New technique reveals insights into lung disease

Doctors at the Universities of Leicester and Nottingham are collaborating to use a magnetic resonance technique to image and quantify the air spaces inside the lungs.

The results of their research may lead to a link between childhood disease and later degenerative lung disease (COPD).

There are relatively few centres around the world which have access to this particular magnetic resonance technique, which is based in Nottingham University. Researchers at the University of Leicester have recruited cohorts of some 10,000 children – the largest to focus on respiratory illnesses in childhood. The two groups have combined forces, with a joint grant from the Wellcome Trust.

The method relies on the fact that certain noble gases (which are relatively rare in the atmosphere and are very un-reactive), when hyper-polarized in a very strong laser beam, can be detected by magnetic resonance methods.

Tests involve individuals inhaling a very small quantity (in this case 10ml or two teaspoons) of the hyper-polarized helium-3 gas. This technique provides the key to unlock a whole new area of research in the field of lung development.

This is quite different from the magnetic resonance scans are now commonplace in British hospitals. However, all magnetic resonance techniques function without the use of radioactive substances or ionising radiation (as is the case with x-ray techniques). They are thus very safe, and have no known side effects and are ideal for research into childhood illness.

Professor Mike Silverman, of the University of Leicester’s Department of Infection, Immunity & Inflammation, commented: “Leicester’s role has been to provide the clinical and developmental research questions and a population of children and young people on whom a lot of data has been collected since early infancy. Leicester has also provided a group of researchers with experience of paediatric projects, and of lung function measurements in infants and children of all ages.

“This combined with the technical expertise of the group in the Department of Physics & Astronomy at Nottingham University led by Professor John Owers-Bradley, has created a very powerful partnership.”

The pulmonary alveolus is the most peripheral structure within the air spaces of the lung, in which the gases carbon dioxide and oxygen move between the air and the blood. There are said to be about 500 million alveoli in the adult lung, and they have a combined surface area equivalent to about one tennis court. All the alveoli are formed by the age of 3 years, so early illnesses and exposures may leave children at risk of later lung disease.

COPD is chronic obstructive pulmonary disease, commonly known as chronic bronchitis and emphysema. This is a degenerative lung condition, enhanced by smoking, in adults beyond middle age.

Professor Silverman added: “The outcome that we are seeking is evidence that in young people and teenagers, there are differences in alveolar structure and number in association with disorders of fetal prenatal development and early childhood disease.

“We anticipate that there is an additional impact of teenage smoking on alveolar structure and function. If these observations are confirmed, they would provide for the first time evidence of impaired alveolar (as opposed to airway) development in childhood.

“This could be the link between childhood disease and later degenerative lung disease (COPD). We will then seek the specific factors (genetic or environmental) which lead to defective lung development, and will propose further research to ameliorate these factors.”