Results of the prospective study appear in the Aug. 15 issue of New England Journal of Medicine. COPD is the fourth-leading cause of death in the U.S., according to the American Lung Association, and fatalities are closely linked to exacerbations. Up to 90 percent of cases of the disease are caused by long-term smoking.

"For years, people have hypothesized that bacteria played a role in COPD exacerbations, but studies performed decades ago found no difference in bacterial presence during stable periods and flare-ups," said Timothy Murphy, M.D., UB professor of medicine and microbiology and senior author on the study.

"Using the new technology of molecular typing, where you can look at turnover of bacteria in the respiratory tract in a more accurate way, we have shown that that hypothesis is correct."

Sanjay Sethi, M.D., UB associate professor of medicine, is first author of the study, which began in 1994. Sethi, Murphy and colleagues found that it is the particular strain within a bacterial species, not the volume of bacteria in general, that is associated with a COPD flare-up. This observation is a change in the way physicians have viewed the role of bacteria in COPD, Murphy noted. The three major pathogens implicated in causing exacerbations were H. influenzae, M. catarrhalis, and Strep. Pneumoniae, the study showed.

In addition to elucidating the role of bacteria in exacerbations, these findings are important because they point to novel ways of treating or preventing exacerbations, Murphy said.

"This information should lead to the development of vaccines to prevent colonization by the offending strains. It also provides a better understandin
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Contact: Lois Baker
ljbaker@buffalo.edu
716-645-5000 x1417
University at Buffalo
14-Aug-2002