Chest
Clinical InvestigationsCOPDAirway Inflammation and Etiology of Acute Exacerbations of Chronic Bronchitis
Section snippets
Chronic Bronchitis Study Clinic
The Human Studies Subcommittee of the Department of Veterans Affairs Western New York Healthcare system approved our study protocol. All participants gave written informed consent. A total of 74 patientswere enrolled in a prospective, longitudinal study of the dynamics andimmune response to bacterial infection in chronic bronchitis from March1994 to December 1997. Inclusion criteria were as follows: (1) thepresence of chronic bronchitis as defined by the American Thoracic Society, 15 (2) the
Patient Demographics
As shown in Table 2, our population was predominantly an elderly male population. Onenrollment, 26 of the subjects (58%) had severe COPD(FEV1 < 50% predicted), 12 subjects (27%) hadmoderate COPD (FEV1 of 50 to 64% predicted), 2subjects (4%) had mild COPD (FEV1 of 65 to 80% predicted), and 5 subjects (11%) had chronic bronchitis only.
Comparison of Expectorated and Induced Sputa
The only significant differences between the induced andexpectorated sputa were that the expectorated sputa were more purulentand viscous on gross examination than
Discussion
Several new research approaches are being used to investigate therole of bacteria in the etiology of AECB. Bronchoscopy with culture ofdistal airway secretions during AECB has demonstrated that pathogenicbacteria are present in about 50% and are likely to be the etiologicagents.181920 We have shown development of strain-specificbactericidal antibodies to infecting strains of H influenzaeafter AECB, further supporting the role of bacteria in causing, AECB.21 Molecular typing of sputum isolates
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Financial support provided by the Department of Veterans Affairs Merit Review.