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Original Research: COPD |

Young “Healthy” Smokers Have Functional and Inflammatory Changes in the Nasal and the Lower AirwaysAirway Dysfunction in Young Smokers

Marina Lazzari Nicola, BSc; Heráclito Barbosa de Carvalho, MD, PhD; Carolina Tieko Yoshida, BSc; Fabyana Maria dos Anjos, PhD; Mayumi Nakao, MD; Ubiratan de Paula Santos, MD, PhD; Karina Helena Morais Cardozo, PhD; Valdemir Melechco Carvalho, MD, PhD; Ernani Pinto, PhD; Sandra Helena Poliselli Farsky, PhD; Paulo Hilario Nascimento Saldiva, MD, PhD; Bruce K. Rubin, MD, MEngr, MBA; Naomi Kondo Nakagawa, PhD
Author and Funding Information

From the Department of Pathology (Mss Nicola and Yoshida and Drs Nakao, Saldiva, and Nakagawa), and Department of Physiotherapy (Mss Nicola and Yoshida and Dr Nakagawa), Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Preventive Medicine (Dr H. B. Carvalho), and Department of Clinical and Toxicological Analysis (Drs Anjos, Pinto, and Farsky), Faculty of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil; Pulmonary Division (Dr Santos), Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Fleury Medicine and Health Institute (Drs Cardozo and V. M. Carvalho), São Paulo, Brazil; and the Department of Pediatrics (Dr Rubin), Virginia Commonwealth University School of Medicine, Richmond, VA.

Correspondence to: Naomi Kondo Nakagawa, PhD, Faculdade de Medicina da Universidade de São Paulo, 455 Av. Dr. Arnaldo, room 1150, Cerqueira Cesar, São Paulo, Brazil, CEP 01246-903; e-mail: naomi.kondo@usp.br


Funding/Support: This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo [FAPESP 13/13598-1 and 13/11401-6].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(5):998-1005. doi:10.1378/chest.13-1355
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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.

Trial registry:  ClinicalTrials.gov; No.: NCT01877291; URL: www.clinicaltrials.gov

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