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Bacterial alterations source of persistent COPD lung infections

BUFFALO, N.Y. - Clever bacteria populations may be changing just enough to keep ahead of patients' immune systems, causing a mysterious intensification of Chronic Obstructive Pulmonary Disease (COPD) -- the fourth leading cause of death in the United States. More commonly know as chronic bronchitis and emphysema, COPD affects nearly 15 million people in this country.

Researchers at the Veterans Affairs (VA) Medical Center in Buffalo, NY have ended decades of controversy by proving populations of infectious bacteria are changing constantly in the lungs of COPD patients, allowing the bacteria to strike again and again sometimes with deadly results. Their findings, appearing in the August 15th issue of The New England Journal of Medicine, may explain why healthy immune systems cannot prevent these recurring infections.

Intensified COPD symptoms deprive patients of oxygen through severe shortness of breath and coughing that produces thick, sticky sputum (phlegm). Researchers studied samples of sputum from 81 patients over a period of 56 months. Findings show patients were fighting populations of bacteria that repeatedly changed over time, possibly keeping one step ahead of immune defenses.

Many of the COPD patients' immune systems seemed to be working normally, yet bacterial infections rebounded after apparently being eliminated. This prompted researchers to look more closely at the nature of the bacteria. Instead of simply measuring the size and intensity of a bacterial infection, Drs. Sanjay Sethi, and Tim Murphy led a VA investigation of the bacteria's molecular identity.

They suspected acquiring a new strain of bacteria brought on the dangerous infections, causing the already sick patients to cough, choke and experience severe shortness of breath. Proving this would require a new way to identify one strain of bacteria from another.

"This study applied state of the art technology to tell whether the bacterial infections tha
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Contact: Arlene Kelly
arlene.kelly@med.va.gov
716-862-8751
VA Research Communications Service
14-Aug-2002


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