Chest
Original Research: SMOKINGSmoking and Asthma: Clinical and Radiologic Features, Lung Function, and Airway Inflammation
Section snippets
Patients
Eighteen- to 45-year-old, corticosteroid-naïve asthma patients were consecutively enrolled from the asthma clinics of Laval Hospital (Quebec City, Canada) and Sacré-Coeur Hospital (Montreal, Canada). Nonsmokers had not smoked in the last year and had a < 2 pack-year history of cigarette smoking; current smokers smoked > 10 cigarettes per day with > 5 pack-years of smoking. Smoking status was evaluated by self-report of study subjects. Patients had a medical history of asthma according to the
Patient Characteristics
Forty-nine patients, 22 smokers and 27 nonsmokers, completed the study (Table 1). The two groups of patients were similar in regard to age and time since diagnosis (Table 1). They included 24 women (11 nonsmokers and 13 smokers) and 25 men (16 nonsmokers and 9 smokers) aged 20 to 44 years (mean, 30 ± 7 years). Smoking history, as expressed by the number of mean pack-years, was 14.0 ± 7.6 pack-years (range, 5 to 32 pack-years). Twenty-five nonsmokers (93%) and 18 smokers (82%) were atopic.
Asthma Control
From
Discussion
Our study provides both confirmatory and original data on the effect of smoking on asthmatic airways and on the relationships between clinical, physiologic, radiologic, and inflammatory features in this population. Compared to nonsmoking asthma patients, smokers had increased respiratory symptoms, lower mean expiratory flows and lung diffusion capacity, and increased lung hyperinflation and induced-sputum neutrophil and bronchial cell counts. Exhaled breath condensate pH was more acidic in
ACKNOWLEDGMENT:
We are grateful to Johanne Lepage for her help conducting this study, Serge Simard for his suggestions on statistical analysis, Philippe Prince for his help with induced-sputum analysis, and Michel Laviolette, Franċois Maltais, Yvon Cormier, and Lori Schubert for reviewing the manuscript.
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2022, Immunology and Allergy Clinics of North AmericaCitation Excerpt :It also has the potential to modulate asthma treatment responses and lead to worse clinical outcomes, in addition to promoting faster decline in lung function.19,42 In this regard, we reported that, compared with nonsmokers with asthma, smokers had more respiratory symptoms despite a possible reduction of perception of bronchoconstriction, a higher functional residual capacity and more severe airway obstruction, particularly at mid-expiratory flow rates, in addition to lower lung diffusion capacity-even if most of these parameters remained in the normal range.18,40 In its recent iterations, the GOLD report no longer refers to asthma–COPD overlap (ACO), but instead emphasizes that asthma and COPD are different disorders, which may share common traits and clinical features such as eosinophilia or some degree of reversibility.20
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Supported by an unrestricted Grant from AstraZeneca Canada.
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