Chronic Bronchitis Patients Have Few Options for Long-Term Relief. Could Philly Researchers Have a Solution?
It wasn’t a surprise for Grace Lawrence when she started having respiratory symptoms.
“I was a daily smoker for 56 years,” the Bucks County retiree says. “I knew for a while I had problems, but it wasn’t until 2011 that I got diagnosed with COPD [chronic obstructive pulmonary disease], and then was later diagnosed with chronic bronchitis.”
For chronic bronchitis patients like Lawrence, daily life tends to involve an endless stream of antibiotics, steroids or both. Even with treatment, many patients struggle with a chronic cough and shortness of breath that can make even the most basic of daily activities — such as climbing the stairs or going grocery shopping — exhausting, or even impossible.
“A lot of patients are somewhat embarrassed by chronic cough and phlegm,” says Dr. Victor Kim, a COPD and chronic bronchitis expert at the Temple Lung Center. “The symptoms of chronic bronchitis, in and of itself, are pretty disturbing to patients and reduce their quality of life.”
Chronic bronchitis can be associated with COPD. Patients with chronic bronchitis suffer from inflamed airways that produce a lot of mucus, leading to chronic coughing and trouble breathing. While cigarette smoking is the most common cause of chronic bronchitis, patients can also develop the disease through breathing in air pollution, e-cigarette smoke, fumes or dust over a long period.
According to Kim, current treatment options — namely inhalers, cough suppressants, steroids and antibiotics — can help manage some symptoms temporarily but are “largely ineffective” when it comes to having a lasting impact. Fortunately for patients like Lawrence, however, that could soon change.
Philadelphia’s own Temple Lung Center is a hotbed for new COPD research and treatments, such as the bronchoscopic lung volume reduction procedure. There are more than a dozen ongoing studies related to these conditions including two innovative chronic bronchitis therapies currently in trial that Kim says are particularly promising.
One involves spraying liquid nitrogen — called Metered Cryospray — in small doses along a thin layer of tissue inside the lung’s airways during a bronchoscopy.
“That, in effect, freezes the lining of the airway and gets rid of mucus-producing cells, and the tissue then grows back with normal amounts of these cells,” Kim says, allowing the patient to have clearer airways.
The second, which also takes place during a bronchoscopy, involves the use of pulse electrical fields to eliminate the mucus-producing cells in the airway.
“There’s good added data in both of these case studies to show that symptoms are dramatically reduced more so than any other medical therapy that we have, so it’s really exciting,” Kim says. “And the effects are pretty durable. Both technologies have great results in terms of symptom management.”
So far, that’s proven true for Lawrence. She came to a seminar at the Temple Lung Center after being unsatisfied with her treatment options at two other hospitals. There she learned about all of the COPD research they were doing, and eventually was accepted as a candidate for the second trial involving electrical fields.
Last winter she received two bronchoscopies — one in each lung — one month apart to eliminate the mucus. She was able to return home the same day she received the treatments and noticed a difference almost immediately.
“My breathing was much better, and I didn’t have as many problems,” she says. “It was much easier to walk up the steps to my second-story apartment, or do normal activities like vacuum my floors… many things that had gotten really difficult.”
Today, Lawrence is seven months post-operation. While she’s had a few symptoms return, so far they’ve been much milder than they were before the trial.
That’s in line with Kim’s data. He says the treatments don’t indicate permanent change — the studies show more of a lasting effect at six months than at 12 — but the durability still far outperforms other products currently on the market.
“It’s not a cure; patients still have some symptoms,” Kim says. “But they are dramatically reduced. Anecdotally, I haven’t met one person involved with either trial who has said it wasn’t worth it.”
Ultimately, Kim is hopeful that both therapies will be on the market soon, giving many patients with chronic bronchitis a higher quality of life and return to activities they love. For Lawrence, that looks like being able to walk her six-month-old mini-Bernedoodle, Sammy.
“It might sound silly, but he has a lot of energy so being able to walk him a lot without struggling to catch my breath makes a big difference,” she says. “Before the trial, I was pushing forward, but it was hard. I am just ever so happy and grateful.”This is a paid partnership between Temple Health and Philadelphia Magazine's City/Studio