Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers
Smoking induced inflammation leads to distal airway destruction. However, the relationship between distal airway dysfunction and inflammation remains unclear, particularly in smokers prior to the development of airway obstruction. Seven normal controls and 16 smokers without chronic obstructive pulm...
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European Respiratory Society
2016-11-01
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doaj-c0a537bfe73a4b7d920f83e8d0c4057c2020-11-24T21:25:18ZengEuropean Respiratory SocietyERJ Open Research2312-05412016-11-012410.1183/23120541.00066-201600066-2016Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokersKenneth I. Berger0Deepak R. Pradhan1Roberta M. Goldring2Beno W. Oppenheimer3William N. Rom4Leopoldo N. Segal5 André Cournand Pulmonary Laboratory, Bellevue Hospital Center, New York, NY, USA André Cournand Pulmonary Laboratory, Bellevue Hospital Center, New York, NY, USA André Cournand Pulmonary Laboratory, Bellevue Hospital Center, New York, NY, USA André Cournand Pulmonary Laboratory, Bellevue Hospital Center, New York, NY, USA Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, New York University School of Medicine, New York, NY, USA André Cournand Pulmonary Laboratory, Bellevue Hospital Center, New York, NY, USA Smoking induced inflammation leads to distal airway destruction. However, the relationship between distal airway dysfunction and inflammation remains unclear, particularly in smokers prior to the development of airway obstruction. Seven normal controls and 16 smokers without chronic obstructive pulmonary disease (COPD) were studied. Respiratory function was assessed using the forced oscillation technique (FOT). Abnormal FOT was defined as elevated resistance at 5 Hz (R5). Parameters reflecting distal lung function included frequency dependence of resistance (R5–20) and dynamic elastance (X5). Inflammation was quantified in concentrated bronchoalveolar lavage utilising cell count differential and cytokines expressed as concentration per mL epithelial lining fluid. All control subjects and seven smokers had normal R5. Nine smokers had elevated R5 with abnormal R5–20 and X5, indicating distal lung dysfunction. The presence of abnormal FOT was associated with two-fold higher lymphocyte and neutrophil counts (p<0.025) and with higher interleukin (IL)-8, eotaxin and fractalkine levels (p<0.01). Reactivity of R5–20 and X5 correlated with levels of IL-8, eotaxin, fractalkine, IL-12p70 and transforming growth factor-α (r>0.47, p<0.01). Distal airway dysfunction in smokers without COPD identifies the presence of distal lung inflammation that parallel reported observations in established COPD. These findings were not evident on routine pulmonary function testing and may allow the identification of smokers at risk of progression to COPD.http://openres.ersjournals.com/content/2/4/00066-2016.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kenneth I. Berger Deepak R. Pradhan Roberta M. Goldring Beno W. Oppenheimer William N. Rom Leopoldo N. Segal |
spellingShingle |
Kenneth I. Berger Deepak R. Pradhan Roberta M. Goldring Beno W. Oppenheimer William N. Rom Leopoldo N. Segal Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers ERJ Open Research |
author_facet |
Kenneth I. Berger Deepak R. Pradhan Roberta M. Goldring Beno W. Oppenheimer William N. Rom Leopoldo N. Segal |
author_sort |
Kenneth I. Berger |
title |
Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
title_short |
Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
title_full |
Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
title_fullStr |
Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
title_full_unstemmed |
Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
title_sort |
distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers |
publisher |
European Respiratory Society |
series |
ERJ Open Research |
issn |
2312-0541 |
publishDate |
2016-11-01 |
description |
Smoking induced inflammation leads to distal airway destruction. However, the relationship between distal airway dysfunction and inflammation remains unclear, particularly in smokers prior to the development of airway obstruction. Seven normal controls and 16 smokers without chronic obstructive pulmonary disease (COPD) were studied. Respiratory function was assessed using the forced oscillation technique (FOT). Abnormal FOT was defined as elevated resistance at 5 Hz (R5). Parameters reflecting distal lung function included frequency dependence of resistance (R5–20) and dynamic elastance (X5). Inflammation was quantified in concentrated bronchoalveolar lavage utilising cell count differential and cytokines expressed as concentration per mL epithelial lining fluid. All control subjects and seven smokers had normal R5. Nine smokers had elevated R5 with abnormal R5–20 and X5, indicating distal lung dysfunction. The presence of abnormal FOT was associated with two-fold higher lymphocyte and neutrophil counts (p<0.025) and with higher interleukin (IL)-8, eotaxin and fractalkine levels (p<0.01). Reactivity of R5–20 and X5 correlated with levels of IL-8, eotaxin, fractalkine, IL-12p70 and transforming growth factor-α (r>0.47, p<0.01). Distal airway dysfunction in smokers without COPD identifies the presence of distal lung inflammation that parallel reported observations in established COPD. These findings were not evident on routine pulmonary function testing and may allow the identification of smokers at risk of progression to COPD. |
url |
http://openres.ersjournals.com/content/2/4/00066-2016.full |
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