Transient increases in albumin and hyaluronan in bronchoalveolar lavage fluid after quitting smoking: possible signs of reparative mechanisms.

Inhalation of tobacco smoke results in an accumulation of cells in the lower respiratory tract. The inflammatory response in the alveoli and lung interstitium may also be reflected by increased bronchoalveolar lavage (BAL) fluid concentrations of extracellular matrix components. The present study investigated the influence of smoking on the BAL fluid concentrations of albumin (ALB), hyaluronan (HA) and fibronectin (FN). Lavage fluids from 18 smokers were analysed before and at 1, 3, 6, 9 and 15 months after smoking cessation. Never-smokers (n = 112) served as a reference group. The total cell concentration and the concentrations of macrophages, lymphocytes, neutrophils and eosinophils were higher (P < 0.001-0.01) in smokers' BAL fluid than in never-smokers', but the values returned to normal within 9 months of smoking cessation. The HA concentration was higher (P < 0.001) in smokers' than in never-smokers' BAL fluid, but FN and ALB did not differ. Transient increases in the concentrations of ALB and HA (P < 0.01 for both) was observed within 6 months of smoking cessation. These findings indicate a temporary heightened alveolar-capillary permeability and an increased production and/or degradation of HA, being enhanced following smoking cessation. The findings probably reflect an initiation of a reparative process.