You should be paying more attention to your lungs. KU Med is helping you do it | Opinion

Why does lung health matter and what is pulmonary fibrosis?

The human body has a remarkable ability to heal injury. When one of my sons takes a corner too fast on his bike and scrapes a knee, it usually only takes a bandage, a reassuring look and a ruffle of the hair before he’s back on the bike, ready to scrape the other knee. Underneath that bandage, an intricate dance between my son’s immune system and cells in his skin form a scab that lasts for a few days — and then voila, one day the scab is gone, and new shiny pink skin is revealed. Two weeks later, you’d be hard pressed to identify which of his knees had met the Kansas City pavement.

When things go right, the human organism has an almost magical ability to heal from these small injuries. But, as a physician-scientist, I study a condition where this healing process goes awry. Imagine if these tiny injuries didn’t heal completely, if they piled up instead, and normal, healthy organs were slowly replaced with scar tissue. If you had to pick an organ where scar formation was most devastating, you’d probably pick the lung.

At the most basic level, the lungs contain millions of tiny chambers where oxygen from the air can pass into the bloodstream, and carbon dioxide can leave. There are so many of these delicate structures, that when laid out flat, they’d make up the size of a tennis court. Think of that, your lung requires a tennis court size of lung surface area to get enough oxygen from the air to power our muscles, heart, eyes and those little legs that pedal bikes around tight corners.

But, just like knees, the lungs sustain injury. In every breath we take, our lungs indiscriminately inhale the air around us, and some of the things in our environment can directly injure these delicate structures of the lungs. Cigarette smoke, pollution and other airborne particles from industrialization can damage those fragile structures in our lungs. And for some people, a combination of these environmental exposures and specific genetic traits means that instead of healing, their lungs build up tiny scars over time so that what started as a tennis court, becomes a pickleball court. When these tiny, delicate structures are overtaken by thick, dense scar tissue the primary job of these lung structures — to allow gas exchange — is forever lost.

Pulmonary fibrosis is the name of this condition, and it leads to irreversible loss of lung function. For my patients with pulmonary fibrosis, the thing that strikes me most in our conversations is how much it takes from them. Breath is essential. Air is essential.

Humans are what we scientists call “obligate aerobes,” meaning that we must have oxygen to survive. The lungs are a necessary conduit between our world and our internal parts to extract the necessary oxygen to power us all. But for people with pulmonary fibrosis, they have oxygen — and we can deliver even more via oxygen tanks — but they just can’t use it. They can’t get that oxygen into their bodies, into the blood cells that carry it to their heart, brain and knees.

While pulmonary fibrosis is relatively rare, its impact is profound. In fact, survival rates for idiopathic pulmonary fibrosis are worse than all solid cancers except for lung and pancreatic cancer. At the University of Kansas Medical Center, I work with patients who have pulmonary fibrosis, and we collaborate to develop research that might one day improve their lives. Recently, our lab received the American Lung Association’s Dalsemer Award for Interstitial Lung Disease Research. This funding will help us continue our work, exploring how the body’s genetic and biological traits interact with these environmental factors in the lungs, studying proteins and metabolites involved in these processes. Our goal is to find new ways to treat pulmonary fibrosis and ultimately make a real difference for those affected by this devastating disease.