Lower Respiratory Tract Inflammation in Chronic Bronchitis: Evaluation by Bronchoalveolar Lavage and Changes Associated With Treatment With Immucytal, a Biological Response Modifier

Chronic bronchitis (CB) is characterized by inflammatory changes in the bronchial tissue and by recurrent bronchitis exacerbations. In addition, defective systemic and local immune mechanisms have been demonstrated and biologic response modifiers (BRMs) have been recently introduced for clinical use in patients with CB. We studied 24 patients with CB by bronchoalveolar lavage (BAL), before and after a 4-week treatment protocol with inhaled Immucytal (Pierre-Fabre Pharma Srl, Milan, Italy), a BRM composed of bacterial ribosomal fractions and membrane proteoglycanes. Compared with normal controls (NC), before treatment BAL in patients with CB contained increased proportions of neutrophils (NC, 0.8 ± 0.2 percent; CB, 3 ± 1 percent), of eosinophils (NC, 0.1 ±0.02 percent; CB, 0.6 ± 0.2 percent); and of lymphocytes (NC, 6 ± 1 percent; CB, 13 ± 2 percent; p + and CD8 + lymphocytes (p 3 neutrophils per milliliter of BAL before, 1.5 ± 0.5×10 3 neutrophils per milliliter after; p