The beneficial effect of alcohol consumption on the prevalence and extent of centrilobular emphysema. A retrospective autopsy analysis.

A collection of 204 inflation-fixed autopsy lungs was divided into three groups: normal, 93; centrilobular emphysema (CLE), 88; and "other," 23; the last includes lungs with other chronic processes. Clinical hospital records were reviewed to ascertain smoking history (no smoking, 31; smoking, 173) and alcohol use (none, 73; slight-to-moderate (Sli-Mod) drinkers, 66; heavy drinkers, 65). Lungs were subjected to morphometric determination of the extent of CLE, mucous gland hyperplasia in large airways, and goblet cell metaplasia in bronchioles. Prevalence of CLE diminished progressively as alcohol use increased. A logistic analysis showed that alcohol use was significantly associated (p less than 0.008) with reduced extent of CLE even after allowing for age and smoking effects. This apparent prophylactic effect of alcohol against CLE probably results from inhibition of inflammatory cells. It suggests that a drug with similar effects but without the deleterious side effects of alcohol might provide a meaningful degree of protection against emphysema in smokers.