Bacteria strains cause COPD flare-ups

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Bacteria strains cause COPD flare-ups

From the Science & Technology Desk

Published 8/14/2002 5:05 PM

BUFFALO, N.Y., Aug. 14 (UPI) -- New strains of bacteria infecting the lungs

of patients with chronic obstructive pulmonary disease, the fourth leading

cause of death in the United States, may be behind some of the mysterious

flare-ups of the condition, new research suggests.

Researchers at the Veterans Affairs Western New York Healthcare System

examined a group of 81 COPD patients for 51 months, gathering bacteria

samples from their sputum and identifying about 4,000 separate strains of

bacteria. They found COPD flare-ups are much more frequent in patients when

a new bacterial strains emerged in their lungs. A patient with Haemophilus

influenzae, for example, a common lung bacteria, would be twice as likely to

suffer worsening of COPD if a new strain of H. influenzae appeared.

" There was a fair amount of controversy and confusion in the literature

about whether bacteria are responsible for (COPD) exacerbations and one of

the major causes of the confusion was that you could isolate the bacteria at

the same rate during stable phases of the disease and during exacerbations, "

Sanjay Sethi, lead investigator in the study, told United Press

International.

Sethi, who also is associate professor of medicine at the State University

of New York at Buffalo, said bacteria often would be seen in COPD patients

whether or not there was a worsening of their condition. The problem, he

said, was standard testing only showed bacterial species and could not

distinguish among strains.

" The study applied state of the art technology to tell whether the bacterial

infections that kept cropping up were just one strain of bacterial lingering

in the body for months or years, or whether different strains of the same

bacteria would come and go, " said Tim , co-author of the study.

, professor of medicine and microbiology at SUNY-Buffalo and chief of

infectious diseases at VA Western New York, told UPI, " This work teaches us

about the dynamic interaction between the bacterium and the human host and

this provides a rationale for proceeding to try to develop ways to prevent

infections or to alter the immune response to bacteria in COPD. "

said the findings could influence the way antibiotics are prescribed

to treat COPD.

Sethi said immune responses in an individual are very specific and do not

protect against every strain of a bacterial species. There may be hundreds

of strains of H. influenzae, for example, and dozens of strains of a number

of other bacteria that were studied, such as Moraxella catarrhalis.

" This is an exciting study because it really gives us more convincing

evidence that bacteria play a role in exacerbations, justifying the use of

antibiotics in many of these patients, " Niederman, editor of the

journal Clinical Pulmonary Medicine and chairman of the department of

medicine at Winthrop-University Hospital in Mineola, N.Y., told UPI.

C. Kleerup, assistant professor at the Geffen School of Medicine

at the University of California at Los Angeles and co-director of the UCLA

asthma and cough center called the new study, " a very solid piece of work. "

He added, however, " The study doesn't really prove cause and effect,

although we all suppose that is probably true. "

Kleerup asked, " Does it prove that we should put everybody on antibiotics? "

His answer: " No. "

COPD affects as many as 15 million Americans and results in about 125,000

deaths each year. The disease permanently obstructs airflow into the lungs.

Most patients suffer a combination of chronic bronchitis and emphysema and

show chronic and excessive secretion of airway mucus, inflamation,

bronchospasms, infections and permanent damage to the very small air sacs in

the lung.

COPD is most commonly caused by smoking and is treated with a variety of

approaches, including bronchodilators, antibiotics, steroids, exercise and

strict abstention from smoking.

The research will be published in the Aug. 15 issue of the New England

Journal of Medicine.

(Reported by Joe Grossman, UPI Science News, in Santa Cruz, Calif.)

Copyright © 2002 United Press International