Cigarette smoking and pathophysiology of asthma and pulmonary emphysema

The influence of long-term cigarette smoking on the pathophysiology of chronic respiratory diseases with obstructive ventilatory dysfunction was discussed in patients with asthma and pulmonary emphysema (PE). 1. In patients with asthma, significant differences in the pathophysiology of the disease were observed between smokers and nonsmokers. A positive RAST score against inhalant allergens, bronchial hyperresponsiveness, and LTB4 generation by leucocytes were significantly more increased in smokers than in nonsmokers. The values of FEV1/FVC and OLco were significantly more decreased, and % RV was significantly more increased in smokers than in nonsmokers. 2. In comparison of asthma with PE, IgE-mediated allergy was significantly more increased in smokers with asthma than in nonsmokers with asthma and in smokers with PE. The values of % FEV1, FEVl %, and % OLco were significantly higher in nonsmokers with asthma than in smokers with PE, however, the % OLco and % RV were not significantly different between smokers with asthma and those with PE. The % LAA of the lungs on HRCT was larger in patients with PE than in smokers and nonsmokers with asthma. The results suggest that cigarette smoking influences the pathophysiology of asthma and PE.

長期間喫煙による気管支喘息および肺気腫の病態的変化について若干の検討を加えた｡1.気管支嘱喘息に関しては,喫煙例と非喫煙例との間に以下のような病態的特徴に差が見られた｡吸入抗原に対する特異的IgE抗体の陽性率,気道過敏性,白血球のI:TB4産生能はいずれも,喫煙例で非喫煙例に比べ有意の亢進を示した｡また,喫煙例では,非喫煙例に比べ,FEV1%や% DLcoは有意の低下,% RVは有意の増加傾向を示した｡2.喘息と肺気腫の比較では,IgEにmediateされるア レルギー反応は,喘息の非喫煙例や肺気腫(全て喫煙例)に比べ,喘息の喫煙例で有意の亢進が見られた｡% FEVl,FEV1,% DLco値はいずれも喘息の非喫煙例で,肺気腫と比べ有意に高い値を示したが,% DLcoと% RV値には,喘息の喫煙例と肺気腫の間に有意の差は見られなかった｡また,肺のHRCT上の% I.AAは,肺気腫において,喘息の喫煙例,非喫煙例いずれよりも有意に高い値を示した｡以上の結果より,長期間の喫煙が喘息や肺気腫の病態に影響を与えることが示された｡