Clinical outcomes and inflammatory biomarkers in current smokers and exsmokers with severe asthma - 30/03/13
, 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
Corresponding author: Neil C. Thomson, MD, Institute of Infection, Immunity & Inflammation, University of Glasgow and Respiratory Medicine, Gartnavel General Hospital, Glasgow, G12 OYN United Kingdom.Abstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : Severe asthma, cigarette smoking, exsmokers, asthma control, exacerbations, health care use, airway inflammation, inflammatory biomarker
Abbreviations used : ACQ, AQLQ, BTS, CT, EuroQoL, Feno50, FVC, HAD, Kco, RV
Plan
| Disclosure of potential conflict of interest: N. C. Thomson is a board member for Asmacure, Chiesi, and Respivert; has received grants from Aerovance, Asthmatx, AstraZeneca, Centocor, GlaxoSmithKline, MedImmune, Novartis, and Synairgen; has received payment for lectures, including service on speakers’ bureaus, from AstraZeneca, Boston Scientific, Chiesi, GlaxoSmithKline, and Novartis; and has received travel expenses from Novartis and Nycomed. R. Chaudhuri has received travel expenses from Novartis. L. G. Heaney has received grants from GlaxoSmithKline, MedImmune, Novartis UK, AstraZeneca, Genentech, Medical Research Council UK, NI Chest Heart and Stroke Association, Hoffmann la Roche UK, and Asthma UK; has received payment for lectures, including service on speakers’ bureaus, from GlaxoSmithKline, Merck Sharpe & Dohme, Nycomed, Novartis, Genentech, and AstraZeneca; and has received travel/accommodations/meeting expenses from AstraZeneca, Chiesi, Novartis and GlaxoSmithKline. C. Bucknall has received travel support from Novartis, GlaxoSmithKline, and Boehringer and has received payment for lectures, including service on speakers’ bureaus, from Novartis and GlaxoSmithKline. R. M. Niven has consultant arrangements with Vectura, has received payment for lectures from GlaxoSmithKline, Novartis, Chiesi, Boehringer, and AstraZeneca; and has received travel expenses from GlaxoSmithKline, Novartis, and Boehringer. A. N. Menzies-Gow has consultant arrangements with Novartis and Roche; has received grants from Asthma UK; has received payment for lectures, including service on speakers’ bureaus, from GlaxoSmithKline and Novartis; and has received travel expenses from Novartis, GlaxoSmithKline, and Boehringer Ingelheim. A. H. Mansur has received travel support from the British Thoracic Society; has consultant arrangements with NAPP and Novartis; has received payment for lectures, including service on speakers’ bureaus, from GlaxoSmithKline, Chiesi, Vectura, and Novartis; and has received travel expenses from Boehringer and Novartis. C. McSharry is employed by the National Health Service and has a grant pending with Medical Research Scotland. |
Vol 131 - N° 4
P. 1008-1016 - avril 2013 Retour au numéro
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