![]() ![]() The investigators compared the patients’ sputum with that of 15 people whose lungs were in good health as well as with sputum from patients who had other conditions affecting the lungs, such as cystic fibrosis. “We analyzed this sputum to see what it’s made of, why it’s so difficult for the lungs to get rid of and how it affects the immune response,” Bollyky said. To collect sputum from severely breathing-impaired COVID-19 patients on the day they entered the intensive care unit, the Stanford researchers suctioned it out of the lungs of 17 consenting patients just after tubes were placed in their tracheas but before they were hooked up to mechanical ventilators. These patients are literally “drowning in their own respiratory secretions,” Bollyky said, but that accumulation is exceptionally difficult to dislodge, contributing to the infamous “dry cough” of COVID-19. Like cystic fibrosis, severe COVID-19 is characterized by sputum - a mishmash of mucus, cellular debris, various immunologically active agents, salts and more - that’s so viscous it sticks in the lungs instead of being cleared out by the method evolution designed: coughing. Lead study co-authors are former postdoctoral fellows Michael Kratochvil, PhD, and Sally Demirdjian, PhD and basic life research scientist Gernot Kaber, PhD.Ī separate clinical trial led by Bollyky and recently published in The Journal of Clinical Investigation has cleared the path for further development of a drug that may be able to break the logjam. These tangles turn patients’ sputum into stiff stuff that’s tough to cough up, recalcitrant to oxygen exchange in the lungs and prone to inflammation - as well as consequent fluid buildup.īollyky shares senior authorship of the study with Carlos Milla, MD, professor of pediatric pulmonary medicine Angela Rogers, MD, associate professor of pulmonary and critical care Andrew Spakowitz, PhD, professor of chemical engineering and of materials science and engineering and Sarah Heilshorn, PhD, professor of materials science and of engineering and director of the Geballe Laboratory for Advanced Materials. ![]() In the study, published online June 22 in JCI Insight, a team of pulmonologists, materials scientists and infectious disease specialists found three substances tangled up in the sputum of COVID-19 patients whose condition is severe enough that they need to be intubated and undergo mechanical ventilation. “But while tens of thousands of studies have analyzed COVID-19 patients’ blood samples, people haven’t looked much at seriously ill COVID-19 patients’ sputum samples - not least because they’re so hard to get.” “Thick, gummy respiratory secretions are at the heart of severe COVID-19,” Bollyky said. Sputum, also known as phlegm, is the elephant in the room that is COVID-19. Their study was the first to analyze in depth the makeup, viscosity and immunological characteristics of sputum from the lungs of patients with severe cases of COVID-19, said Paul Bollyky, MD, PhD, an associate professor of infectious diseases and of microbiology and immunology. ![]() One of these substances may prove especially amenable to treatment with a drug invented long ago for another purpose. Stanford University scientists have implicated a logjam of three long, stringy substances behind deadly thick sputum in COVID-19 patients who need a machine to help them breathe. ![]()
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