Baena-Cagnani Carlos E, Gómez R Maximiliano, Baena-Cagnani Rodrigo, Canonica G Walter
Catholic University of Córdoba, Argentina.
Curr Opin Allergy Clin Immunol. 2009 Apr;9(2):136-40. doi: 10.1097/ACI.0b013e3283294038.
We aim to discuss current insights on the influence of active smoking and environmental tobacco smoke in lower and upper respiratory inflammatory illnesses.
Insight has been gained on the effect of tobacco smoking on the development of asthma from the womb to adolescence. Secondhand tobacco exposure and active smoking play a major role not only in the inception of asthma epidemiological community studies but also in patients already suffering from allergic rhinitis. Tobacco seems to influence innate immunity predisposing to Th2-associated respiratory diseases and increasing the risk for IgE-mediated sensitization. Tobacco smoking is related to worst outcomes in both asthma and rhinitis.
Several deleterious effects have been described in asthma because of smoking: accelerated decline in lung function, more severe symptoms, impairment in quality of life and diminished therapeutic response to steroids. The harmful effect of tobacco smoking is not only on asthma but also on rhinitis playing a role in disease outcomes. Tobacco exposure can influence innate immunity diminishing innate production of antigen-presenting cells cytokines, as well as an impaired response to toll-like receptor ligands. Active smoking is associated with current symptoms of asthma and rhinitis and seems to be a risk factor for developing new asthma in patients with rhinitis. Tobacco smoking has been also found among the factors inducing nasal obstruction and decreased muco-ciliary clearance in nonallergic rhinitis.
我们旨在探讨主动吸烟和环境烟草烟雾对上下呼吸道炎症性疾病影响的当前见解。
已了解到吸烟对从子宫内到青春期哮喘发展的影响。二手烟暴露和主动吸烟不仅在哮喘的发病中起主要作用，在流行病学社区研究中如此，在已患过敏性鼻炎的患者中也是如此。烟草似乎会影响先天免疫，使人易患与Th2相关的呼吸道疾病，并增加IgE介导的致敏风险。吸烟与哮喘和鼻炎的更差预后相关。
吸烟在哮喘中已被描述有多种有害影响：肺功能加速下降、症状更严重、生活质量受损以及对类固醇的治疗反应减弱。吸烟的有害影响不仅体现在哮喘上，对鼻炎也有影响，在疾病转归中起作用。烟草暴露可影响先天免疫，减少抗原呈递细胞细胞因子的先天产生，以及对Toll样受体配体的反应受损。主动吸烟与哮喘和鼻炎的当前症状相关，似乎是鼻炎患者发生新哮喘的危险因素。吸烟还被发现是诱导非过敏性鼻炎患者鼻阻塞和黏液纤毛清除功能下降的因素之一。
