Dr. Crystal Reveals Promising New Diagnostic for Emphysema
April 7, 2011
Researchers in the Weill Cornell Medical College Department of Medicine have pinpointed a biomarker of early-stage emphysema that could provide an advanced new diagnostic tool. In the American Journal of Respiratory and Critical Care Medicine, senior author Ronald G. Crystal, MD, Chief of the Division of Pulmonary and Critical Care Medicine, and colleagues published findings that are promising for early detection of emphysema, which affects 2 million people in the United States each year and is irreversible beyond a certain point. Though further investigation is needed, early detection of the lung disease could come down to a simple blood test.
Dr. Crystal’s group targeted tiny cell fragments called endothelial microparticles (EMPs) circulating in the bloodstream. Previous studies had linked elevated blood levels of EMPs to cell damage in vascular disease, and evidence has quickly grown linking similar cell damage to early emphysema. Dr. Crystal hypothesized that the same biomarker of cell damage in vascular disease might also be present in people with early-stage emphysema. His investigations bore the point out: among both healthy and symptomatic smokers, even those who scored in the “healthy” range of other pulmonary diagnostic tests showed elevated blood levels of EMPs.
Pulmonary specialists already have an advanced diagnostic tool for emphysema; the EMP blood test is only slightly more sensitive — but, in purely practical terms, far more effective. Pulmonologists currently use a test called DLCO, a method that measures the lungs’ ability to diffuse carbon monoxide and is sensitive enough to catch very early physiological signs of pathogenesis. But emphysema can develop and progress asymptomatically for years — many patients never see a pulmonologist or receive the DLCO test until their disease is nearly or completely irreversible. Because EMP levels can be measured with a simple blood test, in any physician’s office, making early detection far more likely.
The research is still in the experimental phase but could have groundbreaking implications. “If we can detect [emphysema] earlier, that would be terrific, because we can’t give back the lung once it is lost,” says Dr. Crystal.
Ronald G. Crystal is Chief of the Division of Pulmonary and Critical Care Medicine, the Bruce Webster Professor of Internal Medicine, and Chairman of the Department of Genetic Medicine at Weill Cornell Medical College; he is an Attending Physician at NewYork-Presbyterian Hospital. He is a member of the Association of American Physicians and the American Society for Clinical Investigation.
Click here to read the abstract in the American Journal of Respiratory and Critical Care Medicine