Study finds genes that lead to loss of lung function in active smokers

Chronic Obstructive Pulmonary Disease (COPD) is a disease caused by smoking that reduces lung function and causes difficulty breathing. It is the third leading cause of death in the world. Current treatments for COPD only affect the symptoms, not the progression. Identifying who will get COPD before they get it is key to knowing how to catch the disease at an early stage.

Researchers at Boston University School of Medicine (BUSM) have identified a panel of genes that are active in smokers and ex-smokers who experience faster loss of lung function over time. They believe these genes could be useful in predicting which people are most at risk for tobacco-related lung function decline.

“Our finding that airway genes change before a rapid decline in lung function should give COPD patients a lot of hope. A test like this could help doctors identify those at risk for COPD beforehand. they do not catch it, and help scientists find new treatments to stop the disease before it gets worse, ”explained corresponding author Katrina Steiling, MD, MSc, assistant professor of medicine at BUSM.

Smoking and smoking-related illnesses create changes in the airways and lungs. These changes can be detected using a procedure called bronchoscopy, where a small flexible camera inserted through the nose or mouth is used to collect cells with brushes on the sides of the airways. The researchers tested the airway brushings of 134 people who were current or former smokers.

They found changes in the activity of specific genes in people who continued to have their lung function worsening more rapidly several years after that initial airway brushing. Some of these genes were more active in people who were losing lung function quickly, while others were less active in those people.

According to the researchers, further study of these genes could provide clues to the causes of the rapid decline in lung function that could be used to develop new treatments to prevent the development of COPD.

Being able to identify those most at risk for worsening lung function could also facilitate clinical trials of COPD drugs, enriching trials testing new drugs for those most likely to benefit from them.

Beth Becker, PhD, study co-author and recent graduate, Bioinformatics Program, Boston University

This study further shows another use of the “airway injury field” hypothesis. “Smoking causes changes in the cells of the lungs and airways. Because the changes in the airways are similar to those that occur deep inside the lungs, the airway cell test can be used. to detect diseases deep in the lungs, “added Marc Lenburg, PhD, professor of medicine and pathology and laboratory medicine at BUSM.


Journal reference:

Becker, EJ, et al. (2021) Signature of bronchial gene expression associated with the rate of subsequent decline of FEV1 in people with and at risk for COPD. Thorax.

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