Abstract
Bronchiectasis is a chronic lung disease characterized by an abnormal dilation of the bronchial lumen caused by weakening or destruction of the muscle or elastic components of the bronchial wall, decreased mucous clearance and frequent infections of the respiratory tract. The golden standard for bronchiectasis diagnosis is high-resolution computed tomography (HRCT) of the chest. Inflammation holds a central role in the development of structural lung changes, as well as airway and lung parenchyma damage. Infection and colonization of the respiratory tract contribute to increased inflammation and further damage to the lung. Upon entry into the respiratory tract, the pathogens activate epithelial cells, macrophages and dendritic cells. Activated inflammatory cells secrete chemical mediators which activate the immune response and thus allow the phagocytosis of pathogens. Early diagnosis, appropriate treatment and interruption of the vicious circle between infection and inflammation in patients suffering from bronchiectasis, prevent the development of structural changes to the airways.
Highlights
a chronic lung disease characterized by an abnormal dilation of the bronchial lumen caused by weakening
Inflammation holds a central role in the development of structural lung changes
appropriate treatment and interruption of the vicious circle between infection and inflammation in patients suffering from bronchiectasis
Summary
Nataša ĐURĐEVIĆ1, Branislava MILENKOVIĆ1,2, Jelena JANKOVIĆ1, Javorka MITIĆ1, Slobodan BELIĆ1, Elena JORDANOVA3, Marko BARALIĆ4. Bronhiektazije predstavljaju hronično oboljenje pluća, koje se karakteriše abnormalnim proširenjem lumena bronha, uzrokovano slabljenjem ili destrukcijom mišićnih i elastičnih komponenti bronhijalnog zida, smanjenim klirensom mukusa, i čestim infekcijama respiratornog trakta. Inflamacija ima centralnu ulogu u nastanku strukturalnih promena u plućima, kao i u oštećenju disajnih puteva i parenhima. Pravovremeno djagnostikovanje, adekvatno lečenje i prekidanje začaranog kruga između infekcije i inflamacije kod pacijenata sa bronhiektazijama, doprinosi prevenciji nastanka strukturnih promena disajnih puteva. Osnovni patološki mehanizam nastanka strukturalnih promena u plućima, i oštećenja disajnih puteva i parenhima, je kaskada događaja u kojima centralnu ulogu ima inflamacija [4]. U patogenezi nastanka oštećenja pluća važno je istaći da nakon ulaska patogena u disajne puteve, dolazi do aktivacije epitelnih ćelija, makrofaga i dendritičkih ćelija. Sve inflamatorne ćelije dalje luče hemijske medijatore, koji aktiviraju imunski odgovor na patogen, i omogućuju fagocitozu uzročnika [9]. Proinfalamtorni citokini uključeni u odgovoru na oštećenje tkiva ili infekciju, kad nisu adekvatno regulisani antiinflamatornim citokinima, mogu da uzrokuju lokalno ili sistemsko oštećenje [12]
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