Unvalidated Laboratory Testing
Commercial laboratories can sell their diagnostic tests directly to the public, or they can be ordered by non-NHS providers of healthcare. The reasons given can sound very persuasive about how useful those test results can be - for example, testing for organic acids in your urine to check your nutritional status or testing for mycotoxins in your urine to assess if you have been exposed to excessive airborne mould spores. Unfortunately, these results are often useless for the purpose intended.
It is important that testing is validated for clinical use for the purpose it is being used for, for example:
- An Organic acid profile in urine is validated and used by the NHS for testing patients for very rare genetic problems that lead to an accumulation of an organic acid and a deficiency in certain cellular products. These levels are likely to be high and the result is clear and consistent from test to test. These tests are likely to be carried in in very young children who have inherited an abnormal gene. https://www.southtees.nhs.uk/services/pathology/tests/organic-acids-urine/.
- An Organic acid profile in urine is NOT validated to run on adults who have a normal genetic profile and have no signs or symptoms of metabolic disease. The results are going to need highly specialised doctors to interpret the results. If used for the purpose of, for example, assessing the nutritional status of a patient there is no evidence that the result will tell you or your doctor anything useful. Consequently these are very unlikely to be worth the cost.
If you are tempted to purchase one of these tests it is well worth checking this website for advice https://labtestsonline.org.uk/tests/unvalidated-or-misleading-laboratory-tests
Osteoporosis (Thinning bones)
Many people with aspergillosis are vulnerable to osteoporosis, partly due to some of the medication they take, partly due to their genetics and partly age.
There is a complete guide for the treatment of osteoporosis by the NHS at the National Institute for Health and Care Excellence (NICE) called Osteoporosis - prevention of fragility fractures and you can read it here.
However, you may prefer the easier-to-read guidelines offered by the Royal Osteoporosis Society which is comprehensive and excellent. There is even a helpline manned by a specialist nurse during office hours Monday-Friday.
There are lots of options for treatment available!
Understanding a Fever
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A fever, also known as pyrexia, is a common symptom that can occur in various illnesses and conditions. But what exactly is a fever, and why do we get one? It's important to understand this symptom, as it's often a sign that our bodies are fighting an infection.
What is a Fever?
A fever is an increase in your body's normal temperature range, usually in response to an illness or infection. While the average body temperature is typically around 36.5 to 37.2 degrees Celsius, a fever is generally agreed upon in the medical field to be a body temperature of 38 degrees Celsius or above.
Why Do We Get a Fever?
Fever is not an illness in itself but rather a symptom, often indicative of an underlying condition. It's essentially a defence mechanism of our bodies. When bacteria or viruses invade our systems, our immune system responds by increasing our body temperature. This elevated temperature helps the body to kill off the invading organisms, as many of them cannot survive in higher temperatures.
Moreover, a fever also boosts the body's immune response by stimulating the production of white blood cells, the soldiers of our immune system, and other substances that help fight off infections.
What Constitutes a Fever?
While it's important to remember that everyone's 'normal' body temperature can vary slightly, the NHS categorises a fever in adults as a body temperature of 38 degrees Celsius or higher. However, even a slight elevation in temperature may cause discomfort and is usually the first sign of an illness. Please note it's not always easy to take a temperature accurately. If you feel hot or shivery, you may have a high temperature even if a thermometer says your temperature is below 38C.
Normal Temperature Limits
While the average body temperature for a healthy adult typically ranges between 36.5 and 37.2 degrees Celsius, it's normal for your body temperature to fluctuate throughout the day. For instance, it tends to be lower in the early morning and higher in the late afternoon and evening.
However, if your body temperature exceeds 38 degrees Celsius, it's usually a sign that your body is fighting an infection or illness. In the case of a very high fever of 39.5 degrees Celsius or higher, it's crucial to seek medical attention immediately, as this could indicate a severe infection.
Why Do We Shake During a Fever?
Fever often comes with chills or shivering, which can seem paradoxical when your body is overheated. This shaking is essentially a side effect of your body trying to increase its temperature. The process is triggered by the hypothalamus, our body's thermostat, which instructs our muscles to contract and relax rapidly to generate warmth, leading to what we recognise as shivering.
So, while fevers can be uncomfortable, they are often a sign that your body is doing exactly what it needs to do to fight off an infection or illness. However, it's important to monitor a fever closely and seek medical help if the fever is high, persistent, or accompanied by other severe symptoms such as confusion, difficulty breathing, or severe pain.
You can read more on the NHS.uk website here.
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Living with & Managing Chronic Illness
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As many of you know, chronic conditions like Aspergillosis require more than just medical intervention. Chronic illnesses necessitate emotional resilience, adaptability, understanding, and physical strength. Patient-centric strategies have proven successful in managing illness and improving overall well-being and health outcomes, irrespective of the condition. The journey can be challenging, particularly when first diagnosed, but having an illness like Aspergillosis doesn't mean enduring a life of constant suffering.
What do we mean by manageable?
"Manageable" does not mean that your illness will completely disappear or you will no longer feel its effects. Instead, it means that the symptoms can be controlled to such an extent that they do not dominate your life or altogether remove your ability to function. Managing a chronic condition involves developing a comprehensive and tailored approach incorporating medication, lifestyle adjustments, emotional well-being, and social support.
Chronic conditions require more than medication
Understanding Your Illness
Knowledge is power. Understanding your illness, its symptoms, triggers, and progression will help you manage it more effectively. Ask your doctor(s) questions, do your own research, and consider joining support groups where you can learn from others' experiences.
Acknowledging limitations
When we discuss acknowledging limitations while living with Aspergillosis, there's a metaphor that captures this struggle: The Spoon Theory.
The Spoon Theory, conceived by Christine Miserandino, is a valuable metaphor within the chronic illness community to explain the energy required to live with such conditions. In this analogy, 'spoons' represent energy units. Each day, a person has a finite number of 'spoons' and must budget their activities to ensure they don't run out of 'spoons' before the day ends.
So, how does this relate to acknowledging limitations with Aspergillosis?
Physical Limitations
With Aspergillosis, common physical symptoms like fatigue or breathlessness may require more 'spoons' than usual. Understanding your body's signals and resting when necessary helps you conserve your 'spoons'.
Emotional Limitations
Chronic illness can be emotionally draining. It's normal to feel uncertain and anxious about your condition. According to the National Institute of Mental Health (NIMH), people with chronic illnesses may be more likely to suffer from depression. Therefore, depression is a common complication of chronic illness.
Managing feelings of anxiety or depression requires 'spoons'. Acknowledging your emotional health and seeking help and support when you need it can assist in managing your emotional energy better.
Social Limitations
Every social activity costs 'spoons'. While it's crucial to maintain a social life, it's equally important to recognise when you might need to prioritise rest and recovery.
Work Limitations
The energy expended at work needs to be factored into your 'spoon' budget. Sometimes, it may require a conversation with your employer to adjust your workload or responsibilities to accommodate your health needs.
Understanding and applying the Spoon Theory to your life can be a powerful tool in acknowledging and managing your limitations. It's not about resigning yourself to these limitations but prioritising and becoming effective at working around them.
Each of you will have a different number of 'spoons' each day, and what may cost one spoon for some may cost five for another. That's why it's so crucial to respect and acknowledge our boundaries.
The power of exercise
Exercise plays an integral role in maintaining our health and well-being. Regular physical activity can significantly improve quality of life, boost mood, enhance lung function, and strengthen the immune system. However, the thought of exercise might seem daunting given the physical constraints of Aspergillosis. But it's about finding what works best for you.
Exercise that suits your abilities
Remember, the objective is not to exhaust yourself but to gradually improve your endurance and strength within your limits. Lower-intensity activities such as walking, stretching exercises, or chair-based workouts can be beneficial starting points. Even small activities like light household chores can contribute to your daily exercise.
Pulmonary Rehabilitation
These are programmes specifically designed for people with lung conditions. They involve a combination of exercises to improve lung function, education, and emotional support. Trained healthcare professionals supervise these programmes to ensure safety and efficacy.
Breathing exercises
Exercises like pursed-lip or diaphragmatic breathing can improve lung capacity and help manage breathlessness, a common symptom in Aspergillosis.
Yoga and Meditation
Gentle yoga poses combined with mindful breathing can improve flexibility, balance, and strength while also helping with stress management.
Staying consistent
The key is regularity rather than intensity. Even 10-15 minutes of exercise daily can make a difference. As your endurance builds, you can gradually increase the duration and possibly the intensity of your workouts.
Work with professionals
Always consult your care team before starting a new exercise regimen. They can guide you.
Listen to your body
Most importantly, listen to your body. If you feel excessively tired or experience difficulty breathing, it's time to rest. Remember, acknowledging your limits is not a weakness; it's an essential part of managing your health.
Mental health matters
Living with a chronic illness like Aspergillosis can be physically challenging, but it also exacts a toll on our mental health. Anxiety, depression, stress, and feelings of isolation are not uncommon. Acknowledging these emotions and finding ways to manage them is as important as managing the physical symptoms of the illness.
Understanding the Impact
Chronic illnesses can lead to a range of emotional responses: fear about what the future holds, frustration over physical limitations, feelings of isolation due to changes in lifestyle or others' inability to fully understand your experience. Understanding that these are normal reactions to your situation is the first step towards addressing them.
Communication
One of the most powerful tools in managing mental health is open communication. This could be with family, friends, a support group, or a professional counsellor. Discussing your feelings can provide relief and offer new perspectives.
Professional Help
Psychologists, psychiatrists, and therapists can provide strategies to cope with the stress, anxiety, and depression that can accompany chronic illnesses. Cognitive-behavioural therapy, mindfulness-based stress reduction, and other techniques can help you navigate your emotional journey.
Peer Support
We talk about this a lot, and many of you reading this will already realise the benefits because you attend our weekly meetings. Connecting with others who are dealing with similar experiences can be incredibly helpful. Support groups provide a platform to share experiences, learn from others, and gain emotional comfort from knowing you're not alone.
Self-care
Prioritise activities that you enjoy and that help you relax. This could be reading, listening to music, gardening, or any hobby that provides a sense of calm. Mindfulness exercises, yoga, and meditation can also be effective in reducing stress and promoting mental well-being.
Depression is not a weakness
It's not just the physical discomfort and limitations that pose a challenge. Still, the emotional burden carried with a persistent health condition can also be substantial. Thus, depression is a common complication of chronic illness. Still, it doesn't have to be a normal part of chronic illness. Depression can manifest through persistent sadness, loss of interest in previously enjoyed activities, difficulty sleeping, or changes in appetite. It's important to recognise that depression is not a sign of weakness or a normal part of living with a chronic illness. It's a serious but treatable condition. If you or someone you care for shows signs of depression, seeking help from healthcare professionals is crucial. Therapies such as cognitive-behavioural therapy, medication, or a combination of both can effectively manage depression. Remember, taking care of your mental health is a critical part of managing a chronic illness.
Remember, it's okay to have tough days. Your illness does not define you, and it's okay to ask for help when needed. Celebrate your achievements, no matter how small, and focus on the strengths that help you navigate your challenges.
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Learning to control antifungal drug resistance from the environment
Spores of fungi including Aspergillus fumigatus, the main species that causes aspergillosis, have been found to propagate the growth of strains of fungi that are already resistant to those antifungal medications most commonly used in medical clinics to treat aspergillosis. This can render the most common treatments for aspergillosis useless, which is a concern for doctors.
Where do these strains come from? Most experts suggest that the use of commercial fungicides by farmers exposes the fungus to pesticides that closely resemble the antifungal drugs used by doctors. This exposure is likely to enrich the numbers of resistant spores found in the environment ie in compost, soil, and of course in/on the plant material produced by the farmers e.g. food crops, and flowering plants.
Can we stop using these antifungal chemicals as pesticides? A multi-disciplinary meeting designed to bring together experts from all sides of the debate took place in London on 13th July and those representing the growers outlined how important it is that farmers use these fungicides to prevent crop damage and to produce enough food to feed us all! Completely stopping their use on crops does not seem to be an option.
Given that it seems that there will be antifungal-resistant spores in the environment we live in for the foreseeable future we need to:
- know where they are
- know how to avoid inhaling them
Where might patients come into contact with most antifungal-resistant spores?
Farmers use antifungal pesticides on many crops including:
- Fruits: Apples, grapes, peaches, strawberries, and tomatoes
- Vegetables: Potatoes, onions, corn, and soybeans
- Grains: Wheat, corn, and rice.
- Nursery crops: Roses, trees, and shrubs
Researchers have found antifungal-resistant Aspergillus fumigatus spores on many of these crops or the soil around them, at low levels (0 - 10% of samples).
Is this level of antifungal-resistant spores increasing?
When scientists looked at spore numbers they found that the number of resistant spores increased during the growing season as antifungal pesticides were applied to the crops, but this resistance did not survive the winter (1) and levels were back down to where they were the previous year.
It is apparent that handling crops, or the soil around them is a potential way to come into contact with some spores that are resistant to antifungal medications given in the clinic.
What is the likelihood of these spores causing an antifungal-resistant infection?
Researchers (1) have looked at how resistant the resistant spores are to the level of antifungal medication they will be exposed to in a patient and found that the proportion of the isolates that were resistant to the levels of antifungal medication used in patients was 1-4% - so very low.
Which crops are worst affected?
The most common material found to contain antifungal-resistant material was plant material waste originating from cut flowers and flowering bulbs and other types of waste produced in the industry in The Netherlands (2), so it is clear that composting can promote the growth of resistant spores. Ways to prevent this from happening are under development.
Other materials tested were household waste, wheat grain, poultry manure, cattle manure, horse manure, maize silage & fruit waste and of those antifungal-resistant spores were found only in fresh household waste.
Other researchers across the world (3) have detected antifungal-resistant spores in a range of crops and soils. Highest numbers of resistant spores (or perhaps in places where most research has been done) tend to be in India (rice), China (maize, some house plants, potato), USA (wheat, roses, apples), The Netherlands (orchids), Spain (onions, strawberries), Colombia (carrots) & Italy (grapes).
These were not exhaustive studies and we know that Aspergillus fumigatus (i.e. not antifungal-resistant) itself is found on far more plants/fruits/vegetables, so it stands to reason that if they are treated with antifungal pesticides then it may be possible to isolate resistant spores from them. It is clear that although there is a risk of inhaling antifungal-resistant spores from this plant material, the risk to the domestic consumer is low. Nonetheless, out of an abundance of caution, it might be best to take a few precautions:
a. Avoid handling cut flowers and flowering bulbs from The Netherlands
b. After purchase wash fruit and vegetables prior to storage in the home
c. Dispose of household waste in a timely manner
Action is being proposed and taken nationally and internationally to reduce the risk to aspergillosis patients in particular of inhaling antifungal-resistant spores of A. fumigatus and other fungi (4). Research is ongoing to learn more about what are the causal factors responsible for the increase in resistant spores, which are the main risks to human health and what we can do about it.
In time we should be able to prevent the growth of resistant isolates, ensuring that we have useful antifungal medication for years to come.
1. Effects of Agricultural Fungicide Use on Aspergillus fumigatus Abundance, Antifungal Susceptibility, and Population Structure
Authors: Amelia E. Barber https://orcid.org/0000-0002-3399-1037, Jennifer Riedel, Tongta Sae-Ong, Kang Kang, Werner Brabetz, Gianni Panagiotou, Holger B. Deising, Oliver Kurzai https://orcid.org/0000-0002-7277-2646AUTHORS INFO & AFFILIATIONS
DOI: https://doi.org/10.1128/mbio.02213-20
2. Emerg Infect Dis. 2019 Jul; 25(7): 1347–1353. doi: 10.3201/eid2507.181625
Environmental Hotspots for Azole Resistance Selection of Aspergillus fumigatus, the Netherlands
Sijmen E. Schoustra, Alfons J.M. Debets, Antonius J.M.M. Rijs, 1 Jianhua Zhang, Eveline Snelders, Peter C. Leendertse, Willem J.G. Melchers, Anton G. Rietveld, Bas J. Zwaan, and Paul E. Verweij
3. Azole-resistant Aspergillus fumigatus in the environment by cburks817 · MapHub
4. Nat Rev Microbiol. 2022; 20(9): 557–571.
Published online 2022 Mar 29. doi: 10.1038/s41579-022-00720-1
Tackling the emerging threat of antifungal resistance to human health
Matthew C. Fisher,1 Ana Alastruey-Izquierdo,2 Judith Berman,3 Tihana Bicanic,4 Elaine M. Bignell,5 Paul Bowyer,6 Michael Bromley,6 Roger Brüggemann,7 Gary Garber,8 Oliver A. Cornely,9 Sarah. J. Gurr,10 Thomas S. Harrison,4,5 Ed Kuijper,11 Johanna Rhodes,1 Donald C. Sheppard,12 Adilia Warris,5 P. Lewis White,13 Jianping Xu,14 Bas Zwaan,15 and Paul E. Verweij11,16
NAC CARES Team Joins European Lung Foundation (ELF) Patient Organisation Network
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The National Aspergillosis CARES Team are excited to announce its membership in European Lung Foundation (ELF) Patient Organisation Network. This collaboration marks a milestone in the team's commitment to enhancing the lives of individuals affected by aspergillosis.
Founded in 2000 and working in partnership with the European Respiratory Society (ERS), ELF is a patient-led organisation that works internationally to bring patients and the public together with healthcare professionals to improve lung health and advance diagnosis, treatment, and care.
The ELF Patient Organisation Network is a hub for respiratory patient organisations throughout Europe, fostering knowledge exchange, collaboration, and advocacy initiatives to improve respiratory health and well-being across the continent. Membership of the network provides the CARES Team with access to invaluable resources, expertise, and opportunities to positively impact the lives of those living with aspergillosis.
As an active participant in this network, the NAC CARES Team will contribute expertise, raise awareness at both national and European levels, and help drive positive change. In addition to knowledge sharing and advocacy, the ELF Patient Organisation Network offers opportunities for networking and collaboration. By connecting with like-minded organisations, the team can establish partnerships, share experiences, and collaborate on joint initiatives to create a more supportive environment for individuals living with aspergillosis in Europe.
You can read more about ELF here: https://europeanlung.org/en/
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NAC CARES Virtual Challenge - We've Made It From Lands End to John O'Groats!
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We're pleased to announce that the NAC CARES Team has successfully completed our virtual journey from Lands End to John O'Groats. Over the past few months, our team has walked, cycled, and run an incredible total of 1744km (1083.9 miles)! Starting on February 1st, World Aspergillosis Day, we set ourselves 100 days to complete the challenge, but, we completed it ahead of schedule, on May 12th, 5 days sooner than anticipated.
Our virtual expedition has been a grand tour of the UK, from the stunning cliffs of Lands End in Cornwall to the rugged shoreline of John O'Groats in Scotland. We virtually journeyed through England's diverse landscape, passing through picturesque countryside, vibrant cities, and historic towns. From the iconic signpost at Lands End to the bustling streets of Bradford, the rich cultural heritage of Huddersfield, the dramatic landscapes of the Peak District National Park, the green spaces and cultural landmarks of Sheffield, and the legendary Sherwood Forest - each place a unique story in our broader narrative.
Crossing the border into Scotland, we continued our journey through the Scottish Highlands, with its breathtaking panoramas and rich history. We passed through the charming village of Fort Augustus, navigated around the famous Loch Ness, and made our way through the Cairngorms National Park, known for its diverse ecosystems, unique flora, and rare wildlife.
Our journey culminated at John O'Groats, traditionally acknowledged as the extreme northern point of mainland Britain, marking a triumphant conclusion to our endeavour.
But the importance of this journey extends far beyond the physical accomplishment. This effort was a symbol of unity, resilience, and determination, resonating with the values we uphold in our battle against fungal infections. We embarked on this challenge to raise much-needed funds and awareness for the Fungal Infection Trust, an organisation dedicated to advancing research, promoting awareness, and improving treatments for individuals affected by fungal infections.
We want to express our gratitude for all the support we have had throughout this journey. However, the fight against fungal infections doesn't stop here.
If you have not yet made a contribution or if you feel moved to give more, please do so via our fundraising page:
https://www.justgiving.com/campaign/LEJOG-for-Aspergillosis
Thank you for your part in this journey and for standing alongside us in this vital cause. We celebrate the difference we've made together and anticipate the positive impacts we will continue to make in the future!
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Charity Walk Update: Nearing the Finish Line
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We're back with what will probably be our penultimate updater on our virtual Lands End to John O'Groats challenge, where we aim to raise money for the Fungal Infection Trust. Our team has continued to walk, run and cycle the virtual challenge and has now covered an impressive 1534.61km (953.56 miles), leaving just 209.59km (130.23 miles) until we reach our destination.
Our team is now on the final stretch, heading towards Inverness before following the coast up to John O'Groats. Along the way, we've passed the famous Loch Ness, a large, deep, freshwater loch extending approximately 37 kilometres southwest of Inverness. Known for its dramatic scenery, Loch Ness is also famous for the legendary Loch Ness Monster, affectionately known as "Nessie."
Interestingly, in 2008, the late American scientist and lawyer Robert Rines, who spent decades searching for Nessie, concluded that the Loch Ness Monster was likely extinct. Rines had captured images in the 1970s that some believed to be evidence of the creature, but subsequent searches yielded no concrete evidence of Nessie's existence.
Our journey has also taken us through the picturesque Fort Augustus, a charming village on the banks of the Caledonian Canal and near the south-western end of Loch Ness. This beautiful area is known for its scenic surroundings and the impressive Fort Augustus Abbey, a former Benedictine monastery.
We've also ventured through the captivating Cairngorms National Park, the UK's largest national park, which is home to rare wildlife such as golden eagles, capercaillie, and wildcats. The park boasts five of the UK's six highest mountains, offering stunning landscapes and diverse ecosystems.
As we approach the end of our challenge, we remain grateful for your support and enthusiasm. Together, we will make a difference in the fight against fungal infections. Stay tuned for or final update as we make the final push towards the finish line, and don't forget to donate via the link below:
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COVID-19 News
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COVID-19 App no longer in use
The NHS COVID-19 app, which alerted close contacts of a positive case and provides the latest health advice about the virus, closed on 27 April 2023.
Over the past year, the success of the vaccination programme, increased access to treatments and high immunity in the population has enabled the government to target its COVID-19 services, meaning the app is no longer needed. The knowledge, technology and lessons learnt from the app will be used to help inform planning and response to future pandemic threats.
It is important that people continue to follow the latest guidance to protect themselves and others:
This includes reporting NHS lateral flow test results on GOV.UK. Those eligible for COVID-19 treatment must report their result so the NHS can contact them about treatment.
COVID-19 vaccination spring programme
The 2023 spring coronavirus (COVID-19) booster programme is now underway. A spring booster dose is being offered to:
- adults aged 75 years and over
- residents in a care home for older adults
- individuals aged 5 years and over who are immunosuppressed
Those eligible can book their vaccination on the National Booking Service or NHS App.
The last date for the public to book spring boosters will be 30 June 2023.
The offer of a first and second dose of the COVID-19 vaccine will also come to an end for many people on 30 June. After this date, the NHS offer will become more targeted to those at increased risk, usually during seasonal campaigns.
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Unblocking Airways: New approaches to preventing mucus plugs
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Excess mucus production is a common problem in people with Allergic Bronchopulmonary Aspergillosis (ABPA), and chronic pulmonary aspergillosis (CPA). Mucus is a thick mixture of water, cellular debris, salt, lipids, and proteins. It lines our airways, trapping and removing foreign particles from the lungs. The gel-like thickness of mucus is caused by a family of proteins called mucins. In individuals with asthma, genetic changes to these mucin proteins can thicken the mucus, making it more difficult to clear from the lungs. This thick and dense mucous builds up and can lead to mucus plugs, blocking the airways and causing breathing difficulties, wheezing, coughing, and other respiratory symptoms.
Doctors usually treat these symptoms with inhalable medications such as bronchodilators and corticosteroids to open the airways and reduce inflammation. Mucolytics can also be used to break down mucus plugs, but the only available medication, N-Acetylcysteine (NAC), is not very effective and can cause unwanted side effects. While current treatments can help manage symptoms, there is a need for effective and safe treatments to directly address the issue of mucus plugs.
To address this issue, 3 approaches are being explored:
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- Mucolytics to dissolve mucus plugs
Researchers at the University of Colorado are testing new mucolytics such as tris (2-carboxyethyl) phosphine. They gave this mucolytic to a group of asthmatic mice experiencing inflammation and excess mucus production. After treatment, mucus flow improved, and the asthmatic mice could clear mucus just as effectively as the non-asthmatic mice.
However, mucolytics work by breaking the bonds which hold mucins together, and these bonds are found in other proteins in the body. If the bonds are broken in these proteins, it could lead to unwanted side effects. Therefore, further research is needed to discover a drug that will only target the bonds in mucins, reducing the risk of side effects.
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2. Clearing crystals
In another approach, Helen Aegerter and her team at the University of Belgium are studying protein crystals which they believe drive mucus overproduction in asthma. These crystals, known as Charcot-Leyden crystals (CLC’s) cause mucus to become thicker, therefore harder to clear from the airways.
To address the crystals directly, the team developed antibodies that attack the proteins in the crystals. They tested the antibodies on mucus samples collected from individuals with asthma. They found that the antibodies effectively dissolved the crystals by attaching themselves to the specific regions of the CLC proteins that hold them together. In addition, the antibodies dampened inflammatory reactions in mice. Based on these findings, the researchers are now working on a drug that could have the same effect in humans. Aegerter believes that this approach could be used to treat a variety of inflammatory diseases that involve excessive mucus production, including sinus inflammation and certain allergic reactions to fungal pathogens (such as ABPA).
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- Preventing excess secretion of mucus
In a third approach, pulmonologist Burton Dickey of the University of Texas is working to prevent mucus plugs by reducing the overproduction of mucus. Dickey's team identified a specific gene, Syt2, that is only involved in excessive mucus production and not in normal mucus production. To inhibit excess mucus production, they developed a drug called PEN-SP9-Cy that blocks Syt2's action. This approach is particularly promising as it targets mucus overproduction without interfering with the vital functions of normal mucus. Normal mucus production plays a critical role in protecting and maintaining the health of the respiratory and digestive systems. Although the initial results are promising, further research is necessary to evaluate the efficacy and safety of these drugs in clinical trials.
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In summary, mucus plugs present uncomfortable symptoms in ABPA, CPA and asthma. Current treatments focus on symptom management rather than directly addressing reduction or removal of mucus plugs. However, researchers are exploring 3 potential approaches, involving mucolytics, clearing crystals, and preventing excess mucus secretion. Additional research is required to confirm their effectiveness and safety, but approaches have shown promising results and may in future be one way we can prevent mucus plugs.
Further information:
Phlegm, mucus and asthma | Asthma + Lung UK
How to loosen and clear mucus
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