An increase in bronchial responsiveness is associated with continuing or restarting smoking.
BACKGROUND
Bronchial responsiveness (BHR) has been found to be associated with smoking, atopy, and lower lung function in cross-sectional studies, but there is little information on determinants of change in adults.


OBJECTIVE
To analyze change in bronchial responsiveness in an international longitudinal community study.


METHODS
The study was performed in 3,993 participants in the European Community Respiratory Health Survey who had bronchial responsiveness measured in 1991-1993, when aged 20 to 44 yr, and in 1998-2002.


METHODS
Bronchial responsiveness was assessed by methacholine challenge. Serum samples were tested for total IgE, and for specific IgE to four common allergens. Smoking information was obtained from detailed administered questionnaires. Change in bronchial responsiveness was analyzed by change in IgE sensitization, smoking, and lung function, with tests of interaction terms with age and sex.


RESULTS
Continuing and restarting smokers had increasing bronchial responsiveness, approximately equivalent to a mean reduction in PD20 of 0.68 and 0.75 doubling doses, respectively, over 10 yr, in addition to a small increase explained by decline in FEV1. No other risk factor for change in bronchial responsiveness was identified.


CONCLUSIONS
Smoking is a risk factor for increasing bronchial responsiveness over and above the effect of decreasing lung function. Neither baseline IgE sensitization nor change in sensitization was shown to be a risk factor for increasing BHR, the latter possibly due to little overall increase or decrease in sensitization.
Chinn
Susan
S
Department of Public Health Sciences, King's College London, London, UK. sue.chinn@kcl.ac.uk
Jarvis
Deborah
D
Luczynska
Christina M
CM
Ackermann-Liebrich
Ursula
U
Antó
Josep M
JM
Cerveri
Isa
I
de Marco
Roberto
R
Gislason
Thorarinn
T
Heinrich
Joachim
J
Janson
Christer
C
Künzli
Nino
N
Leynaert
Bénédicte
B
Neukirch
Françoise
F
Schouten
Jan P
JP
Sunyer
Jordi
J
Svanes
Cecilie
C
Wjst
Matthias
M
Burney
Peter G
PG
D000328:Adult; D017677:Age Distribution; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D005060:Europe / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007073:Immunoglobulin E / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D015201:Meta-Analysis as Topic; D016210:Methacholine Chloride; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000276:immunology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D007073:Immunoglobulin E