UPPER RESPIRATORY-TRACT ENVIRONMENTAL TOBACCO-SMOKE SENSITIVITY
UPPER RESPIRATORY-TRACT ENVIRONMENTAL TOBACCO-SMOKE SENSITIVITY
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DOI：
10.1164/ajrccm/143.6.1304
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发表时间：
1991-06-01
期刊：
影响因子：
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通讯作者：
PROUD, D
中科院分区：
文献类型：
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作者：
BASCOM, R;KULLE, T;PROUD, D
一些患者在暴露于环境烟草烟雾（ETS）后报告鼻炎症状，但缺乏对这种反应的客观评估。此外，这种反应的机制尚不清楚。我们通过对77名参与一项无关研究的健康非吸烟年轻人进行问卷调查，评估了ETS相关症状的频率。34%（26/77）的受试者在暴露于ETS后报告了一种或多种鼻炎症状（充血、流涕或打喷嚏）。然后，我们将10名历史上对ETS敏感（ETS-S）和11名历史上对ETS不敏感（ETS-NS）的受试者暴露在清洁空气中15分钟，然后暴露在侧流烟草烟雾中15分钟（CO浓度为百万分之45）。在这些程序中的选定时间点，我们记录症状，后鼻阻力，肺量测定和进行鼻腔灌洗。ETS-S但不是ETS-NS受试者报告暴露于侧流烟草烟雾后鼻塞、头痛、胸部不适或胸闷以及咳嗽显着增加（p < 0.01）。与ETS-NS受试者相比，ETS-S受试者的鼻漏症状更严重，时间更长。在两个研究组中，气味感知和眼、鼻、喉刺激均显著增加（p < 0.01），但ETS-S受试者报告的鼻、喉刺激显著增加。在ETS-NS组中，后鼻阻力没有发生显著变化，但在ETS-S组中，后鼻阻力显著增加，从暴露前的3.8 +/- 0.5 cm H2O/L/s（平均值+/- SE）上升到烟雾暴露完成后20分钟的8.0 +/- 2.7 cm H2O/L/s峰值（p < 0.001）。两组的肺功能变化幅度较小（< 7%）。鼻灌洗液中组胺、白蛋白、激肽或TAME-酯酶活性水平无显著增加。这些数据提供了客观证据，表明在历史上敏感的受试者对ETS的反应性增加，但表明过敏，IgE介导的机制是不太可能的，因为没有组胺检测到，尽管有症状和生理反应。
Some patients report rhinitis symptoms after exposure to environmental tobacco smoke (ETS), but objective assessments of this response have been lacking. Furthermore, the mechanism of this response is unknown. We assessed the frequency of ETS-related symptoms by administering a questionnaire to 77 healthy nonsmoking young adults who were participating in an unrelated study. Of the subjects 34% (26 of 77) reported one or more rhinitis symptoms (congestion, rhinorrhea, or sneezing) following ETS exposure. We then exposed 10 historically ETS-sensitive (ETS-S) and 11 historically ETS-nonsensitive (ETS-NS) subjects to 15 min of clean air followed by 15 min of sidestream tobacco smoke (CO concentration of 45 parts per million). At selected time points during these procedures we recorded symptoms, posterior nasal resistance, and spirometry and performed nasal lavages. ETS-S but not ETS-NS subjects reported significant (p < 0.01) increases in nasal congestion, headache, chest discomfort or tightness, and cough following exposure to sidestream tobacco smoke. Rhinorrhea symptoms were greater and more prolonged in ETS-S subjects compared to ETS-NS subjects. Significant (p < 0.01) increases in perception of odor and in eye, nose, and throat irritation occurred in both study groups, but ETS-S subjects reported significantly more nose and throat irritation. No significant changes in posterior nasal resistance occurred in the ETS-NS group but a significant increase occurred in the ETS-S subjects, with the resistance rising from 3.8 +/- 0.5 cm H2O/L/s (mean +/- SE) preexposure to a peak of 8.0 +/- 2.7 cm H2O/L/s 20 min after completion of the smoke exposure (p < 0.001). Pulmonary function changes were of a small magnitude (< 7%) in both groups. No significant increases occurred in the levels of histamine, albumin, kinin, or TAME-esterase activity in nasal lavage fluids. These data provide objective evidence of an increased responsiveness to ETS in historically sensitive subjects but suggest that an allergic, IgE-mediated mechanism is unlikely since no histamine was detected despite the symptomatic and physiologic response.