Marina Lazzari Nicola1, Heráclito Barbosa de Carvalho2, Carolina Tieko Yoshida1, Fabyana Maria Dos Anjos3, Mayumi Nakao4, Ubiratan de Paula Santos5, Karina Helena Morais Cardozo6, Valdemir Melechco Carvalho6, Ernani Pinto5, Sandra Helena Poliselli Farsky5, Paulo Hilario Nascimento Saldiva4, Bruce K Rubin7, Naomi Kondo Nakagawa8. 1. Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. Department of Preventive Medicine, Faculty of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil. 3. Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil. 4. Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 5. Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 6. Fleury Medicine and Health Institute, São Paulo, Brazil. 7. Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA. 8. Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: naomi.kondo@usp.br.
Abstract
BACKGROUND: Smoking is responsible for most COPD. Although people with COPD often have concomitant nasal disease, there are few studies that report physiologic or inflammatory changes in the upper airways in young asymptomatic smokers. We investigated physiologic and inflammatory changes in the nasal and lower airways of young smokers and if these changes were related to smoking history. METHODS: Seventy-two subjects aged between 18 and 35 years (32 healthy nonsmokers and 40 young smokers) participated in this study. We measured nasal mucociliary clearance (MCC), nasal mucus surface contact angle, cell counts, myeloperoxidase and cytokine concentrations in nasal lavage fluid, exhaled breath condensate (EBC) pH, and lung function. RESULTS: Smokers had faster MCC, an increased number of cells (macrophages, ciliated cells, and goblet cells), increased lavage myeloperoxidase concentration, and decreased EBC pH compared with nonsmokers. There was a significant inverse relationship between pack-year smoking history and EBC pH. There were no differences in lung function or mucus surface properties comparing smokers to nonsmokers. CONCLUSIONS: Young adult smokers have functional and inflammatory changes in the nasal and lower airways and these correlate with smoking history. However, in these young smokers, smoking history was not associated with pulmonary function decline, probably because it is unlikely that spirometry detects early physiologic changes in the airways. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01877291; URL: www.clinicaltrials.gov.
BACKGROUND: Smoking is responsible for most COPD. Although people with COPD often have concomitant nasal disease, there are few studies that report physiologic or inflammatory changes in the upper airways in young asymptomatic smokers. We investigated physiologic and inflammatory changes in the nasal and lower airways of young smokers and if these changes were related to smoking history. METHODS: Seventy-two subjects aged between 18 and 35 years (32 healthy nonsmokers and 40 young smokers) participated in this study. We measured nasal mucociliary clearance (MCC), nasal mucus surface contact angle, cell counts, myeloperoxidase and cytokine concentrations in nasal lavage fluid, exhaled breath condensate (EBC) pH, and lung function. RESULTS: Smokers had faster MCC, an increased number of cells (macrophages, ciliated cells, and goblet cells), increased lavage myeloperoxidase concentration, and decreased EBC pH compared with nonsmokers. There was a significant inverse relationship between pack-year smoking history and EBC pH. There were no differences in lung function or mucus surface properties comparing smokers to nonsmokers. CONCLUSIONS: Young adult smokers have functional and inflammatory changes in the nasal and lower airways and these correlate with smoking history. However, in these young smokers, smoking history was not associated with pulmonary function decline, probably because it is unlikely that spirometry detects early physiologic changes in the airways. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01877291; URL: www.clinicaltrials.gov.
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