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Bronchial inflammation and colonization in patients with clinically stable bronchiectasis
J Angrill1, C Agustí, R De Celis
1Servei de Pneumologia, Institut Clínic de Pneumologia i Cirurgia Toràcica, Spain.
American Journal of Respiratory and Critical Care Medicine
|November 24, 2001
Summary
Bronchiectasis patients show active airway inflammation, particularly with pathogenic bacteria. Higher bacterial load intensifies this inflammation, suggesting a compartmentalized response.
Area of Science:
- Pulmonary Medicine
- Microbiology
- Immunology
Background:
- Bronchiectasis is a chronic lung disease characterized by irreversible airway dilation.
- Bacterial colonization is common in bronchiectasis and is linked to disease exacerbations.
- The interplay between bronchial inflammation and bacterial load in stable bronchiectasis requires further elucidation.
Purpose of the Study:
- To investigate the bronchial inflammatory response in stable bronchiectasis patients.
- To determine the relationship between bacterial colonization and airway inflammation.
- To assess the systemic inflammatory response in relation to bronchial inflammation.
Main Methods:
- Bronchoalveolar lavage (BAL) was performed on 49 stable bronchiectasis patients and 9 controls.
- BAL fluid underwent differential cell counts, quantitative bacterial cultures, and inflammatory mediator analysis.
- Inflammatory markers included neutrophils, elastase, myeloperoxidase, TNF-alpha, IL-8, and IL-6.
Main Results:
- Bronchiectasis patients exhibited significantly higher neutrophil percentages and levels of elastase, myeloperoxidase, TNF-alpha, IL-8, and IL-6 compared to controls.
- Non-colonized patients showed increased inflammation versus controls.
- Patients colonized with potentially pathogenic microorganisms (MPP) displayed exaggerated inflammation, correlating with bacterial load.
Conclusions:
- Stable bronchiectasis patients have active neutrophilic airway inflammation.
- This inflammation is exacerbated by the presence of MPP and bacterial load.
- The inflammatory process appears largely compartmentalized to the airways with minimal systemic involvement.
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