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At least 595 records · Page 33Linked to original sources
PubMed1993

Effect of inhaled procaterol on cough receptor sensitivity to capsaicin in patients with asthma or chronic bronchitis and in normal subjects.

BACKGROUND: To evaluate the effect of inhaled beta 2 adrenergic agonists on the sensitivity of airway cough receptors, the effect of inhaled procaterol on cough induced by aerosolised capsaicin, a stimulant of C fibres, was studied in patients with asthma or chronic bronchitis and in normal subjects. METHOD: Eleven patients with asthma and 10 with chronic bronchitis and 14 normal subjects participated. Increasing concentrations of capsaicin solution were inhaled for 15 seconds by tidal breathing through the mouth at one minute intervals until five or more coughs were elicited, before and 30 minutes after inhalation of 20 micrograms procaterol or placebo (freon gas alone) through a metered dose inhaler. Cough threshold was defined as the lowest concentration of capsaicin that elicited five or more coughs. To evaluate the bronchodilator effect of procaterol and the bronchoconstrictor effect of inhaled capsaicin, forced expiratory volume in one second (FEV1) was measured before and one minute after a capsaicin provocation test. This test was carried out both before and 30 minutes after treatment with procaterol or placebo. RESULTS: The geometric mean value of cough threshold to capsaicin was significantly increased by procaterol and placebo in both groups of patients but not in the control subjects. The increment in the cough threshold was not significantly different between the treatments with procaterol and placebo in each group. FEV1 was significantly increased by procaterol but not by placebo in all three groups. CONCLUSIONS: Inhaled procaterol has no effect on airway cough receptor sensitivity to capsaicin. The attenuation of the cough sensitivity seen after inhalation of procaterol in patients with asthma and bronchitis may result from tachyphylaxis to capsaicin.

Administration, Inhalation↗
PubMed1987

Use of an oxfendazole pulse release bolus in the control of parasitic gastroenteritis and parasitic bronchitis in first-season grazing calves.

The efficacy of the oxfendazole pulse release bolus system for the control of parasitic gastroenteritis and parasitic bronchitis in first-season grazing calves was evaluated in Belgium. Twenty-two calves were allocated to two groups. The calves in one group received a bolus at the time of turn out, while the other group remained untreated. The efficacy of the bolus was assessed by comparison of faecal worm egg counts, plasma pepsinogen concentrations, the antibody response to Ostertagia, Cooperia and Dictyocaulus species total plasma protein and albumin concentrations, and weight gains throughout the grazing season and the housing period. The oxfendazole pulse release bolus provided good control of parasitic gastroenteritis dominated by ostertagia. The effects of parasitic gastritis were greatly reduced as shown by the significantly lower values of serum pepsinogen and ostertagia antibody titres. The use of the bolus further reduced the adverse effects of parasitism as indicated by better liveweight gains and normal total plasma protein and albumin concentrations whereas in the untreated control group hypoproteinaemia and hypoalbuminaemia were observed. Most animals exhibited clinical signs of parasitic bronchitis at the end of the grazing season, and the bolus may not adequately control parasitic bronchitis in all cases at all times.

Animals↗
PubMed2004

[Pharmacoeconomic analysis of patients with acute exacerbation of chronic bronchitis treated with telithromycin or cefuroxime-axetil].

INTRODUCTION: A pharmacoeconomic analysis was done to compare the efficiency of two treatments in the acute exacerbation of chronic bronchitis: telithromycin and cefuroxime-axetil. METHODS: Restrospective analysis, modeled through a decision tree. The effectiveness of the treatments was estimated through a randomized and double-blind clinical trial in which 800 mg/day (5 days) of telithromycin were compared with 1,000 mg/day (10 days) of cefuroxime-axetil in patients with acute exacerbation of chronic bronchitis (140 and 142 patients, respectively). Resources use was estimated from clinical trial and from Spanish data, and the unit costs through a health costs dabatase. The model was validated by a panel of Spanish clinical experts. RESULTS: Since the clinical trial was designed to demonstrate equivalence, there were no significant differences of effectiveness among both treatments (with a rate of clinical cure of 86.4% and 83.1%, respectively) which means that an analysis of costs minimization was done. In the average case, the average cost of the disease by patient was 174.83 Euros with telithromycin and 194.68 Euros with cefuroxime-axetil (a difference of 19.85 Euros). The results were maintained in the analysis of sensitivity, with favorable differences for telithromycin that ranged between 18.04 Euros and 22.25 Euros. CONCLUSIONS: With telithromycin up to 22 Euros by patient with acute exacerbation of chronic bronchitis could be saved, in comparison with cefuroxime-axetil.

Acute Disease↗
PubMed2001

Obstructive sleep apnoea syndrome is common in subjects with chronic bronchitis. Report from the Obstructive Lung Disease in Northern Sweden studies.

BACKGROUND: In previous studies we have found that subjects with bronchitis have a higher prevalence of 'snoring as a problem' than respiratory healthy subjects. OBJECTIVES: We aimed to study whether the high prevalence of snoring among subjects with bronchitis also represents a high prevalence of obstructive sleep apnoea (OSA). METHOD: Subjects in three age groups born 1919-1920, 1934-1935 and 1949-1950 had been identified as bronchitic in an earlier study (n = 471) and without respiratory symptoms (n = 108). Of the 91 subjects reporting snoring to be a problem, 70 were invited to participate in the study. Sleep investigation was performed in 52 of these 70 subjects. RESULTS: 'Snoring as a problem', predicted OSA to a similar degree in both bronchitic and respiratory healthy subjects. The estimated prevalence for obstructive sleep apnoea with an apnoea/hypopnoea index (AHI) 10 as the cut-off point and concomitant daytime symptoms such as daytime sleepiness or liability to nodding off during breaks in activity in the daytime, was 5.4% for bronchitic subjects and 2.3% for respiratory healthy subjects. Apnoea in addition to snoring predicted OSA better than did snoring alone. Age correlated significantly with AHI, and OSA was most common in the middle-aged group, 61-62 years old. CONCLUSION: OSA is twice as common in subjects with chronic bronchitis as in subjects free of pulmonary disease or symptoms.

Aged↗
PubMed2002

Esberitox N as supportive therapy when providing standard antibiotic treatment in subjects with a severe bacterial infection (acute exacerbation of chronic bronchitis). A multicentric, prospective, double-blind, placebo-controlled study.

53 patients with planned antibiotic therapy for the treatment of acute exacerbation of chronic bronchitis as an example of a severe bacterial infection requiring antibiotics were included in a prospective, multicentre, double-blind, placebo-controlled study. The chronic bronchitis was staged by forced expiratory volume of the 1st second (FEV(1)) measured in the infection-free interval prior to the current episode and had to be between 35 and 75% for the predicted value. Patients were randomly assigned to receive newer macrolide antibiotics plus either Esberitox N or placebo. Antibiotic therapy was administered according to generally accepted guidelines and Esberitox N or placebo was given for 28 days. The baseline-adjusted means for FEV(1) (%) on day 10 were 68.7 points for the Esberitox N group and 59.2 points for the placebo group (p = 0.0303). For FEV(1) the difference between the two treatment groups was 267 ml (p = 0.0499). The time to half maximal improvement was 5.7 days in the Esberitox N group compared to 12.8 days in the placebo group. The treatment was well tolerated; no serious adverse events were documented. In conclusion, comedication of antibiotics with Esberitox N in subjects with acute exacerbation of chronic bronchitis seems to be of benefit for the patient. Apparently, therapy with Esberitox N leads to a faster recovery from this severe bacterial infection, possibly via preventing an impairment of the host's immune system which might otherwise occur as a consequence of aggressive antimicrobial therapeutics.

Adjuvants, Immunologic↗
PubMed1983

Mucociliary clearance in patients with chronic bronchitis and bronchial carcinoma.

We measured the mucociliary clearance rates and lung function data of 40 normal subjects, of 30 smokers with chronic bronchitis and of 64 patients with bronchial carcinoma. The mucociliary clearance rate of cancer patients was significantly lower than that of normal subjects and of patients with chronic bronchitis who smoked the same amount of cigarettes. The fast clearing phase of the central bronchial tree is more delayed than the peripheral mucociliary clearance rate in smokers with and without carcinoma. With our mucociliary clearance measurement we assessed the self-cleaning filter function of about the first 10 generations of the branching bronchial tree where also most bronchial carcinomas develop. The correlation between lung function data (MMEF) and smoking habits is much better (r = 0.73) than with the measured mucociliary clearance rates (r = 0.3), suggesting that inborn errors of mucociliary transport are nearly as important as external lung damage due to smoking and infection in the development of chronic bronchitis and bronchial carcinoma.

Adenocarcinoma↗
PubMed1994

Mast cells in the airway lumen and bronchial mucosa of patients with chronic bronchitis.

In order to evaluate the degree of mast cell infiltration and determine their granulation state in the airways of patients with chronic bronchitis, bronchoscopy was performed in 25 chronic bronchitis subjects (10 smokers and 15 ex-smokers) with mucoid sputum production and in seven normal nonsmoking control subjects. Bronchoalveolar lavage and bronchial biopsies were examined using histochemical techniques. Subjects with chronic bronchitis had higher numbers of mast cells both in the epithelium (1.22 +/- 1 versus 0.22 +/- 0.2 mast cells per mm) and in the bronchial glands (137.4 +/- 37.9 versus 38 +/- 5.1 mast cells per mm2) than did control subjects (p < 0.01 and p < 0.001, respectively), whereas the numbers of mast cells in bronchoalveolar lavage (0.21 +/- 0.1 versus 0.18 +/- 0.1 mast cells percentage, nonsignificant [NS]) and in the lamina propria (87.5 +/- 66.4 versus 87.2 +/- 61.8 mast cells per mm2, NS) were similar in the two groups. In the smoking group of bronchitics an increase in mast cell numbers was observed in epithelium (1.6 +/- 1.3 versus 0.95 +/- 0.7 mast cells per mm, NS), in lamina propria (112.2 +/- 86.5 versus 71.7 +/- 45.7 mast cells per mm2), and in BAL (0.26 +/- 0.21 versus 0.16 +/- 0.17 mast cell percentage of total cells, NS) in comparison with the ex-smoker's group of bronchitics.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchi↗
PubMed1995

Increased airway responsiveness to inhaled methacholine in a rat model of chronic bronchitis.

Chronic exposure of rats to high concentrations of SO2 gas causes pathologic changes in airway similar to those seen in human chronic bronchitis. The purpose of this study was to examine the pulmonary mechanical correlates of these changes and to quantify the extent of mucous hypersecretion by measuring changes in mucous glycoproteins. Female Sprague-Dawley rats were exposed to 250 ppm SO2 gas, 5 h/d, 5 d/wk, for a period of 4 wk. Control rats were exposed to air only. On the day after the last SO2 exposure, rats were anesthetized, instrumented for the measurement of pulmonary resistance (RL) and dynamic compliance (Cdyn), and ventilated. Chronic SO2 exposure caused a small but significant increase in RL and decrease in Cdyn. Airway responsiveness to inhaled aerosolized methacholine was increased in SO2-exposed rats, as indicated by approximately 6.6- and 4.6-fold decreases respectively, in the doses of inhaled methacholine required to double RL or decrease Cdyn to 50% of baseline. SO2 exposure had no effect on the contractile response of the trachea measured in vitro. Tracheae and lungs from SO2-exposed animals exhibited 140 and 535% increases in measured neutral mucous glycoproteins, respectively, and 33 and 37% increases in acid glycoproteins. Our results indicate that this animal model of chronic bronchitis mimics the mucous hypersecretion, airway obstruction, and increased airway responsiveness observed in human bronchitis and may allow us to begin to probe their mechanistic basis.

Animals↗
PubMed1995

Effect of smoking cessation on airway inflammation in chronic bronchitis.

To investigate the effect of smoking cessation on the airway inflammatory process present in nonatopic subjects with chronic bronchitis, we obtained bronchial biopsies from nine current smokers and seven exsmokers, all with symptoms of chronic bronchitis at the time of the study, and from seven healthy nonsmoking subjects. The exsmokers had stopped smoking on average 13 yr before the study, yet cough and production of sputum had persisted. Bronchial biopsies were assessed using immunohistochemical techniques to investigate the number of inflammatory cells, the markers of mononuclear cell activation, and the expression of endothelial adhesion molecules and cytokines in the subepithelium. Current smokers and exsmokers had an increased number of macrophages, IL-2R-positive cells, VLA-1-positive cells, ICAM-1-positive vessels, and E-selectin-positive vessels compared with normal nonsmoking subjects, but the number of cells positive for neutrophils, EG-2, CD3, CD4, CD8, TNF-alpha and IL-1 beta were similar among the three groups. No differences were observed between current smokers and exsmokers for any parameter examined. In conclusion, the inflammatory process present in the airway mucosa of current smokers may persist after smoking cessation in subjects who continue to have symptoms of chronic bronchitis.

Aged↗
PubMed1997

Airway hyperresponsiveness in a rat model of chronic bronchitis: role of C fibers.

We evaluated the role of C fibers in the development of airway hyperresponsiveness in a rat model of chronic bronchitis. Neonatal rats were treated with capsaicin (50 mg/kg, subcutaneously), a procedure which results in permanent depletion of tachykinins from the lungs and airways as well as degeneration of C fibers. Control rats were treated with the vehicle used to dissolve capsaicin. Three months later, rats from both groups were exposed either to SO2 gas (250 ppm, 5 h/d, 5 d/wk for 4 wk) or to filtered air for the same period of time. One day after the last exposure, rats were anesthetized and instrumented for the measurement of pulmonary resistance (R(L)), dynamic compliance (Cdyn), and airway responsiveness to inhaled aerosolized methacholine. There was a small (30%) but significant increase in R(L) in neonatal capsaicin- but not vehicle-treated rats exposed to SO2. Chronic exposure to SO2 resulted in increased airway responsiveness in both groups of rats, but the effect was more pronounced in the neonatal capsaicin-treated animals in which the doses of methacholine required to double R(L) or decrease Cdyn by 50% decreased 6.3-fold and 4.6-fold, respectively, compared with only 2.2- and 1.3-fold decreases in vehicle-treated rats. Morphometric analysis of histologic sections of airways demonstrated that the average area of smooth muscle in the airway wall, normalized by the length of basement membrane, was significantly greater in SO2 compared with air-exposed capsaicin-treated rats, but not in vehicle-treated control rats (p < 0.012). The maximal tension generated by tracheal rings in response to cholinergic agonists was also significantly increased by SO2 exposure in neonatal capsaicin-treated, but not vehicle-treated rats (p < 0.002). These results support the hypothesis that rather than contributing to the pathophysiologic manifestations of bronchitis, C fibers limit the development of airway obstruction and airway hyperresponsiveness during induction of chronic bronchitis by SO2 exposure. The enhanced contractile responses of airways from the SO2-exposed neonatal capsaicin-treated rats may result from increased airway smooth muscle mass and contribute to the increased airway responsiveness observed in these animals.

Animals↗
PubMed1997

Inflammatory cells in the bronchial glands of smokers with chronic bronchitis.

To characterize the inflammatory process in the bronchial glands of smokers with chronic sputum production, we examined lobar bronchi from 18 subjects undergoing lung resection for localized pulmonary lesions, all with a history of cigarette smoking. Nine of the subjects had symptoms of chronic bronchitis and chronic airflow obstruction, and nine were asymptomatic, with normal lung function. The number of neutrophils, eosinophils, mast cells, macrophages, CD4+ and CD8+ T-lymphocytes, and the ratio of CD4+ to CD8+ cells were assessed in the bronchial glands, epithelium, and submucosa. Cells were identified through immunohistochemistry. Smokers with symptoms of chronic bronchitis had an increased number of neutrophils (p = 0.01) and macrophages (p = 0.03) and a decreased CD4+/CD8+ ratio (p = 0.01) in the bronchial glands as compared with asymptomatic smokers. Chronic bronchitic smokers also had an increased number of epithelial neutrophils (p = 0.04), whereas the numbers of macrophages and CD4+ and CD8+ T-lymphocytes in the epithelium and submucosa were similar in the two groups of smokers. No differences in numbers of eosinophils or mast cells were observed between bronchitic and asymptomatic smokers in any of the compartments examined. In conclusion, smokers with chronic sputum production have an increased infiltration of neutrophils and macrophages and an increased proportion of CD8+ T-lymphocytes in their bronchial glands, supporting the important role of bronchial-gland inflammation in the pathogenesis of chronic bronchitis.

Aged↗
PubMed1998

Sputum metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio correlates with airflow obstruction in asthma and chronic bronchitis.

Asthma and chronic bronchitis are inflammatory diseases with extracellular matrix (ECM) remodeling and collagen deposition. Collagen homeostasis is controlled by metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). We evaluated MMP and TIMP balance in induced sputum of 10 control, 31 untreated asthmatic, and 16 chronic bronchitic subjects. We first performed zymographic analysis to identify the profile of MMPs. Zymography revealed a similar MMPs profile in all populations studied and that MMP-9 was the major enzyme released. We then measured, using enzyme immunoassay, the concentrations of MMP-9 and of its inhibitor TIMP-1 and evaluated whether airflow limitation may be associated with an imbalance between these enzymes. MMP-9 and TIMP-1 concentrations were greater in sputum of patients with asthma and chronic bronchitis than in control subjects. The molar ratio between MMP-9 and TIMP-1 was lower in asthmatics and chronic bronchitics than in control subjects, and positively correlated with FEV1 values. In asthma, MMP-9 levels were significantly correlated with the number of macrophages and neutrophils. This study shows that airway inflammation in asthma and chronic bronchitis is associated with an imbalance between MMP-9 and TIMP-1 which may have a role in the pathogenesis of ECM remodeling and airflow obstruction.

Adolescent↗
PubMed1999

Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.

The application of sputum induction and refined methods of sputum examination has provided the opportunity to examine cell and molecular markers of airway inflammation in asthma, COPD, and other airway diseases. The measurements are relatively noninvasive and can be applied safely, with care, even in more severe exacerbations of asthma and severe COPD. Induced sputum examination can be applied at random and repeatedly and gives results that are reproducible, valid, and responsive to changes in treatment. An eosinophilic bronchitis, defined as sputum eosinophilia, is typical of asthma but can also occur in patients with a chronic cough without asthma, and in some patients with COPD in whom the classic inflammatory response is neutrophilic without eosinophilia. When eosinophilia occurs in COPD, it has been considered to be the result of cigarette smoking but it may be due to other causes. The clinical importance of eosinophilic bronchitis is that it responds to treatment with corticosteroid. In contrast, there is increasing evidence that an absence of sputum eosinophilia is associated with steroid resistance. Hargreave FE, Leigh R. Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.

Asthma↗
PubMed2001

Interleukin-4 and interleukin-5 gene expression and inflammation in the mucus-secreting glands and subepithelial tissue of smokers with chronic bronchitis. Lack of relationship with CD8(+) cells.

We wished to determine if the inflammatory cells surrounding the airway mucus-secreting glands in chronic bronchitis (CB) were associated with interleukin (IL)-4 and IL-5 mRNA expression and whether the CD8 T cell population expressed these cytokines. Digoxigenin-labeled IL-4 and IL-5 antisense RNA probes were used to detect gene expression in 11 asymptomic smokers (AS), 11 smokers with CB alone with normal lung function, and 10 smokers with chronic bronchitis and coexisting chronic obstructive pulmonary disease (CB+COPD; FEV(1)% of predicted of 43-77% and FEV(1)/ FVC of 51-68%). There were approximately three times as many IL-4 than IL-5 mRNA(+) cells. The highest number of IL-4 mRNA(+) cells were in the submucosal glands of the CB group with normal lung function (216/mm(2)), significantly higher than the values in either the AS (63/mm(2)) or the CB+COPD (87/mm(2)) groups, respectively (p < 0.01). There were similar group differences when the total numbers of inflammatory cells were compared. Accordingly, there was a positive correlation between the number of IL-4 mRNA(+) cells and the total number of inflammatory cells in both the subepithelium and glandular compartments (r = 0.60; p = 0.01 and r = 0.70; p = 0.02, respectively). There were no significant associations between the numbers of CD8(+) and IL-4 or IL-5 mRNA(+) cells. Of 1328 IL-4(+) and 1404 CD8(+) cells counted none was double labeled. Of 727 IL-5(+) and 1569 CD8(+) cells, none was double labeled. In contrast, as a positive control, 34% of tumor necrosis factor (TNF)-alpha(+) cells were also CD8(+) and 15% of CD8(+) cells were TNF-alpha positive. Thus, cells other than the CD8(+) phenotype produce IL-4 and IL-5 in CB. We conclude that there is increased inflammation and IL-4 gene expression in the mucus-secreting glands and the airway mucosa of smokers with bronchitis: both are lower in those with CB and coexisting COPD suggesting that airway inflammation in CB is reduced when airway obstruction develops.

Aged↗
PubMed1989

Intraepithelial T-lymphocyte subsets in the airways of normal subjects and of patients with chronic bronchitis.

Lymphocyte infiltration of central airway epithelium was evaluated in 13 normal nonsmoking subjects (Group 1), in 11 smokers without clinical signs of chronic bronchitis (Group 2), and in 34 patients who were smokers with chronic bronchitis and mild airflow limitation (Group 3). Bronchial samples were obtained through fiberoptic bronchoscopy. Murine monoclonal antibodies directed against cell-surface antigens and an immunoperoxidase technique were used on cryostat sections to label in situ the following lymphocyte populations: T-lymphocytes (CD3+), helper/inducer T-cells (CD4+), suppressor/cytotoxic T-cells (CD8+) and B-lymphocytes (leu 12+). Virtually no B-cells were found in central airway epithelium from subjects of any group. Conversely, consistent infiltration of epithelial layers with T-lymphocytes of both subsets was observed in all subjects, with a constant predominance of CD8+ over CD4+ cells. For any T-cell marker, differences between mean scores from Group 1 and Group 2 subjects were not statistically significant. On the other hand, mean lymphocyte numbers of both subsets were found increased in patients from Group 3 compared with subjects from the two other groups: statistically significant differences were observed for CD3+, CD4+, and CD8+ cells (p less than 0.001). Furthermore, lymphocyte scores at two different airway generation were compared in some patients from Groups 2 and 3, and a significant positive correlation was observed. These results suggest that T-lymphocyte infiltration of central airway epithelium (1) may be a naturally occurring phenomenon that is amplified in the airways of smokers with chronic bronchitis, and (2) may represent the counterpart to the intraepithelial population of the intestine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

The nutritional status in advanced emphysema associated with chronic bronchitis. A study of amino acid and catecholamine levels.

Advanced emphysema with bronchitis is associated with significant weight loss and malnutrition, the true cause of which has not been clearly identified. The purpose of this exploratory study was to compare plasma amino acids and related compounds and catecholamines in a group of patients with advanced end-stage emphysema with a control group of similar age and sex in an effort to further understand this malnourished state. Fasting blood samples were obtained by venipuncture after a rest period. Plasma amino acid levels were determined by ion exchange high pressure liquid chromatography with fluorometric detection. Plasma catecholamines were determined by radioenzymatic analysis. Anthropometric measurements, the usually accepted biochemical markers of nutrition, dietary analysis, pulmonary function tests, and a historical analysis of the state of health including drug use and smoking history in each subject were analyzed. Ages and heights were comparable, whereas weights were significantly decreased in the patients with emphysema. Total serum protein and serum albumin values were significantly lower in the patient group. Significant respiratory muscle weakness was indicated by reduced negative inspiratory force in these end-stage patients, contrasting with well-preserved muscle strength usually found in obstructive lung disease. The dietary caloric intake of the patients was comparable to that of the control subjects. We conclude that the fine balance of the amino acid pool in patients with bronchitis and emphysema is well preserved, except for significant elevations of aspartic acid, glutamine, and cystine, and a decreased level of leucine. In addition, norepinephrine levels were significantly increased. Weight loss in patients with emphysema and bronchitis is likely due to increased energy demands related to hypermetabolism.

Aged↗
PubMed1975

Goblet cells in the peripheral airways in chronic bronchitis.

It was not possible to demonstrate an increase in the proportion of goblet cells in the bronchioles of patients with chronic bronchitis and no emphysema, whereas other lesions, such as mucous gland hyperplasia, airway narrowing, and airway mucus were easily demonstrated in similar cases. Thus, it seems that goblet cell metaplasia is not an important factor in patients who have chronic bronchitis but little evidence of chronic airflow obstruction. Goblet cell metaplasia is an obvious feature of patients with chronic bronchitis and emphysema, especially in those with symptomatic or fatal chronic airflow obstruction, and it may be responsible for producing obstruction in the peripheral airways of these subjects. The role of goblet cell metaplasia in smokers with little airflow obstruction is uncertain from the data presented. No difference was noted in the proportion of goblet cells between bronchitic patients and nonbronchitic smokers who did not have clinical airflow obstruction.

Autopsy↗
PubMed1975

Characteristics of chronic bronchitis in a warm, dry region.

Subjects residing in the warm, dry climate of Tucson, Arizona showed the same relationship of productive cough to smoking as noted elsewhere, but they less regularly reported seasonal or diurnal exacerbations of their symptoms and they less regularly reported phlegm production along with chronic cough. In this locale, even nonchronic dry cough was associated with an increased frequency of other respiratory symptoms and of ventilatory impairment. In comparing characteristics of subjects with a clinical diagnosis of chronic bronchitis with characteristics of subjects who had only questionnaire-detected chronic productive cough, it was found that smoking habits were more closely related to the presence of chronic cough than to the clinical diagnosis. The clinical diagnosis was associated with other features, such as wheezing, at least as often as with productive cough. This was especially true in children, in whom a suprisingly high prevalence of both chronic cough and clinically confirmed chronic bronchitis was noted. These observations led to questions concerning the appropriateness of using a common clinical term such as chronic bronchitis to describe subjects whose only known abnormality is an affirmative answer to a direct question concerning phlegm production.

Adolescent↗