Gómez René Maximiliano, Croce Víctor Hugo, Zernotti Mario Emilio, Muiño Juan Carlos
Fundación Ayre, Instituto Médico Alas, Salta, Argentina.
Pediatric Allergy Dept., Instituto Modelo Cardiología, Córdoba, Argentina.
World Allergy Organ J. 2021 Jan 17;14(2):100504. doi: 10.1016/j.waojou.2020.100504. eCollection 2021 Feb.
Tobacco smoke has been described as causing increased prevalence of rhinitis symptoms and decreased atopy. Furthermore, these nasal symptoms and quality of life in smokers with Allergic Rhinitis (AR) were not significantly different to non-smokers. As a result of this duality, a comparison study between the quality of life and inflammatory markers of atopy among active smokers and non-smokers having AR was put forward.
Cross-sectional study in adult smokers and non-smokers, with a clinical diagnosis of AR and positive Skin Prick Test (SPT). Smoking status was confirmed by salivary cotinine measurements. Functional respiratory evaluation was performed, and quality of life between groups was compared using Mini-RQLQ questionnaire. Immunological markers in serum and nasal washes (IgE, IL-4, IL 5, IL 13, IL 17, IL 33) were evaluated, while samples from a third group of passive smokers was incorporated for serological comparison exclusively. The statistical analysis included Student T test, x2, Mann Whitney U (Anova 2-way), and Kruskal Wallis for 3 groups analysis. Values of P < 0.05 were considered significant.
Twenty-two patients per group with similar demographics and allergen sensitivity were studied. Regarding inflammatory markers, a reduction of IL 33 in the serum of smokers (P < 0.001) was the only statistically significant different parameter revealed, showing a remarkable trend in nasal lavage. Salivary cotinine levels were absolutely different (P < 0.0001), but pulmonary function evaluations were not statistically significant after multiple adjusting. There were no significant differences in quality of life parameters.
In our study of AR, active smokers do not demonstrate impaired nasal related quality of life or impact on atopic inflammatory parameters, compared to non-smokers. Reduced levels of IL33 could explain a lack of symptoms alerting smokers of the harmful consequences of smoking.
烟草烟雾被认为会导致鼻炎症状患病率增加和特应性降低。此外，患有变应性鼻炎（AR）的吸烟者的这些鼻部症状和生活质量与非吸烟者并无显著差异。由于这种双重性，提出了一项关于患有AR的现吸烟者和非吸烟者的生活质量与特应性炎症标志物之间的比较研究。
对成年吸烟者和非吸烟者进行横断面研究，临床诊断为AR且皮肤点刺试验（SPT）呈阳性。通过唾液可替宁测量确认吸烟状态。进行功能性呼吸评估，并使用Mini-RQLQ问卷比较各组之间的生活质量。评估血清和鼻腔灌洗液中的免疫标志物（IgE、IL-4、IL-5、IL-13、IL-17、IL-33），同时纳入第三组被动吸烟者的样本仅用于血清学比较。统计分析包括学生t检验、x²检验、曼-惠特尼U检验（双向方差分析）以及用于三组分析的克鲁斯卡尔-沃利斯检验。P值<0.05被认为具有统计学意义。
每组研究22例具有相似人口统计学特征和过敏原敏感性的患者。关于炎症标志物，吸烟者血清中IL-33的降低（P<0.001）是唯一显示出统计学显著差异的参数，在鼻腔灌洗中也呈现出明显趋势。唾液可替宁水平绝对不同（P<0.0001），但在多次调整后肺功能评估无统计学意义。生活质量参数无显著差异。
在我们对AR的研究中，与非吸烟者相比，现吸烟者未表现出与鼻腔相关的生活质量受损或对特应性炎症参数的影响。IL33水平降低可能解释了缺乏提醒吸烟者吸烟有害后果的症状。
