Abstract
BackgroundExposure to noxious gases and particles contained in both tobacco smoking (TS) and biomass smoke (BS) are well recognized environmental risk factors for chronic obstructive pulmonary disease (COPD). COPD is characterized by an abnormal inflammatory response, both in the pulmonary and systemic compartments. The differential effects of TS, BS or their combined exposure have not been well characterized yet. This study sought to compare the lung function characteristics and systemic inflammatory response in COPD patients exposed to TS, BS or their combination.MethodsSociodemographic, clinical and lung functional parameters were compared across 49 COPD patients with a history of smoking and no BS exposure (TS COPD), 31 never-smoker COPD patients with BS exposure (BS COPD), 46 COPD patients with a combined exposure (TS + BS COPD) and 52 healthy controls (HC) who have never been exposed neither to TS or BS. Blood cell counts, C-reactive protein (CRP), fibrinogen and immunoglobulin E (IgE) levels were quantified in all four groups.ResultsTS + BS COPD patients exhibited significantly lower oxygen saturation than the rest of groups (p < 0.01). Spirometry and diffusing capacity were significantly higher in BS than in TS or TS + BS patients. CRP levels were significantly higher in TS COPD patients than in BS COPD group (p < 0.05), whereas fibrinogen was raised in COPD patients with a history of smoking (TS and TS + BS) when compared to control subjects (p < 0.01). Finally, COPD patients with BS exposure (BS and BS + TS groups) showed higher IgE levels than TS and HC (p < 0.05).ConclusionsThere are significant physiological and inflammatory differences between COPD patients with TS, BS and TS + BS exposures. The latter had worse blood oxygenation, whereas the raised levels of IgE in BS exposed patients suggests a differential Th2 systemic inflammatory pattern triggered by this pollutant.
Highlights
Exposure to noxious gases and particles contained in both tobacco smoking (TS) and biomass smoke (BS) are well recognized environmental risk factors for chronic obstructive pulmonary disease (COPD)
With data from the PREPOCOL study [12], Torres-Duque et al [13] compared some demographical and functional parameters among 114 COPD patients exposed to wood smoke, 81 COPD patients exposed to TS and 264 COPD patients exposed to both types of smoke, reporting significant decreases in forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) values in patients with a combined exposure [13]
TS and BS exposures were similar in TS COPD and TS + BS COPD and BS COPD and TS + BS COPD, respectively
Summary
Exposure to noxious gases and particles contained in both tobacco smoking (TS) and biomass smoke (BS) are well recognized environmental risk factors for chronic obstructive pulmonary disease (COPD). Given the toxicity of both kinds of smoke, a higher severity of pulmonary damage could be expected in double-exposed subjects Following this line of thought, Dogan et al [11] compared lung histopathological alterations among rats exposed exclusively to TS, those exclusively exposed to BS and a group with combined exposure to TS and BS. With data from the PREPOCOL study [12], Torres-Duque et al [13] compared some demographical and functional parameters among 114 COPD patients exposed to wood smoke, 81 COPD patients exposed to TS and 264 COPD patients exposed to both types of smoke, reporting significant decreases in FEV1 and FEV1/FVC values in patients with a combined exposure [13]. The authors suggested that a combined exposure to TS and BS could have a noxious additive effect in COPD patients and could increase the frequency of COPD symptoms
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