Mediators of Neutrophil Function in Children With Protracted Bacterial Bronchitis

Baines, Katherine J.; Upham, John W.; Yerkovich, Stephanie T.; Chang, Anne B.; Marchant, Julie M.; Carroll, Melanie L.; Simpson, Jodie L.; Gibson, Peter G.

doi:10.1378/chest.14-0131

Cited by 46 publications

(57 citation statements)

References 26 publications

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“…The airway neutrophilia was accompanied by a raised total cell count with a median range of 188-426×10 6 cells·L -1 [4,23,26,36,38,39]. No airway eosinophilia was observed in any study and a single study described an increase in the percentage of lymphocytes [23].…”

Section: Airway Inflammation (Kq5)mentioning

confidence: 80%

“…Studies included in the systematic review describing the BAL inflammatory profile of PBB had similar findings of intense airway neutrophilia (summarised in online supplementary tables S5.1a and S5.1b), with a percentage neutrophil median range of 25.5-44% [4,16,23,26,36,38,39]. The airway neutrophilia was accompanied by a raised total cell count with a median range of 188-426×10 6 cells·L -1 [4,23,26,36,38,39].…”

Section: Airway Inflammation (Kq5)mentioning

confidence: 83%

“…Increased levels of interleukin (IL)-8, active matrix metalloproteinase-9 and IL-1β correlated with the degree of neutrophilia [35,36,38]. Other pro-inflammatory mediators detected at increased levels in the BAL fluid of PBB patients included α-defensin, IL-1 pathway cytokines, and CXCR2 gene and protein expression [23,34,63]. In addition, IL-1β and related mediators were associated with BAL neutrophils, cough symptoms and disease recurrence [23].…”

Section: Airway Inflammation (Kq5)mentioning

confidence: 99%

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ERS statement on protracted bacterial bronchitis in children

et al. 2017

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This European Respiratory Society statement provides a comprehensive overview on protracted bacterial bronchitis (PBB) in children. A task force of experts, consisting of clinicians from Europe and Australia who manage children with PBB determined the overall scope of this statement through consensus. Systematic reviews addressing key questions were undertaken, diagrams in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement constructed and findings of relevant studies summarised. The final content of this statement was agreed upon by all members.The current knowledge regarding PBB is presented, including the definition, microbiology data, known pathobiology, bronchoalveolar lavage findings and treatment strategies to manage these children. Evidence for the definition of PBB was sought specifically and presented. In addition, the task force identified several major clinical areas in PBB requiring further research, including collecting more prospective data to better identify the disease burden within the community, determining its natural history, a better understanding of the underlying disease mechanisms and how to optimise its treatment, with a particular requirement for randomised controlled trials to be conducted in primary care.This article has supplementary material available from

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Section: Airway Inflammation (Kq5)mentioning

confidence: 80%

Section: Airway Inflammation (Kq5)mentioning

confidence: 83%

Section: Airway Inflammation (Kq5)mentioning

confidence: 99%

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ERS statement on protracted bacterial bronchitis in children

et al. 2017

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“…Previous reports have demonstrated that Haemophilus was closely correlated with interleukin-1α (IL-1α) andinterleukin-1β (IL-1β) (21). They could trigger cell death and inflammation, which was responsible for the wet cough in PBB infants (12,21). Whilst, some studies suggested that Bacteroides could promote the differentiation of T helper cell 17 (Th17), and Th17 secreted interleukin-17 (IL-17) could trigger the inflammatory reaction and autoimmune diseases (22,23).…”

Section: Discussionmentioning

confidence: 99%

“…PBB was defined as persistent bacterial infection of the bronchial epithelium, which induces such clinical features as chronic purulent inflammation. The PBB infants should meet the following conditions: (I) the patients should have had a chronic wet cough lasting at least 4 weeks; (II) the cough symptoms should be relieved after 2 weeks of antibiotic treatment; (III) there were more neutrophils in patients with positive bacterial cultures; (IV) other causes of chronic cough were excluded (12). The TM infants who fulfilled the following criteria were included in this study: (I) the patients have more than 50% tracheal lumen collapse; (II) clinical symptoms, which including noisy respiration, tracheal rhonchi, harsh barking cough or expiratory dyspnea, can be observed; (III) the problems of cardiac diseases, neurological disorders and esophageal abnormalities should be ruled out (13).…”

Section: Ethics Statement and Clinical Diagnosismentioning

confidence: 99%

Bronchoalveolar lavage fluid microbiota dysbiosis in infants with protracted bacterial bronchitis

Bao

Li²,

Qiu³

et al. 2018

J. Thorac. Dis.

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Background: Protracted bacterial bronchitis (PBB) is a chronic purulent bronchitis which could cause recurrent coughing and wheezing in infants. Based on previous reports, main pathogens which caused PBB were identified in the patients, but their impacts on lung microbiota dysbiosis remain unclear.Methods: In this study, bronchoalveolar lavage fluid (BALF) was collected from PBB infants and tracheomalacia (TM) infants younger than 3 years old under the instruction of Shenzhen Children's Hospital, and 12 samples were randomly selected for 16S rDNA analysis in each group. Based on the results of bacterial composition, the microbiota diversity and co-occurrence network in PBB and TM group were detected and compared. Results: Microbiota diversity was significantly lower in PBB group than it in TM group (P<0.001 for the comparison of Shannon and Simpson indexes). The PBB group was found to harbor 25 accumulated bacterial agents by comparison with TM group, including Haemophilus (P<0.001) and Bacteroides (P<0.001). Whilst, the populations of Lactococcus (P<0.001) and Lactobacillus (P<0.001) were dramatically smaller in PBB group.The co-occurrence network in PBB group also differed from that of TM group. It contained four core nodes in PBB patients, including Haemophilus, Parabacteroides, Porphyromonas, and Cronobacter. Haemophilus was found to be negatively associated with most counterparts, including Clostridium and Bacillus. Conclusions: PBB infants contained discrepant lung genera and co-occurrence network when compared with TM infants. This retrospective study may deepen our understanding of PBB pathogenesis, and it also provided a foundation for bacterial adjunctive therapy of infantile PBB in accordance with clinical treatment.

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Protracted bacterial bronchitis: The last decade and the road ahead

et al. 2015

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Cough is the single most common reason for primary care physician visits and, when chronic, a frequent indication for specialist referrals. In children, a chronic cough (>4 weeks) is associated with increased morbidity and reduced quality of life. One common cause of childhood chronic cough is protracted bacterial bronchitis (PBB), especially in children aged <6 years. PBB is characterized by a chronic wet or productive cough without signs of an alternative cause and responds to 2 weeks of appropriate antibiotics, such as amoxicillin-clavulanate. Most children with PBB are unable to expectorate sputum. If bronchoscopy and bronchoalveolar lavage are performed, evidence of bronchitis and purulent endobronchial secretions are seen. Bronchoalveolar lavage specimens typically reveal marked neutrophil infiltration and culture large numbers of respiratory bacterial pathogens, especially Haemophilus influenzae. Although regarded as having a good prognosis, recurrences are common and if these are frequent or do not respond to antibiotic treatments of up to 4-weeks duration, the child should be investigated for other causes of chronic wet cough, such as bronchiectasis. The contribution of airway malacia and pathobiologic mechanisms of PBB remain uncertain and, other than reduced alveolar phagocytosis, evidence of systemic, or local immune deficiency is lacking. Instead, pulmonary defenses show activated innate immunity and increased gene expression of the interleukin-1β signalling pathway. Whether these changes in local inflammatory responses are cause or effect remains to be determined. It is likely that PBB and bronchiectasis are at the opposite ends of the same disease spectrum, so children with chronic wet cough require close monitoring.

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Mediators of Neutrophil Function in Children With Protracted Bacterial Bronchitis

Cited by 46 publications

References 26 publications

ERS statement on protracted bacterial bronchitis in children

ERS statement on protracted bacterial bronchitis in children

Bronchoalveolar lavage fluid microbiota dysbiosis in infants with protracted bacterial bronchitis

Protracted bacterial bronchitis: The last decade and the road ahead

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