Bronchial Inflammation and Colonization in Patients with Clinically Stable Bronchiectasis

Angrill, Joaquim; Agustı́, Carlos; Celis, Rosa; Filella, Xavier; Rañó, Ana; Elena, Montserrat; Bellacasa, Jorge Puig de la; Xaubet, Antoni; Torres, Antônio

doi:10.1164/ajrccm.164.9.2105083

Cited by 220 publications

(175 citation statements)

References 21 publications

(20 reference statements)

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“…Persistent bacterial colonisation of the airways in bronchiectasis is caused by impaired mucociliary transport and mucus clearance, and initiates a vicious cycle of inflammation characterised by activated neutrophils and neutrophil proteases. 31 On persistent exposure to PAMPs, we hypothesised and confirmed that innate receptors would be stimulated and activated to induce the production of IL8 and an influx of neutrophils. Subjects with bronchiectasis had increased sputum mRNA expression of TLR2 and supernatant SP-A compared with controls.…”

Section: Discussionmentioning

confidence: 68%

Innate immune activation in neutrophilic asthma and bronchiectasis

Simpson

Grissell

Douwes

et al. 2007

Thorax

291

286

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Background: The role of the innate immune system in the pathogenesis of asthma is unclear. Activation of innate immune receptors in response to bacterial lipopolysaccharide, viral infection and particulate matter triggers a pre-programmed inflammatory response, which involves interleukin (IL)8 and neutrophil influx. The inflammatory response in asthma is heterogeneous. Aim: To test the hypothesis that innate immune activation may be a relevant inflammatory mechanism in neutrophilic asthma where IL8 levels are increased. Methods: Induced sputum was obtained from non-smoking adults with asthma (n = 49), healthy controls (n = 13) and a positive reference group with bronchiectasis (n = 9). Subjects with asthma were classified into inflammatory subtypes using induced sputum cell counts. Sputum was examined for mRNA expression of the innate immune receptors toll-like receptor (TLR)2, TLR4 and CD14, and inflammatory cytokines. A separate sputum portion was dispersed and the supernatant assayed for surfactant protein A, IL8, soluble CD14 and endotoxin. Results: Expression of innate immune receptors was increased in subjects with bronchiectasis and neutrophilic asthma compared with other asthma subtypes and controls. Increased expression of the receptors TLR2, TLR4 and CD14, as well as the pro-inflammatory cytokines IL8 and IL1b, was observed. Subjects with neutrophilic asthma had higher airway levels of endotoxin than the other groups studied. Conclusion: There is evidence of activation of the innate immune system in asthma which results in the production of pro-inflammatory cytokines and may contribute to the pathogenesis of neutrophilic asthma.

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Section: Discussionmentioning

confidence: 68%

Innate immune activation in neutrophilic asthma and bronchiectasis

Simpson

Grissell

Douwes

et al. 2007

Thorax

291

286

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“…One of the most attractive explanations is that the obstructive changes are due to frequent and recurrent infections in the small airways. Colonization of the small airways by pathogenic microorganisms has been reported in patients with clinically stable bronchiectasis [40, 41], and a number of HRCT studies have shown that bronchiectasis is common among RA patients [22, 42–45]. We have also reported that bronchial dilatation is the most frequent HRCT finding both in patients with early RA and in those with longstanding RA [12].…”

Section: Discussionmentioning

confidence: 74%

Small airway obstruction in patients with rheumatoid arthritis

Mori¹,

Koga²,

Sugimoto

2010

Mod Rheumatol

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This work was intended to evaluate the prevalence of obstructive small-airway disease in patients with rheumatoid arthritis (RA) and its association with clinical characteristics. Pulmonary function testing (PFT) and high-resolution computed tomography (HRCT) were performed on 189 consecutive RA patients. Each case was diagnosed based on abnormal HRCT findings. We defined obstructive dysfunction of small airways as a forced expiratory flow from 25% to 75% of vital capacity (FEF25–75) value >1.96 residual standard deviation (RSD) below predicted values. We found 19 patients (10.1%) with an interstitial pneumonia (IP) pattern and 15 (7.9%) with a bronchiolitis pattern; the other 155 (82.0%) had no abnormal HRCT patterns. In patients with neither abnormal pattern, median values of percentage predicted for carbon monoxide diffusing capacity (DLCO) and ratio of DLCO to alveolar ventilation (DLco/VA) were within the normal range, but median FEF25–75, forced expiratory flow at 25% of vital capacity (V25), and V25/height were <70% of predicted values. Forty-seven patients (30.3%) in this group had obstructive small-airway dysfunction. Multivariate logistic regression analysis indicated that this type of abnormality is strongly associated with respiratory symptoms [odds ratio (OR) 5.18; 95% confidence interval (CI) 1.70–15.75; p = 0.012), smoking history (OR 2.78; 95% CI 1.10–6.99; p = 0.03), and disease duration >10 years (OR 2.86; 95% CI 1.27–6.48; p = 0.012). Parenchymal micronodules, bronchial-wall thickening, and bronchial dilatation on HRCT scans were also predictive factors for abnormal FEF25–75, although these morphological changes were too limited for us to diagnose these patients with the bronchiolitis pattern. Obstructive dysfunction of small airways is apparently common among RA patients, even among those with neither the IP nor the bronchiolitis pattern on HRCT scans. Factors significantly associated with abnormal FEF25–75 are respiratory symptoms, smoking history, and RA duration.

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“…31 Recently, a significant increase in IL-6 among other cytokines in bronchoalveolar lavage fluid and sputum in patients with bronchiectasis was demonstrated. 32,33 This inflammatory reaction was exaggerated in subjects colonized by microorganisms with a clear relationship to the bronchial bacterial load.…”

Section: Discussionmentioning

confidence: 99%

Does Mean Platelet Volume in Children with Bronchiectasis Predict Exacerbations?

Uysal¹,

Tunçel²,

Erge³

et al. 2014

UHOD

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Bronchiectasis is a parenchymal lung disease which develops as a consequence of chronic inflammation and recurrent pulmonary infections. It is known that platelets have a role in inflammation and progressive pulmonary damage. Mean platelet volume (MPV) values as a marker of platelet activation, and might be used as an indicator of inflammation. Eighty-one children with the diagnosis of bronchiectasis followed between July 2010-July 2012 were enrolled in the study. The demographical data of patients were recorded and complete blood count (CBC) and MPV values were screened via hospital patient database. Complete blood count and MPV values were compared to age and sex-matched healthy children's data. In addition, CBC and MPV values were compared among chronic disease period without any exacerbation and exacerbation period in the children with bronchiectasis. The study was consisted of 81 children with bronchiectasis and 79 healthy controls. There was no significant difference between MPV values of non-exacerbation period and control group (p>0,05).Mean platelet volumes during acute exacerbation were significantly lower when compared with the values of non-exacerbation period and controls (p= 0,02 and p= 0,01 respectively). MPV and platelet counts (r = -0,502, p= 0,01) as well as leucocyte count and hemoglobin levels were inversely correlated with each other in exacerbation period (r= -439, p= 0.00). Mean platelet volume measured at during acute exacerbation were significantly decreased in children with bronchiectasis. With the result of present study, we suggest that MPV might be used as a predictor marker for diagnosis of acute exacerbations in children with bronchiectasis.

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Bronchial Inflammation and Colonization in Patients with Clinically Stable Bronchiectasis

Cited by 220 publications

References 21 publications

Innate immune activation in neutrophilic asthma and bronchiectasis

Innate immune activation in neutrophilic asthma and bronchiectasis

Small airway obstruction in patients with rheumatoid arthritis

Does Mean Platelet Volume in Children with Bronchiectasis Predict Exacerbations?

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