An Introduction to the Pathogenesis of Bronchiectasis

After describing about the existence of some kind of the congenital bronchiectasis, author discusses the pathogenesis of the acquired bronchiectasis. Many theories were presented; the weakness of the bronchial wall caused by the infection of the concerned wall, the dilating forces from the surrounding tissue of the bronchus causing the bronchiectasis of its territory. In the next place, circulating disturbances were considered. Tremendous hypertrophy of the bronchial arteries and the anastomotic formation with the pulmonary artery, including the “sperr artery of Hayek” and the “formation glomi of Delarue” were always found in the case of bronchiectasis. Neurogenous theory has been assumed from long. But it's proof was done at least 1956 by Prof. Delarue et al. Their experimental study on dogs which demonstrated clearly the nerve destructions of the adventitia at the bronchial wall should be the cause of the bronchiectasis. Tajima et al demonstrated the same nerve alterations at the bronchial wall of the 22 resected lungs, just above the portion of bronchiectasis, without any connections with the presence of the stenosis and the lung conditions around. They found always the nerve destructions in the case of bronchiectasis, excluding the congenital deformations. However the nerve destructions of the bronchial walls were also found in several other lung diseases, such as asthma, emphysema, silicosis etc. without any bronchiectasis, especially in Chagus Diseases, in spite of the extreme decrease of the number of the ganglion cells at the main bronchs, some of the cases do have bronchiectasis in its territory, out the others have not. Further studies are desired in this connection.