Influence Of Cigarette Smoking On Inhaled Corticosteroid Treatment In Asthma

Study objective:In this study,We investigate the impact of cigarette smoking on airway inflammation and the effect on responses to treatment with inhaled corticosteroids(ICS)in patients with asthma.Methods:Thirty-five chronic and stable asthmatic patients were classified according to smoking or not as smokers group or non-smokers group.All patients were treated with ICS,only with inhaled bronchodilators as required,and given a asthmatic diary card and a peak flow meter.Thirty-five patients were visted across 28 days treatment.We recorded the period morning and evening peak expiratory flow(PEF)readings and(1)asthma symptom score and ACT score. (2)Forced expiratory volume in 1 second percent(FEV₁%)predicted,forced expiratory volume in 1 second percent forced vital capacity(FEV₁/FVC%)and PEF%predicted.(3)Induced sputum eosinophil and neutrophil proportion,and examined the levels of interleukin(IL-8)and eotaxin in induced-sputum by enzymatic immunoassay(ELISE).Results:(1)Comparison was made in basieline between smoking and non-smoking asthmatic patients before treatment:there were no significant differences except sexual struction.(2)Comparison was made in clinical effects across 28 days treatment:ACT score(F=39.991 P＜0.05)and asthma symptom score(F=14.418 P＜0.05)of two groups were a better changes across 28 days treatment.ACT score of non-smokers group increase from (14.91±2.35)to(21.77±1.96),smokers group increase from(14.72±2.41)to(17.83±3.42), non-smokers group was a better change than smokers group.There were significant differences across 28 days treatment between two groups(F=14.760 P＜0.05).(3)Comparison was made in lung function across 28 days treatment:lung function of two groups were increased across ICS treatment,FEV₁%(F=56.075 P＜0.05),PEF%(F=53.535 P＜0.05),FEV₁/FVC%(F=11.767 P＜0.05);Non-smokers group was a better changes than smokers group.There were significant differences in FEV₁%(F=25.633,P＜0.05),PEF%(F=20.809 P＜0.05)across 28 days treatment between two groups.(4)Induced sputum eosinophil and neutrophil proportion,IL-8 and eotaxin:eosinophil proportion(F=15.271 P＜0.05)and eotaxin(F=24.172 P＜0.05)of two groups were increased across 28 days treatment;non-smokers group was significant decrease than smokers group. Neutrophil proportion(F=9.632 P＜0.05)and IL-8(F=5.720 P＜0.05)of smokers group were higher than non-smokers;and eosinophil proportion(F=15.879 P＜0.05)and eotaxin(F=12.365 P＜0.05)of smokers group were lower than non-smokers group.Conclusion:(1)There was a significantly greater change in clinical effects,lung function,morning and evening PEF,inflammation media in induced-sputum in two groups,but the effect of smokers than non-smokers was lower.(2)Neutrophil proportion and IL-8 of smokers were higher in induced sputum,and eosinophil proportion and eotaxin were higher in non-smokers...