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Research looks at Small-Airway Obstruction and Emphysema in COPD

Posted: 26 October, 2011

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People who develop COPD begin to lose the smallest airways before emphysematous destruction becomes visible on the regular CT scan, according to a study by a team of researchers in the IHLH community. The study, published in the New England Journal of Medicine on October 27, sought to define the relationship between the obstruction in small airways and the emphysematous destruction of the lung tissue and to precisely determine the point at which the destruction starts. 

Results showed that smaller airways were reduced in number starting in patients with the mildest form of COPD. In addition, much higher resolution obtained by microCT showed that this process of narrowing and destruction begins in much smaller airways than those visible using regular CT.  Importantly it showed that the smallest airways were narrowed and reduced in number even in the normal looking regions of severely diseased lungs.

 These results indicate that interventions designed to prevent and treat COPD should be implemented in the very earliest stages of COPD.

The study was led by John McDonough (First Author) and Dr. James Hogg (Corresponding Author) of the James Hogg Research Centre, located at St. Paul’s Hospital. Other researchers from the Centre, University of British Columbia, Vancouver Coastal Health Research Institute, BC Cancer Agency, University of Pennsylvania and Washington University were involved with the study.

The study may be viewed on the NEJM website here. An editorial in the same issue, by Dr. Wayne Mitzner, titled “Emphysema – A Disease of Small Airways or Lung Parenchyma?” can be obtained here.