Willemse B W M, ten Hacken N H T, Rutgers B, Lesman-Leegte I G A T, Timens W, Postma D S
University Hospital Groningen, Dept of Pathology, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
Eur Respir J. 2004 Sep;24(3):391-6. doi: 10.1183/09031936.04.00117603.
Smoking induces chronic obstructive pulmonary disease (COPD) and is associated with airway inflammation and airway hyperresponsiveness (AHR). It has not been studied in COPD whether direct (methacholine) and indirect (adenosine-5'-monophosphate (AMP)) stimuli are associated with airway inflammation and neither whether smoking cessation improves these features. The current authors cross-sectionally investigated the relationship of AHR to methacholine and AMP with lung function and inflammatory cells in the sputum of 33 smokers with COPD. In addition, changes in these parameters were prospectively assessed in 14 smokers who successfully quit smoking for 1 yr. The presence of AHR to both methacholine and AMP was associated with lower lung function, but not with sputum inflammation. AHR to methacholine and AMP improved significantly after a 1-yr smoking cessation, yet this was unrelated to changes in sputum cell counts. The numbers of neutrophils and epithelial cells significantly increased with smoking cessation. Both direct and indirect airway hyperresponsiveness are associated with lower lung function, but not with sputum inflammation in chronic obstructive pulmonary disease. Interestingly, 1-yr smoking cessation improved both direct and indirect airway hyperresponsiveness, yet without a significant association with changes in lung function or sputum inflammation. Thus, other factors are likely to induce these improvements, e.g. a reduction in stimulation of irritant receptors, airway wall changes or mucus hypersecretion.
吸烟会诱发慢性阻塞性肺疾病（COPD），并与气道炎症和气道高反应性（AHR）相关。在COPD患者中，尚未研究直接（乙酰甲胆碱）和间接（5'-单磷酸腺苷（AMP））刺激是否与气道炎症有关，也未研究戒烟是否能改善这些特征。本文作者对33例COPD吸烟者痰液中的AHR与乙酰甲胆碱和AMP、肺功能及炎症细胞之间的关系进行了横断面研究。此外，还对14例成功戒烟1年的吸烟者这些参数的变化进行了前瞻性评估。对乙酰甲胆碱和AMP均存在AHR与较低的肺功能相关，但与痰液炎症无关。戒烟1年后，对乙酰甲胆碱和AMP的AHR显著改善，但这与痰液细胞计数的变化无关。戒烟后中性粒细胞和上皮细胞数量显著增加。在慢性阻塞性肺疾病中，直接和间接气道高反应性均与较低的肺功能相关，但与痰液炎症无关。有趣的是，戒烟1年改善了直接和间接气道高反应性，但与肺功能或痰液炎症的变化无显著关联。因此，可能有其他因素导致这些改善，例如刺激感受器的刺激减少、气道壁变化或黏液分泌过多。
