Goblet cell hyperplasia and epithelial inflammation in peripheral airways of smokers with both symptoms of chronic bronchitis and chronic airflow limitation

To quantify the number of goblet cells and inflammatory cells in the epithe lium of peripheral airways in smokers with both symptoms of chronic bronchi tis and chronic airflow limitation, we examined surgical specimens obtained from 25 subjects undergoing lung resection for localized pulmonary lesions : 10 smokers with symptoms of chronic bronchitis and chronic airflow limita tion, six asymptomatic smokers with normal lung function, and nine nonsmoki ng control subjects. Peripheral airways were examined with histochemical me thods to identify goblet cells and with immunohistochemical methods to iden tify total leukocytes (CD45(+) cells), neutrophils, macrophages, CD4(+) and CD8(+) cells in the epithelium. When compared with nonsmokers, smokers wit h both symptoms of chronic bronchitis and chronic airflow limitation had an increased number of goblet cells (p < 0.01), CD45(+) cells (p < 0.01), mac rophages (p < 0.05), and CD8(+) cells (p < 0.01) in the epithelium of perip heral airways. When all the smokers were grouped together, they showed an i ncreased number of neutrophils (p < 0.05) along with an increased number of goblet cells, CD45(+) cells, macrophages and CD8(+) cells (p < 0.05) compa red with nonsmokers. In conclusion, smokers with both symptoms of chronic b ronchitis and chronic airflow limitation have an increased number of goblet cells and inflammatory cells in the epithelium of peripheral airways.