Pulmonary epithelial permeability in bronchiectasis

doi:10.1016/0007-0971(88)90008-3

British Journal of Diseases of the Chest

Volume 82, 1988, Pages 56-63

https://doi.org/10.1016/0007-0971(88)90008-3 Get rights and content

Abstract

We measured pulmonary epithelial premeability in 17 non-smoking patients with generalized bronchiectasis, of whom six had cystic fibrosis, by determining the half-time clearance from lung to blood ( $T_{12LB}$ ) of inhaled ^99mTc-labelled diethylene triamine pentaacetate. Their age range was 15–79 years and the range of their FEV₁ measurements was 20–87% of the predicted normal Sputum obtained by prestudy chest physiotherapy revealed significant colonies of Psuedomonas aeruginosa in six, Haemophilus influenzae in three, Staphylococcus aureus in three and Pasteurella mitocida in one patient, while in the remainder there was normal floral only. Lung clearance was significantly faster in the 13 culture-positive patients (mean $T_{12LB} =28$ minutes) compared with the four culutre-negative patients (mean $T_{12LB} =54$ minutes). There was no correlation between $T_{12LB}$ and prestudy FEV₁. The study was repeated in six patients following a course of antibiotics. In two patients only was the sputum cleared of organisms and in those the lung permeability decreased significantly. There was no change in lung permeability in the four patients in whom it was impossible to eradicate the sputum organisms. Thus, in our patients with generalized bronchiectasis, lung permeability was increased only in those with both purulent sputum and significant colonization of the respiratory tract by bacterial pathogens. However, this increase in lung permeability was not associated with worse lung function.

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Cited by (14)

Bronchiectasis in Childhood (Including PBB)
2021, Encyclopedia of Respiratory Medicine, Second Edition
Chronic wet cough in children is a common condition for which patients seek medical attention and there are many etiologies. This article will discuss two pediatric causes: protracted bacterial bronchitis, one of the commonest causes, and bronchiectasis, one of the most serious. They are discussed together as it has been proposed that these conditions represent different ends of a spectrum of endobronchial suppuration and understanding the pathobiology of this will aid in early intervention and management. This article further highlights latest evidence-based updates of both conditions with discussion of pathogenesis, diagnosis and management.
Bronchiectasis and Chronic Suppurative Lung Disease
2019, Kendig's Disorders of the Respiratory Tract in Children
Bronchiectasis, chronic suppurative lung disease, and protracted bacterial bronchitis (PBB) are increasingly recognized conditions. Bronchiectasis is now again increasingly diagnosed, and its renewed interest has resulted in further in-depth studies in children and adults. However, diagnostic labeling of childhood bronchiectasis by radiology using adult-derived criteria has substantial limitations. Thus, pediatric-derived criteria are advocated. A paradigm presenting a spectrum related to airway bacteria, with associated degradation and inflammation products causing airway damage if untreated, entails PBB (at the mild end) to irreversible airway dilatation with cystic formation as determined by chest computed tomography (CT) scan (at the severe end of the spectrum). Increasing evidence suggest that progression of airway damage can be limited by intensive treatment, even in those predestined to have bronchiectasis (e.g., immune deficiency). Treatment is aimed at achieving a cure in those at the milder end of the spectrum to limiting further deterioration in those with severe “irreversible” radiological bronchiectasis.
Anne Chang is supported by Australian National Health and Medical Research Council practitioner fellowship (1058213), Centre for Research Excellence grant (1040830) and project grants (1098443 and 1019834).
Greg Redding is supported in part by Maternal Child Health Grant T72MC00007.
Bronchiectasis and Chronic Suppurative Lung Disease
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Lung permeability in adult obliterative bronchiolitis
1989, Respiratory Medicine
There is histopathological evidence that, in certain inflammatory disorders involving the smaller airways, extension of the inflammatory process may occur distally into the respiratory bronchioles, alveolar ducts and alveoli (1,2). The objective of this study was to perform a non-invasive evaluation of the possible involvement of gas exchanging regions of the lung in obliterative bronchiolitis presenting with severe airways obstruction. We measured the clearance of technetium 99m-labelled diethylene triamine penta-acetate (99m Tc-DTPA) with time from the lungs to the blood, in 11 normal, non-smoking subjects (mean age 30 years), ten non-smoking patients with cryptogenic fibrosing alveolitis (CFA, mean age 57 years) and ten patients who were non-smokers with obliterative bronchiolitis (mean age 51 years). There was a substantial increase in clearance in patients with CFA, (mean T_½ 19·9 min), compared with either patients with obliterative bronchiolitis (mean T_½ 52·2 min; mean difference 32·3; 95% confidence intervals (CI) 18,40; P<0·001) or normal controls (mean T_½ 84·3; mean difference 64·4; 95% CI 55, 74; P<0·001). Clearance was also significantly faster in patients with obliterative bronchiolitis than in normal controls (mean difference 32·1; 95% CI 18,48; P<0·001). Peripheral deposition of 99m Tc-DTPA was uniform in normal subjects and patients with CFA, but patchy in patients with obliterative bronchiolitis, possibly resulting from altered patterns of ventilation associated with patchy distribution of bronchiolitis within affected lungs. Increased clearance of 99m Tc-DTPA from the lungs in these patients suggests that subtle derangement of the alveolar-capillary membrane occurs in adult obliterative bronchiolitis.
Pediatric bronchiectasis: No longer an orphan disease
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Original articlePulmonary epithelial permeability in bronchiectasis

Abstract

Lancet

Lancet

Pseudomomas infection, allergy and cystic fibrosis

Arch Dis Child

A role for neutrophils in the derangements of the bronchial wall characteristics of cystic fibrosis

Am Rrev Resp Dis

The elastolytic activity of sputum and its relationship to purulence and lung function in bronchiectasis

Thorax

Studies of sputum, sol-phase proteins and elastase activity in patients with cystic fibrosis

Eur J Resp Dis

Effects of inhaled histamine, salbutamol and beclomethasone dipropionate on lung epithelial permeability

Thorax

Original article
Pulmonary epithelial permeability in bronchiectasis