Hernández-Zenteno RJ, Flores-Trujillo F, Vázquez-Cortés JJ, Espinosa de los Monteros-Sánchez C, Cosío MG

Language: English
References: 24
Page: 64-69
PDF size: 192.81 Kb.

ABSTRACT

Non-obstructed ever-smokers, with or without symptoms, have generated a great deal of information recently, but few reviews. Even individuals with normal spirometry can present changes in sputum with inflammatory biomarkers (cellular and molecular) and airways and parenchyma with remodeling; when symptomatic (cough, sputum, wheezing, and dyspnea) exacerbations are frequent affecting the individuals’ quality of life, there is an increased use of health resources: more medication, emergency visits, and hospital admissions. Non-obstructed smokers may have exercise limitations, increased lung volumes, low diffusion capacity, air entrapment, peripheral airways obstruction, elevated airways resistance, and abnormal multiple breath nitrogen washout, as well as abnormalities in computed tomography studies, such as airway wall thickening, emphysema, or interstitial lung abnormalities. Quitting smoking comprises a first, inexpensive, and often abandoned intervention to arrest respiratory impairment. It is controversial whether or not this population should be treated with other medications. Further studies should be conducted to elucidate the consequences of follow-up and prognosis in this clinical entity.

REFERENCES

1. Cosio MG, Saetta M. Evasion of COPD in smokers: at what price? Eur Respir J. 2012;39:1298-303.

2. Rodríguez-Roisin R, Han ML, Vestbo J, et al. Chronic respiratory symptoms with normal spirometry: a reliable clinical entity? Am J Respir Crit Care Med. 2017;195:17-22.

3. Cosio MG, Hale KA, Niewoehner DE. Morphologic and morphometric effects of prolonged cigarette smoking on the small airways. Am Rev Respir Dis. 1980;122:265-21.

4. Hale KA, Ewing SL, Gosnell BA, Niewoehner DE. Lung disease in long-term cigarette smokers with and without chronic air-flow obstruction. Am Rev Respir Dis. 1984;130:716-21.

5. Maestrelli P, Saetta M, Mapp CE, Fabbri LM. Remodelling in response to infection and injury. Airway inflammation and hypersecretion of mucus in smoking subjects with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001; 164:S76-80.

6. Saetta M, Turato G, Maestrelli P, Mapp CE, Fabbri LM. Cellular and structural bases of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;163:1304-9.

7. Ballarin A, Bazzan E, Hernández-Zenteno R, et al. Mast cell infiltration discriminates between histopathological phenotypes of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186:233-9.

8. Saetta M, Di Stefano A, Turato G, et al. CD8+ T-lymphocytes in peripheral airways of smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:822-6.

9. Corsico A, Milanese M, Baraldo S, et al. Airway hyperresponsiveness: from molecules to bedside selected contribution: small airway morphology and lung function in the transition from normality to chronic airway obstruction. J Appl Physiol. 2003; 95:441-7.

10. Gao J, Iwamoto H, Koskela J, et al. Characterization of sputum biomarkers for asthma–COPD overlap syndrome. Int J COPD. 2016;11:2457-65.

11. Jiménez-Ruiz CA, Sobradillo V, Gabriel R, et al. Respiratory symptoms and diagnosis of COPD in smokers of various types to tobacco. Results from the IBERPOC study. Bronconeumologia. 2002;38:530-5.

12. Rosi E, Scano G. Cigarette smoking and dyspnea perception. Tob Induc Dis. 2004;2:35-42.

13. Yunesian M, Homayoun-Vash J, Asghari F, Foruzanfar MH, Hosein-Poor AR, Farhud D. Smoking-related respiratory symptoms in Tehran: a cross-sectional study. Arch Iran Med. 2008; 11:507-14.

14. Pillai SG, Grydeland TB, Dirksen A, et al. Quantitative computed tomography measures of emphysema and airway wall thickness are related to respiratory symptoms. Am J Respir Crit Care Med. 2010;181:353-9.

15. Regan EA, Lynch DA, Curran-Everett D, et al. A clinical and radiologic disease in smoker with normal spirometry. JAMA Intern Med. 2015;175:1539-49.

16. Woodruff P, Barr RG, Bleecker E, et al. Clinical significance of symptoms in smokers with preserved pulmonary function. N Eng J Med 2016;374:1811-21.

17. Dransfield M, Kunisaki KM, Strand MJ, et al. Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Resp Crit Care Med. 2017; 195:324-30.

18. Colebatch HJ, Ng CK. Rate of increase in pulmonary distensibility in a longitudinal study of smokers. Thorax 1988;43:175-82.

19. Ben-Gary H, Sanders A, Strulovici-Barel Y, et al. Risk of COPD with obstruction in active smoker with normal spirometry and reduced diffusion capacity. Eur Respir J. 2015;46:1589-97.

20. Jetmalani K, Thamrin C, Farah CS, et al. Peripheral airway dysfunction and relationship with symptoms in smokers with preserved spirometry. Respirology. 2018;23:512-8.

21. Llontop C, Garcia-Quero C, Castro A, et al. Small airway dysfunction in smokers with stable ischemic heart disease. PLoS One. 2017;12:e0182858.

22. Berger KI, Pradhan DR, Goldring RM, Oppenheimer BW, Rom WN, Sega LN. Distal airway dysfunction identifies pulmonary inflammation in asymptomatic smokers. ERJ Open Res. 2016; 2:66-2016.

23. Grydeland TB, Dirksen A, Coxson HO, et al. Quantitative computed tomography: emphysema and airway wall thickness by sex, age and smoking. Eur Respir J. 2009;34:858-65.

24. Washko GR, Hunninghake GM, Fernandez IE, et al. Lung volumes and emphysema in smokers with interstitial lung abnormalities. N Engl J Med. 2011;364:897-906.