BRONCHIAL INFLAMMATION IN CHRONIC-BRONCHITIS ASSESSED BY MEASUREMENT OF CELL PRODUCTS IN BRONCHIAL LAVAGE FLUID

Background - Bronchial inflammation in chronic bronchitis has not been characterised as well as in asthma. The present study was undertaken to assess whether a characteristic pattern of bronchial inflammatory m arkers could be found in patients with chronic bronchitis. Methods - B ronchoscopy with bronchial lavage was performed in 42 patients with ch ronic bronchitis and in 13 healthy controls. Twenty three of the patie nts had non-obstructive chronic bronchitis and 19 had chronic bronchit is and chronic obstructive pulmonary disease (COPD). Eighteen of the p atients with bronchitis had recurrent infective exacerbations and 24 d id not. Intrabronchial bacterial cultures were taken with a protected specimen brush. Results - Increased activity of neutrophils, fibroblas ts, and eosinophils was found in the patients with chronic bronchitis as assessed by the levels of myeloperoxidase (MPO) and interleukin-8 ( IL-8), hyaluronan, and eosinophil cationic protein (ECP), respectively . The levels of tryptase did not differ from the controls. High correl ations were found between the levels of MPO and IL-8, as well as ECP a nd IL-8. No differences were found between the patients with COPD and those with nonobstructive chronic bronchitis. Conclusions - Recruitmen t and activation of both neutrophils and eosinophils seem to be a char acteristic of chronic bronchitis. This activation is associated with I L-8. The patients with intrabronchial cultures of Streptococcus pneumo niae had the highest individual levels of MPO, ECP, and IL-8 of all su bjects in the study, indicating that colonisation with S pneumoniae co uld promote bronchial inflammation.