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Feline asthma and feline chronic bronchitis are considered the most common chronic lower respiratory diseases in cats and are frequently referred to by the term chronic bronchial diseases. In feline asthma, a hypersensitivity reaction type I is suspected. For chronic bronchitis, the aetiology remains largely unknown. Affected cats may suffer from coughing, dyspnoea, and increased respiratory sounds. Both conditions are currently defined by the cytological cell pattern in the bronchoalveolar lavage and may differ in ethology, treatment, and clinical course. For diagnosis, other underlying conditions must be ruled out, in combination with the evidence for non-bacterial, eosinophilic or neutrophilic airway inflammation. In addition to the established therapy with oral or inhaled glucocorticoids and bronchodilators, the article also presents newer therapeutic and diagnostic options.Felines Asthma und feline chronische Bronchitis gelten als die häufigsten chronischen Erkrankungen der unteren Atemwege bei Katzen und werden oft als chronische Bronchialerkrankungen zusammengefasst. Beim felinen Asthma wird ursächlich eine Hypersensitivitätsreaktion Typ I vermutet, bei der chronischen Bronchitis ist die Ätiologie noch weitgehend unbekannt. Betroffene Katzen können Husten, Dyspnoe und Atemgeräusche zeigen. Beide Krankheitsbilder werden zurzeit anhand des zytologischen Zellbildes einer durch Bronchoalveolarlavage gewonnenen Probe definiert und können sich in Ursache, Behandlung und klinischem Verlauf unterscheiden. Die Diagnosestellung beinhaltet den Ausschluss anderer Grunderkrankungen in Kombination mit dem Nachweis einer nicht infektiösen, eosinophilen oder neutrophilen Entzündung der Atemwege. Neben der etablierten Therapie mit oral oder inhalativ applizierten Glukokortikoiden und Bronchodilatatoren werden in dem Artikel auch neuere therapeutische und diagnostische Ansätze vorgestellt.

Methicillin-resistant strains of Staphylococcus aureus (MRSA) are of particular significance for the management of patients with airway infections, since the disease course is often complicated and treatment rendered difficult by multiple resistance. Their prevalence is now slowly declining, but still alarmingly high. Hospital-acquired infections are predominant, but hospital-associated and community-acquired infections do occur, as do rare infections with livestock-acquired strains. Non-nosocomial strains are characterized by different pathogenic factors and a different spectrum of antibacterial resistance; they often have a threatening disease course. Anti-infectives with activity against MRSA are unusual and have particular toxicity profiles. On the other hand, MRSA colonization is eliminated spontaneously in healthy people and acute bronchitis is treatable by common oral antibiotics. However, chronic airway infection in bronchiectasis and other forms of structural airway damage requires a complex systemic and local treatment approach for pathogen elimination.

COPD is not a homogenous disease but consists of at least four different phenotypes: Emphysema, COPD with chronic bronchitis, asthma-COPD overlap syndrome (ACOS), and COPD with recurrent exacerbations. With differentiation, treatment can be designed phenotype-specific. Some modern drugs are not indicated in all phenotypes.COPD stellt kein homogenes Krankheitsbild dar. Mindestens vier häufigere klinische Phänotypen lassen sich differenzieren: COPD mit Emphysem, COPD vom bronchitischen Typ, Asthma-COPD-Overlap-Syndrome (ACOS) und COPD mit häufigen Exazerbationen. Die Festlegung des Phänotyps erlaubt eine Typ-spezifische Behandlung. Manche Therapieformen eignen sich nur für einzelne Phänotypen.La BPCO n'est pas une maladie homogène. Quatre différents phénotypes peuvent être différentiés: BPCO avec emphysème, BPCO avec bronchite chronique, l'asthme-BPCO overlap syndrome (ACOS) et la BPCO avec des exacerbations fréquentes. Avec la différentiation du type la thérapie devient phénotype-spécifique. Quelques médicaments modernes ne sont pas indiqués que dans certains phénotypes.

Prevention of COPD requires appropriate patient education, especially of adolescents, as well as the establishment of an effective national health policy. The new GOLD guidelines represent the current standard of knowledge on the management of chronic, progressive, obstructive pulmonary diseases. It points out that COPD is avoidable and treatable,and hence, there is no reason for therapeutic nihilism. Chronic bronchitis preceding a progressive respiratory obstruction cannot be improved with the presently available respiratory therapeutics. For this reason, therapeutic measures concentrate on the avoidance of exacerbations, which are primarily responsible for the severity of the course of COPD.

Bronchial asthma, COPD and extrinsic allergic alveolitis are respiratory diseases that can be also acquired through occupational exposure. However, the definitive identification of an occupational disease is difficult because the symptoms do not exclusively appear in direct connection with noxious workplace substances but rather also appear in the leisure time. It is still important to make an early and clear correlation in order to establish preventive measures at the workplace if necessary.

In 2020 Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death world-wide causing considerable health costs. Epidemiological data to estimate the future development of COPD in Austria were not available so far.In the context of the international Burden of Obstructive Lung Disease (BOLD) study, a random sample of the population of Salzburg was surveyed to determine the prevalence of COPD. The definition of COPD followed the GOLD classification. A prior physician's diagnosis of COPD, emphysema or chronic bronchitis was evaluated by questionnaire. The age- and sex-specific prevalence of COPD was extrapolated using demographic data of the Austrian population for the years 2005, 2010, 2015 and 2020. Undiagnosed COPD was considered present, whenever irreversible airways obstruction was measured (FEV1/FVC0.7), but a doctor's diagnosis of COPD, emphysema or chronic bronchitis has not been made.For 2005 1.047.150 Austrians aged 40 years and older were estimated in GOLD stage I-IV. 431.080 persons over 40 years were affected by COPD in GOLD stage II-IV needing therapy. The percentage of undiagnosed COPD was 88,5%. For the years 2010, 2015 and 2020 GOLD stage I-IV COPD was projected to rise by 7,8%, 16.1% and 24%, respectively.Measures to prevent COPD are absolutely necessary to forestall the projected burden of this disease in Austria.

Since the early detection of COPD is problematic, nonobstructed smokers with a chronic productive cough are initially assigned to the COPD risk group o. Although there is still a lack of evidence that early pharmacological intervention is associated with benefits in terms of disease progression, the earliest possible diagnosis is still considered a desirable goal. For the sooner triggering noxae, such as cigarette smoke, are eliminated, the more positive are the effects on the subsequent course of the illness. When establishing the diagnosis, a careful case history is of particular importance. With the aid of various diagnostic pulmonary function tests, degrees of severity can be differentiated and the course of COPD can be determined. Since the end of 2004, structured therapeutic programs for COPD have become available.

N-acetylcysteine (NAC) is known to have direct antioxidant properties due to its thiol-group on the one hand as well as indirect antioxidant capacity as cysteine-donor to cellular glutathione-synthesis on the other hand. Therefore NAC appears to be attractive in antioxidant therapy of inflammatory disorders of the lung. This study aimed to investigate the use of antioxidant therapy with NAC in chronic bronchitis.In this randomized, double-blinded and placebo-controlled trial 100 patients divided into four groups were observed over a period of 3 months. The treatment consisted of either 600 mg NAC bid, 500 mg Vitamin C bid, a combination of those two substances using the same dosage or a placebo-preparation. The release of reactive oxygen species from isolated neutrophilic granulocytes and mononuclear cells was quantified before treatment and after three months using chemiluminescence (primary outcome parameter). Furthermore cellular glutathione content of these inflammatory cells was quantified spectrometrically. In addition, leukocyte-count and erythrocyte sedimentation rate as well as spirometry and a standardized symptom-based questionnaire were used to monitor the clinical efficacy.None of the above substances were able to significantly reduce the release of reactive oxygen species from the examined population of inflammatory cells. They also failed to increase intracellular glutathione-levels. Concordantly, no changes in spirometry and the results of the symptom-based questionnaire were found.In summary NAC, Vitamin C and the NAC/ Vitamin C-combination did neither enhance antioxidant protection in the blood nor is it of any clinical benefit in chronic bronchitis. Possible reasons may be a lack of antioxidant deficiency in these patients and negative feedback mechanisms of the glutathione-system.

The aim of this trial conducted in the offices of pneumologists was to evaluate the clinical success of a 5-day course of oral moxifloxacin administered once daily at a dose of 400 mg in 328 patients with acute exacerbation of chronic bronchitis (Anthonisen type 1). In this non-comparative study, the results of treatment were assessed not merely on the basis of the clinical parameters, but also, for the first time, by the surrogate marker of patient satisfaction and the improvement in cough, dyspnea, chest pain and sputum, the severity of which was scored daily by the patient himself.Cough, chest pain and the purulence of the sputum improved rapidly within the first five days of treatment. At least 90% of the patients reported their satisfaction with the antibiotic. The clinical success rate (cure and improvement) for all the patients involved (ITT analysis) was 90.5%. The most common side effect was diarrhea, while the other side effects showed no specific pattern.

Chronic bronchitis is part and precursor of COPD, a complex disease triggered mostly by exposure to cigarette smoke. However COPD develops only in patients with specific susceptibility probably determined by genetic factors or additional risk factors. A specific type of inflammation resides in the bronchial and bronchiolar walls, that infers damage not only to airway structure but also to surrounding alveolar attachments and thus to the lung parenchyma. Chronic bronchitis, fibrosing bronchiolitis and emphysema constitute the three main stems of pathology of the disease but may coexist with varying extent. The clinical picture is therefore quite variable. Treatment exists largely in bronchodilation combining different mechanisms and using long acting drugs usually applied by inhalation. Acute exacerbations promote progression of the disease, which must be counteracted by adaptation and intensification of therapy, in some cases including non invasive or invasive ventilation. Several non-pharmacologic measures such as smoking cessation, rehabilitation, nutritional support, long term oxygen therapy, lung volume reduction and possibly lung transplantation may be available for appropriate patients and have to be considered.

The pathogenesis of allergies can be stimulated by adjuvant effects--i.e. air pollutants such as NOx and particles from diesel engines as well as noise--the latter especially during night-time. During sleep, noise signals which are associated with danger (i.e. lorry noise) have the potential to trigger stress reactions even if the noise level is low. Increases of cortisol in the first half of the night seem to play an important role.--In a blind interview study, the combined effects of chronic exposure to traffic related air pollution and noise, upon the risk of skin and respiratory diseases in children were studied. All children between 5-12 years, who had consulted one of two participating pediatricians were included in the study. The pediatricians' diagnoses of 400 children were analysed together with their parents answers on the density of road traffic on their street and several confounding factors. Multiple regression analyses resulted in relative risks of asthma, chronic bronchitis and neurodermitis, which increased significantly with increasing traffic load. A comparison with the literature on such effects caused by air pollution alone, showed that traffic noise during the night might have an adjuvant effect on the pathogenesis of the mentioned diseases.