Detecting smokers at risk of developing COPD

Summary

The applicant's research will be focussed on improving the understanding of underlying pathophysiology and the nature of early smoking related abnormalities in chronic obstructive pulmonary disease. The applicant will be involved in recruiting and testing 100 smokers at the Woolcock Institute of Medical research. The applicant will receive full training in the use, interpretation and principles of function of conventional and novel, state-of-the-art small airway lung function testing methods. The study hypothesises that early airway abnormalities in smokers are progressive and lead to an accelerated decline in lung function.

Supervisor(s)

Associate Professor Gregory King, Dr Cindy Thamrin

Research Location

Camperdown - Woolcock Institute of Medical Research

Program Type

Masters

Synopsis

Smoking is an important risk factor in development of COPD and the disease manifests in up to 30-50% of the smokers. COPD is currently the fifth most common cause of death worldwide. In early COPD, symptoms are few and mild and the airway changes are not detectable by conventional lung function tests (spirometry). Sophisticated physiological tests which measure ventilation distribution (multiple breath nitrogen washout, MBNW), and respiratory system mechanics (measured by forced oscillation technique, FOT) are both sensitive in detecting mild airways disease and changes in function. The applicant's research will be focussed on improving our understanding of the underlying pathophysiology and the nature of these early smoking related abnormalities using the MBNW and FOT tests. Furthermore the research study will determine whether these early airway changes are progressive and whether they lead to development of overt COPD.

In our previous study (completed in 2013) in 100 smokers with normal spirometry, 50% were identified with early smoking related airway changes measured using FOT and MBNW, Therefore, these findings suggest that these parameters could reflect the early smoking related abnormalities leading to COPD. The aim of the proposed study will be to confirm that presence of early airway abnormalities in smokers are progressive and lead to an accelerated decline in lung function compared to those who do not have early small airway abnormalities.

The applicant will assist in recruiting and testing the same 100 smokers for a follow up visit at the Woolcock Institute of Medical research. The subjects will have measurements of spirometry, lung volumes, diffusion capacity, MBNW and FOT before and after bronchodilator. The applicant will receive full training in the use, interpretation and principles of function of conventional lung function testing methods (spirometry, FOT, plethysmography, DLCO) and sophisticated lung function tests (MBNW and FOT). Relationships between changes in spirometry with baseline MBNW and FOT measures will be determined using correlation analysis.

The need to identify smokers at risk of progression to clinical COPD was recognised many years ago. This study will for the first time enable the identification of smokers at risk of developing COPD before their spirometry is abnormal.

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Keywords

small airways, smoking, chronic obstructive pulmonary disease, Early Detection

Opportunity ID

The opportunity ID for this research opportunity is: 198

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