Disassociation in the mucociliary function of central and peripheral airways of asymptomatic smokers.
Disassociation in the mucociliary function of central and peripheral airways of asymptomatic smokers.
复制标题
无症状吸烟者中央和外周气道粘液纤毛功能的分离。
DOI：
10.1164/arrd.1985.132.3.633
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Bergofsky,EH
中科院分区：
文献类型：
--
作者：
Foster,WM;Langenback,EG;Bergofsky,EH
无症状吸烟者的外周呼吸道粘液纤毛功能可能受损，并导致这些受试者所描述的异常呼吸道改变。对吸烟习惯不一致的健康受试者应用吸入和沉积放射性粒子后再进行伽马相机成像的技术，以确定吸烟是否改变了外周和中央呼吸道的粘液运输。吸烟者(n=8)的平均吸烟年限为26±2年(均值±SEM)，平均吸烟年限为7.5包，肺功能在正常范围内；与同龄的非吸烟者(n=8)相比，其呼气量相似，即吸烟者的FEV1占预测均值的94.5±4%，非吸烟者的FEV1占预测值的98.8±4%。以24 h颗粒滞留和胸腔内颗粒平面分布为周边和中心沉积指标，两组沉积形态相似。粘液清除沉积在气管和支气管上的颗粒以初始沉积和达到75%、50%和25%滞留水平所需时间之间的间隔来量化。8名吸烟者中有6人的保留时间与不吸烟者相当，但50%和25%的保留时间在两组之间有显著差异(p<；0.025)。吸烟者清除肺粘液的速度较慢，即达到25%和50%滞留水平的间隔比不吸烟者观察到的平均值高60%至90%。两组干支气管内粘液的流动速度相似；β-2肾上腺素能刺激增加吸烟者与非吸烟者基线控制率之间的粘液转运。这些数据表明，无症状吸烟者的粘液纤毛功能下降，在颗粒滞留的后期阶段明显，表明从周围呼吸道流出的粘液发生了改变。由于中央肺区的粘液清除率与非吸烟者相当，肺功能的常规测试也在预测的正常范围内，外周粘液转运障碍可能是伴随或先于小气道机械功能障碍的肺部疾病的早期特征。
Mucociliary function of peripheral airways in asymptomatic smokers may be impaired and contribute to the abnormal airway changes described in these subjects. Techniques using the inhalation and deposition of radioactive particles followed by gamma camera imaging were applied to healthy subjects discordant for smoking habit to determine if mucus transport of peripheral and central airways was altered by smoking. Smokers (n=8) averaged 26 ± 2 yr (mean ± SEM) and < 7.5 pack-years of smoking, with pulmonary function within normal limits; when compared with the non-smokers (n=8) of similar age, their expiratory volumes were similar, i.e., FEV1as a percent of predicted averaged 94.5 ± 4% (mean ± SEM) in the smokers and 98.8 ± 4% in the nonsmokers. Using 24-h particle retention and planar distribution of particles in the chest as indexes of peripheral and central deposition, the 2 groups had similar deposition patterns. Mucus clearance of particles deposited onto tracheobronchial airways was quantitated as the interval between initial deposition and the time required to attain 75, 50, and 25% retention levels. Six of the 8 smokers had 75% retention times comparable to those of the nonsmokers, but the 50 and 25% retention times differed significantly between the 2 groups (p < 0.025). Smokers cleared lung mucus at slower rates, i.e., the intervals to attain 25 and 50% retention levels were 60 to 90% greater than the mean values observed for nonsmokers. Velocity of mucus streaming within stem bronchi was comparable for the 2 groups; β2-adrenergic stimulation increased mucus transport in the smokers to the baseline control rates of the nonsmokers. These data suggest that reduced mucociliary function of asymptomatic smokers, apparent in the later stages of particle retention, represents altered mucus flow from peripheral airways. Because mucus clearance of central lung regions was comparable to that in the nonsmokers, and conventional tests of lung function were also within predicted normal limits, impaired transport of peripheral mucus may be an early hallmark of lung disease associated with, or preceding, small airway mechanical dysfunction.