Health

By LAUREN GROVER
Staff Writer

It is fluid, puss and scar tissue that get Dr. Steven Idell excited.

A researcher for nearly 30 years, Idell studies lung injury at the molecular level and the drugs that treat it. The therapies available to pulmonologists today are lacking, he says.

Since 1980, he has curled over microscopes and prodded at mice and rabbits to find better cures. His latest development is a sophisticated enzyme that carefully dines on scar tissue and blood clots that inhibit lung function.

Idell, vice president of research at the University of Texas Health Science Center at Tyler, received a patent for the agent in October.

It's called single-chain urokinase plasmogen activator, or scuPA.

"It could mean for people with pneumonia and pleural disease, you can use a drug instead of surgery," he said.

A common treatment for pleural disease (infection of the pleural cavity surrounding the lungs) is draining, said Dr. Richard Kronenberg of Trinity Mother Frances, but the agents now used to break up puss and scarring are clumsy.

"We often have to throw in general, eat-everything enzymes, like digestive enzymes," Kronenberg said. "It's kind of like treating a hangnail with a sledgehammer."

Dr. David Coultas, UTHCT physician-in-chief, agreed, saying most agents used haven't prevented lung disease pati-ents from undergoing surgery.

"It's a challenge for all pulmonologists, to be as least invasive as possible," he said.

Pleural disease often results from pneumonia, Idell said, and afflicts some 80,000 people in the U.S.

When draining isn't sufficient, a surgical procedure called "decortication" is performed to clean and scrape the cavity, Coultas said. And, the use of a scuPA-like agent for draining isn't consistent: it involves risks and doesn't always prevent surgery.

"If the medication gets into the bloodstream it can increase the risk of bleeding," Coultas said.

Idell said scuPA doesn't act like other agents. It doesn't eat everything away, but instead is slow-acting and only reacts with tissue it is meant to destroy.

"This is better than any other choice of agent," he said.

What's more exciting, Coultas said, is the possibility that scuPA could treat pulmonary fibrosis, a fatal disease.

"It's an interesting thing, a potential novel treatment for pulmonary fibrosis," Coultas said. "Right now we don't have effective treatment."

Although cases of pulmonary fibrosis are as low as 30 in 100,000, death often occurs three to five years after diagnosis, Kronenberg said.

Some of its causes are known, such as asbestos-related pulmonary fibrosis, but others are not.

Coultas said he believes most are related to inhalation of toxic substances. The lungs react by trying to engulf the toxin, causing injury to the lung's lining, scarring, leakage and clotting.

The scarring will eventually cause death, he said.

If scuPA was effective, it could possibly be given through inhalation to treat pulmonary fibrosis, Idell said.

"There is no treatment (now)," Coultas said. "But it's still plausible. That's why Dr. Idell's agent needs to be investigated."

ScuPA could change the cost of treating pleural disease, Idell said - a $200 injection of scuPA is far less than a $2,000 decortication surgery.

Now with intellectual property of the agent, Idell is applying for clinical trials to be conducted by the National Institute of Health.

He has also discussed manufacturing with Texas A&M University.

"It's nice if you can actually have a study in the pre-clinical model that can make it in the clinical stricture," Idell said.

Idell began investigating scuPA in 2001 on his third $1 million NIH grant for lung injury research.

Idell shares space with nearly 30 other researchers whose grants exceed $20.5 million at UTHCT's Center for Biomedical Research.

Updated Thursday, Dec. 6, 2007 at 3:25 p.m. CST

Dr. Steven Idell
()