Doctor is focusing on Rebuilding the lung

[Jeannine]

Emphysema Patients May Breathe Easier
Janauary 26, 2010

http://www.laboratoryequipment.com/N...x?xmlmenuid=51


?We are focused on rebuilding the lung,? says Andrew Hoffman. Photo: Alonso Nichols.
Imagine having to think about every breath you take. Imagine gasping after you walk across a room. Imagine breathing in, and then being unable to expel that breath without effort. That?s how people with emphysema live. The condition?a type of chronic obstructive pulmonary disease?involves progressive and irreversible damage to the air sacs in the lungs and affects more than 3 million Americans, killing 120,000 every year.

The physical effect of emphysema on the lungs is like ?cutting parts of a cobweb or a net. The lung just starts to unravel,? says Andrew Hoffman, a professor of large animal medicine at the Cummings School who researches treatments for lung disease in animals and humans.

It is well known that cigarette smoking is the major cause of emphysema. What?s not known is how the condition spreads in the lung, and whether that process can be halted or reversed.

But hope may be on the horizon, thanks in part to research Hoffman is conducting with support from the National Institutes of Health. He and his colleagues have devised a method to mitigate the symptoms of the disease, using a special kind of epoxy to reduce lung volume, which allows the remaining lung to take in and expel air more efficiently. Now they?re trying to develop ways to rebuild lungs, cell by cell.



As a large animal veterinarian, Hoffman has specialized in diagnosing and treating equine lung disease, which develops from chronic exposure to dusty barns and racetracks and is similar to human chronic obstructive pulmonary disease (COPD). To study emphysema?a type of COPD?he has focused on sheep, since their lung size and anatomy closely resemble those of human lungs. He is collaborating with Edward Ingenito, an assistant professor of medicine at Harvard Medical School and an associate physician at Brigham and Women?s Hospital in Boston.

?We developed methods to evaluate the safety and outcome of treatments intended for humans in the sheep models, and a long-term collaboration between human pulmonologists and veterinary physiologists was born,? says Hoffman.

Ingenito and Hoffman found a non-invasive way to improve lung function in animals and humans, which is now in the final phases of clinical trials. The so-called bronchoscopic lung volume reduction technology uses special glues to reduce the size of the emphysema-affected lung, allowing the remaining lung to work more efficiently. The treatment could mark an important advance in emphysema therapy. Ingenito is the founder of Aeris Therapeutics, a medical company with offices in Woburn, Mass., and on the Cummings School campus that holds the patent for the volume reduction technology.

Additional important advances could follow. ?Using the biocompatible glue to close off the emphysema-damaged lung allows patients significant relief, but the disease will continue to progress,? Hoffman says. ?Part of the reason for that is that patients have already lost a lot of their critical progenitor and stem cells in the lungs?and there?s not much known about stem cells in the lung yet.? He points out, however, that ?the lessons that we learned in developing volume reduction have better prepared us for developing stem cell therapy [for emphysema]. We have learned to take things from animals all the way up to humans.?

Stem cells and progenitor cells are microscopic building blocks of the body. Progenitor cells are specialized in their functions, destined to become only one type of cell when they mature, such as a muscle cell or the particular type of cell that forms alveoli, or air sacs, in the lung. Stem cells, by contrast, have the potential to develop into a variety of cell types and have the ability to replenish damaged cells in many different organs. When a stem cell divides, each new cell created has the potential to remain a stem cell or to become another type of cell, such a red blood cell or a brain cell. Stem cells can replicate indefinitely, while progenitor cells can divide a limited number of times.

?We know that stem cells and progenitor cells are necessary to maintain a healthy cell population in the lung,? Hoffman says. If lung cells get injured, they can be replenished. ?It?s just like your skin: When a few cells come off, new cells come up. The lung also has that capacity to replace certain cells with progenitor cells. With emphysema, those healing cells are targeted and damaged. If you lose your progenitors, you can?t respond to injury any longer.?

Hoffman and his colleagues have worked with lung cells from mice and sheep and with healthy human lung cells harvested through biopsies. Their goal has been to develop ways to grow new progenitor cells from existing healthy cells. Because such cells would be identical to the host lung cells, the diseased lung would be less likely to reject them.

?We are focused on rebuilding the lung,? says Hoffman. ?We want the cells to actually build new air sacs.? The idea is that the new progenitor cells would attract ?the other two main types of cells?those on the blood side of the lung?s structure and those on the air side.? This could allow fine blood vessels to ?run through and pick up oxygen,? lessening the breathing problems patients with emphysema experience.

Hoffman and his colleagues have been able to demonstrate that the lab-grown progenitor cells produce everything they hoped they would. ?They produce elastin [which allows the lung cells to expand and contract] and growth factors and are capable of assembling the scaffolding that other cells can attach to,? he says. ?We have demonstrated that they have the potential to replace damaged cells in the emphysema lung.?

They have also isolated progenitor cells, grown them and put them in mice and sheep with encouraging results. ?We have done two different pre-clinical trials in sheep, and both showed that the cells improved blood flow and increased tissue mass in the emphysema lung,? says Hoffman. He hopes that at the conclusion of his study, in about five years, the lung-rebuilding technique can be tested safely in human emphysema patients. The technology that is being developed to treat emphysema could also potentially be applied to a variety of lung disorders that, while less common, are equally serious.

[barbara]

I received progenitor cells along with many other kinds of stem cells in my last treatment. Maybe, that accounts why I felt so awesome and actually normal 10 days after the treatment. I am sure they are helping to reduce inflammation as well.

I do hope the projection of 5 years mentioned in this article is on target. I cringe when I read articles that mention 15-20 years and frankly don't pay much attention to them. 5 years I can deal with although that is still too long for those waiting anxiously for something to help them.

[Everett]

I haven't asked but do you think that you gained alveoli after your treatments? Did you volume go up? I don't want to sound personal but I have so many unanswered questions floating between the ears. Jeannine, I noted that you haven't had a treatment after your first one. Are you still doing good? How are your improvements doing Barbara? Are you planning further treatments? If affirmative by whom and what?
The work that Dr Hoffman is doing is great and encouraging but five years would make me 81 and I don't know if I have that much time to wait. I am a pure type A perosnality, ( if you haven't guessed yet ), and want everything yesterday or before. I wonder if I went into his office and brayed real good whether he would take me on as a patient? Stay warm--
Everett

[Jeannine]

Everett

I had stem cell treatment almost 3 years ago and I did notice improvements for about 18 months. I know my lung volume increased but not considerably (it went from .62 to .82), but one thing that did improve well actually two things were my shortness of breath and my heart rate. I never get as short of breath as I did before treatment and my heart rate stays in the 80s to low 90s unless I am climbing stairs or doing something more strenuous. Prior to stem cells my heart rate would climb to the 120s when I climbed stairs or exercised.

However, last February I was scheduled for another stem cell treatment and came down very ill the day before we were scheduled to leave. I spent 16 days in the hospital and 6 weeks recovering from a severe case of ulcerative colitis which seemed to have caused me to lose much of the imrovements I'd had and due to the colitis I hadn't been able to take any supplements so I would up with a bad cold that turned into double pnemonia in July. That took its toll on my lungs and I feared I had lost all of my improvements, but I started back on my supplements and for the past 8 weeks or so I have noticed my breathing is back to where it was before I got sick almost a year ago.

So to answer your question - yes I believe my treatment did help me. It didn't cure me but I know I feel better today than I did three years ago.

I am planning to visit Dr F (see RegenMed link above) once again this March. Many improvements have been made to stem cell treatments since I had mine 3 years ago.

All I can tell you is to check out several places and talk to people who have had treatment and see if they saw improvements. Also shop around because prices can range from $7,000 all the way to $65,000

I hope this helps.

[barbara]

Everett - If you don't have to wait (meaning you have funds and can travel now) then by all means, I would recommend stem cell therapy. I will be happy to e-mail you the resource page from our book, "Stem Cell Pioneers." I agree with Jeannine that you should contact several clinics and compare treatments. Disregard testimonials because many times they are just not your best source of information. You never see a testimonial where the patient did not improve and unfortunately this can happen. Stem cell therapy is in its infancy and new, improved therapies are coming down the pike all the time. My last therapy in December consisted of several types of stem cells. I cannot say enough good things about that treatment, however, I also am on a very extensive supplement regimen and I nebulize glutathione twice a day. I believe it is a combination of these things that have made me feel so much better. I also participate in the Stem Cell Advance treatment protocol and have for quite some time. I will not know if I have any documentable regeneration for several more months, but 10 days after my last treatment I was able to chuck the O2 and had so much energy that my legs could not keep up with my lungs. I was walking over a mile on hilly terrain with ease and that was after an hour walking on the doggy beach with my dogs. My husband got tired around 9 PM each night and I was still wanting to go do things. I had zero shortness of breath. I did stay at sea level for a month and when I had to come home, I made it all the way to 4800 ft with no problems. I live at 5700 ft. and have had to go back to using supplemental oxygen, but at a much reduced rate. I continue to feel good and have a lot of energy and will continue my course of stem cell therapy until this disease is totally reversed and my lungs regenerated significantly. I have not had a PFT for awhile, but the last one showed a 2% increase in my FEV1. Not bad for someone who was declining 5% a year previously and was always sick.

[Everett]

Barbara and Jeannine,
I would appreciate getting the resourse page from your book. It so encouraging to recieve the info that you have posted for me. What does the cold weather that you are experiencing where you two live do to you? Down here in Texas the cold cuts in harder because of the humidity being higher. I used to hunt in Colorado in near zero temps and it didn't seem as cold a 32 here in south Texas. My old hunting buddy has retired from law and moved from Denver to southern Colorado. WE went to see them two years ago and I had to be on O2 the whole time. It was wonderful seeing the High Country again. I Google earth a lot and I went up to New Hampshire and was surprised at the country there. It is beautiful. I can see how you would live there and endure the winters. I would never get my Linda up there except in the spring/early summer to travel. I can't imagine being able to travel to higher altitudes again without having trouble breathing. Lord that would be great!!!
Thank you again for your help,
Everett

[Jeannine]

Everett

Although I have spent my entire life in New Hampshire I am sick of cold weather -- especially snow. But I don't spend much time outdoors and the weather doesn't affect my breathing very often. I don't live at a high elevation like Barb does so that isn't a problem for me. I do have problems when it is very hot and muggy (which doesn't happen more than a few times per year here), although back in 2004 I was New Orleans on a 100 degrees, 100% humidity day and had no trouble breathing, I was pretty sticky though.

I visit my inlaws in MS every couple of years and the heat does seem to bother me now more than it did a few years ago.

[barbara]

I do struggle with the altitude in Colorado. After my last stem cell treatment, I was able to chuck the oxygen until I reached 4800 ft. I then had to start using it again. I do not know if I can become strong enough again to overcome the high altitude problem (I live at 5700 ft), but I am tired of the cold and snow in Denver. I really don't like snow and never have. I was born here and you get used to living in a place, but now it might be time to check out a lower altitude. I would love to be a snowbird and live in Denver in the summer and then leave in October for warmer places. That seems ideal to me. The cold is hard on the lungs and we get a lot of wind which plays havoc with me usually.

I sent you the Resource Page via private message

[Bev12452]

I spent most of my life in New Jersey and I have to admit I loved it I miss my family and friends and the food but since I moved to Florida I haven't spent one night in the hospital not one case of bronchitis or even a cold in Jersey I spent so much time in the hospital I actually use the same rooms more than once and knew the nurses on each floor now that is nothing to brag about but i can not say for sure that the climate change is the only reason but I do sit in the sunshine alot and have been feeling really good

[Everett]

It's hard to say what effects moving to another climate or for sure altitude has on the lungs. I was down in the Keys for a week and every morning I would wake up energized and ready to go. If they would move Florida closer to Texas I would visit it more often. Since Dr. Syed has gotten me as a patient and straightened me out I have not been in the hospital. I am starting my third year and it's great. The staff at the hospital probably think that I died. Nearly did on several occasions. I want new aveoli so I can fish the blue waters again. That would be wondeful. Some day