Immunity and bacterial colonisation in bronchiectasis

Whitters, Deborah; Stockley, Robert A.

doi:10.1136/thoraxjnl-2011-200206

Cited by 54 publications

(40 citation statements)

References 73 publications

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“…As we described previously (15), these lengthened cilia are accompanied with impairment of MCC function, which is a potential cause of chronic mucosal inflammation or infection in chronic airway diseases (e.g., rhinosinusitis). In patients with non-CF bronchiectasis, this abnormal-cilia structure will contribute to impaired MCC, making airways susceptible to chronic infection and microbial colonization, favoring a continuous inflammatory response that persists even after infection has been controlled (3,5,7).…”

Section: Discussionmentioning

confidence: 99%

“…In bronchiectasis, the mucus itself is often abnormal and more complex. Tracheobronchial clearance in bronchiectasis has been shown to be slower than in normal control subjects independent of the presence of infection (3,5,7). Over time, retained sputum can cause mucous plugs and airway obstruction, obliteration, and damage resulting in more advanced bronchiectasis (6,7).…”

Section: Discussionmentioning

confidence: 99%

“…Ciliary dyskinesia and mucus over-production weakens clearance of respiratory pathogens from the airway (7). These dysregulated immune responses and repairment contribute to airway structural remodeling, characterized by epithelial hyperplasia, loss of cartilage and fibro-muscular tissues and fibrosis in the bronchi (3,5,9). These pathologic changes might lead to small airways obstruction, chronic inflammation, and progressive lung function impairment (1,9,10).…”

Section: Introductionmentioning

confidence: 99%

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Aberrant epithelial remodeling with impairment of cilia architecture in non-cystic fibrosis bronchiectasis

Chen

Wang

et al. 2018

J. Thorac. Dis.

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Background: Aberrant epithelial remodeling and/or abnormalities in mucociliary apparatus in airway epithelium contribute to infection and inflammation. It is uncertain if these changes occur in both large and small airways in non-cystic fibrosis bronchiectasis (non-CF bronchiectasis). In this study, we aim to investigate the histopathology and inflammatory profile in the epithelium of bronchi and bronchioles in bronchiectasis.Methods: Excised lung tissue sections from 52 patients with non-CF bronchiectasis were stained with specific cellular markers and analyzed by immunohistochemistry and immunofluorescence to assess the epithelial structures, including ciliated cells and goblet cells morphology. Inflammatory cell counts and ciliary proteins expression levels of centrosomal protein 110 (CP110) and dynein heavy chain 5, axonemal (DNAH5) were assessed.Results: Epithelial hyperplasia is found in both bronchi and bronchioles in all specimens, including hyperplasia and/or hypertrophy of goblet cells. The median cilia length is longer in hyperplastic epithelium [bronchi: 8.16 (7.03-9.14) μm, P<0.0001; bronchioles: 7.46 (6.41-8.48) μm, P<0.0001] as compared to nonhyperplastic epithelium (bronchi: 5.60 μm; bronchioles: 4.89 μm). Hyperplastic epithelium is associated with overexpression of CP110 and decreased intensity of DNAH5 expression in both bronchial and bronchiolar epithelium. Though infiltration of neutrophils is predominant (63.0% in bronchi and 76.7% in bronchioles), eosinophilic infiltration is also present in the mucosa of bronchi (30.8%) and bronchioles (54.8%).Conclusions: Aberrant epithelial remodeling with impaired mucociliary architecture is present in both large and small airways in patients with refractory non-CF bronchiectasis. Future studies should evaluate the interplay between these individual components in driving chronic inflammation and lung damage in patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aberrant epithelial remodeling with impairment of cilia architecture in non-cystic fibrosis bronchiectasis

Chen

Wang

et al. 2018

J. Thorac. Dis.

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“…And unlike other forms of chronic infection, the immunologic response to bacterial infections of the airways does not appear to evolve to a classic, adaptive response, but rather maintains an unrelenting neutrophilic response, similar to those in acute infections. 1 It is for this reason chronic lung infections may be better classified as persistent infections, as most bacteria involved in these infections have survived treatment that would normally be predicted to eradicate them, and may continue to persist lifelong in some patients. Most acute lung infections do uphold Koch’s postulates very well, and sputum cultures and staining techniques, when appropriately collected and culture positive, are usually helpful in determining which antibiotics to use.…”

Section: Persistent Lung Infectionsmentioning

confidence: 99%

Understanding Persistent Bacterial Lung Infections

Pragman

Berger

Williams

2016

Clinical Pulmonary Medicine

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The infections found in chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis share a number of clinical similarities, the most striking of which is bacterial persistence despite the use of antibiotics. These infections have been clinically described using culture-based methods usually performed on sputum samples, and treatment has been directed towards the bacteria found in this manner. Unfortunately the clinical response to antibiotics is frequently not predictable based on these cultures, and the role of these cultured organisms in disease progression has been debated. The past 20 years have seen a revolution in the techniques used to describe bacterial populations and their growth patterns. These techniques have revealed these persistent lung infections are vastly more complicated than described by traditional, and still widely relied upon, sputum cultures. A better understanding of the initiation and evolution of these infections, and better clinical tools to describe them, will dramatically alter the way patients are cared for. While clinical tests to more accurately describe these infections are not yet available, the better appreciation of these infections afforded by current science should enlighten practitioners as to the care of their patients with these diseases.

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“…We thank Zimmer et al for their comments1 on our recent article ‘Immunity and bacterial colonisation in bronchiectasis’ 2…”

mentioning

confidence: 99%