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Airway inflammation and bronchial microbial patterns in patients with stable chronic obstructive pulmonary disease
Open accessAbstract
The effect of bacterial colonization of the bronchi on the progress of airflow limitation is not well known. Therefore, the pattern of airway inflammation in smokers and patients with stable chronic obstructive pulmonary disease (COPD) and its relation to bronchial microbial colonization was assessed. Eight nonsmoking and 18 smoking controls as well as 52 patients with COPD (28 mild, 11 moderate and 13 severe) were studied. All subjects were investigated by means of flexible bronchoscopy including protected specimen brush and bronchoalveolar lavage (BAL) sampling. Differential cell counts, cytokine (interleukin (IL)-1beta, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha(TNF-alpha) concentrations and microbial patterns were determined in BAL fluid. Forced expiratory volume in one second (FEV1) % of the predicted value was inversely correlated with pack-yrs of cigarette smoking (r=-0.47, p<0.0001), the percentage of neutrophil (p=-0.56, p<0.0001) and IL-6 (p=-0.37, p=0.01) and IL-8 concentration (p=-0.43, p=0.004) in BAL fluid. Accordingly, pk-yrs of cigarette smoking (p=0.39, p=0.01) and IL-8 (p=0.69, p<0.0001) and TNFalpha (p=0.4, p<0.005) were positively correlated with the percentage of neutrophils in BAL fluid. Smoking controls and COPD patients were mainly colonized in the bronchial tree (33%) by community endogenous potentially pathogenic micro-organisms (PPMs). Colonization rates and patterns of PPMs were not affected by severity of airflow obstruction. The presence of PPMs was significantly associated with higher percentages of neutrophils (33.2+/-10.4% versus 10.1+/-3.5%, p=0.02) and TNF-alpha concentration (29.9+/-10.8 versus 6.3+/-2.1 pg x mL(-1), p=0.01) in BAL fluid. In conclusion, bronchial neutrophilia is a key inflammatory pattern in chronic obstructive pulmonary disease patients. Bronchial colonization with potentially pathogenic micro-organisms may represent an independent stimulus for additional airway inflammation.
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Cited by
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Charlson, E. S., Bittinger, K., Haas, A. R., Fitzgerald, A. S., Frank, I., Yadav, A., Bushman, F. D., & Collman, R. G. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201104-0655oc · Cited by 1,144
New Strains of Bacteria and Exacerbations of Chronic Obstructive Pulmonary Disease
Sethi, S., Evans, N., Grant, B. J. B., & Murphy, T. F. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa012561 · Cited by 1,047
The Microbiome and the Respiratory Tract
Dickson, R. P., Erb-Downward, J. R., Martinez, F. J., & Huffnagle, G. B. (2016) · Annual Review of Physiology · doi:10.1146/annurev-physiol-021115-105238 · Cited by 953
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Metadata
- Authors
- Soler, N., Ewig, S., Torres, A., Filella, X., Gonzalez, J., & Zaubet, A.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 1999-11-01
- Volume
- 14
- Issue
- 5
- Pages
- 1015-1022
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2152702795
- Cited by
- 371
- References
- 0
- FWCI
- 9.49
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Soler, N., Ewig, S., Torres, A., Filella, X., Gonzalez, J., & Zaubet, A. (1999). Airway inflammation and bronchial microbial patterns in patients with stable chronic obstructive pulmonary disease. European Respiratory Journal. https://doi.org/10.1183/09031936.99.14510159
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