Chest
Clinical InvestigationsThe Bronchitis Index: A Semiquantitative Visual Scale for the Assessment of Airways Inflammation
Section snippets
METHODS
The utility of the BI was investigated in three study groups: 86 subjects with a history of cigarette smoking, chronic bronchitis, and airflow obstruction, 15 subjects with a history of cigarette smoking, but without cough or sputum production (asymptomatic smokers), and 25 normal, nonsmoking volunteers. Subjects were included in the chronic bronchitis group if they met the following criteria: (1) cough and sputum production on most days of the month for at least three months a year during the
RESULTS
Because subjects were assigned to groups based on entry criteria that did not include age, several significant differences were noted among the subject groups. Subjects with chronic bronchitis were older (51.2 ± 1.2 years) than asymptomatic smokers (33.2 ±1.7 years) and normal volunteers (33.1 ± 2.1 years) (p<0.01, both groups), while no difference was found between the normal volunteers and asymptomatic smokers. The asymptomatic smokers had smoked less (36.3 ±3.9 pack-years) than the patients
DISCUSSION
Airways inflammation is thought to play a prominent role in the pathogenesis of chronic bronchitis.2, 3, 4, 8 Bronchoalveolar lavage and quantitation of lavage fluid proteins and cells have been used to assess airway inflammation.5, 8, 13 The BI was formulated to provide another bronchoscopic parameter of inflammation. Visual inspection of the airways is limited to larger airways and these may not reflect changes in more peripheral airways. However, the findings that the BI was elevated more in
ACKNOWLEDGMENTS
The authors would like to acknowledge the expert advice of Dr. James Anderson concerning the data analysis and the secretarial assistance of Jeanette Danielsen.
REFERENCES (15)
- et al.
Adult bronchiolitis: evaluation by bronchoalveolar lavage and response to prednisone therapy
Chest
(1985) - et al.
Definitions of emphysema, chronic bronchitis, asthma, and airflow obstruction: 25 years on from the Ciba symposium
Thorax
(1984) - et al.
The relations between structural changes in small airways and pulmonary-function tests
N Engl J Med
(1977) - et al.
Reassessment of inflammation of airways in chronic bronchitis
BMJ
(1985) - et al.
Pathologic changes in the peripheral airways of young cigarette smokers
N Engl J Med
(1974) - et al.
Cellular and protein changes in bronchial lavage fluid after late asthmatic reaction in patients with red cedar asthma
J Allergy Clin Immunol
(1967) - et al.
The effects of chronic bronchitis and chronic air-flow obstruction on lung cell populations recovered by bronchoalveolar lavage
Am Rev Respir Dis
(1985)
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Manuscript received June 22; revision accepted September 15