Recurrent Bronchitis

Recurrent bronchitis is defined as three or more episodes a year. During at least two consecutive years of bronco pulmonary infection, productive cough with or without fever and diffuse rales by physical examination. People with recurrent bronchitis show a greater increase in antibodies after immunization than the controls. Children with this disease show a decrease in humoral immune response to pneumococcal type3 polysaccharides antigen. Mainly defects in the humoral immune response against polysaccharides antigens is an important cause of recurrent bronchitis in children.

Inflammation and epithelial damage of the bronchial mucosa are frequently identified in children with bronchial diseases. Nevertheless, until now the quantitative assessment of the epithelial damage has never been studied in relation to clinical or respiratory function or mucus abnormalities. Bronchial biopsies and brushing were performed in 31 children with recurrent bronchitis and without atopia.

The quantitative histologic data were compared with clinical results, the endoscopic appearance of the mucosa, ciliary beating frequency, mucus transport capacity, leukocyte count, and protein concentration in mucus samples. Most of the biopsies (87%) collected in this group of children without recent acute infections showed extensive epithelial damage.

A significant correlation was observed between the degree of shedding and edema (p < 0.01). Bronchial epithelial edema was associated with a significantly decreased (p < 0.01) mucus transport rate. Inflammation of the sub mucosa was significantly correlated with lymphocyte epithelial infiltration (p < 0.01), total mucus protein content (p < 0.01), and local airway inflammation estimated by bronchoscopy.

These results demonstrate that children with recurrent bronchitis develop a severe bronchial inflammation associated with an increased mucus protein content and a reduction in the mucociliary function.

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