Chronic Bronchitis

Abstract

We have assessed bronchial mucous gland size in a group of 26 patients with severe chronic air-flow obstruction and hypoxemia from the NIH Nocturnal Oxygen Therapy Trial. These patients had their sputum volume assessed at least 4 times when free from exacerbations. Mucous gland size was assessed by the gland/wall ratio (Reid Index), by absolute gland area, and by the volume proportion of glands. The volume of sputum produced was significantly related to the volume proportion of mucous glands (Rho = 0.53, p less than 0.01) and to the absolute gland area (Rho = 0.49, p less than 0.05), but not to the Reid Index, (Rho = 0.35, p greater than 0.05). Volume proportion of glands can be easily and quickly measured using a computer-assisted digitizer, and it is the method of choice for measuring mucous gland size in this series. Neither the Reid Index nor the volume proportion of glands was related to the forced expiratory volume in one second (FEV1), and the measurements were not significantly related to each other. The amount of sputum produced was not related significantly to the FEV1 (Rho = 0.26, p greater than 0.05).

Lung Structural Changes in Chronic Obstructive Pulmonary Diseases

“…If this occurs for three months in the year for at least 2 successive years in the absence of known lung diseases associated with mucus production e.g. Measurements of bronchial gland size do not correlate with airflow obstruction [12]. The term "chronic bronchitis" for this clinical syndrome has produced much confusion and is best avoided, as it has been used interchangeably by some to equate COPD, whereas in fact longitudinal studies have shown that chronic cough and sputum production does not predict decline in FEV1 [9,10].…”