COPD

Clinical Centers


Mission Statement:

We provide diagnostic and therapeutic services for patients with COPD. We also conduct epidemiologic, genetic, clinical, and basic research into the causes, mechanisms, and management of COPD. For those patients with an inherited form of COPD due to alpha-1 anitrypsin deficiency we staff a dedicated clinical Alpha-1 Center providing complete care of individuals and families carrying the ‘alpha-1’ gene mutation. Our mission is to improve the lives of all persons with COPD by providing state-of-the-art patient care along with research aimed at understanding the pathogenesis of and optimizing the management of this common condition.

Background:

All staff physicians and fellows in the Division of Pulmonary and Critical Care Medicine participate in the outpatient care of patients with COPD. We provide education about smoking cessation, the use of inhaled medications, the use of supplemental oxygen, and other key topics relevant to the management of COPD. Patients with COPD are referred from the large primary care internal medicine practice at Boston Medical Center and from the BMC’s network of affiliated neighborhood health centers. We have a full pulmonary function testing laboratory located in our clinic, and Dr Sloan directs the BMC Pulmonary Rehabilitation program. Dr. Andrew Wilson directs the Alpha-1 Clinical Center.

Clinical Activities:

  • Diagnosis and initial assessment of patients with COPD
  • Management of complex cases of COPD and COPD complicating other conditions such as lung cancer or heart disease
  • Ongoing COPD management including smoking cessation, education, supplemental oxygen, and medications
  • Participation in epidemiologic studies and clinical trials with the goal of advancing knowledge about the pathogenesis and treatment of COPD
  • Complete diagnostic and therapeutic care of individuals or families with inherited alpha-1 antitrypsin deficiency through our Alpha-1 Center—an official ‘Clinical Resource Center’ of the national ‘Alpha-1 Foundation.’

Research Activities:

Basic Science Research:

  • Cell-based therapy for alpha-1-antiprotease deficiency: Drs. Wilson and Kotton are using stem cells and lentiviral vectors to create a durable population of pulmonary cells capable of producing alpha-1-antiprotease in mice.

Epidemiology, Genetic Epidemiology, and Genomics Research:

  • Epidemiology and genetics of COPD: Dr. O’Connor is the Director of the Pulmonary Research Center of the Framingham Heart Study. His research in this area uses the traditional tools of pulmonary disease epidemiology in combination with state-of-the-art methods in genomic and biomarker research to gain insights into the causes and biology of COPD. He also studies interactions between COPD and cardiac disease.
  • Genomic and bioinformatic research in COPD: Drs. Steiling, Spira, and Lenburg from the Division of Computational Biomedicine, and Dr. O’Connor from the Pulmonary Division are using mRNA and microRNA array and sequencing methods, along with innovative bioinformatic analytic approaches, to explore gene expression profiles in the bronchial epithelium and lung tissue that characterize the pathogenesis and molecular heterogeneity associated with COPD. These profiles are being leveraged to identify novel approaches and targets for therapy. Dr. Steiling is leading studies to explore the potential of these airway genomic changes to serve as intermediate biomarkers of response to therapy among smokers with COPD.

Clinical and Translational Research:

  • LOTT (Long-Term Oxygen Treatment Trial): Dr. Sloan is the Principle Investigator at BU for the multicenter-NIH sponsored randomized control trial of oxygen in moderate COPD.

Quality Improvement:

  • Dr. Sloan is the Course Director for the BUSM CME Program, “COPD Performance Improvement Initiative: Strategies for Diagnosis and Effective Management,” which aims to increase the compliance with COPD guidelines in participating practices.

Personnel and Collaborators:

  • Darrell Kotton, MD, Associate Professor of Medicine
  • George T. O’Connor, MD, MS, Professor of Medicine
  • Karin A. Sloan, MD, Assistant Professor of Medicine
  • Katrina Steiling, MD, MSc, Assistant Professor of Medicine
  • Andrew Wilson, MD, Assistant Professor of Medicine
  • Avrum Spira, MD, MSc, Associate Professor of Medicine
  • Marc Lenburg, PhD, Associate Professor of Medicine

Selected Publications:

  1. Spira A, Beane J, Pinto-Plata V, Kadar A, Liu G, Shah V, Celli B, Brody JS. “Gene expression profiling of human lung tissue from smokers with severe emphysema.” Am J Respir Cell Mol Biol. 2004;31(6):601-10.
  2. Demeo DL, Mariani TJ, Lange C, Srisuma S, Litonjua AA, Celedon JC, Lake SL, Reilly JJ, Chapman HA, Mecham BH, Haley KJ, Sylvia JS, Sparrow D, Spira AE, Beane J, Pinto-Plata V, Speizer FE, Shapiro SD, Weiss ST, Silverman EK. “The SERPINE2 gene is associated with chronic obstructive pulmomary disease.” Am J Hum Gen. 2006;78(2):253-64.
  3. Wilk JB, Walter RE, Laramie JM, Gottlieb DJ, O’Connor GT. Framingham Heart Study genome-wide association: results for pulmonary function measures. BMC Med Genet. 2007;8 Suppl 1:S8.
  4. Muindi JR, Roth MD, Wise RA, Connett JE, O’Connor GT, Ramsdell JW, Schluger NW, Romkes M, Branch RA, Sciurba FC; FORTE Study Investigators. Pharmacokinetics and metabolism of all-trans- and 13-cis-retinoic acid in pulmonary emphysema patients. J Clin Pharmacol. 2008;48:96-107.
  5. Walter RE, Wilk JB, Larson MG, Vasan RS, Keaney JF Jr, Lipinska I, O’Connor GT, Benjamin EJ. Systemic inflammation and COPD: the Framingham Heart Study. Chest. 2008;133:19-25
  6. Coogan PF, Palmer JR, O’Connor GT, Rosenberg L. Body mass index and asthma incidence in the Black Women’s Health Study. J Allergy Clin Immunol. 2009; 123: 89-95.
  7. Wilk JB, Chen T, Gottlieb DJ, Walter RE, Nagle MW, Brandler BJ, Myers RH, Boreck IB, Silverman EK, Weiss ST, O’Connor GT. A Genome-wide Association Study of Pulmonary Function Measures in the Framingham Heart Study. PLoS Genetics PLoS Genet. 2009 Mar;5(3):e1000429. PubMed PMID: 19300500; PubMed Central PMCID: PMC2652834.
  8. Zhang X, Sebastiani P, Liu G, Schembri F, Zhang X, Dumas YM, Langer EM, Alekseyev Y, O’Connor GT, Brooks DR, Lenburg ME, Spira A. Similarities and differences between smoking-related gene expression in nasal and bronchial epithelium. Physiol Genomics. 2009 Dec 1. [Epub ahead of print] PubMed PMID: 19952278.
  9. D’Armiento JM, Scharf SM, Roth MD, Connett JE, Ghio A, Sternberg D, Goldin JG, Louis TA, Mao JT, O’Connor GT, Ramsdell JW, Ries AL, Schluger NW, Sciurba FC, Skeans MA, Voelker H, Walter RE, Wendt CH, Weinmann GG, Wise RA, Foronjy RF. Eosinophil and T cell markers predict functional decline in COPD patients. Respir Res. 2009 Nov 19;10:113. PubMed PMID: 19925666; PubMed Central PMCID: PMC2785783.
  10. Hancock DB, Eijgelsheim M, Wilk JB, Gharib SA, Loehr LR, Marciante KD, Franceschini N, van Durme YM, Chen T, Barr RG, Schabath MB, Couper DJ, Brusselle GG, Psaty BM, van Duijn CM, Rotter JI, Uitterlinden AG, Hofman A, Punjabi MN, Rivadeneira F, Morrison AC, Enright PL, North KE, Heckbert SR, Lumley T*, Stricker BH*, O’Connor GT*, London SJ*. (*These authors jointly directed this work.) Meta-analyses of genome-wide association studies identify multiple novel loci associated with pulmonary function. Nature Genetics. Nat Genet. 2010 Jan;42(1):45-52. Epub 2009 Dec 13. PMID: 20010835
  11. Steiling K, Lenburg ME, Spira A. “Airway gene expression in chronic obstructive pulmonary disease.” Proc Am Thorac Soc. 2009;6:697-700.
  12. Spira A, Steiling K. Topics in genetics and genomics: Gene Expression. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA 2010.
  13. Mendonça NT, Kenyon J, Laprad AS, Syeda SN, O’Connor GT, Lutchen KR. Airway resistance at maximum inhalation as a marker of asthma and airway hyperresponsiveness. Respiratory Research. 2011 Jul 15;12:96. PubMed PMID: 21762517; PubMed Central PMCID: PMC3143926.
  14. Wilson AA, Murphy GJ, Hamakawa H, Kwok LW, Srinivasan S, Hovav AH, Mulligan RC, Amar S, Suki B, Kotton DN. Amelioration of emphysema in mice through lentiviral transduction of long-lived pulmonary alveolar macrophages. J Clin Invest. 2010 Jan 4;120(1):379-89. doi: 10.1172/JCI36666. Epub 2009 Dec 21.PMID: 20038801 [PubMed - indexed for MEDLINE]

Links:

For Patients:

To schedule a clinic visit or refer a patient, please contact us at:

Shapiro Center
725 Albany St., Suite 9B
Boston, MA 02118
Phone 617-638-7480
Fax 617-638-7486