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PubMed1982

Histamine content of sputum from patients with asthma and chronic bronchitis.

Studies using the guinea pig ileum bioassay technique have previously shown that patients with either asthma or chronic bronchitis have increased amounts of histamine in their sputum. Because of the limitations of this assay technique, a spectrofluorometric method for measuring the histamine content of sputum was developed. Using this technique it was found that the mean histamine concentration of sputum from patients with bronchogenic carcinoma or pneumonia was not significantly different from the mean value for sputum collected during a remission phase from patients with either chronic bronchitis or asthma. However, the mean values in patients with asthma or chronic bronchitis during an exacerbation were significantly higher and returned to basal values as the airways obstruction improved. There was no significant difference in sputum histamine concentration between those patients with extrinsic atopic asthma and those with late onset cryptogenic asthma during as exacerbation although the value in patients with an exacerbation of chronic bronchitis was significantly less. These results indicate that mediators of immediate hypersensitivity may be implicated in the pathogenesis of airways obstruction in disorders other than extrinsic atopic asthma and suggest that histamine release may occur in non-atropic subjects in response to non-antigenic stimuli.

Albuterol↗
PubMed2003

Early determinants of first hospital admissions for asthma and acute bronchitis among Swedish children.

AIM: To assess the changing impact of prenatal and perinatal factors with increasing age on first admissions for asthma and acute bronchitis. METHODS: The Swedish Medical Birth Registry was linked to the National Hospital Discharge Registry for 214,276 Swedish children born in 1987 and 1988. The linkage comprised first admissions for acute bronchitis or asthma from 1987 to 1995. First admissions for gastroenteritis were included to distinguish between factors specific to asthma or bronchitis and non-specific factors related to an increased risk of hospital admission. RESULTS: Admissions for asthma and acute bronchitis before 2 y of age had a close dose-response relationship with maternal smoking, low gestational age, low maternal age and older siblings. Very premature children exposed to more than 9 cigarettes a day in utero ran a 10 times higher risk of hospitalization than postmature children without exposure to maternal smoking. However, the proportion of admissions attributed to maternal smoking was only 4.7% after adjustments for significant covariates. The number of significant determinants declined in children with their first admission for asthma after 2 y of age but male gender and low educational level were independent determinants in all age groups. Older siblings were related to an increased risk of first asthma admission before 2 y of age but a slightly reduced risk of first admission after 2 y of age. CONCLUSION: This study illustrates the varied epidemiology of asthma in different age groups. Maternal smoking was an important determinant for admission before 2 y of age but mainly in combination with other factors. The decline in hospital admissions in early childhood would therefore be small, even after the elimination of maternal smoking, if other significant perinatal and socioeconomic factors were unchanged.

Acute Disease↗
PubMed2005

Diagnostic and therapeutic value of short-term corticosteroid therapy in exacerbation of mustard gas-induced chronic bronchitis.

Chronic bronchitis is the most frequent late respiratory disease among Iranians exposed to mustard gas during the Iraq-Iran war. The aim of this study was to investigate efficacy of oral and intravenous corticosteroid therapy in improving lung function in mustard gas induced chronic bronchitis patients. 65 mustard gas-exposed chronic bronchitis patients, who were not responsive to standard treatments in exacerbation occasions, were randomly divided into two groups: an intravenous group (39 patients) receiving 500 mg intravenous methylprednisolone daily, and an oral group (26 patients) receiving 1 mg/kg oral prednisolone daily. Corticosteroid was tapered over the study period in both groups. Spirometery was performed on admission and on day 8 of therapy for assessment of effectiveness of therapy. There was significant improvement in spirometery indexes of both groups in approximately half of the patients over the study period. Furthermore, there was no difference between the pulse corticosteroid versus oral corticosteroid therapy in these patients. Since short-term corticosteroid therapy has a significant effect on lung function of almost fifty percent of patients with mustard gas-induced chronic bronchitis in exacerbation occasions, we suggest a short-term bolus steroid treatment to triage the patients into responders and non-responders for subsequent treatment.

Administration, Oral↗
PubMed1998

Assessment of the accuracy of thoracic radiography in the diagnosis of canine chronic bronchitis.

Thoracic radiographs from 23 dogs with chronic bronchitis were mixed with those taken from 11 dogs (matched by age and bodyweight) without respiratory disease and interpreted twice by two blinded, independent examiners in an attempt to determine the accuracy of radiography for the diagnosis of chronic bronchitis. The only radiographic signs found more often in dogs with chronic bronchitis were thickening of the bronchial walls and increased numbers of visible bronchial walls (P < 0.01). Other signs, including bronchial calcification and interstitial pattern, occurred with similar frequency in both groups of dogs. The examiners were consistent in their interpretations (kappa > 0.64). The accuracy of radiographic diagnosis of chronic bronchitis is limited principally by insensitivity for bronchial lesions.

Animals↗
PubMed1993

[Clinical study of acute bacterial bronchitis].

Eighty-two episodes (77 cases) in which any pathogens were isolated from transtracheal aspiration (TTA) and which satisfied the new clinical criteria of acute bacterial bronchitis were clinically evaluated. Major pathogens isolated from TTA included H. influenzae, S. pneumoniae and B. catarrhalis. Fever developed in 91.5% of the patients. Sputum volume averaged 16.3 +/- 14.9 ml per day. All the patients suffered from coughs, which were so severe as to disturb sleep in 8.5% of the patients. Inflammatory indices included WBC 9738.0 +/- 3158.5/microliter, CRP 10.1 +/- 7.9 mg/dl and ESR 69.0 +/- 38.8 mm/hr on average, PaO2 fell in most cases. Compared to the group of patients with acute bacterial bronchitis from which a single pathogen was isolated, the numbers of elderly patients and smokers were significantly more in the group of multiple pathogens isolated from TTA. Prior episodes related to the development of acute bacterial bronchitis were upper respiratory inflammation in 46.3% and undergoing bronchoscopy in 4.9% of the patients. Antibiotics therapy cured acute bacterial bronchitis in 96.3% of the patients. In spite of treatment, 3 patients developed pneumonia and died.

Acute Disease↗
PubMed1982

Coronavirus proteins: structure and function of the oligosaccharides of the avian infectious bronchitis virus glycoproteins.

The recent finding that the E1 glycoproteins of murine coronaviruses contain only O-linked oligosaccharides suggested that this unusual modification might be a distinguishing feature of coronaviruses and might play an essential role in the life cycle of this family of viruses. To examine these possibilities, we analyzed the oligosaccharide moieties of the membrane proteins of the avian coronavirus infectious bronchitis virus. In addition, we determined the effect of inhibiting the glycosylation of these proteins on viral maturation and infectivity. Infectious bronchitis virus virions contain nine proteins. Four of these proteins, GP36, GP31, GP28, and P23, are closely related structurally and appear to be homologous to the E1 proteins of murine coronaviruses. We found that the oligosaccharides of GP31 and GP28 could be removed with endoglycosidase H and that neither of these glycoproteins was detectable in tunicamycin-treated cells. These two results indicated that GP31 and GP28 contain N-linked oligosaccharides. Therefore, O-linked oligosaccharides are not a universal feature of the small coronavirus membrane glycoproteins. Tunicamycin inhibited glycosylation of all of the viral glycoproteins but did not inhibit production of virions by infectious bronchitis virus-infected cells. The virions released by these cells contained only the three non-glycosylated viral proteins P51, P23, and P14. These particles were not infectious. Therefore, it appears that glycosylated infectious bronchitis virus polypeptides are not required for particle formation. However, the viral glycoproteins are apparently indispensible for viral infectivity.

Animals↗
PubMed1970

Additional factors in chronic bronchitis.

A review of persons with chronic bronchitis and controls without bronchitis showed several irritants around the home that aggravated cough, such as house dust, flowers and grasses, smoke, strong fumes, hair spray, insecticide, and soap powders. Most subjects with bronchitis were affected by exposure to one or more of these irritants for at least once a day for three months of the year or more. Out of 163 subjects with chronic bronchitis only six non-smokers were free of factors associated with pulmonary irritation. This evidence from non-smokers not exposed to air pollution adds further strength to the hypothesis that daily phlegm is caused by persistent inhalation of irritants.

Adult↗
PubMed1971

Smoking, chronic bronchitis, and lung cancer.

A follow-up was carried out on 21,579 male mass radiography volunteers aged at least 40 who had been the subject of an earlier investigation in which their smoking habits and sputum production were recorded and the prevalence of lung cancer was determined after chest x-ray examination. During the follow-up period, which was a minimum of 36 months and a maximum of 56 months, 64 new cases of lung cancer were identified by cross checking records with the registers of the regional cancer registration bureau. A significantly higher incidence of lung cancer was found in those with chronic bronchitis than in those without this disease. In the smoking categories, cigarette smokers with chronic bronchitis had a higher incidence than those without it, and this relationship was maintained irrespective of age and amount smoked. It is concluded that persons who smoke run a higher risk of chronic bronchitis than non-smokers and those who develop bronchitis run a higher risk of developing lung cancer.

Adult↗
PubMed1986

Comparison of right ventricular weight at necropsy in interstitial pulmonary fibrosis and in chronic bronchitis and emphysema.

The ventricular weights in 43 patients with interstitial pulmonary fibrosis were retrospectively compared with those in 172 patients with emphysema and chronic bronchitis. The mean right ventricular weight of patients with interstitial pulmonary fibrosis and those with emphysema and chronic bronchitis was 85.5 g (SD 23.2) and 88.8 g (34.3), respectively. Thirty five patients (81%) with interstitial pulmonary fibrosis had a right ventricular weight over 65 g compared with 124 (72%) of those with emphysema. Fifty three per cent of both those with interstitial pulmonary fibrosis and those with chronic bronchitis and emphysema had a right ventricular weight greater than 80 g. Differences between the two groups were not significant. These results suggest that the prevalence of right ventricular hypertrophy and pulmonary hypertension in interstitial pulmonary fibrosis is similar to that found in chronic bronchitis and emphysema.

Aged↗
PubMed1989

Predicting 15 year chronic bronchitis mortality in the Whitehall Study.

Fifteen year chronic bronchitis mortality was investigated among 17,717 male civil servants aged 40-64 years participating in the Whitehall Study. Associations were assessed between mortality and Medical Research Council standardised questions about chronic phlegm production and breathlessness, and a measure of lung function. Low FEV1 was the most powerful single predictor of mortality; controlling for age, smoking habits and employment grade, the relative hazards ratio (RHR) was 20. Using mortality rates standardised for age and smoking, the proportion of mortality in the total population statistically attributable to low FEV1 (population excess fraction) was 57%. Breathlessness while walking on the level was the best predictor among the questions and combinations of questions; the relative hazards ratio was 12 and the population excess fraction, 39%. A Medical Research Council definition of chronic bronchitis including chronic phlegm production and breathlessness was also strongly associated with chronic bronchitis mortality (RHR = 13); however, the population excess fraction was only 20%. This definition identified only 30% of the 64 deaths, and added almost nothing to prediction by FEV1 alone. The results suggest that although the combination of chronic phlegm production and chronic airflow limitation is strongly associated with mortality from chronic bronchitis, the presence of chronic phlegm production alone is not associated with mortality.

Adult↗
PubMed1986

Interpretation of the variability of peak flow rates in chronic bronchitis.

Increased diurnal variation of expiratory flow rates has been documented in patients with chronic bronchitis, but this could be secondary to the disease process of bronchitis rather than an associated disease--namely, asthma. Peak expiratory flow was measured twice daily before and after inhalation of 200 micrograms salbutamol in 34 subjects with chronic bronchitis. The FEV1 ranged from 38% to 121% predicted. Diurnal variation (expressed as highest-lowest/highest (%)) was increased in 18 subjects, all but three of whom had airflow obstruction and an increase in methacholine airway responsiveness. There was only a weak correlation between diurnal variation and airway responsiveness (r = -0.54) or the severity of the airflow obstruction. This finding, together with the occurrence of an increase in diurnal variation without an increase in methacholine airway responsiveness in three subjects, suggests that the increased diurnal variation in chronic bronchitis may have a different underlying mechanism from that in asthma.

Airway Resistance↗
PubMed1991

Effects of allergy and age on responses to salbutamol and ipratropium bromide in moderate asthma and chronic bronchitis.

The bronchodilating responses to 400 micrograms salbutamol and 80 micrograms ipratropium bromide were studied in 188 patients with chronic bronchitis (n = 113) or asthma (n = 75) and mild to moderate airflow obstruction (forced expiratory volume in one second (FEV1) above 50% but below 2 SD of predicted value) in a crossover study on two days a week apart. Both the patients with asthma and the patients with chronic bronchitis varied considerably in their responses to the salbutamol and the ipratropium bromide. The mean increase in FEV1 in the subjects with asthma was higher after salbutamol (0.371 or 18% of the prebronchodilator value) than after ipratropium bromide (0.26 1 or 13%). In chronic bronchitis there was no difference between the increase in FEV1 after salbutamol (0.161 or 7%) and after ipratropium bromide (0.191 or 8%). When patients were categorised into those with a better response to salbutamol 400 micrograms and those with a better response to ipratropium bromide 80 micrograms, patients with chronic bronchitis responded better in general to ipratropium bromide whereas asthmatic patients responded better to salbutamol. The response pattern was also related to allergy and age, allergic patients and patients under 60 being more likely to respond better to salbutamol 400 micrograms than non-allergic patients and older patients, who benefited more from ipratropium bromide 80 micrograms. The response pattern was not related to sex, smoking habits, lung function, bronchial reactivity, respiratory symptoms, or number of exacerbations during the preceding year.

Age Factors↗
PubMed1997

Relationship between bronchial reversibility and tracheobronchial clearance in patients with chronic bronchitis.

BACKGROUND: Patients with chronic bronchitis show a large intersubject variation in sputum rheology, tracheobronchial clearance, and reversibility of airflow obstruction to beta 2 agonists. The bronchial mediators which are known to cause bronchoconstriction, mucosal oedema, mucus hypersecretion, and cough can also affect mucociliary transport. The aim of this study was to ascertain whether changes in tracheobronchial clearance and sputum rheological properties in patients with chronic bronchitis were associated with a specific degree of airflow reversibility assessed as the bronchial response to an inhaled beta 2 agonist (fenoterol 400 micrograms). METHODS: Bronchial reversibility (percentage change in baseline forced expiratory volume in one second (FEV1)) was measured in 26 patients with chronic bronchitis on three separate occasions, at least one week apart. Tracheobronchial clearance was evaluated by a non-invasive radioaerosol technique, and an oscillatory viscometer was used for measuring sputum apparent viscosity and elasticity. The number of coughs (productive and nonproductive coughs), the wet weight of sputum, and its radioaerosol content were recorded during the six hour clearance period, as well as the 24 hour sputum production. RESULTS: The change in FEV1 after fenoterol was less than 15% in 12 patients and more than 15% in 14. Patients with airways reversibility of more than 15% had faster tracheobronchial clearance, more coughs, lower sputum viscosity and elasticity, and larger 24 hour sputum production than those with airways reversibility of less than 15%. CONCLUSIONS: In patients with chronic bronchitis a large bronchodilator response is associated with faster clearance of mucus by mucociliary transport and coughing.

Adrenergic beta-Agonists↗
PubMed2002

[Treatment of chronic bronchitis with ivy leaf special extract--multicenter post-marketing surveillance study in 1,350 patients].

BACKGROUND AND OBJECTIVES: The changes of clinical symptoms and the tolerability of Prospan((R)) acute Effervescent Cough Tablets were investigated in a multicenter, prospective post-marketing surveillance (PMS) study focusing on patients with chronic bronchitis. PATIENTS AND METHODS: The study included 1,350 male and female patients aged 4 years and above who were treated in one of 135 participating medical practices and who suffered from chronic bronchitis (with or without airway obstruction). During a scheduled observational period of 4 weeks, the patients had to take 1(1/2) or 2 tablets per day (depending on their age), according to the manufacturer's dosing recommendations, corresponding to 97.5 or 130 mg of dried ivy leaf extract (about 585- 780 mg of drug). Treatment success was assessed by observing the changes in the direct symptoms of chronic bronchitis between the baseline examination and the end of treatment. Safety was evaluated by analyzing adverse events. RESULTS: In comparison to baseline, the following percentages of patients showed improved symptoms or were cured at treatment end: cough 92.2%; expectoration 94.2%; dyspnea 83.1%; respiratory pain 86.9%. In each of the four symptoms at least 38% of the initially affected patients were completely free of complaints. Three patients (0.2%) experienced adverse events in which a causal relationship to the drug under investigation could not be excluded (2x eructation, 1x nausea). CONCLUSIONS: Considering the favorable changes in all investigated clinical symptoms as well as the excellent tolerability in children and adults, the ivy leaf extract preparation Prospan acute Effervescent Cough Tablets can be considered as a therapeutic option in alleviating the symptoms of chronic bronchitis.

Adolescent↗
PubMed1979

Lung function in children with recurrent bronchitis.

Lung function was studied in 29 children suffering from recurrent bronchitis (average number of bronchitis attacks per year: 4.2 +/- 0.5). Most of them (73%) were 1--7 years old. The date of exploration in relation to the last acute bronchitis was on average 6 weeks. Lung mechanics, residual functional capacity, blood gases and regional lung function were measured. Most of the children were suffering from some kind of functional disorder; alteration of lung mechanics -- increase of lung resistance (22/29) decrease of dynamic compliance (15/23); increase of functional residual capacity (6/10), non specific bronchial hypersensitivity (12/17); regional ventilatory and perfusion malfunction. These functional disorders could be the first evidence of the bronchial lesions which cause chronic obstructive bronchitis in adults.

Bronchitis↗
PubMed1990

Local immunity in patients with chronic bronchitis and the effects of a bacterial extract, Broncho-Vaxom, on T lymphocytes, macrophages, gamma-interferon and secretory immunoglobulin A in bronchoalveolar lavage fluid and other variables.

In 28 adult patients with nonobstructive chronic bronchitis we investigated components of the immune system of the lower airways and the effects of treatment with Broncho-Vaxom (BV). An analysis of the washing from bronchoalveolar lavage (BAL) showed, in comparison with healthy controls, an elevation of total cell count (p = 0.003) as well as the IgA/albumin values (p = 0.02) and a reduction of the macrophage activity (p less than 0.001) in patients with chronic bronchitis. After BV a reduction in the total cell count (p = 0.05), an increase in the helper/suppressor T lymphocyte ratio (due mainly to the reduction in the suppressor cells; p = 0.04), a modulation of the IgA/albumin ratio, a stimulation of the impaired alveolar macrophage activity (p = 0.03) and increased concentrations of gamma-interferon (p = 0.03) were found in the BAL fluid of patients with chronic bronchitis. The salivary IgA/albumin ratio remained unchanged, the serum IgE concentration fell (p = 0.02) and the urinary IgA concentration rose (p = 0.002). Bronchial mucosa lesions, evaluated endoscopically in terms of structural damage, hyperemia and mucus production, were improved (p less than 0.01). These findings indicate that orally administered BV modulates disordered local and systemic immune functions in patients with chronic bronchitis.

Adjuvants, Immunologic↗
PubMed1991

Chronic bronchitis in the 1990s: up-to-date treatment.

Prevention is the key to eradicating chronic bronchitis. Smoking is the prime factor involved. Quitting smoking is difficult even with modern aids such as counselling, filters, substitutes, hypnosis and acupuncture, and the success rate is only 20%. Passive smoking is also injurious. The role of atmospheric pollution is less well quantified. Other risk factors include lower social class, occupation, area of residence, housing, temperature, and childhood respiratory illness. Influenza vaccination gives 60-70% immunity. With exacerbations of chronic bronchitis, beta-lactamase-producing bacteria are important, though the overall need for antibiotics is uncertain judging by placebo-controlled studies. Inhaled beta 2-agonist bronchodilators may improve airflow obstruction, as may anticholinergic drugs (e.g. ipratropium), the two being additive. Oral theophyllines have a narrow therapeutic window, serious side-effects and only two thirds of the effect of beta 2-agonists. A corticosteroid trial for 2 weeks may relieve refractory airway obstruction in 17-23% of chronic bronchitis, to be followed by inhaled steroids. Mucolytic drugs remain controversial and are difficult to monitor successfully. Oxygen therapy may be indicated for hypoxic chronic bronchitis, including long-term usage in cor pulmonale. Pulmonary rehabilitation by exercise training has recently been appreciated, and may be used in combination with the above treatment modalities.

Adrenal Cortex Hormones↗
PubMed1995

Elevated substance P content in induced sputum from patients with asthma and patients with chronic bronchitis.

In experimental studies, tachykinins, especially substance P (SP), cause many of the pathophysiological features of neurogenic inflammation. It is unclear whether these peptides are involved in human airway inflammation in diseases such as asthma and chronic bronchitis. To elucidate the relation between neurogenic inflammation and airway inflammatory diseases, we examined the SP concentration in sputum after hypertonic saline inhalation challenge in patients with asthma, patients with chronic bronchitis, and normal volunteers. SP concentration was measured by radioimmunoassay. The sputum SP concentration was significantly higher in patients with asthma (mean +/- SEM, 17.7 +/- 2.4 fmol/ml; p < 0.01) and patients with chronic bronchitis (25.6 +/- 5.5 fmol/ml; p < 0.01) than in normal volunteers (1.1 +/- 0.4 fmol/ml). In patients with asthma, the SP concentration was significantly related to the eosinophil cell count in induced sputum. In all subjects, the SP concentration in induced sputum correlated with FEV1/FVC. These data suggest that neurogenic inflammation may be involved in the airway inflammatory process and subsequent airway narrowing not only in asthma but also in chronic bronchitis.

Adult↗