The inflammatory response in chronic bronchitis

Chronic bronchitis is diagnosed clinically by a chronic productive cough and is characterized by a variety of pathological changes, including bronchial gland hyperplasia, goblet cell metaplasia, and peribronchiolar fibrosis. As implied by the term ;;bronchitis,'' chronic airway inflammation is typically found in the central airways in patients with persistent cough and mucus hypersecretion. Although the exact pathogenesis of chronic bronchitis remains unclear, bacterial colonization and the resulting inflammatory response are thought to be of central importance. The generation of proinflammatory cytokines and chemotactic stimuli by the airway epithelium likely plays a central role in propagating the inflammatory response in patients with chronic bronchitis. Typically, an inflammatory mononuclear cell infiltrate is found in the airway wall, and the airway lumen is filled with neutrophils and their products. Further insights into the initiating events and underlying mechanisms that result in the clinical syndrome of chronic bronchitis will likely provide novel opportunities for therapeutic interventions.