INFLAMMATORY CELLS IN THE BRONCHIAL GLANDS OF SMOKERS WITH CHRONIC-BRONCHITIS

To characterize the inflammatory process in the bronchial glands of sm okers with chronic sputum production, we examined lobar bronchi from 1 8 subjects undergoing lung resection for localized pulmonary lesions, all with a history of cigarette smoking. Nine of the subjects had symp toms of chronic bronchitis and chronic airflow obstruction, and nine w ere asymptomatic, with normal lung function. The number of neutrophils , eosinophils, mast cells, macrophages, CD4(+) and CD8(+) T-lymphocyte s, and the ratio of CD4(+) to CD8(+) cells were assessed in the bronch ial glands, epithelium, and submucosa. Cells were identified through i mmunohistochemistry. Smokers with symptoms of chronic bronchitis had a n increased number of neutrophils (p = 0.01) and macrophages (p = 0.03 ) and a decreased CD4(+)/CD8(+) ratio (p = 0.01) in the bronchial glan ds as compared with asymptomatic smokers. Chronic bronchitic smokers a lso had an increased number of epithelial neutrophils (p = 0.04), wher eas the numbers of macrophages and CD4(+) and CD8(+) T-lympohcytes 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 compartment s examined. In conclusion, smokers with chronic sputum production have an increased infiltration of neutrophils and macrophages and an incre ased proportion of CD8(+) T-lymphocytes in their bronchial glands, sup porting the important role of bronchial-gland inflammation in the path ogenesis of chronic bronchitis.