Asthma in smokers: challenges and opportunities
Asthma in smokers: challenges and opportunities
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DOI：
10.1097/mcp.0b013e32831da894
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发表时间：
2009-01-01
影响因子：
3.3
通讯作者：
Chaudhuri, Rekha
中科院分区：
文献类型：
--
作者：
Thomson, Neil C.;Chaudhuri, Rekha
综述目的：哮喘患者吸烟与症状控制不良和对皮质类固醇敏感性降低有关。我们总结了最近的证据支持吸烟对哮喘的不良影响，并考虑管理这些patients.Recent findingsSmokers有更严重的症状，更有可能被送往医院，由于控制不佳的哮喘相比，非吸烟者的哮喘。哮喘吸烟者对吸入性糖皮质激素敏感性降低的可能原因是非嗜酸性粒细胞性气道炎症、糖皮质激素受体功能受损和/或组蛋白脱乙酰酶活性降低。戒烟可以改善哮喘控制，但戒烟率很低。对于吸烟者哮喘的最佳药物治疗尚未确定，部分原因是在这些患者中进行的临床试验数量较少。然而，初步的数据表明，白三烯受体拮抗剂可能有一个有益的影响，在吸烟者轻度asthma.SummaryCigarette吸烟哮喘是一个危险因素，哮喘控制不良和敏感性降低皮质类固醇。应尽一切努力鼓励吸烟的哮喘患者戒烟。需要进行临床试验，以确定恢复皮质类固醇敏感性或直接改善无法戒烟的哮喘患者症状控制的疗法。
Purpose of reviewCigarette smoking in asthma is associated with poor symptom control and reduced sensitivity to corticosteroids. We summarize recent evidence supporting the adverse effects of smoking in asthma and consider strategies to manage these patients.Recent findingsSmokers have more severe symptoms and are more likely to be admitted to hospital due to poorly controlled asthma compared with nonsmokers with asthma. Possible causes of reduced sensitivity to inhaled corticosteroids in smokers with asthma are noneosinophilic airway inflammation, impaired glucocorticoid receptor function, and/or reduced histone deacetylase activity. Smoking cessation improves asthma control, but quit rates are low. The optimal drug therapy for smokers with asthma is not established due, in part, to the small number of clinical trials performed in these patients. Preliminary data, however, suggest that leukotriene-receptor antagonists may have a beneficial effect in smokers with mild asthma.SummaryCigarette smoking in asthma is a risk factor for poor asthma control and reduced sensitivity to corticosteroids. Every effort should be made to encourage individuals with asthma who smoke to quit. Clinical trials are required to identify therapies that restore corticosteroid sensitivity or directly improve symptom control in individuals with asthma who are unable to stop smoking.