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Asthma and cigarette smoking.

N C Thomson1, R Chaudhuri, E Livingston

  • 1Dept of Respiratory Medicine, Division of Immunology, Infection and Inflammation, Western Infirmary & University of Glasgow, Glasgow, G11 6NT, UK. n.c.thomson@clinmed.gla.ac.uk

The European Respiratory Journal
|November 2, 2004
PubMed
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Cigarette smoking worsens asthma symptoms and lung function decline. Asthmatic smokers show altered inflammation and corticosteroid resistance, necessitating smoking cessation or alternative therapies.

Area of Science:

  • Pulmonology
  • Respiratory Medicine
  • Clinical Immunology

Background:

  • Approximately 25% of adults with asthma are current cigarette smokers in developed countries.
  • Asthma and smoking synergistically lead to severe symptoms, accelerated lung function decline, and reduced corticosteroid effectiveness.
  • Limited data exists on airway pathology in smokers with asthma, with evidence suggesting mixed inflammatory responses.

Purpose of the Study:

  • To review the complex interactions between asthma and cigarette smoking.
  • To explore the mechanisms underlying corticosteroid resistance in asthmatic smokers.
  • To discuss the implications for asthma management and treatment.

Main Methods:

  • Literature review of studies investigating asthma, cigarette smoking, and airway inflammation.

Related Experiment Videos

  • Analysis of data on inflammatory cell phenotypes, glucocorticoid receptor expression, and transcription factor activity.
  • Synthesis of evidence regarding the effects of smoking on asthma control and therapeutic response.
  • Main Results:

    • Smokers with asthma exhibit heightened and suppressed inflammatory responses compared to non-smokers.
    • Mechanisms for corticosteroid resistance may include altered inflammatory cell profiles, changes in glucocorticoid receptor ratios, and dysregulated transcription factor activity.
    • Adverse effects of smoking on asthma control and treatment response are significant.

    Conclusions:

    • Smoking cessation is crucial for individuals with asthma.
    • Further research is needed to fully understand the impact of smoking cessation on reversing adverse effects.
    • Alternative or supplementary therapies are required for asthmatic smokers unable to quit inhaled corticosteroids.