Symptomatology, pulmonary function and response, and T lymphocyte beta 2-receptors during smoking cessation in patients with chronic obstructive pulmonary disease.
OBJECTIVE
To characterize the effect of smoking cessation and nicotine replacement on pulmonary symptomatology, baseline pulmonary function and response to terbutaline, and purified T lymphocyte beta 2-receptor regulation; and the relationship between T lymphocyte beta 2-receptor density and pulmonary function.


METHODS
Open-label, longitudinal, 28-week study.


METHODS
A university clinical research center.


METHODS
Eighteen long-term smokers with mild to moderate chronic obstructive pulmonary disease (COPD) were enrolled and seven completed the study.


METHODS
Subjects stopped smoking with the aid of nicotine substitution and behavioral counseling. Pulmonary response (FEV1) to subcutaneous terbutaline and T lymphocyte beta 2-receptor density (Bmax) and function (cAMP) were measured prior to smoking cessation (week 0), during nicotine replacement (week 8), and after nicotine cessation (week 28).


RESULTS
Serum cotinine concentrations, plasma epinephrine concentrations, and day and night cough decreased significantly after smoking cessation, whereas basal cAMP concentrations increased (p < 0.05). No significant change was seen in baseline FEV1, pulmonary response to terbutaline, or Bmax over the 28 weeks; however, intrasubject changes in Bmax between visits correlated significantly (p < 0.05) with intrasubject changes in pulmonary response between visits.


CONCLUSIONS
Our data indicate that smoking cessation is associated with a significant decrease in the symptomatology of COPD, and that change in T lymphocyte beta 2-receptor density is a good marker of change in pulmonary response to beta 2-agonists.
Leader
W G
WG
College of Pharmacy, University of Kentucky Medical Center, Lexington 40536-0084.
Wolf
K M
KM
Cooper
T M
TM
Chandler
M H
MH
D000328:Adult; D000368:Aged; D003367:Cotinine / Q000097:blood; D000242:Cyclic AMP / Q000097:blood; D004837:Epinephrine / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008173:Lung Diseases, Obstructive / Q000503:physiopathology*; D008875:Middle Aged; D009538:Nicotine / Q000494:pharmacology*; D011943:Receptors, Adrenergic, beta / Q000187:drug effects*; D012129:Respiratory Function Tests; D016540:Smoking Cessation; D013601:T-Lymphocytes / Q000187:drug effects*; D013726:Terbutaline / Q000494:pharmacology; D013997:Time Factors
D011943:Receptors, Adrenergic, beta; D009538:Nicotine; D000242:Cyclic AMP; D003367:Cotinine; D013726:Terbutaline; D004837:Epinephrine