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What‘s the Etiology of Chronic Bronchitis

blue-light / 2011-02-22
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 In general, we divided the etiology of Chronic Bronchitis into internal causes and external causes.

1. The Internal Causes

(1) The respiratory local dysfunction of defense and immune functions: The normal people have a perfect respiratory defensive function, which plays a role in filtrating, heating and humidifying the inhaled air; the mucociliary movement of the trachea and bronchial mucosa and reflex coughs can purify or exclude foreign bodies and excessive secretions; there are also secreted immunoglobulin A (SIGA) in the bronchi and pulmonary alveoli, which play an anti-virus and bacteria role. Therefore, under normal circumstances, the lower respiratory tract always maintains a sterile condition. If the systemic or respiratory partial defensive and immune functions are weakened, it can provide the internal conditions for chronic bronchitis’ attack. The elderly often suffer from respiratory immune dysfunction, reduced immunoglobulin, degradation of respiratory defensive function, recession of monocyte-macrophage function and so on, so they share a higher suffering rate of chronic bronchitis.


(2) The plant nerve dysfunction: As the respiratory parasympathetic response is increased, the normal non-functional weak stimulation can cause bronchial contraction and spasm with increased secretions, which bring about the symptoms such as coughs, expectoration, and asthma.


2. The External Causes

(1) Smoking: The domestic and international studies have shown that smoking is closely related with the incidence of chronic bronchitis. The longer the smoking history is, or the greater the amount of smoking is taken, the higher the prevalence rate is. After dropping smoking, the symptoms can be alleviated or disappeared, the disease is mitigated, even cured. Animal experiments have proved that the parasympathetic excitability has been increased after it absorbs the smoke, which causes the bronchial contraction and spasm; the cilia movement of respiratory membrane epithelial cells has been inhibited; Bronchial goblet cells have been in hyperplasia with increased mucus secretion, which declines the air passage purification; Congestive bronchial mucosa, edema, the accumulation of mucus and the dysfunction of alveolar macrophages can all lead to infections easily. Smokers can easily suffer from the metaplasia of squamous epithelial cells, mucosal hyperplasia and hypertrophy, bronchial spasms, susceptibility and pathogenesis.


(2) Infection: The infection is an important factor in the development of chronic bronchitis. It mainly include the virus and bacterial infection, and the nose virus, mucus virus, adenovirus and respiratory syncytial virus are frequently seen. The secondary bacterial infection can occur on the basis of the hurt air passage mucosa by virus and mycoplasma infection. From the results of sputum culture, it is found that haemophili influenza, pneumococci, streptococci and neisseriae are the most common four types. Although the infection is closely related with the development of chronic bronchitis, but there is not sufficient evidence that it is the initial cause. It is only considered as an important factor in the secondary infection of chronic bronchitis and exacerbating the disease.


(3) Physical and chemical factors: The chronic irritation, such as irritating smoke, dust, air pollution (sulfur dioxide, nitrogen dioxide, chlorine, ozone etc.), is often the induced cause of chronic bronchitis. The workers who contact industrial irritant dust and harmful gases share a far higher prevalence of chronic bronchitis than the people who do not contact them. Therefore, the atmospheric pollution is also an important induced cause of the disease.


(4) Climate: The cold is often the important reason and incentive of the attack of chronic bronchitis. The attack and acute exacerbation of chronic bronchitis are common in cold seasons, particularly in sudden changes of climate. In addition to weakening the defensive function of upper respiratory mucosa, the cold air stimulates the respiratory tract that can also lead to the contraction of bronchial smooth muscles by reflex, mucosal blood circulation impediment and discharging difficulties of secretions, which is prone to secondary infection.


(5) Allergy: According to the investigation, the asthmatic bronchitis patients often have the allergic history. In the patients’ sputum, the number of eosinophils and content of histamine have an increased tendency, which indicates that some patients are related with allergic factors. Dust, dust mites, bacteria, fungi, parasites, pollen and chemical gases can all become allergic pathogenic factors.


All in all, when the body’s resistance to infection is weakened, on the basis of varying degrees of sensitivity (susceptibility) in the air passage, it will develop into chronic bronchitis that there is one or many external causes and they repeatedly affect the body for a long time.


For example, long-term smoking damages respiratory mucosae, with the repeated microbial infections, so that it can bring about chronic bronchitis, even develop into chronic obstructive pulmonary emphysema or chronic heart diseases.


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