Clinical outcomes and inflammatory biomarkers in current smokers and exsmokers with severe asthma

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• 作者：Neil C. Thomson ; MD^a ; ^{neil.thomson@glasgow.ac.uk} ; Rekha Chaudhuri ; MD^a ; Liam G. Heaney ; MD^b ; Christine Bucknall ; FRCP^c ; Robert M. Niven ; MD^d ; Christopher E. Brightling ; PhD^e ; Andrew N. Menzies-Gow ; MRCP^f ; Adel H. Mansur ; FRCP^g ; Charles McSharry ; PhD^a
• 关键词：Severe asthma ; cigarette smoking ; exsmokers ; asthma control ; exacerbations ; health care use ; airway inflammation ; inflammatory biomarker
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：131
• 期：4
• 页码：1008-1016
• 全文大小：143 K

文摘

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Background

Clinical outcomes are worse in current smokers and exsmokers with mild-to-moderate asthma compared with never smokers, but little is known about the influence of smoking status in patients with severe asthma.

Objectives

We sought to examine the association of current or previous cigarette smoking with clinical and inflammatory variables in patients with severe asthma.

Methods

We compared patients' demographics, disease characteristics, and biomarkers of inflammation in current smokers (n?=?69 [9 % ]), exsmokers (n?=?210 [28 % ]), and never smokers (n?=?461 [62 % ]) with severe asthma (n?=?760) recruited to the British Thoracic Society Severe Asthma Registry.

Results

Current smokers had poorer asthma control, more unscheduled health care visits, more rescue courses of oral steroids, and higher anxiety and depression scale scores than exsmokers or never smokers. Current smokers had a reduced proportion of sputum eosinophils compared with never smokers (1 % and 4 % , respectively) and lower fraction of expired nitric oxide (50 mL/s; 14 ppb and 35 ppb, respectively). Exsmokers compared with never smokers had an increased proportion of sputum neutrophils (59 % and 43 % , respectively) but a similar proportion of sputum eosinophils (3 % ) and fraction of expired nitric oxide (50 mL/s; 35 ppb). Both current smokers and exsmokers had reduced serum specific IgE levels to several common environmental allergens.

Conclusion

Current smokers with severe asthma exhibit worse clinical and health care outcomes compared with exsmokers and never smokers with severe asthma. Their inflammatory profiles in sputum and blood differ.