Chronic bronchitis pathophysiology

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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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