0
Original Research: COPD |

Airway Blood Flow Reactivity in Healthy Smokers and in Ex-Smokers With or Without COPD*

Eliana S. Mendes, MD; Michael A. Campos, MD; Adam Wanner, MD
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Miami School of Medicine, Miami, FL.

Correspondence to: Eliana Mendes, MD, Division of Pulmonary and Critical Care Medicine, University of Miami School of Medicine, 1600 NW 10th Ave, 7064-A, Miami, FL 33136; e-mail: emendes@med.miami.edu



Chest. 2006;129(4):893-898. doi:10.1378/chest.129.4.893
Text Size: A A A
Published online

Study objectives: Cigarette smoking has been associated with impaired endothelium-dependent relaxation responses in the brachial and coronary arteries (endothelial dysfunction). The aim of the present study was to determine whether the airway circulation is also affected and whether pharmacologic treatment has an effect on endothelial function in patients with COPD.

Methods and patients: Airway blood flow (Q̇aw) responses to therapy with inhaled albuterol, which causes endothelium-dependent vasodilation, were measured with a noninvasive soluble-gas-uptake technique in age-matched healthy current smokers (n = 10), healthy ex-smokers (n = 10), ex-smokers with COPD (n = 10), and healthy lifetime nonsmokers. In the ex-smokers with COPD, the albuterol responsiveness measurement was repeated after 4 weeks of treatment with fluticasone/salmeterol and after a drug washout period of 4 or 8 weeks.

Results: The mean (± SE) baseline Q̇aw values ranged between 40.7 ± 3.9 and 50.9 ± 2.8 μL/min/mL anatomic dead space in the four groups (differences were not significant). The mean FEV1 was 53.4 ± 2.3% predicted in the ex-smokers with COPD. Albuterol inhalation increased mean Q̇aw significantly in lifetime nonsmokers (50.1 ± 8.3% predicted; p < 0.05) and healthy ex-smokers (37.2 ± 3.4% predicted; p < 0.05), but not in healthy current smokers (13.9 ± 3.2% predicted; difference was not significant) and ex-smokers with COPD (9.7 ± 4.5% predicted; difference was not significant). While fluticasone/salmeterol did not change Q̇aw significantly, it restored albuterol responsiveness (67.6 ± 11.1% predicted; p < 0.05) in the ex-smokers with COPD; this effect was no longer seen after the drug washout period.

Conclusions: Cigarette smoking is associated with a blunted vasodilator response to inhaled albuterol in the airway as an expression of endothelial dysfunction, with a partial recovery of albuterol responsiveness after smoking cessation in healthy ex-smokers but not in ex-smokers with COPD. In the latter group, combined glucocorticoid/long-acting β2-adrenergic agonist treatment restores albuterol responsiveness. The role of endothelial dysfunction in the physiopathology of COPD remains to be examined.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543