The PH unit at the Mater hospital has made significant progress in the treatment of pulmonary hypertension and staff are hopeful that a cure for the disease will be found through their research, writes Bríd Higgins Ní Chinnéide
Staff and patients of a specialist unit at the Mater Hospital are hopeful that their clinical research will lead to a cure for the currently incurable and debilitating blood vessel disease, pulmonary hypertension (PH).
The PH unit at the Mater is part of an international group of specialist research centres that have made significant developments in the treatment of pulmonary hypertension in recent years, according to consultant respiratory physician at the Mater hospital, Dr Seán Gaine.
Gaine established the pulmonary hypertension unit at the Mater in 2003 with the opening of a new clinic and the allocation of a PH nurse specialist. The unit sees itself at the forefront of an international effort to improve treatment and care practices for patients with the disease.
"There's a real belief that we'll be able to capture new treatment therapies and we think we are in a position to drive that in the Mater," Gaine says.
He is optimistic that a cure may be found for the disease in the long-term future through gene manipulation and stem-cell research.
Last year, 180 patients were diagnosed with PH, a progressive disease with rising prevalence that affects men and women, though women of a child-bearing age are most commonly affected. Patients suffer from abnormally high blood pressure due to the narrowing of blood vessels from the right side of the heart to the lungs. The PH sufferer's right ventricle works harder to squeeze the lungs' blood supply through the narrowed vessels, resulting in failure of the right side of the heart.
Initial symptoms of PH include fatigue and unexplained breathlessness that is disproportionate to any underlying respiratory disease, such as asthma. The causes of PH vary from emphysema to rheumatic conditions, but the strain known as idiopathic pulmonary hypertension has no known cause and can run in families.
Gaine says there is a high awareness of the disease and that a simple Echo scan can show elevated tension in the right side of the heart.
Thanks to new developments in PH treatments, the life expectancy of patients diagnosed with pulmonary hypertension disease in the State has risen from two and a half years in 2003 to more than five years today, according to the PH unit at the Mater.
The latest step for the unit has been the recent allocation of two designated beds for PH sufferers in St John's ward, and the specialised training of staff on the ward. It is intended this development will be followed with a seamless admissions policy for PH patients.
"According to international guidelines, PH should be taken care of in specialised centres," says Gaine. He is hopeful that the Mater will continue to be the specialised centre for the State.
"I hope to be able to have the main centre here because that's where the clinical trials will come from. If we don't have enough patients then we won't be on the cutting edge of clinical development. It is great to be able to offer our patients the latest drugs. Some are drugs that may not be widely available for another two or three years, but we have them now," he says.
Ten years ago a PH patient's life expectancy could be as short as two years and, if a patient was not lucky enough to get a lung transplant, he or she would have been sent to the UK for treatment.
However, Gaine believes there is a brighter future for sufferers of the disease and that a cure can be found in the long-term future through gene manipulation and stem-cell research.
"In 10 years we will be using a lot more immune therapies and manipulating with monoclonal antibodies. We think we are in a position to contribute to these developments," he says.
Sinéad Doherty, PH nurse specialist at the Mater, says the focused care of the Mater unit is reassuring for patients, who can avail of 24-hour advice or assistance.
Patients and their families develop a strong rapport with the clinic not only through the care services, but also because many patients contribute to the development of treatment by undergoing trials, she says.
"There is a real connection between the families and the clinic, because they are putting their life in our hands," says Doherty.
Liam Quigley (27) from Carlow says, "I would not be alive today if it wasn't for the new drugs I was put on and the specialist care I'm getting.
"I certainly wouldn't have the new baby, LJ," he adds.
Quigley was diagnosed with PH seven years ago and he has been involved in clinical trials the Mater unit has conducted. "I felt much better straight away when I started treatment," he says.
Quigley, who played football for his county team, has had to give up most physical activities and he hasn't worked for five years.
"I can still have my hobbies like fishing and hunting, though they are trying to get me to stop hunting."
Quigley first noticed symptoms of the disease when he collapsed while playing football. He says that he only began to take his condition seriously two years ago. "Before Debbie [Quigley's wife] or my mother would look after my treatments, but then I started to take notice. Some days I feel great and other days I feel dreadful," he says.