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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. Our Mission is to improve the lives of 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. Our practice includes two nurse practitioners that work closely with our physicians in managing these patients, providing 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.
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
Research Activities:
Basic Science Research:
- Lung matrix and COPD: Dr. Goldstein is studying the role of lung matrix and mesenchymal cells, along with alveolar repair mechanisms, in the pathogenesis of emphysema in animal models.
- Cell-based therapy for alpha-1-antiprotease deficiency: Drs. Wilson and Kotton are using lentivirus vectors to create a durable population of pulmonary cells capable of producing alph-1-antiprotease in mice.
Epidemiology and Genetic Epidemiology Research:
- The role of systemic inflammation, oxidant stress, and lipids in the pathogenesis of COPD: Drs. Walter and O’Connor are conducting these studies of the pathogenesis of chronic airflow obstruction in the three generations of participants in the Framingham Heart Study, using longitudinal pulmonary function data dating back to 1948, supplemented in recent years with measurements of biomarkers of interest.
- Genetic risk factors for COPD: The multi-generational Framingham cohorts include large numbers of extended pedigrees, providing a rich population for family-based genetic studies. Drs. O’Connor, Walter, and Burkart are participating in both genome-wide linkage studies to discover new genetic risk factors and family-based and case-control association studies of candidate genes.
Clinical and Translational Research:
- Feasibility of Retinoid Therapy for Emphysema (FORTE) Study: Drs. O’Connor, Walter, and Goldstein are participating in this 5-center trial of the feasibility of treating emphysema with all-trans retinoic acid and 13-cis retinoic acid. Data collection had ended and data analysis is underway. Dr. O’Connor presented the clinical results of the trial at the 2004 Annual Meeting of the American Thoracic Society.
- Trials of automated telephone-based interventions for COPD: Drs. Sparrow and O’Connor are conducting trials of novel computerized, telephone-based patient education, monitoring, and feedback systems for optimizing self-management and increasing physical activity among patients with COPD.
- Industry-sponsored trials of new therapies for COPD: Pulmonary Center investigators have recently participated in a number of clinical trials of new therapies including the leukotriene B4 receptor anatagonist BIIL 284 BS (Drs. O’Connor and Walter) and tiotropium (Dr. Gottlieb).
Personnel and Collaborators:
- George T. O’Connor, MD, MS, Professor of Medicine
- Ronald Goldstein, MD, Professor of Medicine
- Helen Hollingsworth, MD, Associate Professor of Medicine
- Robert Walter, MD, MPH, Assistant Professor of Medicine
- David Sparrow, DSc, Associate Professor of Medicine
- Jemma Wilk, DSc, Instructor in Medicine and Neurology
- Emelia Benjamin, MD, MSc, Professor of Medicine
- Paula Goncalves, RN, Research Nurse
- Eleana Conway, MSN, NP, Nurse Practitioner
- Claire Murphy, MSN, NP, Nurse Practitioner
LINKS:
For patients:
Selected Publications:
- Walter R, Gottlieb DJ, O’Connor GT. Environmental and genetic risk factors and gene-environment interactions in the pathogenesis of chronic obstructive pulmonary disease. Environmental Health Perspectives 2000; 108 (suppl 4): 733-742.
- Gottlieb DJ, Wilk J, Harmon M, Evans JC, Joost O, Levy D, O’Connor GT, Myers RH. Heritability of longitudinal change in lung function: The Framingham Study. Am J Respir Crit Care Med 2001; 164:1655-1659.
- Joost O, Wilk JB, Cupples A, Harmon M, Shearman AM, Baldwin CT, O’Connor GT, Myers RH, Gottlieb DJ. Genetic Loci Influencing Lung Function . A Genomewide Scan in the Framingham Study. Am. J. Respir. Crit. Care Med. 2002; 165: 795-799.
- Wilk JB, DeStefano AL, Joost O, Myers RH, Cupples LA, Slater K, Atwood LD, Heard-Costa NL, Herbert A, O’Connor GT, Gottlieb DJ. Linkage and association with pulmonary function measures on chromosome 6q27 in the Framingham Heart Study. Hum Mol Genet. 2003; 12:2745-51.
- Walter RE, Beiser A, Givelber RJ, O’Connor GT, Gottlieb DJ. Association between glycemic state and lung function: the Framingham Heart Study. Am J Respir Crit Care Med. 2003; 167:911-6.
- Sanders MH, Newman AB, Haggerty CL, Redline S, Lebowitz M, Samet J, O’Connor GT, Punjabi NM, Shahar E; Sleep Heart Health Study. Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med. 2003;167(1):7-14.
For Patients:
To schedule a clinic visit, refer a pations, or speak with one of our physicians, please contact us at:
Doctors Office Building
Pulmonary/Allergy/Asthma
720 Harrison Avenue, 4th Floot, Suite 402
Boston, MA 02118
617-638-7480
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