A University of Iowa Hospital & Clinics pulmonologist is preparing to test a more permanent treatment for chronic obstructive pulmonary disease.

UI Clinical Associate Professor Alejandro Comellas seeks to use a treatment that directly targets the mucus-producing cells that clog patients airways.

Chronic bronchitis is one of the most common forms that the pulmonary disease can take, according to Healthline, racking nearly 8.9 million Americans with consistent coughing and inflammation of the lungs without a cure.

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“People with this condition have poor quality of life and an increased risk of respiratory infections,” Comellas said. “With these clinical trials, what we’re doing is applying a low level of energy to kill the cells producing mucus, therefore reducing chronic bronchitis.”

Comellas said chronic bronchitis is a difficult condition to create inhalers for, and current treatments include pills that have tried and failed to reduce the amount of mucus in the lungs.

“These cells are really difficult to treat,” Comellas said. “Right now is what we call Phase 1 of the clinical trial, which is looking at the safety of the procedure and recruiting patients.”

He said volunteers will come from not just UIHC but from four other research centers nationwide and will go directly into Phases 2 and 3 to test the efficiency of its potential cure.

UI Assistant Professor Alejandro Pezzulo outlined the symptoms and effects of chronic bronchitis, which patients cannot be formally diagnosed with until they have a productive cough for three months in at least two successive years.

“It’s what we call a syndrome, in a way, because there’s no specific test for it,” Pezzulo said. “There is chronic inflammation, excessive mucus production, a lot of cough, and shortness of breath.”

Pezzulo said making sure patients get their vaccinations, aggressive exercise, applying a combination of inhalers and oxygen are currently manageable aspects of chronic bronchitis and may improve patient survival but not guarantee it.

“I will emphasize the fact there’s really no good therapy at the moment. That’s a big problem,” Pezzulo said. “For the patients with the most severe cases, the mortality rate is actually similar to patients with advanced cancer.”

Chronic bronchitis, he said, is one disease under the pulmonary umbrella that also includes emphysema and other lung-related illnesses.

Mercy Iowa City pulmonologist Andrew Ashby said the main risk factor in each of these cases is smoking, and the primary treatment is simply to quit and take medication to try to minimize further exposure or exacerbation of the disease.

“Chronic bronchitis is usually the end result of years of chronic and recurrent injury to the lungs and airways,” Ashby said. “So the lung itself is remodeled in a way that is permanent injury.”

Ultimately, he said, the airways get really narrow and inflamed, become stuck in that position, and have no good way to dilate. The sooner patients start treatment, the less likely they are to have progressing problems with their lungs.

“It’s becoming even more common,” Ashby said. “Worldwide, the prevalence is around 10 percent of adults have chronic-bronchitis symptoms.”