Spot the difference

EvA files already take up one metre of table space in the office of Professor Loems Ziegler-Heitbrock of the clinical collaboration group for inflammatory lung disease at the Helmholtz Zentrum München. Yet the EvA project – an EU funded project on Emphysema versus Airway Disease - has only just got under way. An initial meeting of the fourteen research partners from nine European countries is planned for some time this summer. Researchers aim to discover molecular characteristics, socalled markers, for two forms of Chronic Obstructive Pulmonary Disease (COPD), emphysema and chronic bronchitis, within the next three years. Ziegler-Heitbrock explains that COPD is a kind of collective term for patients who suffer from various subtypes of the disease. “Specific markers would make the diagnosis of COPD subtypes far easier and of course we hope to find new starting points for treatment too.” COPD, often known under the harmless-sounding name smoker’s cough, is currently the fifth most common cause of death globally and is predicted by current WHO estimates to take fourth place in the statistics by 2030. There are around five million COPD sufferers in Germany and presumably 600 million worldwide.

Most victims are smokers, but the smoke from open fires, often used in developing and emerging countries, is also considered to be one of the main causes of irreversible constriction of the airways, resulting in the coughing, shortness of breath and feelings of suffocation symptomatic of COPD. The disease restricts lung function and the organs can no longer be supplied with sufficient oxygen. Current methods of treatment aim to slow the progress of the disease. Ziegler-Heitbrock explains that there is no specific treatment for COPD, making it all the more important to comprehend the mechanisms behind its different forms. Emphysema destroys the alveoli, whereas chronic bronchitis causes inflammation and swelling of the bronchial walls. “A special computer tomography and complex software to interpret the lung scan should help differentiate between the two types,” Ziegler-Heitbrock explains. The EvA partners aim to recruit 150 patients with emphysema and 150 with chronic bronchitis to apply this new method. Blood and bronchoscope samples from these patients and from 300 healthy control subjects will be taken and examined, enabling researchers to decode in detail mutations and differences with reference to the activated genes and the proteins present in order to detect the differences in the course of the diseases. Researchers also hope to develop a diagnostic test which is as simple, quick and cheap as possible.

Ziegler-Heitbrock and his colleagues have been preparing the study for about two years. Not only must the application be made to the EU, but applications for ethical approval must be made in all participating countries as well, and precise instructions for all experiments and sample taking written. Project coordinator Ziegler-Heitbrock says that they are currently making a video film to show how the bronchoscopy will take place. All data and samples will be collected at the Helmholtz Zentrum München; the detailed schedule including each project member’s tasks is already complete.

But will everyone keep to the plan? Ziegler-Heitbrock emphasises the importance of motivation. An international project of this kind can only work if participants are in close contact by telephone, email and most important, personally. The researchers will meet at least every six months, for example at congresses and conferences. However, the prospect of publications is still the best motivation for researchers – and with EvA, the chances of this are high.