Host-Microbe Relationships in Chronic Respiratory Infection

Cole, Peter

doi:10.1159/000195745

Cited by 35 publications

(21 citation statements)

References 8 publications

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“…More studies are still warranted to confirm the frequently and importance of non-PPM colonizing microorganisms in COPD patients. Additionally, it could help to explain the "vicious circle" hypothesis regarding the role of bacterial infection in COPD [21].…”

Section: Discussionmentioning

confidence: 99%

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Cabello

Torres²,

Celis³

et al. 1997

Eur Respir J

264

216

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In contrast to the healthy population, distal airway bacterial colonization may occur in patients with chronic lung diseases, who often have altered pulmonary defences. However, the information dealing with this issue is insufficient and is based mainly on nonspecific samples, such as sputum cultures.Using quantitative cultures of bronchoscopic protected specimen brush (PSB) and bronchoalveolar lavage (BAL) samples, we studied the bacterial colonization of distal airways in 16 healthy subjects, 33 patients with bronchogenic carcinoma, 18 with chronic obstructive pulmonary disease (COPD), 17 with bronchiectasis, and 32 with a long-term tracheostomy due to laryngeal carcinoma. All patients were without exacerbation, and free from antibiotic treatment at least 1 month before the study protocol. Thresholds for quantitative cultures to define colonization were ≥10 2 colony-forming units (cfu)·mL -1 for PSB and ≥10 3 cfu·mL -1 for BAL.Only one healthy subject was colonized by a potential pathogenic microorganism (PPM) (Staphylococcus aureus 4×10 2 cfu·mL -1 in a PSB culture). Colonization was observed in 14 (42%) bronchogenic carcinoma patients (19 non-PPMs, and 10 PPMs); in 15 (83%) COPD patients (22 non-PPMs and 7 PPMs); in 15 (88%) bronchiectasis patients (20 non-PPMs and 13 PPMs); and in 15 (47%) long-term tracheostomy patients (5 non-PPMs and 13 PPMs). The two most frequent nonPPMs isolated in all groups studied were Streptococcus viridans and Neisseria spp. Haemophilus spp., Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were the most frequent PPMs isolated in bronchogenic carcinoma, COPD, bronchiectasis and long-term tracheostomized patients, respectively. Pseudomonas aeruginosa colonization was infrequent in all the groups.Our results show that distal airway bacterial colonization is a frequent feature in stable patients with chronic lung diseases and also in patients with long-term tracheostomy. However, the pattern of colonization differs among groups studied. The knowledge of different colonization patterns may be important for future antibiotic prophylactic strategies and for the empirical antibiotic regimens when exacerbations occur in these patients.

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Section: Discussionmentioning

confidence: 99%

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Cabello

Torres²,

Celis³

et al. 1997

Eur Respir J

264

216

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“…Several years ago, we proposed a vicious circle hypothesis to explain how chronic bacterial colonization of the lower airways in patients with COPD can perpetuate inflammation and contribute to progression of the disease (Fig. 2) (63,219). A similar mechanism is believed to contribute to the pathogenesis of lung disease in individuals with cystic fibrosis.…”

Section: Vicious Circle Hypothesismentioning

confidence: 99%

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

2001

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SUMMARY Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. The precise role of bacterial infection in the course and pathogenesis of COPD has been a source of controversy for decades. Chronic bacterial colonization of the lower airways contributes to airway inflammation; more research is needed to test the hypothesis that this bacterial colonization accelerates the progressive decline in lung function seen in COPD (the vicious circle hypothesis). The course of COPD is characterized by intermittent exacerbations of the disease. Studies of samples obtained by bronchoscopy with the protected specimen brush, analysis of the human immune response with appropriate immunoassays, and antibiotic trials reveal that approximately half of exacerbations are caused by bacteria. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae are the most common causes of exacerbations, while Chlamydia pneumoniae causes a small proportion. The role of Haemophilus parainfluenzae and gram-negative bacilli remains to be established. Recent progress in studies of the molecular mechanisms of pathogenesis of infection in the human respiratory tract and in vaccine development guided by such studies promises to lead to novel ways to treat and prevent bacterial infections in COPD.

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“…Viral and bacterial infection and airway inflammation are the main contributors to a cycle of events that result in tissue damage and progressive bronchial obstruction [1].…”

mentioning

confidence: 99%

Reduced spontaneous apoptosis in peripheral blood neutrophils during exacerbation of COPD

Pletz

Ioanăş²,

Roux³

et al. 2004

Eur Respir J

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A major feature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is the accumulation of activated neutrophils in the bronchial tree. This phenomenon can be explained by an increased migration and/or by a prolonged survival due to an inhibition of spontaneous apoptosis. The aim of this study was to assess the apoptotic behaviour of peripheral blood neutrophils in COPD patients during an acute exacerbation.Thirty-six hospitalised COPD patients with an acute exacerbation and 10 healthy volunteers were included. Blood samples were obtained at admission, after 3-5 days and at discharge. Spontaneous apoptosis of isolated neutrophils was measured based on Annexin V-PE binding and nuclear morphology after culturing for 18 h.At admission, significantly lower rates of spontaneous apoptosis were noted in COPD patients compared with healthy volunteers (mean¡SD 31¡13% versus 44¡18%). The mean percentages of apoptotic neutrophils were 31¡13% at admission, 39¡15% after 3-5 days and 47¡18% at discharge. There was a statistically significant difference between the rates of spontaneous apoptosis on the first day and at discharge. Neither forced expiratory volume in one second v35% predicted, smoking habit, corticosteroid therapy nor evidence of bacterial infection showed any influence on the spontaneous apopotosis in this study.In conclusion, during acute exacerbations of chronic obstructive pulmonary disease, neutrophil granulocytes show a reduced spontaneous apoptosis that increases progressively after treatment and clinical remission. This raises the question of the importance of neutrophil apoptosis in the development and resolution of exacerbations of chronic obstructive pulmonary disease.

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Host-Microbe Relationships in Chronic Respiratory Infection

Cited by 35 publications

References 8 publications

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

Reduced spontaneous apoptosis in peripheral blood neutrophils during exacerbation of COPD

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