In Vietnam, research related to pulmonary diseases such as silicosis and chronic obstructive pulmonary disease (COPD) has been conducted, yet it remains predominantly clinical, with very few studies addressing risk factors—particularly molecular epidemiology and the application of high-tech methods for disease detection and treatment.
Therefore, studies on risk factors for silicosis will help shape strategies for early diagnosis and counseling for workers, especially those in industrial zones who carry TNF-α (tumor necrosis factor) gene variants that may increase their susceptibility to silicosis.
These studies contribute to counseling individuals at high risk to enable them to choose appropriate occupations and implement suitable occupational health and safety measures.
Applying advanced techniques in the early diagnosis of silicosis
According to reports from the Health Environment Management Agency, silicosis continues to be a significant disease burden in Vietnam.
The actual number of cases and deaths due to silicosis is higher than the figures reported and officially appraised annually.
To date, there is still no specific treatment for this disease, but it can be prevented early. Therefore, early prevention and diagnosis of silicosis are extremely important in protecting and caring for the health of workers.
Silicosis is an irreversible progressive pulmonary fibrosis caused by inhaling free silica dust or silicon dioxide (SiO2) crystals in the working environment. The disease continues to progress even after workers are no longer exposed to silica dust.
Exposure to silica dust can occur across various industries, affecting workers exposed to quartz, sand, granite (containing 60% silica), stone dust, and cement dust.
The research project entitled "Study on molecular epidemiological characteristics, risk factors, and application of advanced techniques in the early diagnosis of silicosis in Vietnam," part of the State-level key science and technology program on researching, applying, and developing advanced technologies for public health protection and care (KC.10/16-20), was jointly implemented by the research team from the School of Preventive Medicine and Public Health (Hanoi Medical University), the Health Environment Management Agency (Ministry of Health), and the National Lung Hospital, successfully introducing a method for the early diagnosis of silicosis.
The project was led by Prof. PhD. Le Thi Huong, Director of the School of Preventive Medicine and Public Health, alongside her associates.
The study was based on the application of advanced techniques to a cohort of over 8,000 workers at production facilities across various regions of the country who have direct contact with silica dust, simultaneously applying several advanced techniques for the early diagnosis of silicosis.
The research team applied molecular biology techniques to determine the molecular epidemiological characteristics and endogenous risk factors of silicosis; determined the prevalence of silicosis and analyzed related factors, blood TNF-α protein concentrations, and next-generation gene sequencing.
Advanced techniques included digital radiography according to the ILO (International Labour Organization) standards, measurement of total lung capacity (TLC), and measurement of the diffusing capacity of the lungs for carbon monoxide (DLCO) to diagnose silicosis early before patients exhibit clinical signs.
The results showed that the prevalence of silicosis in the studied provinces was 12%, with the metallurgy sector accounting for the highest rate (14.9%), followed by the ore/stone mining and processing sector (14.4%), and the ceramic, porcelain, and glass manufacturing sector (13.3%).
The research results also indicated statistically significant associations between gender, age group, occupational seniority, smoking history, duration of silica dust exposure, wearing masks, and the prevalence of silicosis.
Through this project, the research team has mastered the procedure for applying advanced techniques in the early diagnosis of silicosis and stands ready for technology transfer to help improve public health.
The prevalence of silicosis in the studied provinces was 12%, with the metallurgy sector accounting for the highest rate (14.9%), followed by the ore/stone mining and processing sector (14.4%), and the ceramic, porcelain, and glass manufacturing sector (13.3%). (Source: VNA)
Prof. PhD. Nguyen Cong Khanh, Chairman of the Evaluation Council, highly praised the outcomes and emphasized that the research results not only provide scientific evidence for education and research at Hanoi Medical University but also serve community early prevention well, providing scientific evidence for managers to make decisions aimed at early prevention and treatment of silicosis for workers in Vietnam.
At the same job placement, the study also assists the Ministry of Health in reviewing diagnostic criteria for silicosis (regarding minimum exposure duration), developing guidelines for blood TNF-α testing during recruitment health examinations or job placements for workers in high-risk industries such as metallurgy and ore/stone mining.
In particular, the research helps suggest future research directions to continue early detection of silicosis, helping workers remain healthy and increasing labor productivity.
Application of stem cells in the treatment of chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a common, chronic condition characterized by incomplete reversible expiratory airflow limitation, which typically progressive in severity and is associated with an exaggerated chronic inflammatory response in the airways and lung parenchyma to noxious particles and gases.
COPD generally progresses with acute exacerbations and worsens over time despite the application of combined therapeutic measures.
The research project entitled "Application of allogeneic mesenchymal stem cells in the treatment of chronic obstructive pulmonary disease," led by the Vietnam Military Medical University in collaboration with the National Lung Hospital and Van Hanh General Hospital, was evaluated and approved at the State level by the Ministry of Science and Technology council in mid-June 2021, opening up a new treatment direction and bringing value and confidence to patients and society.
This is one of the pioneering projects applying stem cells to improve the health of patients with chronic obstructive pulmonary disease.
Stem cells are unspecialized cells with the potential to develop into many different cell types and possess self-renewal capabilities.
Stem cells and mesenchymal stem cells have been proven to possess anti-inflammatory, immunomodulatory, and regenerative properties.
Thanks to their unique immunomodulatory properties, mesenchymal stem cells have become valuable cells in treating and healing tissue injuries or in managing chronic inflammatory and autoimmune diseases.
Due to the superior properties of stem cells, autologous and allogeneic stem cell therapies for COPD are currently undergoing clinical trials worldwide, initially yielding positive results and hope for patients.
Through researching and implementing this project, scientists at the Vietnam Military Medical University have mastered new and modern treatment techniques regarding the isolation and culture of mesenchymal stem cells from umbilical cord tissue for COPD treatment.
Among sources of stem cells, the umbilical cord is a source of mesenchymal stem cells with high application potential.
Umbilical cord-derived mesenchymal stem cells feature a simple collection procedure, are easy to harvest, contain multiple types of stem cells in large quantities, and possess numerous distinct advantages over mesenchymal stem cells derived from other sources.
Consequently, using allogeneic umbilical cord mesenchymal stem cells to treat inflammatory conditions such as COPD is a scientifically sound option aimed at targeting the pathomechanism of the disease.
Prof. PhD. Pham Gia Khanh, Head of the KC.10/16-20 Programme, emphasized: The objectives of COPD treatment are to reduce symptoms, slow disease progression, decrease exacerbations, enhance physical activity capacity and quality of life for patients, and reduce mortality.
Several intervention measures have been applied to treat COPD, including lung volume reduction surgery, bronchoscopic lung volume reduction, and lung transplantation.
Current treatment modalities, including both pharmacological and non-pharmacological measures, have yet to fully meet patients' primary desire: improving quality of life by increasing exercise capacity and reducing hospital admissions due to exacerbations.
Therefore, according to the research team, given that the pathogenesis is linked to inflammation and hyperactivity of the immune system, a rational treatment modality that aligns with the immunological mechanisms of the disease is urgently needed.
Grounded in practical issues, the research team deployed the project with the objective of establishing a procedure for applying allogeneic mesenchymal stem cells in COPD treatment.
Simultaneously, the team evaluated the safety and efficacy of allogeneic mesenchymal stem cell transplantation in COPD treatment.
The research team successfully established the procedure for applying allogeneic mesenchymal stem cells in COPD treatment while evaluating the safety and efficacy of allogeneic mesenchymal stem cell transplantation.
The results demonstrated that allogeneic mesenchymal stem cell transplantation therapy is safe, with no anaphylactic shock or mortality observed immediately post-transplantation, nor at 24 hours, 1 week, and 1 month post-transplantation.
This method exhibited therapeutic efficacy throughout 6 and 12 months of post-treatment follow-up.
The achievements of the project add scientific evidence regarding the feasibility of utilizing stem cells in the regeneration/repair of damaged cells and tissues, contributing to the advancement of regenerative medicine, which is receiving intense attention and represents one of the novel trends in medicine.
Simultaneously, it confirms that scientists have mastered new, modern treatment techniques concerning the isolation and culture of mesenchymal stem cells from umbilical cord tissue, stem cell transplantation techniques, and the evaluation of the efficacy in COPD patients treated with allogeneic umbilical cord-derived mesenchymal stem cell transplantation.
This is one of the pioneering projects utilizing stem cells to improve the health of COPD patients, opening a new direction in the treatment of COPD in particular and other diseases in general using allogeneic umbilical cord-derived mesenchymal stem cells, bringing value and confidence to patients and society./.