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Front Pediatr. 2017 Feb 15;5:19. doi: 10.3389/fped.2017.00019. eCollection 2017.

Persistent and Recurrent Bacterial Bronchitis-A Paradigm Shift in Our Understanding of Chronic Respiratory Disease.

Frontiers in pediatrics

Alya Ishak, Mark L Everard

Affiliations

  1. Department of Respiratory Medicine, Princess Margaret Hospital , Subiaco, WA , Australia.
  2. Department of Respiratory Medicine, Princess Margaret Hospital, Subiaco, WA, Australia; University of Western Australia, Crawley, WA, Australia.

PMID: 28261574 PMCID: PMC5309219 DOI: 10.3389/fped.2017.00019

Abstract

The recent recognition that the conducting airways are not "sterile" and that they have their own dynamic microbiome, together with the rapid advances in our understanding of microbial biofilms and their roles in the causation of respiratory diseases (such as chronic bronchitis, sinusitis, and chronic otitis media), permit us to update the "vicious circle" hypothesis of the causation of bronchiectasis. This proposes that chronic inflammation driven by persistent bacterial bronchitis (PBB) causes damage to both the epithelium, resulting in impaired mucociliary clearance, and to the airway wall, which eventually manifests as bronchiectasis. The link between a "chronic bronchitis" and a persistence of bacterial pathogens, such as non-typable

Keywords: bronchiectasis; chronic cough; endobronchial infection; protracted bacterial bronchitis; recurrent bronchitis

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