COPD is defined
by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as “a
common preventable and treatable disease, is characterized by persistent
airflow limitation that is usually progressive and associated with an enhanced
chronic inflammatory response in the airways and the lung to noxious particles
and gases. Exacerbations and comorbidities contribute to the overall severity
in individual patients” (GOLD 2011).
This progressive worsening of lung function is caused by narrowing
of the small airways due to increased mucus production, the proliferation of the
smooth muscle cells and fibrosis. This is also accompanied by the destruction
of the alveoli structure (emphysema) and chronic bronchitis (Fig. 1)(Barnes 2007).
Weight loss, nutritional abnormalities and skeletal muscle dysfunction are also
recognised symptoms of COPD (Vogelmeier and Bals 2007). Physical manifestations
of the disease include breathlessness (dyspnea), chronic cough with/without
sputum, wheezing and intolerance to exercise (Qaseem, Wilt et al. 2011).
Figure 1.: Histopathology of COPD small airways (A) Normal airway with an open lumen (B) Small airway lumen filled with mucus (C)Acute inflammation and mucus surrounded by thick airway wall (D) Chronic inflammation: fibrosis and hyperplasia of smooth muscle cells accompanied by fibrosis resulting in the obstruction of the airway. Adapted from Hogg (2004).
Epidemiology and prevalence
COPD is ranked as the fifth most common cause of death
globally and predicted to be the fourth leading killer by 2030. It is just
below ischemic heart disease, cerebrovascular disease, and HIV/AIDS (Mathers
and Loncar 2006). It is believed that the lifetime risk of developing COPD is
28% by age 80 (Gershon, Warner et al. 2011). The World Health Organisation
(WHO) projected that it could become the 3rd biggest cause of
mortality by 2020 worldwide (Fig. 2) (Buist, McBurnie et al. 2007). The
prevalence of COPD among the world population counts for about 10%. According
to WHO, there are more than 64 million people affected by COPD (Mathers and Fat
2008). However, this is underestimated and the actual number is higher than 600
million (Sin and Vestbo 2009). Most COPD
patients are either misdiagnosed or unrecognised even long after being severely
disabled (Barnes 2007; WHO 2008). The rate of COPD has increased in the
affluent countries in comparison with the developing countries mainly due to the ageing population and better management of other major illnesses such as cancer
and cardiovascular diseases (Nowak, Berger et al. 2005). One-quarter of the general
adult population age 40 or above have mild airflow obstruction (Buist, McBurnie
et al. 2007; Mannino and Buist 2007; Menezes, Perez-Padilla et al. 2008). For
example, there are estimated 12.2
million (14.3%) people aged ≥ 40 suffers from mild airflow limitation in the
five major cities of Latin American countries (Brazil, Mexico, Uruguay, Chile
and Mexico) (Menezes, Perez-Padilla et al. 2008). Epidemiological studies have
shown that the prevalence of COPD in the USA has doubled between 1979 and 2002 (Decramer,
Janssens et al. 2012). It affects 5% of the adult population and costs the economy
$49.9 billion per annum (Qaseem, Wilt et al. 2011). In Canada, a 2% increase in the numbers of
females with COPD was observed between 1996 and 2007 and 9.5% of the Canadian population
suffer from COPD (Gershon, Wang et al. 2010).
There are still many parts of the world, for example, Africa and Asia,
from which detailed epidemiological data are yet to be reported (Soriano and
Rodriguez-Roisin 2011).
According to the Department of Health (DoH), 25,000 people die
from COPD a year in England and Wales. COPD accounted for 4.8% of all deaths in
England between 2007 and 2009. The DoH reveals that around 835,000 people
suffer from COPD in the UK and an estimated 2.2 million (13% of the population of
England) aged 35 and above remain undiagnosed (Department of Health 2011). COPD
also places an enormous financial burden on the health system and economy as a
direct result of hospitalisation and time lost from work (Barnes 2007; Gruffydd-Jones
2008). It has been reported that GP consultation and hospitalisation has
increased for COPD compared with cardiovascular diseases, resulting in a
greater than 3-fold increase in healthcare costs (Barnes 2007). An estimated
cost for COPD is over £800 million annually in addition to £2.7 billion in lost
working days in the UK alone (Department of Health 2010). It is clear that COPD
poses a serious problem socially and economically that needs to be addressed.
Figure 1.2: World map of estimate
mortality rate caused by COPD in
male patients per 100,000 (WHO updated 2004) (Mathers and Fat 2008; Bhome 2012).
Aetiology
Tobacco smoking is the primary risk factor linked to COPD in
prosperous Westernised countries and environmental pollution, especially indoor
biomass smoke, is associated in the developing world (Decramer, Janssens et al.
2012). Cigarette smoke (CS) is a complex mixture of noxious particles,
chemicals and reactive oxidant species (ROS) (Rahman and Adcock 2006; Min,
Bodas et al. 2011). Physical barriers and the immune system protect the human lung
from harmful environmental agents such as pollution, bacteria, viruses and
fungi (Nikota and Stampfli 2012). However, continuous cigarette smoking affects
these barriers by increasing epithelial permeability and impairing mucociliary
clearance (van der Vaart, Postma et al. 2004; Forteza, Casalino-Matsuda et al.
2012). In addition, both COPD and
smokers are susceptible to respiratory infection, which is the main cause of
exacerbations in COPD patients especially during later stages of the disease
(GOLD III-IV) (Arcavi and Benowitz 2004; Churg, Cosio et al. 2008).
Not all smokers develop COPD and there have been reports of
COPD in non-smokers. A number of risk
factors have been identified, other than cigarette smoking, such as age,
occupational exposure to organic dust, asthma, respiratory infection, biomass
fuel combustion and poor socioeconomic status (Fig. 3) (Salvi and Barnes 2009;
Clancy and Nobes 2012; Forteza, Casalino-Matsuda et al. 2012). In addition,
susceptibility to COPD is also influenced by genetic risk factors. It is long
known that deficiency in alpha1-antitrypsin due to a mutation in the gene
serpin peptidase inhibitor, clade A, member 1 (SERPINA1) leads to COPD and accounts for 1-2% of COPD cases (Kukkonen,
Tiili et al. 2011; Clancy and Nobes 2012).
Recent studies of genomic-wide association (GWA), that
examine the association between common genetic variation and associated phenotype
between groups of individuals, have
identified a number of candidate genes that are associated with COPD (Berndt,
Leme et al. 2012; Bosse 2012; Foreman, Campos et al. 2012). Among these, COPD
patients show a correlation between lung function and single nucleotide
polymorphisms (SNPs) in three loci (GSTCD,
TNS1 and HTR4) (Soler Artigas, Wain et al. 2011). GSTCD gene encodes for glutathione s-transferase C-terminal
domain-containing protein. GSTCD protein catalyses glutathione (GSH) binding to
oxidative stress products and regulates lipid mediators (prostaglandins and
leukotrienes); thereby preventing cellular damage (Hayes, Flanagan et al. 2005).
GSH is an antioxidant that donates an electron (H++e-) to
unstable molecules such as ROS to become oxidised glutathione disulphide (GSSG)
(Flohe 2012). TNS1 gene encodes for tensin-1 adhesion protein that shows binding
preference to actin with SH2 (Src homology 2) domain. Tensin-1 is associated
with cell signalling and migration (Hall, Balsbaugh et al. 2010). HTR4 gene encodes for 5-hydroxytryptamine
4 (5-HT) receptor which is a member of G-protein-coupled receptors (GPCRs) and
expressed in neurones and epithelial type cells (Ghavami, Stark et al. 1999; Wilk,
Shrine et al. 2012). GPCRs are generally expressed in phagocytes for chemokines
and chemoattractants (Sun and Ye 2012). Similarly, BICD1 (Bicaudal D homology 1) is another gene that has been
studied in telomere shortening and cellular senescence (Savale, Chaouat et al.
2009). Leukocytes from COPD patients have reduced telomere lengths compared
with healthy smokers and non-smokers (Savale, Chaouat et al. 2009). This
premature reduction is associated with oxidative stress and inflammatory damage
(Kawanishi and Oikawa 2004). SNP analysis of BICD1 reveals genetic
variation between emphysematous patients and healthy control (Kong, Cho et al.
2011). These loci may provide some
explanation to the underlying cause of COPD but it is ultimately the interaction
between nature (environmental risk factors) and nurture (genotype) that leads
to COPD (phenotype) (Ober, Butte et al. 2010).
Figure 3: Risk factors associated with COPD. Tobacco smoking is the primary risk factor for COPD in about 90% of cases. However, the susceptibility of an individual to COPD also depends on other environmental and genetic risk factors (Salvi and Barnes 2009; Berndt, Leme et al. 2012). Depiction obtained and modified from the Global Initiative for Chronic Obstructive Lung Disease (2011).
Pathophysiology of COPD
COPD is a generic term to describe a number of diseased
conditions including emphysema, chronic bronchitis and small airways disease.
Each condition has its unique clinical features but they all contribute to the
continued restriction of airflow throughout respiratory airways (Barnes 2007; Vestbo,
Hurd et al. 2012). The normal function of the lung is to provide a continuous
supply of oxygen and remove carbon dioxide. It is achieved through simple
diffusion which occurs between alveoli and blood. This exchange mechanism is
vital for survival (Clancy and Nobes 2012). Lung function decreases with age
but it is accelerated in COPD patients due to cigarette smoke (CS) (Fig. 4) (Fletcher
and Peto 1977; Bednarek, Gorecka et al. 2006). Noxious particles in CS cause
irritation of the airways which results in enlargement of the mucus gland, mucus
hypersecretion, ciliary dysfunction and epithelial-cells hyperplasia in the
early stage of the disease. This is accompanied by an increase in goblet cells,
smooth muscle cell mass, and fibrosis (Barnes 2004; Rogers 2005).
Figure 4: The effect of
cigarette smoking on lung function.
Lung function decreases with senescence, however, this is rapidly decreased in COPD patients. Adapted from Fletcher and Peto (1977) and Bednarek, Gorecka
et al. (2006).
CS and other irritants trigger an inflammatory reaction in the
small airways, lung parenchyma and elsewhere in the body (systemic) (Barnes
2008; Voelkel, Gomez-Arroyo et al. 2011). Inflammation occurs not only in COPD
patients but also in healthy smokers (Willemse, Postma et al. 2004). However,
the degree of intensity varies depending on individual susceptibility, genetics
and the magnitude of CS exposure (Dewar and Curry 2006). Persistent
inflammation and ongoing repair of the airways leads to remodelling involving a decrease in airway lumen and an increase in the surrounding tissues (Fig. 5).
This remodelling is accompanied by excess mucus in the airways, causing airflow
obstruction (Decramer, Janssens et al. 2012).
In addition, chronic inflammation and increase proteinases such as
elastase and matrix metalloproteinases (MMPs) released from macrophages and
neutrophils cause the disappearance of surrounding alveoli, leaving behind
abnormal enlarged airspace-termed emphysema. This has an impact on the O2
and CO2 exchange mechanism (Min, Bodas et al. 2011; Voelkel,
Gomez-Arroyo et al. 2011).
Figure 5: Comparison between
healthy and COPD airways. (A) Normal airway: Large lumen and
thin structural walls (B) COPD airway: Lumen is narrowed and surrounded
by inflamed tissues (Decramer, Janssens et al. 2012).
COPD and asthma share some similar clinical features but
there are major differences. Both are inflammatory disorders of the respiratory tract
and cause narrowing of the airways. However, asthma often starts in childhood
and inflammation is localised to larger airways, whereas, COPD develops in the age
above 40 and is associated with inflammation of small airways (Barnes 2008; Barnes
2008). The inflammatory response in asthma is mainly triggered by allergen and
mediated by dendritic cells, eosinophils, activated mast cells, CD+4
T cells (Th2 cells). In contrast, COPD is associated with CS and recruit
macrophages and neutrophils and CD+ 8 T cells at the site of
inflammation (Fig. 6) (Barnes 2008; Zanini, Chetta et al. 2010). Steroids are the most effective
anti-inflammatory drugs and are frequently used in asthma. However, they are
ineffective in most patients with COPD (Barnes 2006).
Figure 6: The difference
between asthma and COPD. There are some similarities and differences
between asthma and COPD including both histopathological and immunological
changes which are highlighted above.
Adapted and modified from Barnes (2008).
Diagnosis
COPD is diagnosed depending on signs, symptoms and medical
history. However, a spirometry test is frequently used to assess lung function.
Spirometry test shows an irreversible decrease in forced expiratory volume in 1
second (FEV1) and the ratio of FEV1 to forced vital
capacity (FEV1/FVC) (Mannino and Buist 2007; 2011). The severity of
the disease is classed into 4 categories depending on FEV1/FVC ratio
(Table 1.). X-ray and quantitative computed tomography (CT) are also utilised
to evaluate lung function and structure (Mets, de Jong et al. 2012). The chest CT scans assess lung density, which
is proportional to lung airspace enlargement otherwise known as emphysema (Berndt,
Leme et al. 2012).
|
Classification of COPD severity
|
Classification based on post-bronchodilator lung function
|
|
GOLD 1 (mild)
|
FEV1/FVC
<0·70 and FEV1 ≥80% predicted
|
|
GOLD 2 (moderate)
|
FEV1/FVC
<0·70 and 80% >FEV1 ≥ 50% predicted
|
|
GOLD 3 (severe)
|
FEV1/FVC
<0·70 and 50% >FEV1 ≥ 30% predicted
|
|
GOLD 4 (very severe)
|
FEV1/FVC
<0·70 and FEV1 <30% predicted or FEV1 <50%
predicted plus chronic
respiratory failure
|
The multifaceted nature of COPD has proved challenging to
develop a treatment that can target all the components of the disease (Barnes
2010). Currently, combinations of pharmacological and non-pharmacological
strategies are used in the management of COPD. Pharmacological options include
bronchodilators, inhaled corticosteroids (ICS), combination therapy and
long-term oxygen therapy (LTOT). Non-pharmacological interventions are smoking
cessation, pulmonary rehabilitation, mechanical ventilation and
lung-volume-reduction surgery (LVRS) (Hanania, Ambrosino et al. 2005). Among these treatments, bronchodilators and
ICS are frequently prescribed (Barnes and Stockley 2005).
Bronchodilators are used for symptomatic relief, which
consists of short-acting 2-agonists (Salbutamol) and long-acting
(Salmeterol and Formoterol) or anti-muscarinic drugs like Tiotropium. They
improve FEV1 in some patients, but, the effect on lung function,
reduction in inflammation and exacerbation remain poor (Hanania, Ambrosino et
al. 2005; Barnes 2010; Bhome 2012). ICS are
also used either alone or in combination with bronchodilators in the management
of inflammation in COPD patients. However,
they provide little or no benefits to COPD patients (Hakim, Adcock et al. 2012).
It has minimal significant effects on
some of the key inflammatory mediators such as CXCL8/IL-8, tumour necrosis
factor-alpha (TNF-a) and MMPs (Barnes 2007). ICS and antibiotics are
recommended by GOLD for symptomatic treatments in patients with exacerbation
and whose FEV1<50% of predicted (GOLD 2011; Mackay and Hurst 2012). Glucocorticoids are the most effective and
widely used therapy in many inflammatory and immune diseases with exception
of COPD (Barnes and Adcock 2009). This lack of response is partially explained
by cigarette smoke and oxidative stress, reducing HDAC2 activity and expression
as well as impairing GR translocation (Barnes and Adcock 2003; Barnes 2009).
However, it may also be due to other epigenetic changes, including alteration
in DNA and histones status, under oxidative stress (Adcock, Tsaprouni et al.
2007; Adcock, Chou et al. 2009).
Disclaimer: The
information in this blog is for general purposes only. A patient must seek clinical advice and treatment from a qualified physician.
The information may not be up to date and should not be used as accurate
and reliable. Any reliance you place on such information is therefore strictly
at your own risk.
Selected references for further reading
Barnes, P. J. (2007). "Chronic obstructive pulmonary
disease: a growing but neglected global epidemic." PLoS Med 4(5): e112.
Barnes, P. J. (2010). "New therapies for chronic
obstructive pulmonary disease." Med Princ Pract 19(5): 330-338.
Barnes, P. J. (2012). "Development of New Drugs for
COPD." Curr Med Chem. Sep 3. [Epub ahead of print] PMID: 22963554
Hogg, J. C. (2004). "Pathophysiology of airflow
limitation in chronic obstructive pulmonary disease." Lancet 364(9435): 709-721.
Hogg, J. C. (2006). "Why does airway inflammation
persist after the smoking stops?" Thorax 61(2): 96-97
Department of Health
(2011). "An outcomes strategy for people with chronic obstructive
pulmonary disease (COPD) and asthma in England." from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_127974.
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ReplyDeleteDr Akhighe also cured diseases like, HERPES, DIABETES, HIV/AIDS, COPD, CANCER,ASTHMA,STROKE,LUPUS,JOINT PAIN,CHRONIC DISEASES,PARKINSON DISEASES,TUBERCULOSIS,HIGH BLOOD PRESSURE,BREAST INFECTION,WOMEN SEXUAL PROBLEM, ERYSIPELAS,STAPHYLOCOCCUS,HERPATITIS A/B, QUICK EJACULATION,GONORRHEA,SYPHILIS,WAST/BACK PAIN,PELVIC INFLAMATORY, DICK ENLARGEMENT,HEART DISEASES,TERMINAL ILLNESS,SHIFT IN FUCUS,ATAXIA,COMMON COLD,CROHN'S DISEASES,ALCOHOL SPECTRUM DISORDER,GRAVES DISEASE,HEARING LOSS, INTERSTITIA CYSTITIS,LEUKEMIA,MULTIPLE SCLEROSIS,OBESITY,RABIS,SCOLIOSIS,INFLUENZA, POLIO,JACOB,ETC. If you are out there looking for your cure please contact dr Akhigbe by his email drrealakhigbe@gmail.com or contact his whatsapp number +2349010754824
God bless you Dr Akhigbe for your good hand work on my life
My battle with Emphysema started over 9 years ago which I finally got rid of with the help of organic treatment..I had the disease for over 9 + years..I'm in a good health now because Multivitamin herbal cure formula improve my condition drastically..the last time I went to the emergency PFT which is this year January I was told that my lung and breathing are working perfectly which was the help of this herbal medication..I don't have breathing problems anymore(Shortness of breath)..the Multivitamin herbal cure build up my lungs gradually after completing their prescription ,am able to cough it up no problem....I also met a lung specialist who told me that my lung is working perfectly so we don’t have to give it up because today i am here telling the world about my final victory with emphysema with the help of Multivitamin herbal care and the help of their Natural herbal products and roots to cure and heal me completely from emphysema disease within the range of 15 weeks that I used the herbal medication. And if you have this kind of illness , there is no need to waste money on Corticosteroids or Zephyr Valve, or allowing doctors to waste their time on you instead why don’t you go get herbal products from multivitamincare.org use it and see for yourself And they also cures and heal other diseases, it very important you recommend this formula to anyone at there suffering from this illness people don’t know they exist .
ReplyDeleteAfter years of working in construction and smoking cigarettes,I was diagnosed with COPD and pulmonary fibrosis. As my illness progressed, I found myself relying on supplemental oxygen around the clock. Even getting out of bed became a challenge.My doctors and specialists recommended a lung transplant, but after researching the pros and cons of such a drastic procedure, I decided to try something less invasive. I contacted multivitamin herbal cure cape town for organic natural treatment you can search for them on google. Following the COPD and pulmonary fibrosis herbal treatment procedure , my lung function has improved dramatically after my first four weeks of the herbal formula .My quality of life has gotten a lot better. I was amazed that I could breathe without any dead air. I no longer need oxygen and look forward to continued improvement because a specialist told me already I have a 99% chance of getting my condition totally due to the herbal treatment effectiveness . If you or someone you love has COPD, pulmonary fibrosis or another chronic lung disease, and would like to see improvements like mine they even guarantee me totally cure once the treatment is done , their website is www.multivitamincare.org Call (or SMS) them : +1 (786) 544-5148 they will put you through on the herbal process .
ReplyDeleteRead carefully, it's said that Huntington disease has no cure, yes with the western medication but not with herbal medicine, my daughter's situation made me to realize that with doctor Bharat herbal medicine it can be cured. In 2014 she experienced difficulty in concentrating, memory lapses and depression, at first I taught it was stressed from her place of work until I took her to hospital and the doctor made me to understand that it's juvenile Huntington disease because she is still in her late 20s, which she inherited from my late husband that died of the same disease, the doctor told me it has no cure, but gave her some medicine which I noticed that it has side effects, my daughter situation got worst each day that passes, she was the best at her place of work, now a shadow of her self because of this deadly disease, she speaks to herself often, she was really going insane, I do not want to lose my daughter the same way I lost her father, in 2018 I carried out research on internet and bumped into a comment of a lady that got cured of Huntington disease, without wasting time I contacted doctor Bharat whose name was mentioned in the comment, now is been 3 years my daughter is living her best life again, for those that have the disease or have any love one suffering from Huntington disease, contact doctor Bharat via dr.bharatkings@gmail.com
ReplyDeleteDoes anyone still doubt natural herbs? I have seen the great importance of natural herbs and the wonderful work they have done in people's lives. I wonder why people still spend their money on English medicine when natural herbs can cure all kinds of mental diseases. I have seen it with my own eyes. My dad and aunt were cured from Huntington disease with Dr Bharet herbal medicine. He used BUJA herbal medicine to cure my dad and aunt from Huntington disease, I know it is hard to believe but am a living testimony. My dad was diagnosed with Huntington's disease in 2016, we have made use of all western medication yet no improvement and his doctors said there is no cure yet but still carrying out research, my dad experienced depression, anxiety and memory lapses that made him hallucinate always, he speaks to himself often and that made me shed tears each night that passes by. 2019 I searched through the internet for a solution and i came across a comment on a blog written by [Robert Jane] saying she was cured of Huntington disease that she suffered from for 8years. Without wasting time I quickly contacted Dr Bharat whose name was mentioned in the comment Via his email. He asked me questions which I answered correctly he sent his herbal medicine to us here in Ireland through DHL, in less than one month I started seeing positive improvement on my Dad's health so I introduced the medication to my aunt as well, is been 4 years now, my dad and aunt are living their best life again. Though i gave the medication as i was instructed. My dad and aunt are Huntington disease negative after the medication, Huntington disease is completely gone from my family lineage. With Bharat herbal medicine called BUJA Huntington patients can smile again. For those with Huntington disease or having their love ones diagnosed with Huntington's disease contact Dr Bharat now via dr.bharatkings@gmail.com you will come back to testify
ReplyDeleteI want to make this testimony public and as a sign of gratitude to Dr Bharat. On how he saved my husband from Huntington's disease with his herbal medicine called BUJA, i decided to reach out to those still suffering from this disease.
ReplyDeleteMy husband suffered Huntington disease and it was really tough and heartbreaking for me because he was all i have and the symptoms were terrible, my husband experience hallucination, depression, anxiety, abnormality walking, involuntary movement and memory impairment. We tried various therapies prescribed by our neurologist but none could cure him instead the situation got worsen each day that passes by. I spent much money yet no improvement, I really do not want my husband to die so i searched for a cure on the internet and i bumped into a testimony of (Ronda Jasil) who got cured from Huntington's disease. and she left the e-mail address of the Herbal doctor who has the cure of Huntington disease. I never imagined Huntington's disease has a cure until i contacted him and he assured me my husband will be fine. I got the herbal medication he recommended and my husband used it and in one month we started seeing improvement, now is been 1year and 6 months my husband is okay and full of life again. Huntington's disease has a cure and it is a herbal medicine called BUJA. contact doctor Bharat now on dr.bharatkings@gmail.com Thanks for reading my testimony
I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their email at ultimatehealthhome@gmail.com . I can breath much better and It feels comfortable!
ReplyDeleteHi everyone, this is good news, a perfect and greats one. My daughter of
ReplyDelete38years who has suffered of Huntington's disease for 2 and half years has been
cure by a Herbal doctor called Dr Bharat who uses herbal and traditional
medicine to cure people. I have spent so much money on my daughter's health for
years but no improvement. A friend told me about this herbal man who cure
people with herbal medicine. he cures all mental sickness, diseases, viruses, and
infections with his different herbal curing medicine.The result that
declares my daughter healed was from a hospital here in USA, And the
results of the test says my daughter was okay. Dr Bharat said my daughter will be heal in 8weeks(2 months) if she uses the medicine as directed. And
In 2 weeks i started seeing great improvement, exactly 8weeks we went to confirm from the central hospital and several test that
was done says my daughter is Huntington's disease negative. She got cured with Dr Bharat herbal medicine, this is super amazing. My daughter is fully okay and back to her work again. I can boldly say that Huntington's disease is 100% curable with doctor Bharat herbal medicine, is real, anyone with Huntington's disease or have love ones that is suffering from Huntington's disease should contact doctor bharat now on his mail. dr.bharatkings@gmail.com
I was infected with Genital Herpes Virus six months ago, ever since then i have been searching for cure everywhere because i was feeling so uncomfortable with it. I have been dating for almost 5 years until i contracted Genital Herpes from my ex-boyfriend. Since then i became very sad about the whole situation, always going online checking if i could get a cure to Genital Herpes, then i came across so many testimonies. Due to my seriousness and eagerness to be completely cured, i became a victim of fraud after contacting several so-called herbal doctors i was referred to. I lost a lot of money but i didn't stop searching for a cure. Then one faithful day, i came across a testimony of a lady saying that she got her Genital herpes cured by a Great Herbal Doctor she called Dr Ogudugu by contacting him through his email address. And she advised anyone with Genital Herpes or Simplex Herpes to contact the herbal doctor for Herbal Cure. I contemplated for about 4 hours whether or not to contact him. then something inside of me told me 'Nothing good comes easy'. I then contacted him through his email and told him my problem. He told me all the things I needed to do and also gave me instructions to follow, which i did properly. Just within weeks of drinking and applying the herbal medication he sent to me through dhl delivery service, i started seeing changes, i went to my medical doctor for check-up, i was so happy when the doctor told me i was no more having Genital Herpes Virus, it was all tears of Joy from that moment, People think herpes is really a minor skin irritation herpes has a long term effects on health and if i could ever meet a Genuinely Great Herbal Doctor. I'm so grateful to him. i am completely free from Genital Herpes Virus, i introduced a family friend who have Simplex Herpes virus to him, He called me and told me he was also cure completely. I promised to share my own testimony like that of the lady on the internet. Friends, if you are also struggling with Herpes disease you can as well Contact him via Email: greatogudugu@gmail.com
ReplyDeleteI started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their email at ultimatehealthhome@gmail.com . I can breath much better and It feels comfortable!
ReplyDeleteAfter years of working in construction and smoking cigarettes, Ruben C. was diagnosed with COPD and pulmonary fibrosis. As his illness progressed, Ruben found himself relying on supplemental oxygen around the clock. Even getting out of bed became a challenge.
ReplyDeleteDon’s doctors and specialists recommended a lung transplant, but after researching the pros and cons of such a drastic procedure, he decided to try something less invasive. Ruben contacted the multivitamin herbal cure. Following herbal restoration treatment, Ruben lung function has improved drastically
“My quality of life has gotten a lot better. I was amazed that I could breathe without any dead air,” said Ruben.
He no longer needs oxygen and looks forward to continued improvement. Ruben says his life is better now, and he’s amazed at how well he can breathe.
If you or someone you love has COPD, pulmonary fibrosis or another chronic lung disease, and would like to see improvements like my brother Ruben, contact +1 (956) 758-7882 multivitamincare .org to learn more about the herbal treatment options.
Rhonda S.’s COPD made her feel short of breath and like she was constantly dragging. While her inhalers helped some, she just didn’t feel like herself anymore.
ReplyDeleteAfter having life-threatening pneumonia, she knew something had to change. A friend of hers mentioned multivitamin herbal formula restoration treatment, so Rhonda did
some research and decided to receive treatment at the multivitamin herbal cure. “I started to feel better almost right away,” Rhonda said.
And, along with feeling better, she began to do things she couldn’t do before treatment. Now, Rhonda can take showers, work in her flower garden, and she enjoys having more energy. It’s with a great deal of hope, Rhonda says, “I feel more like myself.”
Like Rhonda, you can breathe easier and bring normal life back within reach. If you or someone you love has a chronic lung disease and would like more information, contact us today by calling (+1 (956) 758-7882 to visit their website multivitamincare .org
I was excused from normal life responsibilities but natural herbs from multivitamincare org really helped a but sometimes I think is God prodigy that I was able to treat my Chronic obstructive pulmonary disease but multivitamin care herbal formula has a big impact on my recovery because my heart condition has been fully reversed . They do things for me, and were too happy to comply with their service. This is an equitable way to get off your COPD emphysema .
ReplyDeleteI was diagnosed with severe COPD and emphysema at 48. I had LVRS (lung volume reduction surgery) a year later, which I am forever grateful for because it actually led me to multivitamincare org . I have read some of their stories online before using their natural herbal formula. I had a very hard time breathing then, and even more so at night, it was so bad I couldn't sleep. I get up with a tight chest that feels blocked and can’t breathe well at all,I was excused from normal life responsibilities but natural herbs from multivitamincare org really helped a but sometimes I think is God prodigy that I was able to treat my Chronic obstructive pulmonary disease but multivitamin care herbal formula has a big impact on my recovery because my heart condition has been fully reversed . They do things for me, and were too happy to comply with their service. This is an equitable way to get off your COPD emphysema .
ReplyDeleteHey! I am matina from UK. My husband battled with COPD for years but I am glad right now that his condition swiftly changed positively as my husband can now breathe normal as every other person after undergoing COPD herbal remedies from ULTIMATE LIFE CLINIC and their website is www.ultimatelifeclinic.com
ReplyDelete