as "pulmonary fibrosis". It can occur due to certain health conditions and exposure to hazardous materials.
Lung scars can result from illness or medical treatment, and they are permanent.
Small scars may not cause noticeable symptoms, but extensive scarring can make it hard for a person to breathe, as it can affect the transfer of oxygen into the bloodstream. As a result, the brain and other organs may not receive the oxygen that they need.
Idiopathic pulmonary fibrosis (IPF) is a long-term condition in which lung scarring becomes gradually worse. It can be life threatening.
In this article, we look at why lung scarring happens and discuss some of the treatment options available.
Several conditions can cause scarring of the lungs.
Interstitial lung diseaseInterstitial lung disease involves inflammation of the air sacs or the web of tissue (interstitium) that surrounds them in the lungs. The inflammation can sometimes cause scar tissue to build up within the lungs, resulting in fibrosis.
IPF is the most common type of interstitial lung disease. If doctors describe a condition as idiopathic, this means that they do not know exactly what causes it.
IPF typically appears between the ages of 50 and 70 years. There are up to 207,000 people affected in the United States, and about 58,000 new cases are diagnosed each year.
Other causes and risk factorsOther risk factors for interstitial lung disease include:
In some cases, there may be a family history of the disease.
Some people experience exacerbations, during which symptoms suddenly worsen. These last for a while and then resolve. Exposure to triggers, such as tobacco smoke, may cause a flare.
The scarring of lung tissue makes it thick and stiff. As the lung tissue thickens, it becomes increasingly difficult for the body to transfer oxygen from the lungs into the bloodstream. As a result, the brain and other organs may not receive enough oxygen.
The symptoms depend on the amount of scarring and how much of the lung it affects, but they may include:
Scarring may also increase the risk of lung cancer.
Idiopathic pulmonary fibrosisThe symptoms of IPF may not be noticeable at first, but they tend to develop and worsen over time, making it increasingly difficult to breathe.
Eventually, pulmonary hypertension or respiratory failure can develop, both of which can be life threatening because they prevent oxygen from reaching the body's organs.
Many factors can lead to a cough or breathlessness, and many conditions can result in lung scarring.
Anyone who has concerns about breathing symptoms should seek medical help. A doctor will carry out a physical examination.
They will ask the person about:
After this, the doctor may carry out some tests, such as:
They may also carry out specific tests to rule out other conditions, such as TB.
As with scars on the skin, scars on the lung are permanent. It is not usually possible to remove them. The lungs are resilient, however, and small scars often do not cause any adverse effects.
Proper diagnosis and monitoring of the scars are key to treatment.
Scars that remain unchanged fortwo years or more are not usually a cause for concern. However, if they spread, they could indicate pulmonary fibrosis.
Idiopathic pulmonary fibrosisCurrently, a lung transplant is the only cure for IPF. However, a doctor can prescribe medications to help slow the progression of the disease and prevent flares. Pirfenidone (Esbriet) and nintedanib (Ofev) are two drugs that have proven effective.
As the disease progresses, the symptoms can become more severe. They can also worsen during a flare. In these cases, a person may need to spend time in the hospital. Treatment will include supplemental oxygen to support the person's breathing.
Occasionally, a doctor may recommend a transplant. This procedure can cure the condition, but the person will need to take medications for the rest of their life.
Lifestyle tips that may help prevent or relieve symptoms include:
It is important to talk to a doctor before making any significant lifestyle or dietary changes. A doctor can advise on a suitable exercise regimen, for example.
The outlook for pulmonary fibrosis varies among individuals and depends partly on a person's age and overall health. The person will need regular assessments.
In the past,most people diagnosed with IPF had a life expectancy of 3–5 years.
However, new medications may slow the progression of the condition and reduce the risk of death in the first few years after diagnosis. Doctors hope that the outlook will continue to improve.
Below are some commonly asked questions about lung scarring.
Is scarring of the lungs serious?Yes, scarring of the lungs, also known as pulmonary fibrosis, may be a serious condition.
When lung tissue becomes damaged and scarred, it leads to stiffness in the lungs and makes it difficult for them to function properly.
This can result in symptoms such as shortness of breath, persistent dry cough, fatigue, and, in severe cases, respiratory failure.
How are scarred lungs treated?Treatment options for scarred lungs, particularly in the case of IPF, often involve a combination of medication, lifestyle changes, and supportive therapies.
Two medications that have shown effectiveness in slowing down the progression of scarring of the lungs are pirfenidone and nintedanib.
Can a person live 20 years with pulmonary fibrosis?People with pulmonary fibrosis experience disease progression at different rates. Some people progress slowly and live with the condition for many years, while others decline more quickly.
Ultimately, it is a serious disease but research advancements are being made all the time that allow people to live longer and have a better quality of life.
What is the life expectancy of someone with ILD?Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring of the lungs.
Therefore, a person's life expectancy can vary widely depending on several factors, including the specific type and severity of the ILD, their overall health, whether they smoke, and how well they respond to treatment.
Pulmonary fibrosis, or lung scarring, causes thickened and less elastic lung tissue.
Risk factors include having a previous viral infection or pneumonia, gastroesophageal reflux disease (GERD), smoking, and aging. Alternatively, the condition can be idiopathic – meaning the exact cause is unknown.
Diagnosis entails tests like X-rays and CT scans, with treatments encompassing medication to decelerate progression. Lifestyle modifications, such as stopping smoking and weight management, may also aid symptom management. In more severe cases, a lung transplant may be necessary.
Despite a traditionally restricted life expectancy, these advancements in medications give hope for better outcomes.
Cannabis May Reduce Deadly COVID-19 Lung Inflammation: Researchers Explain Why
Researchers are studying cannabis' potential as an adjunct treatment for COVID-19.
GettyAs COVID-19 cases continue to rise, researchers have started to look for solutions in an unlikely place - the cannabis plant. Cannabis' active compounds have a number of properties that make it appealing as a potential adjunct treatment for infections from the novel coronavirus, and recently scientists have begun looking at its potential for reducing susceptibility to the disease, and even discussed whether it could be used as an antiviral medication.
This month, researchers from the University of Nebraska and the Texas Biomedical Research Institute are recommending more research into how cannabis-derived CBD might help treat dangerous lung inflammation from the novel coronavirus. The authors detailed the evidence for how cannabis' anti-inflammatory powers may help in a peer reviewed article in this month's issue of Brain, Behavior, and Immunity.
In the article, researchers explain that "recent reports have suggested that acute infection is associated with a cytokine superstorm, which contributes to the symptoms of fever, cough, muscle pain." These extreme instances of inflammation can lead to severe pneumonia which clog up the lungs, make breathing difficult or impossible. So, one of the important strategies that scientists are studying in the fight against COVID-19 is reducing inflammation.
In particular, researchers are looking at drugs which reduce IL-6 cytokine activity. In a recent study, one such drug, Tocilizumab, was able to clear out patients' lungs, and resulted in recovery for 90% of the patients treated. Unfortunately, it also produced serious negative side effects like inflammation of the pancreas and hypertriglyceridemia (a risk factor for coronary artery disease). This has led researchers to continue the search for anti-inflammatory strategies - preferably ones that aren't as harsh on these already critically ill patients.
Cannabis can be smoked in its raw form, or infused into tinctures like this one.
GettyThat's where cannabis comes in. The authors explain that several cannabinoids in the cannabis plant have anti-inflammatory properties. In particular, they point to CBD as the most likely candidate for treating COVID-19 related inflammation. CBD has shown serious anti-inflammatory properties in previous studies, it doesn't create the disorienting psychotropic effects associated with cannabis' most common chemical THC, and it has already been approved by the FDA as safe for children with intractable epilepsy. If successful at reducing inflammation for COVID-19 patients, it could be a safer alternative to other anti-inflammatory options.
Why do researchers believe CBD can help with COVID-19, specifically?
For one thing, the authors explain that previous research has shown that CBD can reduce a number of pro-inflammatory cytokines including IL-6, the one reduced by other drugs being studied for COVID-19. CBD was also shown to reduce interleukin (IL)-2, IL-1α and β, interferon gamma, inducible protein-10, monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, and tumor necrosis factor-α - all of which are associated with the pathology of severe cases of COVID-19. In addition to reducing these pro-inflammatory cytokines, CBD has also been shown to increase the production of interferons, a type of signaling protein that activates immune cells and prevents viruses from replicating.
Previous research also supports the idea that CBD can specifically reduce lung inflammation. In an animal study on asthma, CBD was able to reduce production of proinflammatory cytokine production, actually reducing airway inflammation. In the same study CBD also reduced pulmonary fibrosis - a condition where lung tissue becomes damaged and scarred, thickening lung tissue and making breathing more difficult. This is important, because COVID-19 can also leave patients with serious pulmonary fibrosis.
The authors also note that CBD isn't the only cannabinoid that shows promise as an anti-inflammatory medicine. THC has also shown powerful anti-inflammatory results, but it's less well tolerated than CBD, with common symptoms like disorientation, anxiety, and increased heart rate. Research on CBD, on the other hand, shows it to be safe and well-tolerated with dosing as high as 1500 mg a day, for a period of up to two weeks. The authors explain that this "suggests its feasibility to reduce SARS-CoV2 induced lung inflammation/ pathology and disease severity."
NEW YORK, NEW YORK - MAY 05: A sign placed outside a CBD store in Murray Hill during the coronavirus ... [+] pandemic on May 5, 2020 in New York City. (Photo by Noam Galai/Getty Images)
Getty ImagesWhile negative side effects are minimal with CBD, the article's authors point out that CBD may have a side benefit for patients with the disease - reduced anxiety. "The many uncertainties associated with the COVID-19 pandemic such as status of the economy, employment and loss of connection can fuel depression, fear and anxiety" they explain, pointing out that the increased inflammation in COVID-19 may also trigger increased levels of anxiety. But CBD has shown serious promise for the management of anxiety, and may help reduce these challenging levels of stress.
No peer reviewed studies to date show that cannabis or its compounds can help with COVID-19 specifically, but the authors of this article say the evidence suggesting that it may help is worth further investigation. They recommend that scientists begin studies to investigate whether CBD can be used to reduce inflammation and anxiety in COVID-19 cases, as an adjunct to antiviral medications.
While this doesn't suggest cannabis should be considered a cure or treatment of COVID-19 on its own, it does suggest that it may have potential to help bring down inflammation and reduce anxiety in those suffering from the disease. But until more studies are done, this is just a well-supported theory. Direct experimentation is needed to bring us real answers.
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