Persistent Airway Inflammation and Emphysema Progression on CT Scan in Ex-Smokers Observed for 4 Years
Persistent Airway Inflammation and Emphysema Progression on CT Scan in Ex-Smokers Observed for 4 Years
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DOI：
10.1378/chest.10-0705
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发表时间：
2011-06-01
期刊：
影响因子：
9.6
通讯作者：
Broide, David H.
中科院分区：
文献类型：
--
作者：
Miller, Marina;Cho, Jae Youn;Broide, David H.
背景：吸烟是慢性阻塞性肺疾病-肺气肿(COPD-E)的主要原因。戒烟至少4年是否能阻止既往吸烟者的呼吸道炎症和COPD-E的进展尚不清楚。在这项研究中，我们调查了患有GOLD(全球慢性肺病倡议)阶段LIB(中度)COPD-E的戒烟约4年是否阻止了呼吸道炎症(即痰生物标记物)并阻止了胸部CT扫描的COPD-E的进展。方法：10名戒烟的COPD-E前吸烟者接受胸部CT扫描，以记录COPD-E的程度，评估肺功能(FEV和肺一氧化碳弥散能力)，诱导痰中炎症的生物标志物(用酶联免疫吸附试验测量)，以及在基线和大约4年后的血液Cotinine水平。结果：戒烟约4年后，COPD-E患者痰中炎症介质(髓过氧化物酶、白三烯B4、IL-8、单核细胞趋化蛋白-1、基质金属蛋白酶-9)水平持续升高，结论：重度吸烟者中重度OPD-E患者的戒烟行为与4年后COPD-E的持续气道炎症和CT上COPD-E的进展有关。戒烟可能会减缓中度COPD-E的进展速度，但它不能阻止持续的呼吸道炎症和CT扫描显示的COPD-E的显著进展。2011年；139(6)：1380-1387
Background: Tobacco smoking is a principal cause of COPD-emphysema (COPD-E). Whether discontinuing smoking for at least 4 years halts airway inflammation and progression of COPD-E in prior smokers is unknown. In this study we investigated whether discontinuing smoking for approximately 4 years in ex-smokers with GOLD (Global Initiative for Chronic Lung Disease) stage lib (moderately severe) COPD-E stopped airway inflammation (ie, sputum biomarkers) and halted the progression of COPD-E on chest CT scan.Methods: Ten ex-smokers with COPD-E who had quit smoking underwent chest CT scans to document the extent of COPD-E, assessment of lung function (FEV, and diffusing capacity of lung for carbon monoxide), sputum induction for biomarkers of inflammation (measured by enzyme-linked immunosorbent assay), and blood cotinine levels at baseline and approximately 4 years later. Normal healthy subjects (n = 7) and normal current smokers with no CT scan evidence of COPD-E (n =8) served as sputum biomarker comparison groups.Results: After approximately 4 years of not smoking (documented by cotinine levels), ex-smokers with COPD-E had persistent increased levels of mediators of inflammation in sputum (myeloperoxidase, leukotriene B4, IL-8, monocyte chemoattractant protein-1, matrix metalloprotease-9), which was associated with significant progression of COPD-E on chest CT scan.Conclusions: Cessation of tobacco smoking in heavy smokers with moderately severe OPD-E is associated with evidence of persistent airway inflammation and progression of COPD-E on CT scan 4 years later. Discontinuing smoking may slow the rate of progression of moderate severity COPD-E, but it does not prevent persistent airway inflammation and significant progression of COPD-E on CT scan. CHEST 2011; 139(6):1380-1387