Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters

Austin Bassett Thompson, D. Daughton, R. A. Robbins, M. A. Ghafouri, M. Oehlerking, S. I. Rennard

Research output: Contribution to journalArticle

288 Citations (Scopus)

Abstract

In order to characterize intraluminal airway inflammation in subjects with chronic bronchitis, bronchoscopy and bronchoalveolar lavage were performed in 28 subjects with chronic bronchitis with fixed airway obstruction and, for comparison, 15 asymptomatic smokers and 25 normal nonsmoking volunteers. The chronic bronchitics had a cough productive of sputum on most days of the month for 6 months in the preceding 2 yr, had at least one exacerbation requiring medical intervention in each of the previous 2 yr, and had an FEV1 <76% of predicted without response to bronchodilator. During bronchoscopy the airways were assessed for visual evidence of inflammation by assigning them a score, the bronchitis index, that graded the airways according to the apparent severity of airway edema, erythema, friability, and secretion. Bronchoalveolar lavage was performed by sequentially instilling and retrieving with gentle suction five 20-ml aliquots of sterile normal saline into each of three separate lobes. The first aliquots, the 'bronchial' sample, were pooled and processed separately from the final four aliquots, the 'distal' sample. Cell counts, cell differentials, and albumin were determined for both the bronchial and distal samples. In order to correlate inflammation with clinical parameters, sputum was collected for 24 hr prior to bronchoscopy; spirometry was performed just prior to bronchoscopy, and smoking histories were obtained. Visual inspection of the airways, as quantified by the bronchitis index, demonstrated significantly more evidence for inflammation in the chronic bronchitics than in either the asymptomatic smokers or the normal subjects. The bronchial sample lavage fluids from the chronic bronchitics tended to contain more cells (6.1 ± 2.2 x 106 cells) than the bronchial sample fluids from the asymptomatic smokers (3.6 ± 0.6 x 106 cells) or normal subjects (3.7 ± 0.5 x 106 cells). Furthermore, the chronic bronchitics had a higher percentage of neutrophils in their bronchial lavage fluid (35.8 ± 5.6%) than did either the asymptomatic smokers (20.7 ± 2.6%, p = 0.0001) or the normal subjects (10.3 ± 5.6%). The distal sample lavage fluid also recovered more neutrophils from both the chronic bronchitics (15.0 ± 4.2%, p = 0.0012) and asymptomatic smokers (5.7 ± 1.3%, p = 0.002) than from the normal subjects (2.8 ± 0.4%). The chronic bronchitics were divided into two groups: those with low (<20%) and those with high (>20%) bronchial sample neutrophils. Those with higher bronchial sample neutrophils had significantly more sputum production and lover FEV1, FEV1/FVC, and FEF25-75 than did the subjects with lower bronchial sample neutrophils. Furthermore, among the chronic bronchitics, quantitatiion of airway neutrophils correlated with pack-years of cigarett smoked (r2 = 0.65, p < 0.001). Thus, chronic bronchitis is associated with intraluminal airway neutrophilia. Furthermore, in this group of chronic bronchitics, airway neutrophils correlated with sputum production and airway obstruction.

Original languageEnglish (US)
Pages (from-to)1527-1537
Number of pages11
JournalAmerican Review of Respiratory Disease
Volume140
Issue number6
DOIs
StatePublished - Jan 1 1989

Fingerprint

Chronic Bronchitis
Neutrophils
Inflammation
Sputum
Airway Obstruction
Bronchoscopy
Bronchoalveolar Lavage
Cough
Healthy Volunteers

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters. / Thompson, Austin Bassett; Daughton, D.; Robbins, R. A.; Ghafouri, M. A.; Oehlerking, M.; Rennard, S. I.

In: American Review of Respiratory Disease, Vol. 140, No. 6, 01.01.1989, p. 1527-1537.

Research output: Contribution to journalArticle

Thompson, Austin Bassett ; Daughton, D. ; Robbins, R. A. ; Ghafouri, M. A. ; Oehlerking, M. ; Rennard, S. I. / Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters. In: American Review of Respiratory Disease. 1989 ; Vol. 140, No. 6. pp. 1527-1537.
@article{c5017186b9664b628f29f171d655acbf,
title = "Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters",
abstract = "In order to characterize intraluminal airway inflammation in subjects with chronic bronchitis, bronchoscopy and bronchoalveolar lavage were performed in 28 subjects with chronic bronchitis with fixed airway obstruction and, for comparison, 15 asymptomatic smokers and 25 normal nonsmoking volunteers. The chronic bronchitics had a cough productive of sputum on most days of the month for 6 months in the preceding 2 yr, had at least one exacerbation requiring medical intervention in each of the previous 2 yr, and had an FEV1 <76{\%} of predicted without response to bronchodilator. During bronchoscopy the airways were assessed for visual evidence of inflammation by assigning them a score, the bronchitis index, that graded the airways according to the apparent severity of airway edema, erythema, friability, and secretion. Bronchoalveolar lavage was performed by sequentially instilling and retrieving with gentle suction five 20-ml aliquots of sterile normal saline into each of three separate lobes. The first aliquots, the 'bronchial' sample, were pooled and processed separately from the final four aliquots, the 'distal' sample. Cell counts, cell differentials, and albumin were determined for both the bronchial and distal samples. In order to correlate inflammation with clinical parameters, sputum was collected for 24 hr prior to bronchoscopy; spirometry was performed just prior to bronchoscopy, and smoking histories were obtained. Visual inspection of the airways, as quantified by the bronchitis index, demonstrated significantly more evidence for inflammation in the chronic bronchitics than in either the asymptomatic smokers or the normal subjects. The bronchial sample lavage fluids from the chronic bronchitics tended to contain more cells (6.1 ± 2.2 x 106 cells) than the bronchial sample fluids from the asymptomatic smokers (3.6 ± 0.6 x 106 cells) or normal subjects (3.7 ± 0.5 x 106 cells). Furthermore, the chronic bronchitics had a higher percentage of neutrophils in their bronchial lavage fluid (35.8 ± 5.6{\%}) than did either the asymptomatic smokers (20.7 ± 2.6{\%}, p = 0.0001) or the normal subjects (10.3 ± 5.6{\%}). The distal sample lavage fluid also recovered more neutrophils from both the chronic bronchitics (15.0 ± 4.2{\%}, p = 0.0012) and asymptomatic smokers (5.7 ± 1.3{\%}, p = 0.002) than from the normal subjects (2.8 ± 0.4{\%}). The chronic bronchitics were divided into two groups: those with low (<20{\%}) and those with high (>20{\%}) bronchial sample neutrophils. Those with higher bronchial sample neutrophils had significantly more sputum production and lover FEV1, FEV1/FVC, and FEF25-75 than did the subjects with lower bronchial sample neutrophils. Furthermore, among the chronic bronchitics, quantitatiion of airway neutrophils correlated with pack-years of cigarett smoked (r2 = 0.65, p < 0.001). Thus, chronic bronchitis is associated with intraluminal airway neutrophilia. Furthermore, in this group of chronic bronchitics, airway neutrophils correlated with sputum production and airway obstruction.",
author = "Thompson, {Austin Bassett} and D. Daughton and Robbins, {R. A.} and Ghafouri, {M. A.} and M. Oehlerking and Rennard, {S. I.}",
year = "1989",
month = "1",
day = "1",
doi = "10.1164/ajrccm/140.6.1527",
language = "English (US)",
volume = "140",
pages = "1527--1537",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "6",

}

TY - JOUR

T1 - Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters

AU - Thompson, Austin Bassett

AU - Daughton, D.

AU - Robbins, R. A.

AU - Ghafouri, M. A.

AU - Oehlerking, M.

AU - Rennard, S. I.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - In order to characterize intraluminal airway inflammation in subjects with chronic bronchitis, bronchoscopy and bronchoalveolar lavage were performed in 28 subjects with chronic bronchitis with fixed airway obstruction and, for comparison, 15 asymptomatic smokers and 25 normal nonsmoking volunteers. The chronic bronchitics had a cough productive of sputum on most days of the month for 6 months in the preceding 2 yr, had at least one exacerbation requiring medical intervention in each of the previous 2 yr, and had an FEV1 <76% of predicted without response to bronchodilator. During bronchoscopy the airways were assessed for visual evidence of inflammation by assigning them a score, the bronchitis index, that graded the airways according to the apparent severity of airway edema, erythema, friability, and secretion. Bronchoalveolar lavage was performed by sequentially instilling and retrieving with gentle suction five 20-ml aliquots of sterile normal saline into each of three separate lobes. The first aliquots, the 'bronchial' sample, were pooled and processed separately from the final four aliquots, the 'distal' sample. Cell counts, cell differentials, and albumin were determined for both the bronchial and distal samples. In order to correlate inflammation with clinical parameters, sputum was collected for 24 hr prior to bronchoscopy; spirometry was performed just prior to bronchoscopy, and smoking histories were obtained. Visual inspection of the airways, as quantified by the bronchitis index, demonstrated significantly more evidence for inflammation in the chronic bronchitics than in either the asymptomatic smokers or the normal subjects. The bronchial sample lavage fluids from the chronic bronchitics tended to contain more cells (6.1 ± 2.2 x 106 cells) than the bronchial sample fluids from the asymptomatic smokers (3.6 ± 0.6 x 106 cells) or normal subjects (3.7 ± 0.5 x 106 cells). Furthermore, the chronic bronchitics had a higher percentage of neutrophils in their bronchial lavage fluid (35.8 ± 5.6%) than did either the asymptomatic smokers (20.7 ± 2.6%, p = 0.0001) or the normal subjects (10.3 ± 5.6%). The distal sample lavage fluid also recovered more neutrophils from both the chronic bronchitics (15.0 ± 4.2%, p = 0.0012) and asymptomatic smokers (5.7 ± 1.3%, p = 0.002) than from the normal subjects (2.8 ± 0.4%). The chronic bronchitics were divided into two groups: those with low (<20%) and those with high (>20%) bronchial sample neutrophils. Those with higher bronchial sample neutrophils had significantly more sputum production and lover FEV1, FEV1/FVC, and FEF25-75 than did the subjects with lower bronchial sample neutrophils. Furthermore, among the chronic bronchitics, quantitatiion of airway neutrophils correlated with pack-years of cigarett smoked (r2 = 0.65, p < 0.001). Thus, chronic bronchitis is associated with intraluminal airway neutrophilia. Furthermore, in this group of chronic bronchitics, airway neutrophils correlated with sputum production and airway obstruction.

AB - In order to characterize intraluminal airway inflammation in subjects with chronic bronchitis, bronchoscopy and bronchoalveolar lavage were performed in 28 subjects with chronic bronchitis with fixed airway obstruction and, for comparison, 15 asymptomatic smokers and 25 normal nonsmoking volunteers. The chronic bronchitics had a cough productive of sputum on most days of the month for 6 months in the preceding 2 yr, had at least one exacerbation requiring medical intervention in each of the previous 2 yr, and had an FEV1 <76% of predicted without response to bronchodilator. During bronchoscopy the airways were assessed for visual evidence of inflammation by assigning them a score, the bronchitis index, that graded the airways according to the apparent severity of airway edema, erythema, friability, and secretion. Bronchoalveolar lavage was performed by sequentially instilling and retrieving with gentle suction five 20-ml aliquots of sterile normal saline into each of three separate lobes. The first aliquots, the 'bronchial' sample, were pooled and processed separately from the final four aliquots, the 'distal' sample. Cell counts, cell differentials, and albumin were determined for both the bronchial and distal samples. In order to correlate inflammation with clinical parameters, sputum was collected for 24 hr prior to bronchoscopy; spirometry was performed just prior to bronchoscopy, and smoking histories were obtained. Visual inspection of the airways, as quantified by the bronchitis index, demonstrated significantly more evidence for inflammation in the chronic bronchitics than in either the asymptomatic smokers or the normal subjects. The bronchial sample lavage fluids from the chronic bronchitics tended to contain more cells (6.1 ± 2.2 x 106 cells) than the bronchial sample fluids from the asymptomatic smokers (3.6 ± 0.6 x 106 cells) or normal subjects (3.7 ± 0.5 x 106 cells). Furthermore, the chronic bronchitics had a higher percentage of neutrophils in their bronchial lavage fluid (35.8 ± 5.6%) than did either the asymptomatic smokers (20.7 ± 2.6%, p = 0.0001) or the normal subjects (10.3 ± 5.6%). The distal sample lavage fluid also recovered more neutrophils from both the chronic bronchitics (15.0 ± 4.2%, p = 0.0012) and asymptomatic smokers (5.7 ± 1.3%, p = 0.002) than from the normal subjects (2.8 ± 0.4%). The chronic bronchitics were divided into two groups: those with low (<20%) and those with high (>20%) bronchial sample neutrophils. Those with higher bronchial sample neutrophils had significantly more sputum production and lover FEV1, FEV1/FVC, and FEF25-75 than did the subjects with lower bronchial sample neutrophils. Furthermore, among the chronic bronchitics, quantitatiion of airway neutrophils correlated with pack-years of cigarett smoked (r2 = 0.65, p < 0.001). Thus, chronic bronchitis is associated with intraluminal airway neutrophilia. Furthermore, in this group of chronic bronchitics, airway neutrophils correlated with sputum production and airway obstruction.

UR - http://www.scopus.com/inward/record.url?scp=0024805189&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024805189&partnerID=8YFLogxK

U2 - 10.1164/ajrccm/140.6.1527

DO - 10.1164/ajrccm/140.6.1527

M3 - Article

VL - 140

SP - 1527

EP - 1537

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 6

ER -