title: Acute inhalation of cigarette smoke increases lower respiratory tract nitric oxide concentrations.
abstract: BACKGROUND
  Cigarette smoking is associated with a number of common pulmonary diseases including chronic airflow limitation and bronchial carcinoma. Lower respiratory tract (LRT) nitric oxide (NO) concentrations are reduced in habitual cigarette smokers between cigarettes, and although this finding has been implicated in the pathogenesis of smoking related disease, the underlying mechanisms are unclear. A study was undertaken to determine the nature and time course for changes in LRT NO concentrations following acute inhalation of cigarette smoke.
  
  
  METHODS
  Twenty four healthy habitual smokers were studied. The concentration of LRT NO in exhaled breath before, one and ten minutes after smoking a single cigarette was measured using chemiluminescence.
  
  
  RESULTS
  LRT NO concentrations increased in all subjects from a mean (SE) of 2.6 (0.27) to 4.8 (0.26) ppb (p < 0.0001) at one minute, and at 10 minutes remained significantly raised above the baseline level at 3.2 (0.25) ppb (p = 0.003). The mean (95% CI) increases in NO concentrations were 2.2 (1.7 to 2.7) and 0.6 (0.2 to 1.0) ppb, respectively.
  
  
  CONCLUSIONS
  These findings were unexpected in both their direction and time course. They suggest a novel mechanism for the handling of NO in the human lung. We hypothesise that NO is trapped in the epithelial lining fluid (ELF) of the normal human respiratory tract in bioequivalent forms such as S-nitrosothiols or peroxynitrite and that this trapping mechanism is sensitive to the redox state of the ELF. LRT NO concentrations will thus increase with oxidant exposure and decline as pulmonary antioxidant defence mechanisms take effect. These findings may have implications for the pathogenesis and diagnosis of oxidant mediated pulmonary disease.
authors.affiliation: Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: Chambers
authors.forename: W S
authors.initials: WS
authors.lastname: Tunnicliffe
authors.forename: J G
authors.initials: JG
authors.lastname: Ayres
mesh_terms: D000328:Adult; D001944:Breath Tests; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism*; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D009569:Nitric Oxide