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Inflammation and chronic colonization of Haemophilus influenzae in sputum in COPD patients related to the degree of emphysema and bronchiectasis in high-resolution computed tomography.
- Source :
-
International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2017 Nov 01; Vol. 12, pp. 3211-3219. Date of Electronic Publication: 2017 Nov 01 (Print Publication: 2017). - Publication Year :
- 2017
-
Abstract
- The presence of bacteria in the lower airways in COPD results in inflammation, further airway structural damage, and might lead to repeated exacerbations. We have previously shown that chronic colonization of Haemophilus influenzae during stable disease is related to increased inflammation, and we now aimed to relate previous findings of bacterial colonization and inflammation to the degree of radiological findings of bronchiectasis and emphysema. Thirty-nine patients with COPD were included in their stable state, and a high-resolution computed tomography of the lung was performed. They were followed-up monthly for up to a maximum of 6 months or until exacerbation, and they answered questionnaires, performed spirometry, and induced sputum at every visit. Thirty-five patients had emphysema with an emphysema degree of median 20% (interquartile range 10-50), and five patients had bronchiectasis, of which only four could expectorate sputum. The degree of emphysema correlated with several inflammatory mediators in sputum, such as interleukin-8 concentration, myeloperoxidase activity, and Leukotriene B <subscript>4</subscript> concentration. Ten patients were chronically colonized with H. influenzae (ie, had a positive culture for H. influenzae at all visits). The four sputum patients with bronchiectasis were chronically colonized with H. influenzae and showed higher degree of H. influenzae growth compared to patients without bronchiectasis. During exacerbation, there was no longer any correlation between emphysema degree and inflammation, but patients with bronchiectasis showed higher sputum purulence score than patients without bronchiectasis. Emphysema and bronchiectasis in COPD patients show different clinical features. The presence of emphysema is more related to inflammation, while bronchiectasis is associated with bacterial colonization. We believe that both emphysema and bronchiectasis are therefore COPD phenotypes of highest impact and need evaluation to prevent further disease progression.<br />Competing Interests: Disclosure The authors report no conflicts of interests in this work.
- Subjects :
- Aged
Aged, 80 and over
Bronchiectasis diagnostic imaging
Bronchiectasis physiopathology
Disease Progression
Female
Haemophilus Infections diagnostic imaging
Haemophilus Infections physiopathology
Haemophilus influenzae growth & development
Humans
Lung diagnostic imaging
Lung physiopathology
Male
Middle Aged
Phenotype
Pneumonia, Bacterial diagnostic imaging
Pneumonia, Bacterial physiopathology
Predictive Value of Tests
Pulmonary Disease, Chronic Obstructive diagnostic imaging
Pulmonary Disease, Chronic Obstructive physiopathology
Pulmonary Emphysema diagnostic imaging
Pulmonary Emphysema physiopathology
Risk Factors
Severity of Illness Index
Time Factors
Bronchiectasis microbiology
Haemophilus Infections microbiology
Haemophilus influenzae isolation & purification
Lung microbiology
Pneumonia, Bacterial microbiology
Pulmonary Disease, Chronic Obstructive microbiology
Pulmonary Emphysema microbiology
Sputum microbiology
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1178-2005
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- International journal of chronic obstructive pulmonary disease
- Publication Type :
- Academic Journal
- Accession number :
- 29138549
- Full Text :
- https://doi.org/10.2147/COPD.S137578