Clinical studyAssociation between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis☆
Section snippets
Study sample and design
We recruited three groups of patients with stable chronic bronchitis (1) who were treated in specialist outpatient clinics between 1996 and 1999. The first group consisted of subjects with chronic obstructive pulmonary disease (COPD) related to smoking. The second group was recruited from an alpha1-antitrypsin deficiency clinic; these patients had COPD with serum alpha1-antitrypsin concentrations less than 11 μM (10) and the PiZ alpha1-antitrypsin phenotype (11). The remaining group of subjects
Results
The participants in the three study samples represented a wide spectrum of patients with chronic bronchitis (Table 1). Those with COPD (with or without alpha1-antitrypsin deficiency) had substantially worse pulmonary function than patients with bronchiectasis.
We analyzed 336 sputum samples from patients while they were clinically stable (72 samples from the 55 patients with COPD and normal alpha1-antitrypsin levels, 179 samples from the 62 patients with COPD and alpha1-antitrypsin deficiency,
Discussion
We used quantitative bacterial cultures to demonstrate that airway bacterial load varies greatly among several groups of patients with chronic sputum production. Although our sample does not reflect the usual spectrum of patients with COPD, excluding the patients with alpha1-antitrypsin deficiency or bronchiectasis did not influence the overall relation between colonizing load and airway inflammation. Increasing airway bacterial load was strongly related to several markers of inflammation in
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Supported by an unrestricted research grant from Bayer as part of the ADAPT Programme.