Smoking Affects Therapeutic Response to Inhaled Corticosteroid in Patients with Asthma_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Li ¹ , DU Yongcheng ² , XU Jianying ² , YANG lili. ²

Datong School of Medicine, Shanxi Datong University.Datong, Shanxi,037009, ChinaCorresponding Author: ZHANG Li, E-mail: zhangli_yhw@ sohu. com;

Corresponding author：

Keywords：

Asthma; Smoking; Inhaled corticosteroid; Lung function

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To determine if the therapeutic response to an inhaled corticosteroid is attenuated in individuals with asthma who smoke.Methods 38 outpatients with chronic stable asthma who visited during March 2008 and January 2009 were enrolled in the study. 23 cases were nonsmokers and 15 cases were smokers. All of them were treated by daily inhaled budesonide, and β2 agonist when necessary.They were required to record symptoms and peak expiratory flow every day on an asthmatic diary card. The
patients were followed 28 days. ACT score, asthma-symptom score, Asthma Control Test ( ACT) score,pulmonary function, and peak expiratory flow were compared between the non-smoking and the smoking asthmatic patients. Results All of the patients had statistically significant increases in ACT score, mean morning and night PEF, mean forced expiratory volume in 1 second, and a significant decrease in asthmasymptom score after budesonide treatment compared with before. There were significantly greater changes in
any of these parameters in the non-smokers than in the smokers. Conclusions Active cigarette smoking impairs the efficacy of short term inhaled corticosteroid treatment in asthma. This finding has important implications for the management of patients with asthma who smoke.

Citation： ZHANG Li,DU Yongcheng,XU Jianying,YANG lili.. Smoking Affects Therapeutic Response to Inhaled Corticosteroid in Patients with Asthma. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(4): 365-368. doi: Copy

1.	Precht DH, Keiding L, Madsen M. Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study. Pediatrics, 2003, 111 : e562-e568 .
2.	Chalmers GW, MacLeod KJ, Thomson L, et al. Smoking and airway inflammation in patients with mild asthma. Chest, 2001, 120: 1971 -1922.
3.	中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南. 中华结核和呼吸杂志, 2008, 31: 177-185 .
4.	何权瀛, 高莹慧. 关于吸烟问题若干名词定义. 中华结核和呼吸杂志, 2009 , 32: 26.
5.	王曾礼, 冯玉麟, 主编. 呼吸病诊疗手册. 北京: 人民卫生出版社, 2000, 101-102.
6.	Piccillo G, Caponnetto P, Barton S, et al. Changes in airway hyperresponsiveness following smoking cessation: comparisons between Mch and AMP. Respir Med, 2008, 102 : 2561 -2565 .
7.	Polose R, Knoke JD, Russo C, et al. Cigarette smoking is associated with a greater risk of incident asthma in allergic rhinitis. J Allergy Clin lmmunol, 2008, 121: 1428 -1434 .
8.	Chaudhuri R, Livingston E, McMahon AD, et al. Cigarette smoking impairs the therapeutic response to oral corticosteroids in chronic asthma. Am J Respir Crit Care Med, 2003, 168 : 1308 -1311 .
9.	Churg A, Dai J, Tai H, et al. Tumor necrosis facter-α is central to acute cigarette smoke-induced inflammation and connective tissue breakdown. Am J Respir Crit Care Med, 2002, 166: 849-854.
10.	Webster JC, Oakley RH, Jewell CM, et al. Pro-inflammation cytokines regulate human glucocorticoid receptor gene expression and lead to the accumulation of the dominant negative bisoform: a mechanism for the generation of glucocorticoid resistance. Proc Natl Acad Sci USA, 2001, 98: 6865-6870.
11.	Ito K, Caramori G, Lim S, et al. Expression and activity of histone deacetylases in human asthmatic airways. Am J Respir Crit Care Med, 2002, 166: 392-396.
12.	Maestrelli P, Saetta M, Mapp CE, et al. Remodeling in response to infection and injury. Airway inflammation and hypersecretion of mucus in smoking subjects with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2001, 164: S76-S80.
13.	Chalmers GW, MacLeod KJ, Little SA, et al. Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax,2002, 57: 226-230 .

1. Precht DH, Keiding L, Madsen M. Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study. Pediatrics, 2003, 111 : e562-e568 .
2. Chalmers GW, MacLeod KJ, Thomson L, et al. Smoking and airway inflammation in patients with mild asthma. Chest, 2001, 120: 1971 -1922.
3. 中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南. 中华结核和呼吸杂志, 2008, 31: 177-185 .
4. 何权瀛, 高莹慧. 关于吸烟问题若干名词定义. 中华结核和呼吸杂志, 2009 , 32: 26.
5. 王曾礼, 冯玉麟, 主编. 呼吸病诊疗手册. 北京: 人民卫生出版社, 2000, 101-102.
6. Piccillo G, Caponnetto P, Barton S, et al. Changes in airway hyperresponsiveness following smoking cessation: comparisons between Mch and AMP. Respir Med, 2008, 102 : 2561 -2565 .
7. Polose R, Knoke JD, Russo C, et al. Cigarette smoking is associated with a greater risk of incident asthma in allergic rhinitis. J Allergy Clin lmmunol, 2008, 121: 1428 -1434 .
8. Chaudhuri R, Livingston E, McMahon AD, et al. Cigarette smoking impairs the therapeutic response to oral corticosteroids in chronic asthma. Am J Respir Crit Care Med, 2003, 168 : 1308 -1311 .
9. Churg A, Dai J, Tai H, et al. Tumor necrosis facter-α is central to acute cigarette smoke-induced inflammation and connective tissue breakdown. Am J Respir Crit Care Med, 2002, 166: 849-854.
10. Webster JC, Oakley RH, Jewell CM, et al. Pro-inflammation cytokines regulate human glucocorticoid receptor gene expression and lead to the accumulation of the dominant negative bisoform: a mechanism for the generation of glucocorticoid resistance. Proc Natl Acad Sci USA, 2001, 98: 6865-6870.
11. Ito K, Caramori G, Lim S, et al. Expression and activity of histone deacetylases in human asthmatic airways. Am J Respir Crit Care Med, 2002, 166: 392-396.
12. Maestrelli P, Saetta M, Mapp CE, et al. Remodeling in response to infection and injury. Airway inflammation and hypersecretion of mucus in smoking subjects with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2001, 164: S76-S80.
13. Chalmers GW, MacLeod KJ, Little SA, et al. Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax,2002, 57: 226-230 .

Chinese Journal of Respiratory and Critical Care Medicine

Smoking Affects Therapeutic Response to Inhaled Corticosteroid in Patients with Asthma

Abstract Full text Figures/Tables Video References Cited by

Format

Content