title: Young "healthy" smokers have functional and inflammatory changes in the nasal and the lower airways.
abstract: BACKGROUND
  Smoking is responsible for most COPD. Although people with COPD often have concomitant nasal disease, there are few studies that report physiologic or inflammatory changes in the upper airways in young asymptomatic smokers. We investigated physiologic and inflammatory changes in the nasal and lower airways of young smokers and if these changes were related to smoking history.
  
  
  METHODS
  Seventy-two subjects aged between 18 and 35 years (32 healthy nonsmokers and 40 young smokers) participated in this study. We measured nasal mucociliary clearance (MCC), nasal mucus surface contact angle, cell counts, myeloperoxidase and cytokine concentrations in nasal lavage fluid, exhaled breath condensate (EBC) pH, and lung function.
  
  
  RESULTS
  Smokers had faster MCC, an increased number of cells (macrophages, ciliated cells, and goblet cells), increased lavage myeloperoxidase concentration, and decreased EBC pH compared with nonsmokers. There was a significant inverse relationship between pack-year smoking history and EBC pH. There were no differences in lung function or mucus surface properties comparing smokers to nonsmokers.
  
  
  CONCLUSIONS
  Young adult smokers have functional and inflammatory changes in the nasal and lower airways and these correlate with smoking history. However, in these young smokers, smoking history was not associated with pulmonary function decline, probably because it is unlikely that spirometry detects early physiologic changes in the airways.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01877291; URL: www.clinicaltrials.gov.
authors.affiliation: Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Marina Lazzari
authors.initials: ML
authors.lastname: Nicola
authors.affiliation: Department of Preventive Medicine, Faculty of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Heráclito Barbosa de
authors.initials: HB
authors.lastname: Carvalho
authors.affiliation: Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Carolina Tieko
authors.initials: CT
authors.lastname: Yoshida
authors.affiliation: Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Fabyana Maria Dos
authors.initials: FMD
authors.lastname: Anjos
authors.affiliation: Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nakao
authors.affiliation: Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Ubiratan de Paula
authors.initials: UP
authors.lastname: Santos
authors.affiliation: Fleury Medicine and Health Institute, São Paulo, Brazil.
authors.forename: Karina Helena Morais
authors.initials: KHM
authors.lastname: Cardozo
authors.affiliation: Fleury Medicine and Health Institute, São Paulo, Brazil.
authors.forename: Valdemir Melechco
authors.initials: VM
authors.lastname: Carvalho
authors.affiliation: Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Ernani
authors.initials: E
authors.lastname: Pinto
authors.affiliation: Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Sandra Helena Poliselli
authors.initials: SHP
authors.lastname: Farsky
authors.affiliation: Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Paulo Hilario Nascimento
authors.initials: PHN
authors.lastname: Saldiva
authors.affiliation: Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Rubin
authors.affiliation: Department of Pathology, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: naomi.kondo@usp.br.
authors.forename: Naomi Kondo
authors.initials: NK
authors.lastname: Nakagawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000388:Air / Q000032:analysis; D001944:Breath Tests; D002452:Cell Count; D045853:Exhalation; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D009079:Mucociliary Clearance / Q000502:physiology*; D017817:Nasal Lavage Fluid / Q000737:chemistry / Q000166:cytology; D009297:Nasal Mucosa / Q000378:metabolism*; D009195:Peroxidase / Q000378:metabolism*; D020545:Respiratory Mucosa / Q000378:metabolism*; D012907:Smoking / Q000009:adverse effects / Q000378:metabolism* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D009195:Peroxidase