Friday, August 31, 2012

Pulmonx to commence US study of emphysema therapy

Pulmonx to commence US study of emphysema therapy




The US Food and Drug Administration (FDA) has given pulmonary medical device manufacturers Pulmonx permission to initiate an investigational device exemption (IDE) pivotal clinical study for its Zephyr endobronchial valve therapy, designed to treat emphysema.

The multi-centre trial is designed to study the safety and efficacy of Zephyr in reducing volume in the diseased portion of the lungs, thereby improving the ability of the healthier portions of the lungs to function.

The trial will incorporate the use of the Pulmonx Chartis system to plan valve treatment, according to the company.

A recent multi-centre European study of Zephyr, using Chartis, demonstrated a statistically significant improvement in target lobe volume reduction and FEV1 at 30 days compared to those who were predicted not to respond.

The patients also showed a mean percentage increase in FEV1 of 16% and a mean improvement in quality of life as scored by the St. George's Respiratory Questionnaire (SGRQ), a clinically validated quality-of-life measure.

Temple University School of Medicine pulmonary and critical care medicine chief and Zephyr trial co-principal investigator Dr Gerard J Criner said a recently published trial in Europe highlighted the benefits of Chartis technology in planning endobronchial valve treatments.
"If we can confirm these benefits in this pivotal trial, Pulmonx's Zephyr EBV therapy could represent an important breakthrough in the treatment of emphysema in the US," Criner said.

The company intends to use the IDE study data to support a premarket approval application (PMA) to the FDA for the approval of Zephyr.

 new medical device for emphysema therapy

gene profiling in emphysema, looking for a cure

How gene profiling in emphysema is helping to find a cure


Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States and is thought to affect almost three million people in the UK. New research published in BioMed Central's open access journal Genome Medicine has identified genes whose activity is altered with increasing lung damage and, using a database of drug effects on gene activity (the Connectivity Map), finds that the compound Gly-His-Lys (GHK) affects the activity of these genes. When tested on human cells from lungs damaged by emphysema, GHK was able to restore normal gene activity and repair cell function.


The strongest cause of COPD is smoking, and at least 25% of smokers will develop this disease. Tobacco smoke and other irritants cause oxidative stress and chronic inflammation, which over time results in emphysema, the destruction of lung alveolar cells. Without these cells, the lungs are not able to efficiently exchange oxygen for carbon dioxide, leaving the patient continuously short of breath and with low levels of oxygen in their blood.

In a ground breaking, multi-centre, study funded by the National Institute of Health (NIH), researchers used cells taken from lungs donated by patients undergoing double lung transplant, whose own lungs were irrevocably damaged by COPD. Profiling of these samples showed that 127 genes had changes in activity that was associated with worsening disease severity within the lung. As would be expected from the nature of the disease, several genes associated with inflammation, such as the genes involved in signalling to B-cells (the immune system cells which make antibodies), showed increased activity.

In contrast genes involved in maintaining cellular structure and normal cellular function, along with the growth factors TGFβ and VEGF, were down-regulated and showed decreased activity. This included genes which control the ability of the cells to stick together (cell adhesion), produce the protein matrix which normally surrounds the cells, and which promote the normal association between lung cells and blood vessels.
Dr Avrum Spira and Dr Marc Lenburg, who co-led this study from the Boston University School of Medicine, explained, "When we searched the Connectivity Map database, which is essentially a compendium of experiments that measure the effect of therapeutic compounds on every gene in the genome, we found that how genes were affected by the compound GHK, a drug known since the 1970s, was the complete opposite of what we had seen in the cells damaged by emphysema."

Dr Joshua Campbell explained, "What got us especially excited was that previous studies had shown that GHK could accelerate wound repair when applied to the skin. This made us think that GHK could have potential drug's as a therapy for COPD."
Prof James Hogg, from the University of British Columbia continued, "When we tested GHK on cells from the damaged lungs of smokers with COPD, we saw an improvement in the structure of their actin cytoskeleton and in cell adhesion, especially to collagen. GHK also restored the ability of cells to reorganise themselves to repair wounds and construct the contractile filaments essential for alveolar function."
GHK is a natural peptide found in human plasma, but the amount present decreases with age. While more testing needs to be done on its effects in COPD, these early results are very promising. Therapeutic studies with GHK in animal models of COPD are now underway with the ultimate goal of moving this compound into clinical trials.

As more gene activity signatures are discovered, this method of matching drug to disease may provide a rapid method for discovering potential uses for existing drugs and compounds.

Wednesday, August 15, 2012

Temple testing lung foam for emphysema

Temple testing lung foam for emphysema

PHILADELPHIA - August 14, 2012 (WPVI) -- An innovative new treatment for emphysema is being tested in the Philadelphia area.



Dr. Gerard Criner of Temple University Hospital, is studying a foam tended to help those with the lung disease breathe easier.

Science & Tech newsIn emphysema, parts of the lungs become less elastic, so air gets trapped in them.

"If you could do something to lessen the air in the chest, then the lungs that remain and the breathing muscles in the chest wall work more normally," says Dr. Criner.

Surgery can do that, but it has risks, and emphysema patients are often too weak to go through it.

Instead, a bronchoscope and a thin catheter put a liquid into diseased areas.
It turns to foam, sealing them off.

In earlier tests here & overseas, the Aeriseal lung foam worked well.

"They had about a 30% improvement in lung function, their ability to walk during 6 minutes, an improvement in quality of life, and reduction in breathlessness," notes Dr. Criner.
And the effects appear to be long-lasting.

"Up to a year that's been studied so far," he says.

In the Temple study, 3 patients will receive the treatment for every that aren't, but at the end of 1 year, those who don't get treated initially can get the treatment if they want, and if they still qualify.



For more information, call the temple lung center at 215-707-1359, or email to: breathe@temple.edu.