Lung Health News, Spring / Summer 2004
The American Lung Association has been fighting lung disease for a century. From the devastation of tuberculosis and related laws to prohibit spitting on the sidewalk to the Proposition 99 tobacco tax and smoke-free bars, research has been the guiding force behind the organization's programs and policy issues.
When the American Lung Association was founded 100 years ago in 1904, tuberculosis (TB) was the dreaded disease. It struck down young and old alike and the association, then called the Tuberculosis Society, vowed to stop it.
"Through research, we were able to find drugs to treat tuberculosis," says Spencer Koerner, MD, former director of Pulmonary and Critical Care Medicine at Cedars-Sinai Hospital in Los Angeles who has reviewed hundreds of research projects on behalf of both the statewide and nationwide American Lung Association. "Now the vast majority of people who get TB can be cured within a few months."
Over the last 80 years, the nationwide American Lung Association has granted millions of dollars to scientific studies that have formed the basis for new treatments and helped further our understanding of lung disease and ways to prevent it. Since 1985, the association has invested more than $58 million in lung disease research, funding more than 2,000 scientists.
Major Discoveries Save Lives
American Lung Association-funded researchers have produced major discoveries over the years, including Mary Ellen Avery, MD, who helped uncover the importance of surfactant in the lungs, which led to a dramatic rise in the survival of premature babies, and Michael Iannuzzi, MD, who helped discover the cystic fibrosis gene. The often fatal lung disease affects 30,000 Americans and is the result of a defective gene that causes the body to produce abnormally thick mucus, which clogs the lungs and leads to life-threatening lung infections.
Today, with asthma rates rising in epidemic proportions and no cure in sight for lung diseases like asthma, emphysema and lung cancer, the American Lung Association of California is finding new ways to raise awareness about the need for more lung disease research and new avenues for raising additional funds. Through statewide legislation, the association secured a spot on the 2003 California state income tax return.
The Asthma and Lung Disease Research Fund is located under Contributions on the state tax form and supports the American Lung Association of California's research program. Taxpayers just need to write in their donation amount and add it to their tax payments or deduct it from their refunds.
California Program Funds Important Studies
The American Lung Association of California launched its research program in 1958. The association funds basic research and in the last decade alone nearly $5 million has been granted to scientists in California.
"Basic research allows us to better understand the underlying mechanisms that control our respiratory system," says Roslyn Bienenstock, RRT, MPH, former chief respiratory therapist at the Children's Hospital at Stanford and chair of the American Lung Association of California's Research Administrative Committee. "Discoveries made today could someday lead to a cure for lung diseases such as asthma and lung cancer."
The American Lung Association of California currently awards research grants in three categories representing various stages in an investigator's career. Research Training Fellowships are for researchers in training, while Research Grants and Clinical Research Grants are for new investigators who are not yet established. These grants often provide the "seed" money young investigators need to attract additional funding.
This year the association funded 21 projects, which range from clinical research on the effects of inhaled corticosteroids on small airway inflammation in asthma to basic research on the molecular mechanisms underlying lung development, asthma, pulmonary edema, primary pulmonary hypertension, mucus production and lung cancer.
"Basic research is an important investment," Bienenstock says. "Understanding the mechanisms of disease takes hundreds of hours in the laboratory, but it is absolutely necessary if we want to help people with lung disease lead more quality lives through better treatments and ultimately reach our goal of a world free of lung disease."
Centers Focus on Asthma
Research has led to important discoveries that have helped people with asthma better manage their lung disease through more effective treatments that actually control inflammation. However, despite significant advances in understanding the underlying mechanisms of asthma, the lung disease continues to be a serious public health problem that affects more than 20 million Americans.
The American Lung Association launched a major public health initiative in 2000 when it funded a network of 19 Asthma Clinical Research Centers around the country to conduct large clinical trials that will have a direct impact on patient care and asthma treatment. In the last five years, the American Lung Association has invested nearly $10 million in the Asthma Clinical Research Centers, which is the nation's largest not-for-profit network of clinical research centers dedicated to asthma. Like other research funding, the network has also attracted additional monies from outside sources totaling more than $17 million for asthma research.
Clinical trials are expensive and require a large number of participants. The Asthma Center network creates a framework for clinical research using the joint resources of all the centers and has attracted some of the best asthma investigators from across the globe.
The results from the first research study have already been released. It examined whether the influenza vaccine is safe for people with asthma and concluded that flu vaccinations are indeed safe and should be administered. The findings have important public health implications because in California alone, flu vaccinations could reduce pediatric hospitalizations for asthma by more than 6,800 each year.
More Research Needed
As the American Lung Association takes on the challenges of the next century, research will be even more vital to accomplishing its mission to prevent lung disease and promote lung health. Despite important advances, there still is no cure for lung diseases like asthma, emphysema, chronic obstructive pulmonary disease (COPD), and lung cancer. Yet these diseases are taking their toll.
Asthma rates have nearly doubled in the last 20 years. An estimated $9.4 billion is spent each year on direct medical costs for treating asthma, which is the leading cause of school absenteeism. COPD and other respiratory illnesses are also on the rise.
An estimated 4.2 million Californians have been diagnosed with lung disease and 40,000 of them will die this year because of it.
"If we really want to achieve our goal of a world free from lung disease, it's going to require some incredible science to achieve that," Koerner says. "Research is the only way we will ever eliminate lung disease and stop the suffering it causes."
