Breathe It All In: Respiratory Disease Roundup

May 20, 2015

Respiratory disease is the main reason why patients visit primary care practices. This brief summary highlights the latest in research and patient care.

Respiratory Disease Tops in Primary Care

In “Top 10 Reasons Why Patients Come to Primary Care,” we took a look at the leading diagnostic categories in primary care practice.

Then, in “Respiratory: The Top Reason Patients Come to Primary Care,” we highlighted the number 1 diagnostic category in primary care-respiratory diseases.

Here we bring you a brief roundup of the latest developments in respiratory disease research and patient care.

Turn the page for the first respiratory news item, a study about pneumonia and asthma risk.

Asthma Risk in Early Childhood is Higher With Pneumonia

• The risk of asthma appears to be higher in children who contract pneumonia during the first 3 years of life.

New research findings raise concern that early childhood respiratory problems may have an enduring and negative effect on growing lungs.

The authors noted that their study cannot prove that early pneumonia definitely caused asthma or later impaired lung function-children in whom pneumonia developed may have already had impaired lung function that made them more susceptible to pneumonia.

Acute Respiratory Infection Linked to Airway Microbiota

Acute respiratory infections (ARIs), such as bronchiolitis and pneumonia, are the leading cause of hospitalization of infants in the United States.

Authors at Massachusetts General Hospital and Harvard Medical School proposed a “risk and resilience” model in which airway microbiota are associated with an increased or decreased incidence and severity of ARI in children.

They also proposed that modulating airway microbiota during early childhood can optimize airway immunity and decrease ARI incidence and severity.

Cleaner Air Early in Life Means Healthier Lungs and Hearts Later

• Cleaner air provides a major public health benefit, according to a study published in the New England Journal of Medicine.

In the study, children in a 21st-century group had stronger gains in lung function by age 15 years than children from 2 earlier periods. The percentage of those with abnormally low lung function at that age declined from nearly 8% to less than 4% in the most recent group.

The improvements paralleled significant reductions in local levels of some major air pollutants, including nitrogen dioxide and fine particulate matter.

Children’s lung function matters in the short-term and is tied to their risk of heart and lung disease later in life, the researchers concluded.

Cigarette Smoking Interferes With Key COPD Protein

• Cigarette smoke interferes with a specific protein that plays a key role in the development of chronic obstructive pulmonary disease (COPD), according to a new study led by researchers at Yale School of Medicine and Brown University.

In this study, researchers hypothesized that cigarette smoke could target the protein NLRX1, abrogating its activity causing the lung tissue damage typically seen in patients with COPD.

In analyzed patients with COPD, expression of NLRX1 was markedly reduced, and this reduction directly correlated with disease severity and a poorer pulmonary function, prognosis, and quality of life.

Finding that cigarette smoke inhibits NLRX1 expression, the researchers proposed that NLRX1 levels could be used as a potential predictor of a patient’s risk of COPD and of disease severity.

Cystic Fibrosis, a Chloride Pumping System, and a Human Parasite

• There is a link between an incorrectly functioning cellular pumping mechanism in patients with cystic fibrosis (CF) and the most common human parasite, Toxoplasma gondii (Toxo), a study found.

Researchers found that Toxo causes the chloride pumping system, which releases chloride irons to produce a surface liquid lining to prevent airborne pathogens from being inhaled, to function improperly.

This is the first study that indicates a connection between infection with Toxo and a defect in the chloride pumping system being linked to diseases such as CF.

The findings could be vital in developing new therapeutic targets.

COPD Screening Tool in Primary Care?

• An early diagnosis of COPD in primary care is halted by a lack of concern, awareness, and simple diagnostic tools, according to a recent study.

Exhaled carbon monoxide (eCO) is an easy, user-friendly, harmless, rapid, and low-cost test routinely used to monitor cigarette smoke consumption in tobacco weaning programs, researchers stated.

They hypothesized that systematic eCO measurement in primary care could be a valuable tool to improve COPD awareness and help introduce acceptance of a COPD screening.

eCO was found to increase the debate among patients concerning smoking consequences and COPD, especially among smokers.

eCO measurement in primary care did not promote patients’ acceptance of early COPD screening. The researchers suggested larger studies to determine more definitively whether eCO can be a useful tool for COPD screening acceptance in primary care.

Respiratory Disease Testing Market Expanding

The global respiratory disease testing market is expected to reach an estimated $3.1 billion in 2022, up from $2.3 billion in 2013.

The increasing prevalence of asthma, COPD, cystic fibrosis, pneumonia, and other respiratory diseases is creating immense potential for equipment used to detect pulmonary abnormalities.

The growing geriatric population and technological advances would drive the market, but a low adoption rate of digital radiography and portable spirometers is projected to be a limiting factor.

Of the global respiratory disease testing market segments-imaging test, spirometry, peak flow test, blood gas test, lung volume test, and others-the imaging test segment accounted for the largest share.

Imaging tests were dominant primarily because demand is high, especially for x-ray films, and because they are considered the first line of diagnostic tests for respiratory diseases.  

The largest end-user segment of the respiratory disease testing market in 2013 was hospitals, followed by physician offices and clinical laboratories.

North America was the largest market for respiratory disease testing in 2013, primarily because of an increasing prevalence of respiratory diseases, a rising popularity of portable devices, and growing demand for home health care devices and services.