Relation between duration of smoking cessation and bronchial inflammation in COPD
Relation between duration of smoking cessation and bronchial inflammation in COPD
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DOI：
10.1136/thx.2005.040519
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发表时间：
2006-02-01
期刊：
影响因子：
10
通讯作者：
Mauad, T
中科院分区：
文献类型：
--
作者：
Lapperre, TS;Postma, DS;Mauad, T
背景：慢性阻塞性肺疾病（COPD）与气道炎症有关。虽然戒烟可以改善COPD患者的症状和肺功能下降，但目前尚不清楚确诊COPD患者的支气管炎症是否随戒烟时间而变化。方法：114例COPD患者（99例男性），平均（SD）年龄62（8）岁，中位（IQR）吸烟史42（31-55）包年，未吸入或口服皮质类固醇，所有当前或既往吸烟者（n=42，戒烟> 1个月，中位戒烟持续时间3.5年），使用支气管扩张剂后FEV 1 63（9）%预测值和FEV 1/IVC 48（9）%进行横断面研究。上皮下T淋巴细胞数量在支气管活检标本中测量了CD 3、CD 4、CD 8、中性粒细胞、巨噬细胞、嗜酸性粒细胞、肥大细胞和浆细胞（中位数（IQR）/0.1 mm（2））。结果：既往COPD吸烟者的CD 3+、CD 4+和浆细胞数量高于当前吸烟者=0.023和9.0 COPD患者（分别为149（88-225）v 108（61-164），p =0.036; 58（32-90）v 40（25-66），p = 0.023;和9.0（5.5-20）v 7.5（3.1-14），p=0.044），但在其他炎性细胞中没有差异。短期戒烟者（= 3.5年）的CD 8+细胞数量低于短期戒烟者（p=0.009），CD 8/CD 3比值低于当前吸烟者和短期戒烟者（分别为p=0.012，p=0.003），浆细胞数量高于当前吸烟者结论：随着戒烟时间的延长，CD 8细胞数量减少，浆细胞数量增加。这表明支气管T淋巴细胞和浆细胞计数，而不是其他炎症细胞，与COPD患者戒烟时间有关。
Background: Chronic obstructive pulmonary disease (COPD) is associated with airway inflammation. Although smoking cessation improves symptoms and the decline in lung function in COPD, it is unknown whether bronchial inflammation in patients with established COPD varies with the duration of smoking cessation.Methods: 11 4 patients (99 men) with COPD of mean (SD) age 62 (8) years, a median (IQR) smoking history of 42 (31-55) pack years, no inhaled or oral corticosteroids, all current or ex-smokers (n=42, quit > 1 month, median cessation duration 3.5 years), post-bronchodilator FEV1 63 (9)% predicted, and FEV1/IVC 48 (9)% were studied cross sectionally. The numbers of subepithelial T lymphocytes (CD3, CD4 CD8), neutrophils, macrophages, eosinophils, mast cells, and plasma cells were measured in bronchial biopsy specimens (median (IQR)/0.1 mm(2)) using fully automated image analysis.Results: Ex-smokers with COPD had higher CD3+, CD4+, and plasma cell numbers than current smokers =0.023 and 9.0 with COPD (149 (88-225) v 108 (61-164), p =0.036; 58 (32-90) v 40 (25-66), p = 0.023; and 9.0 (5.5-20) v 7.5 (3.1-14), p=0.044, respectively), but no difference in other inflammatory cells. Short term ex-smokers (= 3.5 years) had lower CD8+ cell numbers than short term ex-smokers (p=0.009), lower CD8/CD3 ratios than both current smokers and short-term ex-smokers (p=0.012, p=0.003; respectively), and higher plasma cell numbers than current smokers (p=0.003).Conclusions: With longer duration of smoking cessation, CD8 cell numbers decrease and plasma cell numbers increase. This indicates that bronchial T lymphocyte and plasma cell counts, but not other inflammatory cells, are related to duration of smoking cessation in patients with COPD.