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Hyperinflated Lungs?
I hope AI is used more often to read CT scans and X-rays. Prior to my diagnosis of Bronchiectasis (not MAC) by use of the CT scan, I had several X-ray's over two - three years.
I finally got copies of all of them. I can see infection (I know that now). My physician said my X-rays were fine. The X-ray tech had written some hyperinflation of lungs on the first X-ray. That was dismissed by my doctor even though I was developing other symptoms. Eventually a few years after other X-rays, infections, no targeted antibiotics, symptoms worse, the doctor callously mentioned that the ‘x-ray is only as good as the person reading it.’ I’ll never forget that.
My physician declined my requests for CT scans and Sputum tests. I finally got a new appointment to see a pulmonologist who promptly sent me for a CT scan and introduced airway clearance.
Did anyone else have hyperinflated lungs early on in a diagnosis? I’ve read it can be evidence of Bronchiectasis but not always.
Since most people don’t get CT scans before the standard X-Ray, perhaps a combination of unexplained but related symptoms like cough, mucus, fatigue, infections etc coupled with other factors like gender, body type, sinus infections, etc AND hyperinflation, could be a new standard to warrant an earlier CT scan. It might help other patients.
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That is wonderful news! So pleased for you.
Dupixant is available on PBS here in Australia.
Does anyone else have any opinion/information on our maybe utilising Dupixant to reduce mucus/inflammation?
Side effects?
DUPIXENT (dupilumab) helps reduce lung inflammation and phlegm in bronchiectasis patients by targeting type 2 inflammation pathways, which are key drivers of the disease. It does this by blocking the IL-4 and IL-13 pathways, which are responsible for various inflammatory responses, including mucus production.
This helps to reduce airway inflammation, improve lung function, and reduce the amount of mucus in the airways.
Here's a more detailed explanation:
Targeting Type 2 Inflammation:
Dupilumab specifically targets type 2 inflammation, which is a major factor in bronchiectasis.
This inflammation is characterized by the involvement of certain immune cells and inflammatory molecules, including IL-4 and IL-13.
Blocking IL-4 and IL-13 Pathways:
Dupilumab works by blocking the IL-4 and IL-13 pathways, which are involved in the production of mucus and other inflammatory responses.
Reducing Mucus Production:
By blocking these pathways, dupilumab helps to reduce the amount of mucus produced in the airways, making it easier for patients to clear their lungs and breathe.
Improving Lung Function:
Dupilumab also improves lung function by reducing airway inflammation and improving airflow.
Clinical Evidence:
Studies have shown that dupilumab can reduce inflammation, improve lung function, and reduce the frequency of exacerbations in bronchiectasis patients.
In essence, DUPIXENT helps to reduce lung inflammation and phlegm in bronchiectasis by targeting the root cause of the problem, rather than just treating the symptoms.
(Source: AI generated summary)
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2 ReactionsAnother AI generated summary in response to my question of the use of Duplixent for the treatment of Bronchiectasis. I read research papers typically but it is interesting to see what AI offers as a summary statement.
It takes below that it is not considered a replacement for Bronchiectasis treatment or airway clearance!
Dupilumab (Dupixent), an anti-IL-4/IL-13 antibody, is being explored for its potential to treat bronchiectasis, particularly in cases with underlying type 2 inflammation, such as in patients with asthma or allergic bronchopulmonary aspergillosis (ABPA).
While not directly approved for bronchiectasis, studies suggest it may improve symptoms, reduce exacerbations, and lower the need for oral corticosteroids in patients with related conditions like asthma and ABPA.
Here's a more detailed look at the potential benefits and considerations:
1. Mechanisms of Action and Potential Benefits:
Targeting Type 2 Inflammation:
Dupilumab works by blocking the IL-4 and IL-13 signaling pathways, which play a key role in type 2 inflammation, a common feature in asthma and ABPA, and potentially in some cases of bronchiectasis.
Improved Lung Function:
Studies in asthma patients have shown that dupilumab can lead to improvements in lung function measures like FEV1 (forced expiratory volume in one second).
Reduced Exacerbations:
In some studies, dupilumab has been associated with a reduction in the frequency of asthma exacerbations, which can also be relevant in the context of bronchiectasis.
Decreased Corticosteroid Use:
The medication has shown promise in reducing the need for oral corticosteroids, particularly in patients with ABPA.
Improved Mucus Clearance:
In a case report, dupilumab was associated with the complete resolution of mucus plugging in a patient with bronchiectasis.
2. Current Use and Limitations:
Not Approved for Bronchiectasis:
Dupilumab is currently approved for the treatment of conditions like asthma, atopic dermatitis, and severe COPD, but not specifically for bronchiectasis.
Off-Label Use:
In some cases, dupilumab may be used off-label for bronchiectasis, especially in patients with related conditions like asthma or ABPA, where there is a strong suspicion of type 2 inflammation.
Limited Evidence:
While there's growing interest in dupilumab for bronchiectasis, more research, particularly large-scale trials, is needed to fully understand its efficacy and safety in this patient population.
3. Important Considerations:
Type 2 Inflammation:
Dupilumab is likely most beneficial in patients with bronchiectasis and a strong type 2 inflammatory component, such as those with asthma or ABPA.
Individualized Treatment:
The decision to use dupilumab for bronchiectasis should be made on a case-by-case basis, considering the patient's specific condition, underlying etiology, and potential benefits and risks.
Other Treatments:
Dupilumab is not a replacement for standard bronchiectasis treatments, such as antibiotics and lung hygiene techniques.
Monitoring:
Patients receiving dupilumab should be closely monitored for potential side effects, such as hypersensitivity reactions, conjunctivitis, and eosinophilic conditions.
4. Ongoing Research:
Future Trials:
Researchers are actively exploring the potential role of dupilumab and other biologics in the treatment of bronchiectasis.
Precision Medicine:
The focus is on identifying patients with bronchiectasis who are most likely to benefit from type 2 targeted therapies like dupilumab.
In summary, while dupilumab is not directly approved for bronchiectasis, there is evidence to suggest it may be a promising treatment option for certain patients with type 2 inflammation, particularly those with asthma or ABPA. More research is needed to fully understand its role in the management of bronchiectasis and to identify the best candidates for this therapy.
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2 Reactions@jnmy by “coaching” I mean during the PFT itself, by the respiratory therapist. My first ever PFT was after my MAI diagnosis. The tech sat at his computer and gave verbal instruction but I found the whole process very confusing and disorienting. Afterwards I told my spouse they should give us one practice run through first just so we know what we are doing before they “test”. I then went to pulmonary rehab. There, the therapists taught us that good coaching during a PFT can make a lot of difference in the PFT’s results. This was just an abstract comment until I went for my second PFT. This second therapist was fantastic, very animated, standing before me “blow, blow, blow!!! … now DEEP INHALE!” … etc. she really brought the instruction to life and pushed/pulled me through the test with verbal and visual cues. What a difference. I am having another PFT soon and have requested the same fantastic therapist. Fingers crossed I get her!
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5 ReactionsThank you so much for all that interesting information!
I am seeing my GP this week so will discuss this with him.
I dont wantvto expide myself to unnecessary risjs with medications
hiwever i would ve very curious to know if this would reduce the amount of mucus.
Very much appreciate your information sharing.
You’re welcome. Yes, only the specialists can determine whether the medication is appropriate for you and worth trying!
All the best with your appointment.
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1 ReactionYes...my GP = General Practitioner, however still interested in his reading of this situation.
Very best wishes.
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