Genetic Factors for Smoking Boost Chronic Bronchitis Risk

The study, which analyzed data on more than 40,000 twins born in 1958 or earlier, found that inherited genes accounted for 40 percent of the risk for chronic bronchitis and that 14 percent of the genetic risk was also linked to a genetic predisposition to smoke, whether or not a person actually smoked.

The findings are published in the first issue for March of the American Journal of Respiratory and Critical Care Medicine.

"(This) study on the population-based Swedish Twin Registry, showing a genetic effect for the development of chronic bronchitis that does not differ by sex, is the first to our knowledge to quantify heritability of the disease," Jenny Hallberg, of the department of public health sciences at Karolinska Institutet in Stockholm, said in a prepared statement.

Previous research had suggested that women were more likely than men to develop chronic bronchitis, so the findings that prevalence didn't differ by sex pointed to a number of intriguing possibilities, she noted.

"It is possible that women are more prone to report symptoms. Or, more likely, this could be an effect of smoking being more harmful for women due to their smaller lungs from start [exposure to cigarette smoke relative to body size]," Hallberg wrote.

The finding that genetic factors that contribute to chronic bronchitis are largely independent of smoking shouldn't be interpreted to mean that smoking has no effect on the disease, she cautioned.

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Bronchitis.

Chronic bronchitis is a disease of the lung. The lungs consist of a series of folded membranes (the alveoli) which are located at the ends of very fine branching air passages (bronchioles).

Chronic bronchitis is a persisting infection and inflammation of the larger airways of the lungs - the bronchi. There are two main bronchi in the lungs (the right and left) which divide from the trachea, as seen in the figure to the right. Chronic bronchitis occurs as part of the disease complex known as chronic obstructive pulmonary disease (COPD) which also includes emphysema and small airways disease. Chronic bronchitis specifically refers to chronic cough and daily mucus production for at least three months of two or more consecutive years. Other causes of chronic cough must be excluded before making the diagnosis.


Chronic bronchitis is characterized by a chronic cough and chronic mucus production without another known cause (such as infection). Cells that line the airways in the lungs normally produce mucus as part of the bodies’ defense mechanism against bacteria, viruses, and other foreign particles. The mucus traps these particles and tiny hair-like projections in the airways (called cilia) sweep the dirty mucus up and out of the lungs.

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Bronchitis Causes.

Acute bronchitis is generally caused by lung infections; approximately 90% of these infections are viral in origin, 10% bacterial. Chronic bronchitis may be caused by one or several factors. Repeated attacks of acute bronchitis, which weaken and irritate bronchial airways over time, can result in chronic bronchitis.

Industrial pollution is another culprit. Chronic bronchitis is found in higher-than-normal rates among coal miners, grain handlers, metal molders, and other people who are continually exposed to dust. But the chief cause is heavy, long-term cigarette smoking, which irritates the bronchial tubes and causes them to produce excess mucus. The symptoms of chronic bronchitis are also worsened by high concentrations of sulfur dioxide and other pollutants in the atmosphere.

When a Cold Becomes Bronchitis

When you catch a cold, does it often turn into bronchitis, which is sometimes called a chest cold? It's important to recognize what's normal and to know when something more serious is going on. Here's what you must know when that nasty cold turns into bronchitis.

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Alteratives Treatment

The goal of therapy for chronic bronchitis is to provide relief of symptoms, prevent complications and slow the progression of the disease. Quitting smoking is also essential for patients with chronic bronchitis, since continuing to use tobacco will only further damage the lungs. Our Tobacco Education Center offers classes as well as individual consultations with doctors trained in treating tobacco addiction. We help smokers maximize the likelihood of success in their efforts to quit.

Medications:

• Bronchodilator Medications
-- Inhaled as aerosol sprays or taken orally, bronchodilator medications may help to relieve symptoms of chronic bronchitis by relaxing and opening the air passages in the lungs.


• Steroids -- Inhaled as an aerosol spray, steroids can help relieve symptoms of chronic bronchitis. Over time, however, inhaled steroids can cause side effects, such as weakened bones, high blood pressure, diabetes and cataracts. It is important to discuss these side effects with your doctor before using steroids.

• Antibiotics -- Antibiotics may be used to help fight respiratory infections common in people with chronic bronchitis.

• Vaccines -- Patients with chronic bronchitis should receive a flu shot annually and pneumonia shot every five to seven years to prevent infections.

• Oxygen Therapy -- As a patient's disease progresses, they may find it increasingly difficult to breathe on their own and may require supplemental oxygen. Oxygen comes in various forms and may be delivered with different devices, including those you can use at home.

• Surgery -- Lung volume reduction surgery, during which small wedges of damaged lung tissue are removed, may be recommended for some patients with chronic bronchitis.

• Pulmonary Rehabilitation -- An important part of chronic bronchitis treatment is pulmonary rehabilitation, which includes education, nutrition counseling, learning special breathing techniques, help with quitting smoking and starting an exercise regimen. Because people with chronic bronchitis are often physically limited, they may avoid any kind of physical activity. However, regular physical activity can actually improve a patient's health and wellbeing.

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