Coffee (Caffeine) Can Block Inflammation in the Body: New Research Findings

New Research Study Shows that Coffee (Caffeine) Blocks Inflammation

Dear Dr. Mahler:

I recently read in our local newspaper that researchers claim the coffee drinkers could live longer. What are your thoughts? I am 70 years old and have had COPD for eight years. I try to eat right and do some physical activity for 20-30 minutes each day. My doctor has prescribed Advair for me which I take twice a day. Thanks for answering my question.

Shannon from Birmingham, AL

Dear Shannon:

I have received many questions about drinking coffee (caffeine) and possible benefits. Also, my post “Will coffee help my COPD?” on January 18, 2015, is the most viewed topic on the website.

coffee beans contain caffeine

coffee seeds commonly called beans

Before discussing the recent study, here is some brief information about inflammation (redness and swelling). In Latin, inflammation means “set afire.”  It is an important part of the body’s immune system to heal an injury or fight an infection.

However, if this persists and is chronic, inflammation plays a key role in various diseases – like asthma, diabetes, heart disease, bowel disease – in addition to COPD.

In a recent study published in the journal Nature Medicine, researchers at Stanford University analyzed the genes of 114 individuals who were part of an aging study. They found that older people between the ages of 60 and 89 tend to increase the production of inflammatory cells. Too much of these over a long time has been linked to heart disease, cancer, and Alzheimer’s disease.

Cup of Coffee (caffeine) that reduces inflammation

cup of coffee

Based on what the subjects reported in a questionnaire, those in the less inflamed group consumed more caffeine drinks like coffee, soda, and tea. The researchers also looked at the effects of caffeine on inflammatory cells in a culture (like a test tube). The cells soaked in caffeine produced far lower levels of inflammatory cells compared with those not soaked in caffeine.

In summary, the study showed a correlation between caffeine consumption and older people with low levels of inflammation in the blood. One of the authors, Dr. Mark Davis, commented that, “That something many people drink – might have a direct benefit came as a surprise to us.” While the researchers did not prove that caffeine causes better health, they came up with a possible way (mechanism) it could be doing so.

In the mean time, enjoy your coffee or tea. There are many proven benefits. For someone who has COPD, caffeine relaxes the muscle that wrap around the breathing tubes that hopefully might make it a little easier to breathe.

 

Resveratrol Reduces Inflammation in the Airways of Mice

Resveratrol is Found in Grapes, Berries, and Nuts

Background: Inflammation (redness and swelling) is prominent in the breathing tubes (airways) of those with COPD. Cigarette smoking, inhaling irritants in the air  (dust, second hand smoke, fumes,etc.), and a chest infection all cause inflammation in the lungs. Some treatments for COPD aim to reduce inflammation in the breathing tubes.

Resveratrol is a phosphodisesterase (PDE) inhibitor that has potential as a therapy to reduce airway inflammation. It is in found in the skin of grapes, blueberries, raspberries, and nuts.

The skin of purple grapes contain resvetrol

Purple grapes

Study: Dr. Carla Andrews and colleagues at Georgia State University in Atlanta studied the effects of resveratrol on the cells lining the inside of the breathing tubes of mice. The study was published in the September 28, 2016, issue of the journal Nature.

Results: In brief, resveratrol reduced the levels of two different inflammatory mediators. In addition, it had anti-inflammatory effects on the airways or mice after infection with the bacteria Haemophilus influenzae.

Raspberries contain resveratrol

Raspberries contain resveratrol

My Comments: At the present there are two different anti-inflammatory medications approved to treat those with COPD. One is inhaled corticosteroids which are combined with an inhaled bronchodilator (beta-2 agonist). The other is roflumilast – a pill which is used to reduce the risk of a flare-up (exacerbation) of COPD.

In addition, oral and intravenous corticosteroids are used to treat those with COPD who have a sudden increase of shortness of breath, cough, and mucus production (exacerbation). These medications are typically prescribed for a short time (5 – 14 days).

To my knowledge, there are no scientific studies that have examined whether eating foods containing resveratrol has a direct effect on those with COPD. However, grapes, berries, and nuts are foods that promote good health. Red wine is also a good source of this substance.

Hopefully, in the future researchers will study the effects of resveratrol on the lining of the breathing tubes on humans who have COPD.

New Inhaler with Ectoin® Protects Against Effects of Air Pollution

Inhaled Ectoin® Provides Natural Barrier in Airways

Dear Dr. Mahler:

I live in London where there we have air pollution. My COPD is fairly stable, but I have breathing problems when I go outside and walk my dog. I check the air quality index each day, and try to limit activities to early AM and late afternoon. However, both my dog and I have to get out of the apartment several times a day or else we go crazy. Is there anything else that I can do?

Willie of London, UK

Dear Willie,

As you know, outdoor air pollution is a global health issue that kills over 3 million people a year. Research is showing new impacts on health in addition to lung and heart disease, such as Alzheimer’s, mental illness, and diabetes.

A new inhaler has been developed by a German medical device company called bitop AG. The inhaler has a molecule called Ectoin® which was discovered in the 1980s in a desert bacteria. According to Dr. Andreas Bilstein at bitop, “It is quite an inert molecule that does one main thing, which is bind water, which stablizes cell membrane tissues against physical or chemical damage.”

Ectoin may help to reduce damage to airways from air pollution

Particulate matter coming out of smokestacks in city

When inhaled, Ectoin® provides a natural barrier to help prevent damage caused by air pollution particles that can lead to inflammation of the breathing tubes (airways).  Dr. Bilstein stated that the perfect situation is that the person inhales it in the morning and evening at home.

So far, the inhaler has been tested in small groups of patients with asthma, COPD, and bronchitis considered to be at risk from air pollution.

Ectoin® does not interact with cell receptors so it is classified as a medical device rather than a drug. This means that large clinical studies are not required for official approval and the inhaler could be on sale soon. The estimated cost will be 17 pounds ($22) per month.

Bitop AG is the worldwide producer of Ectoin®. The company has about 35 employees with headquarters in Witten, Germany.

I suggest that you keep an eye out for when Ectoin® will be available. In the meantime, considering eating a lot of fruits and vegetables. These foods contain antioxidants which can provide some protection from inhaling air pollutants.

Sincerely,

Donald A. Mahler, M.D.

Lifestyle Options to Reduce Inflammation in COPD

How to Reduce Inflammation in COPD

Dear Dr. Mahler:

I read in your book that inflammation is part of COPD.  What does that actually mean?  I am 67 years old and was diagnosed with chronic bronchitis form of COPD about 3 years ago.  I quit smoking at the time, and still work selling real estate.  If inflammation is bad, what can I do to get rid of it? Thanks.

Bill from Pensacola, FL

Dear Bill,

In Latin, inflammation means “set afire.”  It is an important part of the body’s immune system to heal an injury or fight an infection. However, if this persists and is chronic, inflammation plays a key role in various diseases – like asthma, diabetes, heart disease, bowel disease – in addition to COPD.

woman holding candle

Smoking cigarettes and inhaling irritants causes injury to the breathing tubes and air sacs.  In response, the body calls in, or recruits, white blood cells to the area of injury.  This results in redness and swelling of the area – the features of inflammation.  See the figure on the right below.

Right photo shows acute bronchitis with inflammation

Photo on right shows acute bronchitis with yellow mucus inside the airway along with redness and swelling of the wall.

If someone continues to smoke, the inflammation persists and becomes chronic. This causes swelling in the lining of the breathing tubes that narrows the opening and reduces the ability to exhale air. In addition, inflammation makes it more likely that the muscle that wraps around the breathing tubes will constrict or tighten. This is called bronchoconstriction and further reduces the flow of air out of the lungs.

Here is what you can do to try to reduce inflammatory changes in your lungs:

  1. Don’t smoke.  It is great that you already quit.
  2. Avoid inhaling irritants in the air like smog, dust, smoke, fumes, fibers, soot, etc.
  3. Eat healthy foods that includes lots of fruits, vegetables, whole grains,
    Salmon

    Salmon

    beans, nuts, olive oil, and fish especially salmon –  that have anti-inflammatory effects.  Blueberries are the BEST.

  4. Consider spices – such as ginger root, cinnamon, clove, black pepper, and tumeric – which may provide anti-inflammatory benefits. More research is needed to know whether these and other spices help with inflammation in COPD.
  5. Get enough sleep. Studies show that when healthy individuals are sleep deprived, there is an increase of inflammation in the body. How this happens is unclear.
  6. Try to exercise at least 3 – 4 times a week.k13084522
  7. For a treat, eat dark chocolate which is loaded with organic compounds that are biologically active and function as antioxidants. These include polyphenols, flavanols, and catechins.

 

I hope that this information answers your question.

Best wishes,

Donald A. Mahler, M.D.

 

COPD and Obstructive Sleep Apnea Overlap

Obstructive Sleep Apnea Increases Inflammation in COPD

Background: Obstructive sleep apnea (OSA) is a common condition that affects about 5% of adults over the age of 40 years. Apnea is a medical word that means to stop breathing for at least 10 seconds. This can occur during sleep at night when the muscles of the throat relax and block the flow of air into and out of the lungs. The person then wakes up and starts to breathe again. This process of stopping breathing and waking up to start breathing can occur hundreds of times during the night and cause poor sleep quality.

In one study 66% of those with COPD who enrolled in pulmonary rehabiliation tested positive for obstructive sleep apnea (Ann Am Thorac Soc. 2015;12(8):1219-25. dos: 10.1513/AnnalsATS.201407-336OC ). Some of these individuals with both COPD and OSA (called overlap syndrome) had pulmonary hypertension (high blood pressure in the blood vessels of the lungs).

Study: In the September 2015 issue of the journal Sleep Medicine (volume 16, pages 1123-1130), Wang and colleagues studied whether OSA affects inflammation in the lungs of those with COPD. They studied 47 individuals with overlap syndrome (both COPD and OSA) along with 28 with moderate to severe COPD. A tube was passed into the mouth and into the lungs (called bronchoscopy) and fluid was injected and then suctioned to obtain samples of cells from the lungs.

Results: Those with the overlap syndrome had more inflammation (neutrophils, tumor necrosis factor-α, and interleukin-8) in the lungs than those with COPD alone. The tumor necrosis factor-α was significantly correlated with the percentage of nighttime spent with the oxygen level less than 90%.

Conclusion: OSA increases inflammation in those with COPD.

My Comments: Inflammation in the lungs is considered “bad” for those with COPD because it can: 1. can increase narrowing of the airways (bronchoconstriction), 2. lead to damage in the lungs, and  3. increase the risk of sudden worsening (a COPD exacerbation).

Daytime sleepiness, fatigue, and/or insomnia are common in people with untreated OSA.

Daytime sleepiness, fatigue, and/or insomnia are common in people with untreated OSA.

Typical symptoms of OSA are snoring, stop breathing during sleep (ask your sleep partner about this), fatigue, and daytime sleepiness. I encourage you to ask your health care provider about OSA if you have any of these symptoms. A sleep study is performed to diagnose OSA. Treatments are available that can help keep your throat open when you sleep and prevent drops in your oxygen level during sleep. This can also lead to improvement in our COPD and quality of life.