Test for Deadly Lung Disease Is Used for First Time in Texas

Friday, May 31, 2019

A UT Health San Antonio lung specialist is the first in Texas to use a new genomic test to better and less invasively diagnose a patient with idiopathic pulmonary fibrosis (IPF), a serious, chronic, progressive and scarring lung disease with an average survival time of less than five years after diagnosis.

Anoop M. Nambiar, MD, MS, utilized the novel diagnostic test in February at University Hospital in San Antonio during a standard-of-care bronchoscopy, a nonsurgical procedure, on a male patient to differentiate IPF from other interstitial lung diseases (ILDs). The procedure and use of the test were successful without any complications.

Three to five lung tissue samples were obtained through a bronchoscope and sent to a lab for analysis. The lung biopsy samples are scanned for 190 genes commonly associated with fibrosis (scarring of the lungs) and lung inflammation.

A computer algorithm then predicts with high probability whether the lung biopsy tissue demonstrates a pattern of fibrosis consistent with IPF.

Benefits to patients

An earlier, more accurate diagnosis of IPF is critical for earlier referral to a lung transplant center, enrollment in IPF clinical trials, initiation of appropriate antifibrotic therapy and avoidance of harmful treatments such as corticosteroids like prednisone.

Currently, a high-resolution CT chest scan is the first step to diagnosing a patient with suspected IPF. However, a CT scan without specific characteristic, radiologic features may miss up to 50% of patients who may have IPF. In these cases, IPF clinical practice guidelines recommend that patients undergo a surgical lung biopsy, an invasive procedure that may be associated with potentially significant harm, including death. Currently, about 30% of IPF patients require a surgical lung biopsy to confirm the diagnosis.

“There is a significant unmet need for safer and better ways to diagnose IPF patients and differentiate them from other types of interstitial lung diseases,” says Dr. Nambiar, Associate Professor of Medicine in the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio. He is the Founding Director of the institution’s Interstitial Lung Disease Program, one of 60 Pulmonary Fibrosis Foundation Care Centers in the United States.

University Hospital, site of the bronchoscopy performed on the patient, is part of University Health System, which is a major clinical partner of UT Health San Antonio.

Unique signatures

Precision medicine is an envisioned future approach of diagnosing and treating patients as unique individuals based on their genetic codes. The novel diagnostic test identifies a specific genetic signature present in the lung biopsy samples to help detect IPF.

“My hope is that this first step in better diagnosing IPF patients will lead to more precise ways of treating IPF patients in the future,” Dr. Nambiar says. “As the first medical center to offer this innovative diagnostic test in the state of Texas, the future is now for diagnosing IPF without surgery here in Texas.”

Anoop M. Nambiar, MD, MS, specializes in critical care medicine, internal medicine and pulmonary disease at UT Health Physicians, the medical practice of the Long School of Medicine at UT Health San Antonio. The Interstitial Lung Disease Program, offered through UT Health Physicians, is one of 60 Pulmonary Fibrosis Foundation Care Centers in the United States. For more information, call 210-567-5792.