UAB now hosts the better Breathers’ Club, a project of the American Lung Association for people with chronic obstructive pulmonary disease. the better Breathers’ Club provides support, education and socialization for people with COPD, their family members, and their caretakers.

The club will meet 3:30-4:30 p.m. every other month at UAB Highlands Hospital in the first floor board room. the first meeting is scheduled for June 13 and the topic is oxygen delivery devices. Meeting dates through the end of 2013 can be found at uabmedicine.org/conditions-and-services/copd-patients.

COPD is a slowly progressive disease of the airways that is characterized by a gradual loss of lung function. COPD includes chronic bronchitis, emphysema or a combination of these conditions. there are effective treatments for COPD, particularly if the disease is diagnosed while still in the early stages. the symptoms of COPD can range from chronic cough and sputum production to severely disabling shortness of breath. in America, the most important risk factor for COPD is cigarette smoking. the most important measure for preventing COPD — and for slowing disease progression — is to quit smoking.

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During a regular annual physical exam, blood is usually drawn to check the health of a person’s heart, kidneys and liver. now, researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center say a blood test that detects the early development of emphysema—well before symptoms occur—may someday also be offered.

In the March 11 online edition of the American Journal of Respiratory and Critical Care Medicine, the researchers say that because most cases of emphysema are caused by smoking, the test they are developing can warn smokers about impending development of the untreatable disease—which is currently a major cause of disability and death in the U.S.

Not all smokers develop emphysema, but those who find out they are at risk will be motivated to quit to halt progression of the disease, says the study’s lead investigator, Dr. Ronald G. Crystal, chairman and professor of genetic medicine and the Bruce Webster Professor of Internal Medicine at Weill Cornell Medical College and chief of the Division of Pulmonary and Critical Care Medicine at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. 

“We know, from other studies, that smokers who learn from objective evidence that their health is in danger are much more likely to quit,” he says. “That is the only thing that will help them avoid this deadly disorder.”

Emphysema and chronic bronchitis are the twin disorders that make up chronic obstructive pulmonary disease (COPD), which is now the fourth leading cause of death in Americans. Given the aging population, COPD is soon expected to move up to third in mortality prevalence, Dr. Crystal says.

The new test measures particles that are shed by tiny blood vessels known as capillaries that surround air sacs (alveoli) in lungs. These particles are debris shed by ongoing injury to the air sacs—damage that eventually results in devastation of the sacs and the “Swiss cheese” appearance of the lungs. the alveoli are where critical gas exchanges occur: blood in the capillaries brings carbon dioxide from the rest of the body for release into the air sacs, and the oxygen in the sacs (taken in from breathing) is taken up by the blood and transported to the rest of the body.

As the sacs are destroyed, people develop shortness of breath because they cannot take in enough oxygen to feed the body and eventually cannot remove carbon dioxide from the blood.

Dr. Crystal and his colleagues reasoned that as capillaries surrounding the air sacs are being injured, the debris would be carried out by the blood supply and could potentially be quantified as a disease biomarker. so they began to look for evidence of what they called endothelial microparticles (EMP).

“Our blood vessels are always being replenished, so we all have some level of EMPs in our blood,” he says. “What we are looking for are elevated levels of EMPs. for smokers, this is the equivalent of a smoke detector sounding its alarm; elevated levels of EMPs suggest their air sacs are being injured and it is time to act.”

To do this, the researchers enrolled three groups of people—healthy nonsmokers, healthy smokers, and smokers with early evidence of lung destruction. Study participants had their medical histories taken, and to gauge lung function in these participants, all underwent two pulmonary function tests. one is spirometry, which measures the volume and speed of air as it is inhaled and exhaled from the lungs. the other, known as DLCO, is the only lung function test available today that can detect emphysema in patients. it uses a machine that measures the ability of gases to diffuse across the alveolar-capillary membrane.

The researchers found a 95 percent positive correlation between elevated EMPs in the blood and an abnormal DLCO test result, meaning that it detected nearly all verified cases of early emphysema in participants.

Two other independent groups of participants were then given the same group of tests—spirometry, DLCO and the EMP blood test—and, once again, a positive EMP finding correlated with an abnormal DLCO 95 percent of the time. Differences in the spirometry findings had no bearing on results of DLCO or EMP.

DLCO, which must be administered by a pulmonologist, is most often used to confirm a suspicion of emphysema, Dr. Crystal says. By contrast, the EMP blood test is designed to be a simple, low-cost screening tool that can pick up development of emphysema in individuals who show no signs of the disorder.

“We need a blood test that can be administered to the 20 percent of American adults who smoke as well as nonsmokers exposed to secondhand smoke—all who may not understand their risk of developing this progressive lung disease,” says Dr. Crystal.

The researchers are conducting further studies of the EMP test in larger groups of participants in order to validate these initial findings.

The study was funded by grants from the National Institutes of Health.

Co-authors include Drs. Cynthia Gordon, Kirana Gudi, Anja Krause, Rachel Sackrowitz, Ben-Gary Harvey andYael Strulovici-Barel, all from NewYork-Presbyterian/Weill Cornell and Dr. Jason Mezey from Cornell University, Ithaca, N.Y.

For more information, patients may call (866) NYP-NEWS.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances—including the development of the Pap test for cervical cancer; the synthesis of penicillin; the first successful embryo-biopsy pregnancy and birth in the U.S.; the first clinical trial for gene therapy for Parkinson’s disease; the first indication of bone marrow’s critical role in tumor growth; and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian/The Allen Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar.

Contact: John Rodgers 212-821-0560New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

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Researchers have found a way to detect emphysema in the blood before any symptoms appear.

Until now, the only way to diagnose the disease was when symptoms like shortness of breath start. Scientists hope this will save lives by getting smokers to quit sooner and will lead to a simple blood test for the disease. Chronic Obstructive Pulmonary Diseases like emphysema are the fourth leading killer of Americans.

Emphysema destroys air sacs in the lung, making it hard to breath.

That’s usually the first sign of the disease, but now researchers have developed a way to find it with a simple blood test. More study is needed before the blood test is approved for widespread use, but some doctors say it could convince smokers to quit earlier.

Finding emphysema early could save lives. Obstructive lung diseases like emphysema and chronic bronchitis are the third leading cause of death in the U.S.

Almost all those deaths are due to smoking.

OTTAWA — Canadians with asthma and other chronic lung diseases could see their symptoms worsen if they pick up the swine flu and should get their conditions under control before the expected second wave of the pandemic hits.

According to the Lung Association, people with asthma, bronchitis and emphysema are more likely to experience severe symptoms of the swine flu, also known as the H1N1 virus, and to need hospitalization.

In a conference call hosted Tuesday by the Lung Association, Dr. Darcy Marciniuk, head of the division of respirology at Royal University Hospital in Saskatoon, said now is the time for all Canadians, but especially those with a lung disease, to prepare.

"the symptoms may differ and the severity may be different in people with underlying lung disease but moreover, it may also serve as a precipitant to exacerbate or worsen their underlying lung disease," he said.

Marciniuk explained the advice being offered by the Lung Association on its website, which includes telling people with asthma (about three million Canadians have asthma) and other lung diseases to get their symptoms under control so that their lungs are in good condition and able to fight off the flu.

The association recommends people get an "action plan" from their doctor so they know what to do if their condition worsens, and it has templates for a plan on its website.

The group also emphasized the importance of people taking their medications to prevent and control their symptoms and of having an extra supply of medicine on hand.

"A key message will be the vaccination when it becomes available, to get in line early, not only for any specific H1N1 vaccination that will become available, but also for the regular flu seasonal vaccination as it becomes available this fall," said Marciniuk.

The regular seasonal flu vaccine will be available in early fall, as usual. the new swine flu vaccine is currently being produced and won’t be ready until November. Canada has ordered 50.4 million doses of the new vaccine and is awaiting the results of clinical trials to determine if one or two shots will be needed to provide immunity.

Dr. Ken Scott, from the pandemic preparedness division at the Public Health Agency of Canada, said during the call that officials suspect two doses will be needed, probably 21 days apart.

Concerns have been raised about the scheduled delivery of the vaccine and whether it will come too late, especially if the second wave of the swine flu hits early in the fall instead of December when the flu season normally begins. Public health officials have said that if an early arrival is the case, antivirals and other measures will be used to "buy time" until the vaccine is ready. Scott said officials want to make sure the vaccine is safe and effective. By rolling it out in November, Canada has the benefit of viewing months worth of safety data from the clinical trials that are currently underway around the globe, said Scott.

"We don’t know what the attack rate will be this fall. so far this influenza has been a relatively mild illness. We’ll keep our fingers crossed and hopefully that’s the way its going to stay. But we are planning for the worst and I think that’s the appropriate thing to do," he said.

People who do contract the swine flu, or other influenza viruses, can be treated with antiviral medication if necessary. Tamiflu and Relenza are the two main drugs that are approved in Canada and so far, have been effective against the swine flu. there have been reports of complications with Relenza, however, in people with lung diseases.

Marciniuk said it’s not clear if the complications are only in people whose asthma is not well-controlled but it’s yet another reason why people with the condition should ensure they are in good shape.

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COPD (chronic obstructive pulmonary disease) kills more than 120,000 adults each year — one death every four minutes on average, or more than breast cancer and diabetes combined.

In COPD, sometimes referred to as emphysema or chronic bronchitis, the tubes that carry air in and out of the lungs are partially blocked, which makes it hard to breathe.

“Yet people go undiagnosed and untreated because they don’t recognize the symptoms,” says James P. Kiley, director of the National Heart, Lung and Blood Institute, part of the National Institutes of Health.

The institute has launched a public service announcement campaign to highlight common COPD signs and symptoms, including frequent shortness of breath, chronic cough, wheezing and excessive phlegm production. Kiley discusses the disease.

Q. you indicate that this serious health problem is often associated with former smokers.

A. too many people think it’s part of getting older or being out of shape. Smoking accounts for as many as nine out of 10 COPD-related deaths. However, as many as one out of six people who have COPD never smoked.

Q. if not from smoking, what causes COPD?

A. it can be environmental — exposure to chemicals, dusts and pollutants as well as from exposure to secondhand smoke. Doctors just can’t say to stop smoking and the disease threat will never happen or go away.

Lower- and middle-income women seem to be particularly vulnerable, although many have never smoked.

In can be the result of indoor pollution, a not-well-ventilated environment, as well as poorly ventilated homes.

We are not sure why we have a continuing growing number of nonsmoking women getting the disease.

Q. it takes awhile for the disease to appear in former heavy smokers, I understand.

A. it takes quite a long time for most people — even those who were heavy smokers — to develop the disease. But, of course, the boomer population is aging.

We have had a good effect in lowering the smoking rates in this country, but there are people in the pipeline who still will get lung cancer and COPD as a result of smoking years ago.

Q. What can you do to help people find out if they have COPD?

A. well, we need to get people to recognize the symptoms and to talk to their health care providers. There is a simple breathing test called spirometry that is quick and painless and can be taken at a doctor’s office.

There is no cure for COPD, but the earlier a person gets diagnosed and receives treatment, the better their chance to improve quality of life. It’s all a matter of better education.

Q. People are living longer these days. Does that contribute to more cases?

A. well, yes, it could.

There also is a genetic version of the disease that is not lethal but also produces almost the same manifestations of COPD. One in five persons with the disease has a genetic background. Perhaps with further research, we can learn about protective genes.

Q. There are commercials on TV that feature an inhaler.

A. That’s the drug commonly used.

Another treatment that improves lung conditions and even prolongs life is exercise.

There also are resources available to people to quit if they are still smoking.

Q. bottom line?

A. if you do or have smoked, you may have the symptoms or be susceptible to COPD. it is a treatable disease and we have tools available to improve you quality of life. But you must see your health care professional.

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Jane Glenn Haas writes for the Orange County (Calif.) Register. E-mail her at