St. Paul’s researchers identify cells that cause initial airway destruction in COPD patients’ lungs

Previous research conducted at St. Paul’s by Dr. Tillie Hackett and her team found that by the time people are diagnosed with mild chronic obstructive pulmonary disease (COPD), more than 40 per cent of the smallest airways in the lungs are already destroyed.  

Today, they published new research which now identifies the cells responsible for this small airway destruction in the American Journal of Respiratory and Critical Care Medicine.

COPD is the third leading cause of death worldwide. About 380 million people globally live with it and each day, they struggle simply to breathe. The disease is commonly associated with risk factors, such as smoking, exposure to air pollution, and genetic predisposition.

Understanding the cells involved in small airway loss can lead to more effective treatments for COPD patients, says Dr. Tillie Hackett, Professor at the University of British Columbia (UBC) Centre for Heart Lung Innovation at St. Paul’s Hospital. “This is the closest we have come to finding a way to potentially prevent COPD,” says Dr. Hackett, who is also a Tier I Canada Research Chair in asthma and COPD.

Using lung tissue samples donated by forty COPD patients to the lung biobank at St. Paul’s Hospital, Dr. Hackett and her team performed high-resolution imaging studies to investigate small airway disease at the single-cell level.

The authors found that in patients with COPD, there is a progressive loss of alveolar attachments, which normally hold the small airways open.

“Airways are like flexible pipes that bring air in and out of the lung, and the alveolar are like cables that attach around the airway wall and hold it open,” says Dr Hackett.  Without these attachments, the airways collapse and airflow is obstructed, making breathing difficult.

“By using these imaging techniques, we have been able to identify the specific cell types involved in the inflammatory response that destroys the small airways,” says Dr. Steven Booth, first author of today’s publication and PhD student of Dr. Hackett.

For the American Journal of Respiratory Care study, the authors created a single-cell “atlas” of COPD small airways using imaging mass spectrometry. This technology is the first of its kind on the West Coast of Canada and is funded in part through the St. Paul’s Foundation. Using the equipment, every cell within a disease lesion can be studied, whereas previously researchers could only look at one cell at a time. This technology enables researchers to create a map of the disease lesion in order to understand which cells are causing the damage, says Dr. Booth.

Dr. Hackett’s groundbreaking research into COPD was supported by St. Paul’s Foundation and the Canada Foundation for Innovation. Visit their website to learn how you can support COPD research.

COPD by the numbers

COPD is the third leading cause of death worldwide, responsible for 3.23 million deaths globally in 2019.

Tobacco smoking and air pollution are the most common causes of COPD.

COPD costs the healthcare system $1.5 billion annually in Canada.