Smoking attenuates the age-related decrease in IgE levels and maintains eosinophilic inflammation
Smoking attenuates the age-related decrease in IgE levels and maintains eosinophilic inflammation
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DOI：
10.1111/cea.12073
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发表时间：
2013-06-01
影响因子：
6.1
通讯作者：
Mishima, M.
中科院分区：
文献类型：
--
作者：
Nagasaki, T.;Matsumoto, H.;Mishima, M.
背景流行病学研究表明，吸烟会增加特应性和哮喘的倾向。然而，吸烟对哮喘患者（包括老年人）的特应性和嗜酸性粒细胞炎症的影响仍不清楚。目的探讨吸烟对各年龄段支气管哮喘患者血清免疫球蛋白E（IgE）水平及嗜酸性粒细胞炎症的影响。方法对307例激素初治哮喘患者的血清IgE水平、血嗜酸性粒细胞计数和呼出气一氧化氮（FeNO）水平与吸烟和年龄的关系进行横断面评估。还分析了促进Th2炎症的痰嗜酸性粒细胞和胸腺基质淋巴细胞生成素（TSLP）的水平。在分析FeNO的影响因素时，排除了当前吸烟者。结果不吸烟者血清IgE、血嗜酸性粒细胞和FeNO水平均随年龄增长而下降，而目前吸烟者血清IgE水平并未随年龄增长而下降。此外，当前吸烟与较高的血液嗜酸性粒细胞计数相关。在特应性哮喘患者中，与年龄相关的血清IgE水平下降在戒烟者中比在从不吸烟者中不那么陡峭，并且特应性哮喘的戒烟者显示出更高的血嗜酸性粒细胞计数和更高的FeNO，而与年龄无关。最后，痰TSLP水平与痰嗜酸性粒细胞比例和包年相关。目前和戒烟者的TSLP水平高于从不吸烟者。结论和临床意义在激素初治哮喘患者中，吸烟可减轻年龄相关的IgE水平下降，并维持嗜酸性粒细胞炎症，TSLP可能参与其中。
Background Epidemiological studies have shown that smoking increases the propensity for atopy and asthma. However, the effects of smoking on atopy and eosinophilic inflammation in asthmatics, including the elderly, remain unknown. Objective To determine the effects of smoking on serum immunoglobulin E (IgE) levels and eosinophilic inflammation in asthmatics of all ages. Methods The associations of serum IgE levels, blood eosinophil counts and fractional exhaled nitric oxide (FeNO) levels with smoking and age in steroid-naive asthmatics were cross-sectionally assessed (n=307). Levels of sputum eosinophil and thymic stromal lymphopoietin (TSLP) that promotes Th2 inflammation were also analysed. Current smokers were excluded when analysing contributing factors of FeNO. Results Levels of serum IgE, blood eosinophil and FeNO decreased with increasing age in never-smokers, whereas decrease in serum IgE levels with increasing age was not observed in current smokers. In addition, current smoking was associated with higher blood eosinophil counts. In atopic asthmatics, age-related declines in serum IgE levels were less steep in ex-smokers than in never-smokers, and atopic ex-smokers with asthma showed higher blood eosinophil counts and higher FeNO irrespective of age. Lastly, sputum TSLP levels were associated with sputum eosinophil proportions and pack-years. Current and ex-smokers had higher TSLP levels than never-smokers. Conclusions and Clinical Relevance In steroid-naive asthmatics, smoking may attenuate the age-related decrease in IgE levels and maintain eosinophilic inflammation, in which TSLP may be involved.