Chronic bronchitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief:
Overview
Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks. Chronic bronchitis is not necessarily caused by infection and is generally part of a syndrome called chronic obstructive pulmonary disease (COPD); it is defined clinically as a persistent cough that produces sputum (phlegm) and mucus, for at least three months in two consecutive years.
Historical Perspective
Bronchitis was first described by Charles Badham in 1808. Rene Laennec, described COPD in details and categorized it as emphysema and chronic bronchitis[1][2].
Pathophysiology
- Hyperplasia and hypertrophy of the goblet cells (mucous gland) of the airway are the common pathologic features of chronic bronchitis. Chronic inflammation due to lymphocyte infiltration seen on microscopy[3].
- On microscopic histopathological analysis there is infiltration of the airway walls with inflammatory cells, particularly CD8+ T-lymphocytes and neutrophils[4]. *Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airways
Causes
- Chronic bronchitis as a subtype of COPD is caused by multiple environmental and genetic factors. Smoking is the leading cause of chronic bronchitis. Other causes include: air pollutants, occupational exposures to dusts and coal and auto-immune diseases[5][6][7][8].
Differentiating Chronic bronchitis from other Diseases
In clinical practice, COPD is defined by its characteristically low airflow on lung function tests.[9] In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time. It should be differentiated from certain conditions that have similar presentation for instance congestive heart failure, chronic asthma, bronchiectasis, and bronchiolitis obliterans.
Epidemiology and Demographics
COPD occurs in 34 out of 1000 greater than 65 years old. In England, an estimated 842,100 of 50 million people have a diagnosis of COPD; translating into approximately one person in 59 receiving a diagnosis of COPD at some point in their lives. In the most socioeconomically deprived parts of the country, one in 32 people were diagnosed with COPD, compared with one in 98 in the most affluent areas. In the United States, the prevalence of COPD is approximately 1 in 20 or 5%, totalling approximately 13.5 million people in USA,[10] or possibly approximately 25 million people if undiagnosed cases are included.[11]
Risk Factors
Chronic obstructive pulmonary disease is a group of diseases characterized by the pathological limitation of airflow in the airway that is not fully reversible. A full comprehensive diagnosis is needed to eliminate related conditions and isolate the influence of lifestyle and behavior risk factors on condition outcome. Some common risk factors are cigarette smoking, occupational pollutants, air pollution and genetics. Other risk factors are increasing age, male gender, allergy, repeated airway infection.
Screening
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
Ultrasound
Other Imaging Studies
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
References
- ↑ terms(2016)https://lunginstitute.com/blog/history-of-chronic-bronchitis/accessed on September,13 2016
- ↑ Klippe HJ, Kirsten D (2009). "[200 years of bronchitis--from 1808 to 2008]". Pneumologie (in German). 63 (4): 228–30. doi:10.1055/s-0028-1119572. PMID 19343614.
- ↑ Hogg JC (2004). "Pathophysiology of airflow limitation in chronic obstructive pulmonary disease". Lancet. 364 (9435): 709–21. doi:10.1016/S0140-6736(04)16900-6. PMID 15325838.
- ↑ Baraldo S, Turato G, Badin C, Bazzan E, Beghé B, Zuin R, Calabrese F, Casoni G, Maestrelli P, Papi A, Fabbri LM, Saetta M (2004). "Neutrophilic infiltration within the airway smooth muscle in patients with COPD". Thorax. 59 (4): 308–12. PMC 1763819. PMID 15047950.
- ↑ MedicineNet.com - COPD causes
- ↑ Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD (2009). "COPD prevalence is increased in lung cancer, independent of age, sex and smoking history". Eur. Respir. J. 34 (2): 380–6. doi:10.1183/09031936.00144208. PMID 19196816. Unknown parameter
|month=ignored (help) - ↑ Devereux, Graham (2006). "Definition, epidemiology, and risk factors". BMJ. 332 (7550): 1142–4. doi:10.1136/bmj.332.7550.1142. PMC 1459603. PMID 16690673. Unknown parameter
|month=ignored (help) - ↑ Kennedy SM, Chambers R, Du W, Dimich-Ward H (2007). "Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men?". Proceedings of the American Thoracic Society. 4 (8): 692–4. doi:10.1513/pats.200707-094SD. PMID 18073405. Unknown parameter
|month=ignored (help) - ↑ Template:Cite doi [1]
- ↑ wrongdiagnosis.com > Prevalence and Incidence of COPD Retrieved on Mars 14, 2010
- ↑ MORBIDITY & MORTALITY: 2009 CHART BOOK ON CARDIOVASCULAR, LUNG, AND BLOOD DISEASES National Heart, Lung, and Blood Institute