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A non-negative nicotine

Nicotine usually, and for the most part rightfully, gets a pretty bad rap.

But ironically, the highly addictive substance found in tobacco products might play a positive role in those suffering from a specific lung disease.

Doctors at The Ohio State University Wexner Medical Center are researching whether nicotine can help people suffering from an ailment called sarcoidosis.

Sarcoidosis is the growth of tiny collections of inflammatory cells in different parts of the body. Most commonly, they’re found in the lungs, lymph nodes, eyes and on the skin. Left untreated, the disease can cause severe lung damage and even death.

“It’s tricky because it mimics other diseases,” said Dr. Elliot Crouser, a pulmonologist specializing in sarcoidosis. “Sarcoidosis can look like lung nodules, pneumonia, scar tissue, even lung cancer. It can involve other vital organs, and it differs from one person to the next.”

Current treatments, such as the use of steroids, often cause effects harsher than the symptoms of the disease itself. So Crouser decided to test nicotine as a less-problematic treatment.

A small initial study showed that the use of nicotine patches, normally used to help people stop smoking, had beneficial effects. Now, in conjunction with the Cleveland Clinic, Crouser is conducting a larger, randomized trial.

“Why nicotine? Around 2000, we learned two things. There was new evidence that nicotine is an anti-inflammatory, and from other studies we discovered smokers were less likely to get sarcoidosis,” Crouser said.

Trial participants are first randomized — some get the nicotine patch while others get a placebo. They wear the patches for seven months. Afterward, researchers evaluate lung function with computerized axial tomography (CAT scans) and computer models to monitor disease progression or improvement.

There was new evidence that nicotine is an anti-inflammatory, and from other studies, we discovered smokers were less likely to get sarcoidosis.

Dr. Elliot Crouser

Crouser said there isn’t a lot of data on sarcoidosis, but they’re consistently learning more. There are more cases being diagnosed overall, likely due to increased awareness and more sensitive testing.

According to Crouser, more research is needed not only to better understand the disease, but also improve the current standards of patient care.