Document Detail

Chronic bronchitis and chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  23204254     Owner:  NLM     Status:  MEDLINE    
Chronic bronchitis (CB) is a common but variable phenomenon in chronic obstructive pulmonary disease (COPD). It has numerous clinical consequences, including an accelerated decline in lung function, greater risk of the development of airflow obstruction in smokers, a predisposition to lower respiratory tract infection, higher exacerbation frequency, and worse overall mortality. CB is caused by overproduction and hypersecretion of mucus by goblet cells, which leads to worsening airflow obstruction by luminal obstruction of small airways, epithelial remodeling, and alteration of airway surface tension predisposing to collapse. Despite its clinical sequelae, little is known about the pathophysiology of CB and goblet cell hyperplasia in COPD, and treatment options are limited. In addition, it is becoming increasingly apparent that in the classic COPD spectrum, with emphysema on one end and CB on the other, most patients lie somewhere in the middle. It is known now that many patients with severe emphysema can develop CB, and small airway pathology has been linked to worse clinical outcomes, such as increased mortality and lesser improvement in lung function after lung volume reduction surgery. However, in recent years, a greater understanding of the importance of CB as a phenotype to identify patients with a beneficial response to therapy has been described. Herein we review the epidemiology of CB, the evidence behind its clinical consequences, the current understanding of the pathophysiology of goblet cell hyperplasia in COPD, and current therapies for CB.
Victor Kim; Gerard J Criner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2012-11-29
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  187     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-04     Completed Date:  2013-04-03     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  228-37     Citation Subset:  AIM; IM    
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.
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MeSH Terms
Adrenergic beta-Agonists / therapeutic use
Anti-Bacterial Agents / therapeutic use
Antioxidants / therapeutic use
Bronchitis, Chronic / etiology*,  physiopathology,  therapy
Cholinergic Antagonists / therapeutic use
Disease Progression
Expectorants / therapeutic use
Glucocorticoids / therapeutic use
Goblet Cells
Phosphodiesterase Inhibitors / therapeutic use
Pulmonary Disease, Chronic Obstructive / complications*,  physiopathology,  therapy*
Smoking / adverse effects,  physiopathology
Smoking Cessation
Xanthines / therapeutic use
Grant Support
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Anti-Bacterial Agents; 0/Antioxidants; 0/Cholinergic Antagonists; 0/Expectorants; 0/Glucocorticoids; 0/Phosphodiesterase Inhibitors; 0/Xanthines; 28109-92-4/methylxanthine

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