Yale COPD Program

Mission Statement:

The missions of the Yale COPD Program are to serve as a locally, regionally and nationally recognized center of excellence for comprehensive, state-of-the-art, evidence-based care of COPD patients with the full spectrum of disease severity, clinical phenotypes and comorbidities across the trajectory of illness and across healthcare venues. Additional aims are to educate trainees in the discipline of COPD, and to collaborate with investigators within and outside Yale on research in the field of COPD.

Center Description:

The Yale COPD program provides comprehensive and multidisciplinary treatment to patients with the full spectrum of disease severity, clinical phenotypes and comorbidities associated with COPD. We care for individuals with emphysema, chronic bronchitis, COPD with associated bronchiectasis, asthma/COPD overlap, COPD/obstructive sleep apnea overlap, combined emphysema and pulmonary fibrosis (in conjunction with our interstitial lung disease team), as well as people who experience frequent disease exacerbations and/or hospitalizations, those under consideration for surgical therapies for emphysema (such as bullectomy, lung volume reduction surgery and lung transplantation), those in need of pre-operative respiratory assessment for other forms of surgery, those with suspected genetic basis for their disease (such as alpha-1-antitrypsin deficiency) and those with chronic respiratory failure related to COPD.

The program is staffed by 2 pulmonologists, a pulmonary specialist nurse practitioner, nurses and respiratory therapists with special expertise in COPD.  We collaborate closely with and arrange visits for patients with other specialist providers as needed, including (but not limited to) cardiologists, thoracic surgeons, thoracic oncologists, palliative care specialists, otolaryngologists, allergist/immunologists, sleep medicine specialists, and health psychologists.

Particularly appropriate referrals to the Yale COPD Program include people with difficult-to-control symptoms and/or frequent acute disease exacerbations, those who have suboptimal responses to routine medical therapies, complex medical comorbidities or overlap syndromes (as detailed above), those who may require surgical therapies and those who have advanced disease with chronic respiratory failure. Providers in the COPD Program perform thorough and comprehensive evaluations and develop individualized care plans for all patients, with a goal of partnering closely with individuals’ primary care and other specialist providers. Opportunities to participate in clinical research trials of new therapies in COPD are often available through our collaboration with the Yale Center for Asthma and Airways Disease (203-500-3808).

A broad range of services are also available from members of Yale PCCSM at VA Connecticut Healthcare System (West Haven and Newington Campuses). Dr. Rochester also directs the Pulmonary Rehabilitation Program at the VA, to improve the symptoms, functional capacity, exercise tolerance and quality of life of people with COPD and other forms of chronic respiratory disease.

COPD-Related Events at/near Yale:

COPD CME Course, April 2016

State-wide Readmissions Summit sponsored by the COPD Foundation, New Haven, CT, March 2017

West Haven Collaborative Breathe-Strong Rally, West Haven CT, November 2017

Future Events:

West-Haven Collaborative Breathe-Strong Rally, November 2018

Helpful Links for Patients:

American Thoracic Society (patient information and pulmonary rehabilitation assembly):
www.thoracic.org

Patient information: www.livingwellwithcopd.org

The COPD Foundation: COPD360social (patient community and patient information): copdfoundation.org

Lung life Pulmonary Rehabilitation Program, Yale New Haven Health: 203-789-3995; ynhh.org, pulmonary outpatient services

Alpha-1 Foundation: information and links to patient support groups: alpha1.org

Better breathers Clubs, Patient support groups: www.lung.org

Smilow Smoking Cessation/Tobacco Treatment Program: quitsmoking@ynhh.org or 203-688-1378

Connecticut Quit Line: www.quitnow.net or portal.ct.gov (Tobacco Control Program)

American Lung Association: Information and Tobacco Cessation: www.lung.org

COPD In the News

The updated 2018 WHO/NIH GOLD Report is now available via the weblink: www.goldcopd.com

The recently published National Action Plan for COPD is available at the weblink: COPD.NIH.gov


COPD Program Team

Bio Profile

Carolyn L. Rochester, MD, FCCP

Professor

Medical Director, Yale COPD Program

Medical Director, Pulmonary Rehabilitation Program, VA Connecticut Healthcare System

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Bio Profile

Jill Stewart

Staff Affiliate - YNHH

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Research in COPD

Chronic obstructive pulmonary disease (COPD) is a major focus of both scientific and clinical interest in the Yale Section of Pulmonary, Critical Care and Sleep Medicine (PCCSM). Drs. Patty Lee, Naftali Kaminski, Charles Dela Cruz, Maor Sauler and Min-Jong Kang have recently identified novel mechanisms that likely contribute to the pathogenesis of pulmonary emphysema using transgenic and other mouse models of emphysema and airways inflammation.

Several members of Yale PCCSM are currently collaborating in translational research studies that are testing the applicability of their findings to human disease. Topics under investigation are molecular mechanisms underlying the clinical heterogeneity of COPD and the factors that affect the rate of decline in lung function among individuals with COPD.

Publications

Spruit MA, Singh SJ, Rochester CL, Greening NJ, Franssen FME, Pitta F, Troosters T, Nolan C, Vogiatzis I, Clini EM, Man WD, Burtin C, Goldstein RS, Vanfleteren LEGW, Kenn K, Nici L, Janssen DJA, Casaburi R, Shioya T, Garvey C, Carlin BW, ZuWallack RL, Steiner M, Wouters EFM, Puhan MA: Pulmonary rehabilitation for patients with COPD during and after an exacerbation-related hospitalisation: back to the future? Eur Respir J. 2018 Jan; 2018 Jan 11. PMID: 29326328

Korde A, Jin L, Zhang JG, Ramaswamy A, Hu B, Kolahian S, Guardela BJ, Herazo-Maya J, Siegfried JM, Stabile L, Pisani MA, Herbst RS, Kaminski N, Elias JA, Puchalski JT, Takyar SS: Lung Endothelial MicroRNA-1 Regulates Tumor Growth and Angiogenesis. Am J Respir Crit Care Med. 2017 Dec 1. PMID: 28853613

Rochester CL, Spruit MA: Maintaining the Benefits of Pulmonary Rehabilitation. The Holy Grail. Am J Respir Crit Care Med. 2017 Mar 1. PMID: 28248138

Vogiatzis I, Rochester CL, Spruit MA, Troosters T, Clini EM, American Thoracic Society/European Respiratory Society Task Force on Policy in Pulmonary Rehabilitation.: Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement. Eur Respir J. 2016 May. PMID: 27132269

Takyar S, Zhang Y, Haslip M, Jin L, Shan P, Zhang X, Lee PJ: An endothelial TLR4-VEGFR2 pathway mediates lung protection against oxidant-induced injury. FASEB J. 2016 Mar; 2015 Dec 11. PMID: 26655705

Pimienta G, Fok V, Haslip M, Nagy M, Takyar S, Steitz JA: Proteomics and Transcriptomics of BJAB Cells Expressing the Epstein-Barr Virus Noncoding RNAs EBER1 and EBER2. PLoS One. 2015; 2015 Jun 29. PMID: 26121143

Ahangari F, Sood A, Ma B, Takyar S, Schuyler M, Qualls C, Dela Cruz CS, Chupp GL, Lee CG, Elias JA: Chitinase 3-like-1 regulates both visceral fat accumulation and asthma-like Th2 inflammation. Am J Respir Crit Care Med. 2015 Apr 1. PMID: 25629580

Rochester CL, Fairburn C, Crouch RH: Pulmonary rehabilitation for respiratory disorders other than chronic obstructive pulmonary disease. Clin Chest Med. 2014 Jun. PMID: 24874132

Rochester CL, Spanevello A: Heterogeneity of pulmonary rehabilitation: like apples and oranges - both healthy fruit. Eur Respir J. 2014 May. PMID: 24789943

Franssen FM, Rochester CL: Comorbidities in patients with COPD and pulmonary rehabilitation: do they matter? Eur Respir Rev. 2014 Mar 1. PMID: 24591670

Takyar S, Vasavada H, Zhang JG, Ahangari F, Niu N, Liu Q, Lee CG, Cohn L, Elias JA: VEGF controls lung Th2 inflammation via the miR-1-Mpl (myeloproliferative leukemia virus oncogene)-P-selectin axis. J Exp Med. 2013 Sep 23; 2013 Sep 16. PMID: 24043765

Lee CG, Ma B, Takyar S, Ahangari F, Delacruz C, He CH, Elias JA: Studies of vascular endothelial growth factor in asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2011 Nov. PMID: 22052929

Ma B, Dela Cruz CS, Hartl D, Kang MJ, Takyar S, Homer RJ, Lee CG, Elias JA: RIG-like helicase innate immunity inhibits vascular endothelial growth factor tissue responses via a type I IFN-dependent mechanism. Am J Respir Crit Care Med. 2011 May 15; 2011 Jan 28. PMID: 21278304

Lee CG, Da Silva CA, Dela Cruz CS, Ahangari F, Ma B, Kang MJ, He CH, Takyar S, Elias JA: Role of chitin and chitinase/chitinase-like proteins in inflammation, tissue remodeling, and injury. Annu Rev Physiol. 2011. PMID: 21054166

Vaz Fragoso CA, Concato J, McAvay G, Van Ness PH, Rochester CL, Yaggi HK, Gill TM: Chronic obstructive pulmonary disease in older persons: A comparison of two spirometric definitions. Respir Med. 2010 Aug; 2010 Mar 3. PMID: 20199857

Vaz Fragoso CA, Concato J, McAvay G, Van Ness PH, Rochester CL, Yaggi HK, Gill TM: The ratio of FEV1 to FVC as a basis for establishing chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010 Mar 1; 2009 Dec 17. PMID: 20019341

Rochester CL: Rehabilitation in the intensive care unit. Semin Respir Crit Care Med. 2009 Dec; 2009 Nov 25. PMID: 19941223

Vaz Fragoso CA, Concato J, McAvay G, Van Ness PH, Rochester CL, Yaggi HK, Gill TM: Defining chronic obstructive pulmonary disease in older persons. Respir Med. 2009 Oct; 2009 May 21. PMID: 19464159

Kang MJ, Homer RJ, Gallo A, Lee CG, Crothers KA, Cho SJ, Rochester C, Cain H, Chupp G, Yoon HJ, Elias JA: IL-18 is induced and IL-18 receptor alpha plays a critical role in the pathogenesis of cigarette smoke-induced pulmonary emphysema and inflammation. J Immunol. 2007 Feb 1. PMID: 17237446

Rochester CL: Exercise training in chronic obstructive pulmonary disease. J Rehabil Res Dev. 2003 Sep-Oct. PMID: 15074454

Rochester CL, Mohsenin V: Respiratory complications of stroke. Semin Respir Crit Care Med. 2002 Jun. PMID: 16088617

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Winchester Chest Clinic
Fitkin Memorial Pavilion
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New Haven, CT 06519

Appt:    (203) 785-4198
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