哮喘联盟

   摘要
   背景：与从不吸烟者相比，伴有轻度至中度哮喘的现在吸烟者和戒烟者，哮喘临床转归更差，但吸烟状态对严重哮喘的影响了解较少。
   目的：本试验在严重哮喘患者中研究现在吸烟和过去吸烟与临床和炎症标志物的关系。
   方法：伴有严重哮喘的现在吸烟者（n=69 [9%]）、戒烟者（n=210 [28%]）和从不吸烟者（n=461 [62%]）入选英国胸科协会严重哮喘注册研究。比较这些患者的人口统计学参数、疾病特征和炎症生物标志物。
   结果：与戒烟者和从不吸烟者相比，现在吸烟者具有更差的哮喘控制、更多的无预约的健康机构就诊、更多的急救性口服皮质激素和更高的焦虑和抑郁评分。与从不吸烟者相比，现在吸烟者痰液嗜酸性粒细胞比例较低（分别为1%和4%），呼出气一氧化氮分数较低（50 mL/s; 分别为14 ppb和35 ppb）。与从不吸烟者相比，戒烟者痰液中性粒细胞比例增加（分别为59%和43%），但痰液嗜酸性粒细胞比例（3%）和呼出气一氧化氮分数（50 mL/s; 35 ppb）相似。现在吸烟者和戒烟者血清中数个常见的环境过敏原特异性IgE水平下降。
   结论：与患有严重哮喘的戒烟者和从不吸烟者相比，患严重哮喘的现在吸烟者其临床和健康转归更差。两者在痰液和血液的炎症方面存在差异。
 

（刘国梁 审校）
JAllergyClinImmunol.2013Feb15.pii:S0091-6749(13)00090-0.doi:10.1016/j.jaci.2012.12.1574.[Epub ahead of print]
 

Clinical outcomes and inflammatory biomarkers in current smokers and exsmokers with severe asthma.
 
Thomson NC, Chaudhuri R, Heaney LG, Bucknall C, Niven RM, Brightling CE, Menzies-Gow AN, Mansur AH,McSharry C.

Source
Respiratory Medicine, Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom. Electronic address: neil.thomson@glasgow.ac.uk.

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 severeasthma (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.
 

JAllergyClinImmunol.2013Feb15.pii:S0091-6749(13)00090-0.doi:10.1016/j.jaci.2012.12.1574. [Epub ahead of print]