Hello Health Rounds readers! For the first time in people, doctors have used patients’ own lung cells to repair damage from emphysema, as we report below. We also report on the possibility that at least some cases of bleeding in the brain may be due to a yet-unrecognized infectious agent. And finally, we highlight a study suggesting that physical therapy might be useful for people with episodes of dizziness.
We’re glad to be back after an unexpected absence on Tuesday this week. Next week, we’ll return to our regular schedule.
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Human lung progenitor cells like the ones shown here were collected from patients’ airways, cloned, and then transplanted back into the patients’ lungs to repair damage from emphysema, in a recent pilot trial. Wei Zuo of Tongji University’s School of Medicine and Regend Therapeutics in China/Handout via REUTERS
Doctors use patients’ own lung cells to repair COPD damage
Transplanting patients’ own lung cells helped repair tissue damage from chronic obstructive pulmonary disease (COPD) in a small preliminary trial, researchers reported on Tuesday at the European Respiratory Society International Congress in Milan. COPD, often caused by smoking, includes emphysema and chronic bronchitis.
In 17 patients with emphysema, doctors used a small brush to collect so-called P63+ progenitor cells from the airways.
“P63+ progenitor cells are known for their ability to regenerate the tissues of the airways, and previously we and other scientists have shown in animal experiments that they can repair the damaged epithelial tissue in the alveoli – the tiny air sacs in the lungs that play a crucial role in the exchange of gases between air breathed in and the blood supply to the lungs,” study leader Wei Zuo of Tongji University’s School of Medicine and Regend Therapeutics in China, said in a statement.
Zuo’s team cloned the progenitor cells to create millions more and then transplanted them back into the patients’ lungs to repair the damaged lung tissue. Twelve weeks later, the body’s ability to transfer oxygen from air sacs in the lungs to the red blood cells in the lungs’ blood vessels had on average increased to 40%, from a baseline of 30%, the researchers found.
The benefit still was present at 24 weeks, they reported.
“We found that P63+ progenitor cell transplantation not only improved the lung function of patients with COPD, but also relieved their symptoms, such as shortness of breath, loss of exercise ability and persistent coughing,” Zuo said.
Roughly a third of the study participants had severe COPD and more than half had extremely severe COPD, Zuo said. Lung damage in COPD is typically permanent, but in two participants with mild disease, the treatment repaired the damage, Zuo added.
Zuo’s team is planning additional trials to test the treatment in larger groups of patients.
“We hope to develop the treatment for clinical use within about two to three years,” Zuo said.
A transmissible agent in blood may be responsible for some cases of spontaneous “bleeding strokes” in the brain, according to researchers who tracked such intracerebral hemorrhages in blood donors and recipients.
More research is needed to confirm the findings and then to determine what might be causing the link – perhaps a bacterium, a virus or some sort of toxin – and how to screen for it, the researchers wrote on Tuesday in JAMA.
Their study involved 759,858 patients in Sweden and 329,512 in Denmark who received red blood cell transfusions between 1970 and 2017. Receiving blood from donors who later developed multiple spontaneous intracerebral hemorrhages nearly tripled recipients’ risk of a brain bleed during the next decade, compared with receiving a transfusion from donors without a subsequent intracerebral hemorrhage, the researchers found
There was also an extra risk of a hemorrhagic stroke in recipients of blood from donors who had only one such event after donating, but the increase was not statistically significant.
Physical therapy might help dizzy adults avoid falls
People experiencing episodes of dizziness may benefit from a course of physical therapy to prevent falls, according to a large study.
The research involved more than 805,000 U.S. adults who sought medical care for dizziness at outpatient clinics or emergency departments between 2006 and 2015, including 45,771 who received physical therapy within the next three months to help improve their strength, flexibility and balance.
Over the ensuing year, 7% of the patients had a fall that required medical attention – most of them under age 65, according to a report published on Thursday in JAMA Otolaryngology – Head & Neck Surgery. Receipt of physical therapy was associated with an 86% reduction in the odds of such a fall, the researchers found.
The study was not a randomized trial and so it does not prove physical therapy prevented falls in patients who experienced dizziness. The researchers also noted that physical therapy was not associated with a complete absence of falls in these people.
Patients with dizziness and multiple medical conditions may require additional fall prevention strategies including low-intensity exercise, step training, home safety modifications and support for caregivers, the researchers said.