RT Journal Article
SR Electronic
T1 Variability and effects of bronchial colonisation in patients with moderate COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 295
OP 302
DO 10.1183/09031936.00126808
VO 35
IS 2
A1 A. Marin
A1 E. Monsó
A1 M. Garcia-Nuñez
A1 J. Sauleda
A1 A. Noguera
A1 J. Pons
A1 A. Agustí
A1 J. Morera
YR 2010
UL http://erj.ersjournals.com/content/35/2/295.abstract
AB Sputum and lung function were periodically assessed in stable moderate chronic obstructive pulmonary disease (COPD) outpatients to determine relationships between bronchial colonisation and inflammation. Relationships between potentially pathogenic microorganism (PPM) typology, bronchial inflammation (neutrophilia, tumour necrosis factor-α, interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-12) and post-bronchodilator decline in forced expiratory volume in 1 s (FEV1) were analysed. PPMs periodically showing the same molecular profile using pulse field gel electrophoresis were considered long-term persistent. Bronchial colonisation was observed in 56 out of 79 follow-up examinations (70.9%) and was mainly due to Haemophilus influenzae, Pseudomonas aeruginosa and enterobacteria (n = 47). These PPMs were all related to sputum neutrophilia (p≤0.05, Chi-squared test), and H. influenzae was related to higher levels of IL-1β (p = 0.005) and IL-12 (p = 0.01), with a dose–response relationship (Spearman’s correlation coefficient of 0.38 for IL-1β (p = 0.001), and of 0.32 for IL-12 (p = 0.006)). Haemophilus parainfluenzae was not associated with an identifiable inflammatory response. Long-term persistence of the same strain was observed in 12 examinations (21.4%), mainly due to P. aeruginosa or enterobacteria. A neutrophilic bronchial inflammatory response was associated with a statistically significant decline in FEV1 during follow-up (OR 2.67, 95% CI 1.07–6.62). A load-related relationship to bronchial inflammation in moderate COPD was observed for colonisation by H. influenzae, but not for colonisation by H. parainfluenzae.