The impact of smoking on clinical and therapeutic effects in asthmatics.
Smoking is associated with poor symptom control and impaired therapeutic responses in asthma. A total of 843 patients with asthma were recruited. The patients received treatment for 1 yr according to the severity of their asthma. We compared the forced expiratory volume in 1 sec (FEV1), the ratio of FEV1 to forced vital capaity (FVC), atopy, total IgE, emphysema on high-resolution computed tomography (HRCT), the number of near-fatal asthma attacks, and physiological fixed airway obstruction between the smoking and nonsmoking groups. The study population consisted of 159 (18.8%) current smokers, 157 (18.7%) ex-smokers, and 525 (62.5%) nonsmokers. Although the prevalence of atopy was not different between the smoking and nonsmoking groups, the total IgE was higher among the smokers than the nonsmokers. Compared with the nonsmoking group, the smokers had a lower FEV1 % predicted and forced expiratory flow between 25 and 75% of FVC. A greater prevalence of emphysema and a significantly higher number of asthmatic patients with fixed airway obstruction were detected in the smoking versus nonsmoking group. The 37.5% of asthmatic patients who were former or current smokers showed decreased pulmonary function and increased IgE, emphysema on HRCT, and fixed airway obstruction, indicating that smoking can modulate the clinical and therapeutic responses in asthma.
Jang
An-Soo
AS
Asthma and Allergy Research Group, Division of Allergy and Respiratory Diseases, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
Park
Jong-Sook
JS
Lee
June-Hyuk
JH
Park
Sung-Woo
SW
Kim
Do-Jin
DJ
Uh
Soo-Taek
ST
Kim
Young-Hoon
YH
Park
Choon-Sik
CS
D000402:Airway Obstruction / Q000209:etiology; D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000209:etiology; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000209:etiology; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D007073:Immunoglobulin E