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Haemophilus influenzae in chronic bronchitis.
Autor – Murphy TF
Zeitschrift/Erscheinungsdatum – Semin Respir Infect 2000 Mar;15(1):41-51.
STUDY OBJECTIVES:
Colonization of the adult respiratory tract with nontypable Haemophilus
influenzae is a dynamic process with new strains being acquired and replacing
old strains periodically.The organism is a common cause of exacerbations
of chronic bronchitis based on 3 lines of evidence: quantitative culture
of the lower airways obtained by protected specimen brush, antibiotic
trials, and serological studies. Nontypable H. influenzae expresses multiple
adhesin molecules that mediate adherence to the respiratory tract mucosa.
Recent studies have established that the bacterium penetrates the mucosal
surface and survives intracellularly and in the interstitium of the submucosa.
The organism shows a remarkable degree of antigenic diversity on its surface,
including phase variation of lipooligosaccharide, antigenic heterogeneity
of surface proteins, point mutations in genes encoding surface proteins
and horizontal transfer of genes. These strategies facilitate evasion
of the human immune response. Substantial progress has been made in identifying
vaccine antigens to prevent infections caused by nontypable H. influenzae.