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{{Chronic bronchitis}}
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==Overview==
==Overview==
Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.<ref name=ohcm>Longmore M, Wilkinson I, Rajagopalan S (2005). ''Oxford Handbook of Clinical Medicine'', 6ed. [[Oxford University Press]]. pp 188-189. ISBN 0-19-852558-3.</ref>. Chronic bronchitis is hallmarked by [[hyperplasia]] (increased number) and [[hypertrophy]] (increased size) of the goblet cells ([[mucous gland]]) of the airway, resulting in an increase in secretion of mucus which contributes to the airway obstruction.  [[Microscope|Microscopically]] there is [[Infiltration (medical)|infiltration]] of the airway walls with [[Inflammation|inflammatory]] cells, particularly [[neutrophils]]. Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airway. Further progression leads to [[metaplasia]] (abnormal change in the tissue) and [[fibrosis]] (further thickening and scarring) of the lower airway. The consequence of these changes is a limitation of airflow.<ref name=kc>Kumar P, Clark M (2005). ''Clinical Medicine'', 6ed. Elsevier Saunders. pp 900-901. ISBN 0702027634.</ref>.
[[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 is seen on microscopy.


==Pathophysiology==
===Pathogenesis===
*Hallmark features include: [[hyperplasia]] (increased number) and [[hypertrophy]] (increased size) of the [[Goblet cell|goblet cells]] ([[mucous gland]]) of the airway, resulting in an increase in secretion of [[mucus]], which contributes to the airway obstruction.<ref name="pmid15325838">{{cite journal |vauthors=Hogg JC |title=Pathophysiology of airflow limitation in chronic obstructive pulmonary disease |journal=Lancet |volume=364 |issue=9435 |pages=709–21 |year=2004 |pmid=15325838 |doi=10.1016/S0140-6736(04)16900-6 |url=}}</ref>
*Narrowing of the airways reduces the rate at which air can flow to and from the air sacs ([[alveoli]]) and limits the effectiveness of the lungs.
===Microscopy===
*On microscopic histopathological analysis, there is infiltration of the airway walls with [[Inflammation|inflammatory]] cells, particularly [[CD8+ T cells|CD8+ T-lymphocytes]] and [[neutrophils]].<ref name="pmid15047950">{{cite journal |vauthors=Baraldo S, Turato G, Badin C, Bazzan E, Beghé B, Zuin R, Calabrese F, Casoni G, Maestrelli P, Papi A, Fabbri LM, Saetta M |title=Neutrophilic infiltration within the airway smooth muscle in patients with COPD |journal=Thorax |volume=59 |issue=4 |pages=308–12 |year=2004 |pmid=15047950 |pmc=1763819 |doi= |url=}}</ref> Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airways.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 20:56, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

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 is seen on microscopy.

Pathophysiology

Pathogenesis

  • Hallmark features include: hyperplasia (increased number) and hypertrophy (increased size) of the goblet cells (mucous gland) of the airway, resulting in an increase in secretion of mucus, which contributes to the airway obstruction.[1]
  • Narrowing of the airways reduces the rate at which air can flow to and from the air sacs (alveoli) and limits the effectiveness of the lungs.

Microscopy

  • On microscopic histopathological analysis, there is infiltration of the airway walls with inflammatory cells, particularly CD8+ T-lymphocytes and neutrophils.[2] Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airways.

References

  1. 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.
  2. 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.

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