Taylor D C, Clancy R L, Cripps A W, Butt H, Bartlett L, Murree-Allen K
Faculty of Medicine, University of Newcastle, Australian Institute for Mucosal Immunology.
Immunol Cell Biol. 1994 Apr;72(2):143-51. doi: 10.1038/icb.1994.22.
Acute episodes of bronchitis have been shown to be unequally distributed within a population of subjects with chronic bronchitis. Two groups were identified based on incidence of acute bronchitis--subjects who were 'infection-prone' (2-5 infections per year) and those who were 'non-infection-prone' (0-1 infections per year). Minor differences in clinical parameters existed, except for smoking experience. The non-infection-prone group included more current smokers, and the total smoking experience (in 'pack years') was significantly greater in this group. Between-year analysis demonstrated a stability of classification, established after a minimum of two years' prospective observation. Parameters of the host-parasite relationship were assessed in both groups. A significantly greater polybacterial colonization of the oropharynx was observed for chronic bronchitics, both infection-prone (P < 0.0001) and non-infection-prone (P < 0.001), compared with control subjects. Infection-prone chronic bronchitics had significantly greater total bacteria cultured from the oropharynx compared to the non-infection-prone group (P < 0.05); adherence of indigenous microflora to buccal epithelial cells, in particular Gram-positive cocci (P < 0.01) and in vitro adherence of non-serotypable Haemophilus influenzae to buccal cells (P < 0.05) compared with the control and non-infection-prone groups. These studies suggest that an important variation in subjects with chronic bronchitis is the binding capacity of epithelial cells for bacteria, which when increased enhances susceptibility to colonization and clinical infection.
支气管炎的急性发作在慢性支气管炎患者群体中分布不均。根据急性支气管炎的发病率确定了两组——“易感染”（每年2 - 5次感染）和“不易感染”（每年0 - 1次感染）的患者。除吸烟经历外，临床参数存在微小差异。不易感染组中当前吸烟者更多，且该组的总吸烟量（以“包年”计）显著更高。年度间分析表明，经过至少两年的前瞻性观察后确定的分类具有稳定性。对两组患者的宿主 - 寄生虫关系参数进行了评估。与对照组相比，慢性支气管炎患者（包括易感染组（P < 0.0001）和不易感染组（P < 0.001））的口咽部多细菌定植明显更多。与不易感染组相比，易感染的慢性支气管炎患者从口咽部培养出的细菌总数显著更多（P < 0.05）；与对照组和不易感染组相比，本地微生物群对颊上皮细胞的黏附，特别是革兰氏阳性球菌（P < 0.01）以及不可分型流感嗜血杆菌对颊细胞的体外黏附（P < 0.05）。这些研究表明，慢性支气管炎患者的一个重要差异是上皮细胞对细菌的结合能力，这种能力增强时会增加定植和临床感染的易感性。
