Nasal Mucociliary Clearance in Subjects With COPD After Smoking Cessation.
BACKGROUND
Exposure to cigarette smoke causes significant impairment in mucociliary clearance (MCC), which predisposes patients to secretion retention and recurrent airway infections that play a role in exacerbations of COPD. To determine whether smoking cessation may influence MCC and frequency of exacerbations, the following groups were evaluated: ex-smokers with COPD, smokers with COPD, current smokers with normal lung function, and nonsmokers with normal lung function.


METHODS
Ninety-three subjects were divided into 4 groups: ex-smokers with COPD (n = 23, 62.4 ± 8.0 y, 13 males), smokers with COPD (n = 17, 58.2 ± 8.0 y, 6 males), current smokers (n = 27, 61.5 ± 6.4 y, 17 males), and nonsmokers (n = 26, 60.8 ± 11.3 y, 7 males). MCC was evaluated using the saccharin transit time (STT) test, and the frequency of exacerbations in the last year was assessed by questionnaire. The Kruskal-Wallis test followed by Dunn's test were used to compare STT among groups, and the Goodman test was used to compare the frequency of exacerbations.


RESULTS
STT of smokers with COPD (16.5 [11-28] min; median [interquartile range 25-75%]) and current smokers (15.9 [10-27] min) was longer compared with ex-smokers with COPD (9.7 [6-12] min) and nonsmokers (8 [6-16] min) (P < .001). There was no difference in STT values between smokers with COPD and current smokers, and these values in ex-smokers with COPD were similar to the control group (P > .05). The frequency of exacerbations was lower in ex-smokers with COPD compared with smokers with COPD.


CONCLUSIONS
One year after smoking cessation, subjects with COPD had improved mucociliary clearance.
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente.
Juliana T
JT
Ito
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente.
Dionei
D
Ramos
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente.
Fabiano F
FF
Lima
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente.
Fernanda M M
FM
Rodrigues
Clinic of Medical Specialties, a partner of UNESP, Clinical Center, Presidente Prudente.
Paulo R
PR
Gomes
Department of Medicine in Pneumology, Federal University of São Paulo/Paulista School of Medicine, São Paulo.
Graciane L
GL
Moreira
Department of Pathology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.
Mariangela
M
Macchione
Department of Pathology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.
Alessandra C
AC
Toledo
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente ercy@fct.unesp.br.
Ercy M C
EM
Ramos
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000502:physiology*; D009297:Nasal Mucosa / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism* / Q000503:physiopathology / Q000534:rehabilitation; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D013997:Time Factors
chronic obstructive pulmonary disease; disease exacerbation; mucociliary clearance; respiratory infections; smoking; smoking cessation