How to restore smoky lungs?
A new approach to the treatment of smokers' emphysema
S.Kholin, Scientific.ru
Despite widespread widespread propaganda of the harm of smoking, the defeat of people by diseases caused by tobacco smoke continues to increase annually (Schroeder, New Evidence That Cigarette Smoking Remains the Most Important Health Hazard // N. Engl. J. Med., 2013). First of all, this applies to such pathological processes as chronic bronchitis of a smoker, cancer of the bronchi and lungs, other oncological processes, severe cardiovascular diseases, emphysema of the lungs, etc. (Washko et al., Lung Volumes and Emphysema in Smokers with Interstitial Lung Abnormalities // N. Engl. J. Med., 2011). All of them require long-term treatment, and it can not always be effective, so such complications of smoking have negative socio-economic consequences for any state.
Emphysema of the lungs is a chronic disease characterized by pathological expansion of the air spaces of the small bronchi (distal bronchioles), accompanied by a serious violation of the structure and function of the walls of the alveoli, which contribute to prolonged inflammatory processes in the lung tissue. In addition, emphysema disrupts the ratio of lung ventilation and blood flow in them, and thus leads to a decrease in the saturation of arterial blood with oxygen, as well as to a violation of acid-base parameters and blood gas composition, that is, to the development of respiratory acidosis. Emphysema of the lungs has a number of characteristic symptoms, many of which significantly reduce the quality of life of patients. First of all, it is shortness of breath (sometimes severe with signs of "puffing"), a barrel chest, a decrease in the amplitude of respiratory movements, low standing of the diaphragm, a decrease in its mobility, an increase in the transparency of the pulmonary fields on the X-ray. In addition, due to the deterioration of ventilation of the lung tissue, the cleansing and protective functions of the mucous membrane of the bronchi and alveoli suffer; as a result, the respiratory system becomes much more vulnerable to bacterial factors. That is why, in the absence of timely treatment against the background of emphysema, chronic inflammatory diseases of the lungs and bronchi develop, which require long and expensive therapy.
Why do smokers have emphysema of the lungs? This is explained by the fact that after ingestion of tobacco smoke (while smoking experience, as a rule, does not matter much) lung macrophages significantly activate a number of their enzymes, which begin to destroy the structural (matrix) molecules of the wall of the lung alveoli (collagen, elastin, etc.). Because of this, the alveoli lose elasticity and lose their function.
The process is aggravated by the appearance of autoimmune reactions, that is, the formation of antibodies, the action of which is directed against the tissue of the lungs and bronchi. However, the features and mechanisms of such reactions have not been studied to date.
A group of scientists from the USA led by Ming Shan (Agonistic induction of PPARgamms reverses cigarette smoke-induced emphysema // J Clin Invest., 2014) conducted a complex experimental study aimed at determining the relationship between a smoker's emphysema and the PPAR-gamma receptor (this is a gamma receptor activated by the peroxisome proliferator). This substance is contained in pulmonary macrophages and actively regulates their function. It was previously found out that PPAR-gamma is able to influence the performance of a number of lung and bronchial cells, their maturation, activation and migration, change the introduction of antigens to them, as well as the production of biologically active substances (cytokines). The efforts of scientists were aimed at establishing the features of the functioning of PPAR-gamma in the body of laboratory animals exposed to tobacco smoke.
As a result of the study, it was revealed that with the specific blocking of PPAR-gamma macrophages, spontaneous destruction of lung tissue occurs according to the type of emphysema of smokers. After the introduction of substances into the animal body that enhance the activity of PPAR-gamma, the structural and functional characteristics of the alveoli and bronchioles of the lungs are normalized, and then there is a gradual disappearance of emphysema and the restoration of the respiratory system.
Thus, a new direction has been discovered in the treatment of emphysema of the lungs in smokers, the principle of which is to enhance the activity of macrophage receptors PPAR-gamma. The development of pharmacological drugs with a similar effect will significantly increase the effectiveness of therapy for this serious disease.
Portal "Eternal youth" http://vechnayamolodost.ru04.04.2014