Identifying COPD Low Flyers

Once a patient is diagnosed with COPD, treatment is reactionary. Dr. Francesca Polverino thinks there’s a way to be more proactive.

Recent studies have shown that events occurring early in one’s life can cause chronic airflow limitations beginning at birth, yet there is little research on efficacy and safety of existing and novel treatments for those who begin experiencing COPD early in life. Polverino, Lester and Sue Smith Associate Professor of Pulmonary Medicine, believes that if more patients, researchers and healthcare providers can recognize the impact that these early life events can have on lung health at an early age, effective early interventions can lead to significant improvements in COPD treatment.

A person with the tip of an inhaler between their lips.“Right now, we lack disease modifying therapies for COPD,” Polverino said. “Once people already have their lung function completely compromised, it’s too late to intervene with any sort of treatment.”

Polverino’s research identifies several potential prenatal and perinatal factors, including maternal smoking, non-vaginal birth, premature birth and childhood respiratory infections, as driving factors for classification of a patient as a “low flyer,” someone who cannot force out much air in a one-second trajectory starting from childhood. Low flyers can begin exhibiting symptoms of COPD as early as their 30s and may have different lifestyles than those typically diagnosed with COPD.

“Patients need to be aware that they do not need to be smokers or older adults in order to have COPD,” Polverino said. “Let’s investigate what’s happening in the first years of life of these people,” Polverino said. “Were they born on term? Did they have asthma, and if so, until which age? Did they experience passive maternal smoke? This is all important information.”

Polverino, who recently won the European Respiratory Society’s Mid-Career Gold Medal in COPD for her contributions to the field of COPD pathogenesis, spreads awareness about low flyers through publications and interviews and at various pulmonary conferences across the world. It was at one of these conferences that she and John Linnell met.

John Linnell is a COPD patient and low flyer and was on a panel with her at a pulmonary conference.

“Dr. Polverino messaged me afterward and said that she was speaking at the American Thoracic Society 2022 International Conference in San Fransisco and wanted me to present with her,” Linnell said. “I immediately accepted.”

Linnell works as an advocate for other COPD patients and makes it his mission to not only remind others that the disease is not the end, but also help them find COPD resources to improve their quality of life.

“When I was first diagnosed with COPD, I had no idea what to do. I didn’t know where I was going to get my medications or see a doctor. People shouldn’t have to go through that alone,” Linnell said. “I’ve had COPD for 17 years and many people think it’s a death sentence, but it’s not. It’s a different chapter in my book.”

Learn about the Lung Institute at Baylor Medicine. 

By Aaron Nieto

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