Relevance of lower airway bacterial colonization, airway inflammation, and pulmonary function in the stable stage of chronic obstructive pulmonary disease

Eur J Clin Microbiol Infect Dis. 2010 Dec;29(12):1487-93. doi: 10.1007/s10096-010-1027-7. Epub 2010 Aug 20.

Abstract

The objective of this investigation was to verify the hypothesis that the presence of lower airway bacterial colonization (LABC) can be a stimulating factor of airway inflammation, more frequent exacerbation, and impact on pulmonary function, independent of current tobacco smoking in the stable phase of chronic obstructive pulmonary disease (COPD). A total of 46 ex-smokers with moderate to severe COPD, 19 healthy non-smokers, and 17 ex-smokers without COPD were included in this study. Their sputum specimens were collected at the first baseline visit and at the second visit after a follow-up of one year. The samples were analyzed for bacterial growth by culture, and the levels of interleukin (IL)-6, IL-8, and tumor necrosis factor alpha (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). The frequencies of exacerbations and pulmonary function were compared at visit 2. At visit 1, 37.0% (17/46) were found to have LABC with bacterial loads ≥10⁶ CFU/ml in their sputum specimens. Haemophilus influenzae was the predominant pathogenic organism isolated. IL-8, IL-6, and TNF-α in these patients' sputum were significantly higher than those without LABC (p < 0.05). It was the presence of LABC that contributed to the significantly elevated IL-8 and IL-6 at the 1-year period (p < 0.05). LABC was also associated with significantly increased frequencies of exacerbations and declined forced expiratory volume in 1 s (FEV₁) (p < 0.05). LABC was documented in a subpopulation of stable COPD patients; it may be responsible for the deterioration of pulmonary function of COPD patients by promoting airway inflammation and/or increased frequency of exacerbations independently of tobacco smoking.

MeSH terms

  • Aged
  • Bacterial Load*
  • Female
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Inflammation / immunology
  • Inflammation / microbiology*
  • Interleukin-6 / biosynthesis
  • Interleukin-8 / biosynthesis
  • Lung / immunology
  • Lung / microbiology*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / immunology
  • Pulmonary Disease, Chronic Obstructive / microbiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Respiratory Function Tests
  • Sputum / immunology
  • Sputum / microbiology*
  • Tumor Necrosis Factor-alpha / biosynthesis

Substances

  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha