What exactly is COPD?

COPD stands for “Chronic Obstructive Lung Disease” and is a Chronic obstructive pulmonary disease, which currently affects about 384 million people worldwide, and about 10.6 million people in Germany.

It is a slowly developing chronic lung disease with persistent cough, mucus, sputum, and shortness of breath (v.a(under exertion) and tightness in the chest. The airways are chronically constricted and inflamed.

The starting point is usually chronic obstructive bronchitis.

As a consequence of COPD, infections occur more frequently, as does the development of pulmonary emphysema ("inflated lung") with overinflation and destruction of the lung tissue, especially the alveoli, and possibly also cor pulmonale (right heart failure).

In COPD, inflammation, oxidative stress and mucus hypersecretion cause the symptoms.

What are the possible causes of COPD?

• Predominantly pollutant particles (z.B. (e.g., through smoking, particulate matter) or gases
• Genetically determined alpha-1 antitrypsin deficiency (AAT breaks down tissue destroyed during inflammation)

What is the classic therapy for COPD?

Classical therapy knows v.aThe following measures:

• Lifestyle changes and quitting smoking
• Breathing exercises and physiotherapy
• Bronchodilators, corticosteroids, mucolytics, oxygen
• Operation (z.B(Removal of destroyed alveoli, lung transplantation)

What can micronutrients do for COPD?

One fifth of patients with chronic obstructive pulmonary disease is malnourishedIn severe COPD, it's almost half. The causes are increased energy consumption due to the disease (more energy is needed for breathing because of the narrowing of the airways), insufficient food intake due to loss of appetite, and reduced energy production in the mitochondria because less oxygen is available for "burning" than in healthy individuals.

It has also been shown (see ESPEN 2006) that in COPD patients, even in the early stages, a Muscle loss This can occur due to lack of exercise caused by breathing problems, nutrient deficiency (s.o.) and/or be caused by chronic inflammatory processes resulting from COPD. Therefore, magnesium, which is directly involved in muscle function, is a standard component of micronutrient therapy for COPD. Furthermore, the Protein intake slightly increased For muscle building, 2.5 g of protein per kilogram of body weight is required; for maintenance, 1.9 g/kg (see Bargon J, Müller U; Nutrition in COPD; Nutrition Review 2012; 2: 96).

Finally, about 1/3 of all COPD patients have a osteoporosis (cf. COPD-deutschland.deThe cause has not yet been fully clarified, but a connection with inhaled corticosteroid (ICS) therapy is suspected (see COPD guideline 2018).Therefore, supplementation is a sensible option in cases of accompanying osteoporosis. calcium and Vitamin D3 && K2, which is central for regulating calcium metabolism.

Since COPD involves chronic inflammation in the airways and lung tissue, two components play a central role in micronutrient therapy:

• Omega 3 fatty acids with a high EPA share (therefore, algae oil should not be used, as it contains harmful substances) i.d.R. only a relevant DHA component, but not an EPA component) (cf. Wey S; Orthomolecular therapy for obstructive airway diseases; EHK 2018; 67(05): 291-300)
• Antioxidants (e.g., an antioxidant complex such as ANTI-OX) as a free radical scavenger, because chronic inflammation leads to free radicals, which in turn lead to chain reactions and tissue damage.

In addition to the information on chronic inflammation in the Academy article (https://qidosha.com/blogs/qidosha-academy/chronische-entzundungenIn addition to the studies on Omega 3 and antioxidants already cited, there are also studies that have a clear focus on respiratory diseases, such as:

• “Omega-3 fatty acids increase pneumonia resistance (caused by Klebsiella) in mice through anti-inflammatory effects and upregulation of the innate and adaptive immune systems” (cf. Sharma S et al.; Dietary Supplementation With omega-3 Polyunsaturated Fatty Acids Ameliorates Acute Pneumonia Induced by Klebsiella Pneumoniae in BALB/c Mice. Can J Microbiol 2013, 59 (7), 503-10)
• “Omega-3 fatty acids improve survival, bacterial invasion, and inflammation in the lungs of mice. The data can be extrapolated to humans and improve patient outcomes and pneumonia risk” (see Hinojosa CA et al.; Omega-3 Fatty Acids in Contrast to omega-6 Protect Against Pneumococcal Pneumonia. Microb Pathog 2020, 141, 103979)

Another important role in micronutrient supply for COPD is played by... Amino acid L-cysteine, which, for example, in the new edition of CLEAN It will be included as a central component. There is also a good body of research on this, such as:

• “Cysteine ​​1500 mg significantly reduces the exacerbation rate by 25% compared to placebo in COPD, but only after at least 3 months of therapy. Furthermore, quality of life and activity levels improved significantly” (see Zheng JP et al.; Effect of carbocisteine ​​on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study; Lancet 2008; 371, 2013-2018)

Flavonoids such as... Quercetin Flavonoids are known to have immunomodulatory effects. And there are already significant studies regarding respiratory diseases, such as: Flavonoids (0.2-1.2 g/day) reduce the incidence of upper respiratory tract infections by 33%. The number of sick days decreased by 40% (see Sommerville VS et al.; Effect of flavonoids on upper respiratory tract infections and immune function; Adv Nutr 2016).

The two medicinal mushrooms also make for an exciting combination. Hericium && Reishi We have written a separate Academy article about their importance for the gut microbiome: https://qidosha.com/blogs/qidosha-academy/vitalpilze And like the lungs, the intestines also have a barrier function and microbiota, although less so than the gut:

The more than 100 known microbiota species (bacteria, viruses, bacteriophages, fungi) “sit” on the epithelium of the lung.They come primarily from the throat (the main pathogens there are Neisseria, Prevotella and Veillonella) and less frequently from the nose or intestines (z.B. by microaspiration).

Its composition differs from the microbiota in the throat/nose and intestines (z.B(They contain no digestive bacteria, but do contain germs from the upper respiratory tract). But just as in the gut, the same applies to the lungs: The higher the germ diversity and the better the balance of germs, the better the protection and lung function.

Dysbiosis can occur with a decrease in bacterial diversity (z.B. in COPD only 28% of a healthy person!) and increase in potentially pathogenic germs (z.B. Pseudomonas), z.Bas a result of

• cystic fibrosis, COPD, asthma, allergies, infections
• Use of medications (z.B. Antibiotics, corticosteroids)
• Pollution with pollutants (z.B(Smoking, particulate matter)

Dysbiosis affects barrier function and immunity. It triggers inflammation, increases disease risk, and worsens disease stage and lung function. See also Engel M et al.; Influence of lung CT changes in chronic obstructive pulmonary disease (COPD) on the human lung microbiome; Plos One 2017; doi: 10.1371/journal.pone.0180859): In chronic obstructive pulmonary disease (COPD), structural changes in the lungs and dysbiosis can occur over time, which promotes the colonization of potentially pathogenic bacteria.

And a healthy gut microbiome is also of great importance for the lung microbiome, because the lungs and intestines are connected via the so-called... "Gut-lung axis" The lungs develop in the fourth week of embryonic development as a folding of the foregut, and, as with the gut microbiome, the development of the lung microbiome also takes place in early life (the "neonatal window of opportunity"). Similar measures to those used for the gut microbiome are effective here. d.h. v.a. z.BBreastfeeding and a healthy diet.

The gut flora and oral probiotics influence the lung microbiota. z.B. via “Cross Talk” (information exchange) and protect z.B. against allergies:

• Direct effects z.B. through microaspiration in the lungs
• Indirect effects u.a. via short-chain fatty acids (SCFAs), which improve the reactivity of the lung immune system

Therefore, measures taken in the gut (such as those using medicinal mushrooms) are also relevant for the lungs.