Mucus plugs could be targeted to help reduce fatalities from chronic obstructive pulmonary disease.
Breaking up the Mucus plugs in COPD patients could potentially improve outcomes for these patients, offering a promising avenue for intervention. The study, published in JAMA and presented at the American Thoracic Society 2023 International Conference, provides valuable insights for clinicians in minimizing the death toll caused by COPD, a prevalent and life-threatening respiratory disease (1✔ ✔Trusted Source
Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease
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COPD: The Incurable Chronic Disease
A lot of people with chronic obstructive pulmonary disease (COPD) suffer from mucus plugs, a deposit of phlegm in the lungs that can impair their everyday life and lung function (2✔ ✔Trusted SourceClinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease
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“As a chronic disease, COPD can’t be cured, but our findings suggest that using therapies to break up these mucus plugs could help improve outcomes for COPD patients, which is the next best thing,” said corresponding author Alejandro A. Diaz, MD MPH, an associate scientist in the Division of Pulmonary and Critical Care Medicine at the Brigham.
“Mucus is something that we already know a lot about from a basic science standpoint, and there are also a lot of mucus-targeting therapies that either already exist or are in development for other diseases, so it’s an extremely promising target.”
COPD affects 15.9 million people in the United States and is the fourth leading cause of death. It most often occurs as a result of cigarette smoking or long-term exposure to air pollutants. The progression of COPD can be slowed by eliminating exposure to these pollutants, but there is no way to cure the disease. And the standard therapeutic approach for COPD has gone largely unchanged for many years.
“For the last four decades we’ve had only two targets for COPD therapies –either promoting bronchial dilation, which means making the airways themselves wider, or reducing bronchial inflammation,” said Diaz. “This is telling us that there may be more we can do about this disease than we realized before.”
The current study was an observational retrospective analysis of data from the Genetic Epidemiology of COPD (COPDGene) study, a large-scale clinical study that aimed to investigate the underlying genetic risk factors of COPD. The study included over 10,000 participants, recruited between 2007 and 2011, and included people with COPD at different stages, from the mildest to the most severe.
Mucus Plugs: A Potential Target to Reduce Mortality in COPD
For this new observational study, the researchers looked at data from over 4,000 of these patients. To determine which patients had mucus plugs, the researchers analyzed chest CT scans from the patients, taken at their first visit to the clinic. Performing CT scans on all patients regardless of their self-reported symptoms allowed the researchers to find mucus plugs even in patients who did not feel sick.Advertisement
The researchers found that over the course of the study, the mortality rate for COPD patients with no detectable mucus plugs was 34 percent. For patients with mucus plugs in up to two lung segments, the mortality rate jumped to 46.7 percent. For patients with plugs in three or more lung segments, the mortality rate was 54.1 percent.
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In the meantime, the research demonstrates that there are factors affecting COPD mortality that we still know little about and that not all these factors will necessarily appear as symptoms for the patient.
“The fact that these mucus plugs were associated with mortality across different disease phases tells us that there are aspects of COPD progression that can be picked up by a CT scan even if they’re not felt by the patient,” said Diaz. “It’s not so simple as to say every person with COPD needs to run out and get a CT scan tomorrow, but it’s something for clinicians to consider when they’re working with their patients.”
References:
- Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease - (https://jamanetwork.com/journals/jama/fullarticle/2805343)
- Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease - (https://pubmed.ncbi.nlm.nih.gov/27847895/)
Source-Eurekalert