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Erythrocyte membrane fatty acid composition of smokers and non-smokers: effects of vitamin E supplementation.

OBJECTIVE: Adequate dietary intakes of vitamin E and essential polyunsaturated fatty acids are important to maintain cell membrane integrity, and deficiencies have been associated with smoking related cardiovascular disease. Sufficient vitamin E is required to prevent free radical mediated peroxidation of membrane lipids. Consequently, smokers may have a greater requirement for this antioxidant. To investigated, we assessed the concurrent influences of smoking, vitamin E supplementation and red blood cell (RBC) PUFA composition on the susceptibility of the cells to lipid peroxidation in adult males. DESIGN AND SUBJECTS: Thirty male smokers and thirty male non-smokers were randomly ascribed to daily 280 mg vitamin E or placebo supplements for 10 weeks. RBC were analysed at weeks 0 and 10 for fatty acid methyl esters, vitamin E, and their susceptibility to in vitro H202 induced lipid peroxidation. RESULTS: Concentrations of essential fatty acids (EFA) in RBC were lower in smokers than in non-smokers. supplementation with vitamin E increased levels of RBC EFA in smokers and non-smokers was inversely correlated with their susceptibility to peroxidation. CONCLUSIONS: An adequate vitamin E to PUFA ratio is required to protect cell membranes from oxidative damage. The significant correlation between susceptibility to peroxidation and the PUFA content of RBC before supplementation suggests an inadequate intake of vitamin E in relation to PUFA intake. Moreover, the requirement for vitamin E appears to be greater in smokers than in non-smokers.

Adult↗

Extracellular elastolytic activity in human lung lavage: a comparative study between smokers and non-smokers.

Unrestrained proteolysis in the lung is believed to initiate emphysema, a disease common among tobacco smokers. However, few studies have found extracellular protease activity in human lung lavage. In this investigation, elastase and serine protease activities were measured in bronchoalveolar lavage supernatants (BAL) from patients undergoing routine investigations. Significantly more elastolytic activity (against insoluble [3H]-elastin) was recovered in the lavage of smokers than that of non-smokers. However, no significant difference was found when the levels of serine proteolytic activity (against N-succinyl-L-trialanyl-p-nitroanilide) were compared. The elastolytic component of the protease activity rose from 5% in non-smokers' BAL to over 30% in that of smokers, suggesting that elastase activity is selectively enhanced by smoking. In lavages from most smokers, 80% or more of the elastase activity was serine-dependent, whereas lavages from non-smokers contained variable proportions of serine elastase. Both alpha 1-proteinase inhibitor (alpha 1-PI) and a low molecular weight antiprotease, bronchial mucus proteinase inhibitor (BMPI) were detectable in the lavage samples, the latter contributing up to 76% of the total antiprotease quantified in the lavage. Functional antiprotease was detected in 85% of the lavages. Since there were no differences in either antiprotease levels or functional inhibitory capacities between lavages from smokers and controls, it is concluded that the imbalance in the protease/antiprotease profile of the smokers' lung results from an enhancement of proteases, specifically of elastolytic activity, rather than a reduction in inhibitory capacity.

Adolescent↗

Self-reporting of periodontal diseases and clinical assessment outcome in a Swedish urban population of smokers and non-smokers.

The aim of this study was to determine whether there is an association between self-reporting of periodontal diseases and outcome in a clinical examination, and whether any difference is present in awareness of periodontal status between smokers and non-smokers. Participants comprised 1676 adults (838 M and 838 F aged between 31 and 40 years), 564 of whom reported being smokers. Subjects were asked via questionnaire whether they thought they had periodontal disease and why. A total of 1655 subjects answered the questionnaire and were subsequently divided into those who suspected having periodontal disease (Yes-group) and those who did not (No-group). A full-mouth clinical examination was carried out in all subjects. Female smokers in the Yes-group had a significantly higher number of teeth with pockets > or = 5 mm (P < 0.001) and a higher calculus index (CI-S, P < 0.01) than female smokers in the No-group. Male smokers in the Yes-group had significantly less remaining teeth (P < 0.01), more teeth with pockets > or = 5 mm (P < 0.001), and a higher CI-S (P < 0.05) than their counterparts in the No-group. For smokers, multivariate logistic regression analysis yielded an odds ratio (OR 3.21 [95% CI 1.73 5.74]) of self-reported periodontal disease to periodontitis outcome which was significant (P < 0.001). This association remained significant (P < 0.01) after adjustment for confounding factors. Subjects who reported having periodontal disease, especially those who also reported having movable teeth, were confirmed to have the disease. Smokers were more aware of their periodontal status than non-smokers.

Adult↗

Protective effects of raw vegetables and fruit against lung cancer among smokers and ex-smokers: a case-control study in the Tokai area of Japan.

In a hospital-based case control study, the protecting effects of fruit, raw and green vegetables against lung cancer risk among male smokers were studied in 282 cases and the same number of controls. The current smokers showed a 6.61-fold increased risk of lung cancer. The odds ratio (OR) declined markedly with starting age of smoking habit and increased markedly with number of cigarettes smoked per day. The ex-smokers showed a 3.56-fold increased risk of lung cancer. The ORs gradually decreased with years passed since cessation of smoking. In the single factor analysis, significant protective effects of fruit, raw vegetables, green vegetables, lettuce and cabbage against lung cancer were found. The risk for all lung cancer decreased to 0.45 (95% confidence intervals (CI) 0.30-0.67), 0.64 (95% CI 0.43-0.97) and 0.44 (95% CI 0.26-0.73) with increment of intake frequency of fruit, raw and green vegetables respectively. The OR for lung cancer decreased to 0.41 (95% CI 0.24-0.72) and 0.56 (95% CI 0.32-0.99) with increasing intake frequency of fruit and raw vegetables among current smoking males. Lettuce and cabbage showed protective effects against lung cancer, and the OR for risk of lung cancer decreased to one-half among the high intake frequency group. The risk of lung cancer among current smokers declined markedly with increasing intake of lettuce and cabbage. A similar effect was observed among ex-smokers and non-smokers, but there was no statistical significance. In the multivariate analysis, fruit and raw vegetables showed the strongest protective effects against lung cancer among current smokers (P = 0.01). Among ex-smokers, the protective effect of fruit is also statistically significant (P = 0.03). These results suggest that fruit and raw vegetables may play an important role in protecting smokers from lung cancer.

Adult↗

Oral microbiota in smokers and non-smokers in natural and experimentally-induced gingivitis.

The present study primarily aimed at investigating the oral microbiota in smokers and non-smokers with established gingivitis and monitoring its composition during experimental gingivitis. Secondly, it aimed at examining whether the composition of the microbiota is associated with different levels of gingival inflammation during this experimental gingivitis trial. For this purpose, 25 non-dental university students with gingivitis were recruited. 11 subjects were smokers and 14 were non-smokers. After achieving gingival health, they entered a 14-day experimental gingivitis trial. Plaque and bleeding were assessed before entering into the study (intake), at day 0, day 5 and at day 14 of the experiment. Microbiological samples from mucosal sites and dental plaque (taken at intake, day 0, and day 14) were analysed for the presence of Actinomyces species, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Streptococcus species. At day 14 of the experimental period, the level of plaque formation was not different between smokers and non-smokers, but bleeding scores were lower in smokers than in non-smokers (15% and 30% respectively, p=0.01). The change from natural gingivitis to a state of gingival health and a subsequent change from gingival health to experimentally induced gingivitis was accompanied by quantitative alterations in the cultivable microbiota in both groups. Changes were most prominent in the transition from gingival health to experimental gingivitis and were found in dental plaque for Actinomyces species, C. rectus, F. nucleatum, and P. intermedia. Within the group of non-smokers, a distinction was made between subjects with a 'weak' or 'strong' inflammatory response. No relationship with a single bacterial species could be established which would likely explain the differences in levels of inflammation. It is concluded that differences in response to experimental gingivitis are not caused by major differences in the composition of the oral microbiota.

Actinomyces↗

Elastase in gingival crevicular fluid from smokers and non-smokers with chronic inflammatory periodontal disease.

OBJECTIVE: To compare elastase concentrations in gingival crevicular fluid (GCF) from individual sites of smokers and non-smokers. MATERIALS AND METHODS: Twelve pairs of smokers and non-smokers with untreated, moderate to advanced chronic inflammatory periodontal disease were matched for gender, age, ethnicity and the clinical and radiographic extent of disease. Durapore filter strip samples were collected over 30 s from two mesiopalatal sites on upper left posterior teeth. Samples were analysed for: 1) polymorphonuclear neutrophil leucocyte (PMNL) cell counts; 2) PMNL elastase-alpha 1-antitrypsin complex in the GCF supernatant by ELISA; and 3) functional elastase, free or bound to alpha 2-macroglobulin, estimated from activity against N-tert-butoxycarbonyl-alanyl-prolyl-norvalyl-p-chlorothiobenzyl ester in supernatant and lysates of GCF PMNLs. RESULTS: There were no differences in disease parameters between groups except that bleeding on probing was less extensive in smokers (P<0.001). Cell counts and elastase content of crevicular PMNLs showed no differences between groups. Lower concentrations of elastase were found in GCF supernatants from smokers than non-smokers. This difference was observed for functional elastase (mean [s.d.] = 30.21 [17.60] against 73.77 [75.26] ng microliter(-1), p<0.05) and elastase complexed with alpha 1-antitrypsin (8.97 [6.54] ng microliter(-1) against 25.71 [22.07] ng microliter(-1), p<0.001). CONCLUSIONS: Smokers have lower elastase concentrations in GCF than non-smokers. Further investigation is required to elucidate the underlying cause and its relationship with periodontal disease.

Adult↗

Smokers, non-smokers and the attribution of addiction.

Questionnaries concerned with attitudes towards cigarette smoking were completed by 368 respondents who were taking part in a survey of audience reactions to one week's television programmes. Cigarette smokers were asked how difficult it would be for them to give up cigarettes, whether they would like to do so, whether they felt they were addicted to cigarettes, and how often a cigarette gave them real pleasure. Non-smokers were asked parallel questions to determine their perceptions of the average cigarette smoker. In comparison to how smokers saw themselves, non smokers saw the average smoker as more addicted, and as deriving less pleasure from cigarettes. Smokers who saw themselves as more addicted felt it would be more difficult for them to give up, smoked more cigarettes per day, said they would like to give up more, and derived somewhat more pleasure from cigarettes. Among those who had never smoked cigarettes, the attribution of addiction to the average smoker was related only to perceived difficulty of giving up. Lesser self-attributed addiction was also relevant to the prediction of which smokers claimed to be trying to reduce or give up smoking. Implications of these data for attribution theory, and for health education, are discussed.

Adolescent↗

Effect of cigar smoking on carboxyhaemoglobin and plasma nicotine concentrations in primary pipe and cigar smokers and ex-cigarette smokers.

Five ex-cigarette smokers and five primary pipe and cigar smokers each smoked a large cigar. Carboxyhaemoglobin (COHb) and plasma nicotine levels were measured. In the ex-cigarette smokers mean COHb rose from 2.9% to 9.6% and plasma nicotine from 79.0 nmol/l to 281 nmol/l (12.8-45.6 ng/ml). This response was similar to that of cigarette smokers smoking cigarettes, which indicated that the subjects had inhaled and absorbed significant amounts of nicotine. In the primary pipe and cigar smokers the mean COHb rose from 0.8% to 1.0% and the plasma nicotine from 21 nmol/l to 32 nmol/l (3.4-5.2 ng/ml), indicating neither significant inhalation nor significant nicotine absorption.Since ex-cigarette smokers do not seem to lose their habit of inhaling when they change to cigars, measures aimed at persuading smokers to switch to cigars will have little effect on their health. Pipe and cigar smokers who have never smoked cigarettes do not inhale, which probably accounts for their reduced incidence of coronary heart disease and lung cancer. But they also appear not to absorb nicotine, which suggests that nicotine is absorbed largely from the lung and that the buccal mucosa is unimportant. It also raises the interesting question of why primary pipe and cigar smokers do smoke.

Adult↗

When does the risk of acute coronary heart disease in ex-smokers fall to that in non-smokers? A retrospective study of patients admitted to hospital with a first episode of myocardial infarction or unstable angina.

Nine hundred and seventy eight patients admitted with a first myocardial infarction or episode of unstable angina were studied to determine for how long after they gave up smoking did the risk in ex-smokers continue to resemble those of current smokers. Logistic regression was used to calculate a score, based on a combination of age, cholesterol, and hypertension, that separated current smokers from lifetime non-smokers. When this function was applied to ex-smokers, only those who had given up at least 15 years before the attack had a risk factor profile similar to that of non-smokers. Those who had given up less than five years before the ischaemic attack had a significantly higher level of other risk factors than current smokers; those who had stopped for between five and 15 years had levels similar to those of current smokers. Ex-smokers are at higher risk of acute coronary disease for at least 15 years after stopping, but some immediate reduction in risk is possible.

Angina Pectoris↗

Non-smokers seeking help for smokers: a preliminary study.

OBJECTIVES: To examine the phenomenon of non-smokers spontaneously taking action to seek help for smokers; to provide profiles of non-smoking helpers by language and ethnic groups. SETTING: A large, statewide tobacco quitline (California Smokers' Helpline) in operation since 1992 in California, providing free cessation services in English, Spanish, Mandarin, Cantonese, Korean, and Vietnamese. SUBJECTS: Callers between August 1992 and September 2005 who identified themselves as either white, black, Hispanic, American Indian, or Asian (n = 349,110). A subset of these were "proxies": callers seeking help for someone else. For more detailed analysis, n = 2143 non-smoking proxies calling from October 2004 through September 2005. MAIN OUTCOME MEASURES: Proportions of proxies among all callers in each of seven language/ethnic groups; demographics of proxies; and proxies' relationships to smokers on whose behalf they called. RESULTS: Over 22 000 non-smoking proxies called. Proportions differed dramatically across language/ethnic groups, from mean (+/-95% confidence interval) 2.7 (0.3)% among English-speaking American Indians through 9.3 (0.3)% among English-speaking Hispanics to 35.3 (0.7)% among Asian-speaking Asians. Beyond the differences in proportion, however, remarkable similarities emerged across all groups. Proxies were primarily women (79.2 (1.7)%), living in the same household as the smokers (65.0 (2.1)%), and having either explicit or implicit understandings with the smokers that calling on their behalf was acceptable (90.0 (1.3)%). CONCLUSIONS: The willingness of non-smokers to seek help for smokers holds promise for tobacco cessation and may help address ethnic and language disparities. Non-smoking women in smokers' households may be the first group to target.

Adolescent↗

Expression of protease activated receptor-2 (PAR-2) in central airways of smokers and non-smokers.

BACKGROUND: Protease activated receptor-2 (PAR-2) is a transmembrane G protein coupled receptor preferentially activated by trypsin and tryptase. The protease activated receptors play an important role in most components of injury responses including cell proliferation, migration, matrix remodelling, and inflammation. Cigarette smoking causes an inflammatory process in the central airways, peripheral airways, lung parenchyma, and adventitia of pulmonary arteries. METHODS: To quantify the expression of PAR-2 in the central airways of smokers and non-smokers, surgical specimens obtained from 30 subjects undergoing lung resection for localised pulmonary lesions (24 with a history of cigarette smoking and six non-smoking control subjects) were examined. Central airways were immunostained with an antiserum specific for PAR-2 and PAR-2 expression was quantified using light microscopy and image analysis. RESULTS: PAR-2 expression was found in bronchial smooth muscle, epithelium, glands, and in the endothelium and smooth muscle of bronchial vessels. PAR-2 expression was similar in the central airways of smokers and non-smokers. When smokers were divided according to the presence of symptoms of chronic bronchitis and chronic airflow limitation, PAR-2 expression was increased in smooth muscle (median 3.8 (interquartile range 2.9-5.8) and 1.4 (1.07-3.4) respectively); glands (33.3 (18.2-43.8) and 16.2 (11.5-22.2), respectively); and bronchial vessels (54.2 (48.7-56.8) and 40.0 (36-40.4), respectively) of smokers with symptoms of chronic bronchitis with normal lung function compared with smokers with chronic airflow limitation (COPD), but the increase was statistically significant (p<0.005) only for bronchial vessels. CONCLUSIONS: PAR-2 is present in bronchial smooth muscle, glands, and bronchial vessels of both smokers and non-smokers. An increased expression of PAR-2 was found in bronchial vessels of patients with bronchitis compared with those with COPD.

Aged↗

Intra-alveolar macrophage numbers in current smokers and non-smokers: a morphometric study of tissue sections.

BACKGROUND: The alveolar macrophage is believed to be important in the defence of the lung and possibly in the pathogenesis of lung disease. Cell counts in bronchoalveolar lavage fluid have suggested that smokers have an increased number of alveolar macrophages but have not enabled the number to be related to a measure of lung structure. METHODS: The number of alveolar macrophages was counted in histological sections from lung resection specimens from a group of smokers and non-smokers. The results were related to a measurement of lung structure obtained by means of an automated morphometric technique and expressed in terms of units of lung volume or of lung surface area. RESULTS: The smokers had a significantly increased number of alveolar macrophages per unit lung volume and per unit surface area, through the relative increase was less than has appeared from bronchoalveolar lavage studies. When smokers and non-smokers with similar lung structure were compared the smokers had more alveolar macrophages, indicating that smoking and not loss of lung structure is responsible for the increase. CONCLUSIONS: Smokers had more alveolar macrophages than non-smokers when the number was expressed quantitatively with respect to the underlying architecture. Changes in cell populations postulated to be important in the pathogenesis of disease within the lung should be related to lung architecture because this may vary considerably between individuals.

Adult↗

Matched-pair analysis of survival of never smokers and ever smokers with squamous cell carcinoma of the head and neck.

PURPOSE: To compare survival rates between patients with squamous cell carcinoma of the head and neck (SCCHN) without a history of smoking (never smokers) and those with a current or previous history of smoking (ever smokers). PATIENTS AND METHODS: Fifty never smokers with newly diagnosed SCCHN were matched to 50 ever smokers according to sex, age, tumor site, overall stage, nodal stage, and treatment. Survival analysis was performed using Kaplan-Meier estimates. Matched-pair survival was compared using the Cox proportional hazards model. RESULTS: The never smokers had a greater overall survival (P =.020), disease-specific survival (P =.022), and recurrence-free survival (P =.016). Furthermore, matched-pair analysis demonstrated smoking was associated with a significant increase in risk of overall death (relative risk [RR] = 3.50; 95% CI, 1.14 to 10.77; P =.029), risk of death owing to disease (RR = 3.98; 95% CI, 1.11 to 14.33; P =.034), and risk of disease recurrence (RR = 3.29; 95% CI, 1.18 to 9.14; P =.023). Smoking was associated with three-fold increases in risk for overall death, death owing to disease, and recurrence after adjustment for cancer-associated symptom severity and alcohol use, but the 95% CI for these adjusted risk estimates each included the null. CONCLUSION: Survival differed significantly between never smokers and ever smokers with SCCHN. These results are not substantively explained by differences in cancer-associated symptoms or alcohol use, but the CIs are wide and some imprecision remains. Regardless, possible fundamental differences in SCCHN between ever smokers and never smokers may exist, and further molecular characterization of these tumors is needed to determine whether biologic differences needing targeted therapies exist.

Adult↗

Serum parathyroid hormone (PTH) levels in smokers and non-smokers. The fifth Tromsø study.

OBJECTIVE: Smoking is associated with reduced bone density and calcium absorption, and reduced serum levels of vitamin D. A compensatory increase in serum parathyroid hormone (PTH) would therefore be expected as a result of an altered calcium balance. However, reports on PTH levels in smokers are conflicting. As serum PTH levels give important information on the calcium balance, the PTH levels in smokers are of interest. SUBJECTS AND METHODS: In the fifth Tromsø study, smoking status was recorded and serum PTH measured in 7896 subjects. Intakes of calcium and vitamin D were evaluated with a food-frequency questionnaire. In a follow-up study on 205 subjects, serum 25-hydroxyvitamin D, calcium absorption, and renal excretion of calcium were measured in addition. RESULTS: The serum PTH levels were significantly lower in smokers than non-smokers (3.1+/-1.4 vs 3.6+/-1.9 pmol/l in males; 3.1+/-1.5 vs 3.6+/-1.8 pmol/l in females (P < 0.001) after correcting for confounding variables, linear regression). In the smokers, there was no association between number of cigarettes smoked and serum PTH. One year after quitting smoking, serum PTH levels were similar to those of people who had never smoked. The smokers had significantly lower intake of vitamin D, lower serum levels of 25-hydroxyvitamin D and lower calcium absorption. The intake of calcium and the renal excretion of calcium were similar to that in non-smokers. CONCLUSIONS: Smokers have lower serum PTH levels than non-smokers. This cannot be explained by the predictors of serum PTH measured in our study.

Adult↗

Immunohistochemical study of vestibular gingival blood vessel density and internal circumference in smokers and non-smokers.

BACKGROUND: This study was undertaken to determine: 1) if sections stained with monoclonal antibody to CD34 can be used for measurement of gingival blood vessel density and circumference and 2) if long-term smoking affects either of these 2 parameters. METHODS: Vestibular gingival biopsy samples were obtained from 17 adults (5 smokers and 12 non-smokers) who were undergoing routine periodontal surgery independently of this study. Hematoxylin and eosin staining was used for histological assessment of inflammation, while immunohistochemical staining with CD34 mouse monoclonal antibody was used to mark the endothelial cells of the blood vessels within each sample. Stringent selection criteria were applied to the 17 biopsy samples, and 7 (from 3 smokers and 4 non-smokers) were chosen to have their vascular density (number of vessels/unit area) and internal vessel circumference (IC) measured under a blinded protocol. RESULTS: Repeated measurements of vascular density and internal circumference showed small standard deviations, indicating the high reproducibility of the measurement technique. The smoker group showed a higher proportion of small (IC < 50 microns) and a lower proportion of large blood vessels (IC > 100 microns), which was statistically significant (P = 0.0403 and P < 0.001, respectively). The difference between the vascular density of smokers and non-smokers was not significant (P = 0.092). CONCLUSIONS: The present study indicates that the CD34 immunohistochemical staining technique is a simple and reproducible method for the measurement of density and internal circumference of gingival blood vessels. Based on this technique, cigarette smokers show a higher percentage of smaller blood vessels and a lower percentage of larger vessels, but similar vascular density, to non-smokers.

Adult↗

Interactions between smokers and non-smokers in public places: a qualitative study.

Few studies have employed a qualitative approach to better understand how both smokers and non-smokers experience and make sense of no-smoking restrictions in their daily lives. We describe qualitative research involving an examination of self-reported interpersonal interactions between smokers and non-smokers in public places regarding exposure to environmental tobacco smoke (ETS). Five focus group discussions and twenty individual in-depth interviews were conducted with smokers and non-smokers in the Metropolitan Toronto region as a complement to a quantitative survey of the adult population of Ontario. Strategies used by non-smokers in responding to ETS exposures included verbal confrontations, non-verbal cues, use of a third party, and moving away. The perceived consequences of such actions, as described by both smokers and non-smokers, are discussed, together with implications for tobacco control policy and practice.

Adolescent↗

Evaluation of keratinization and AgNORs count in exfoliative cytology of normal oral mucosa from smokers and non-smokers.

OBJECTIVE: In smokers with clinically normal buccal mucosa,cytological changes such as increased keratinization, and higher nucleolar activity have been observed. In these studies the cells for cytological smears were obtained with a wooden spatula. Our objectives were to evaluate the depth of cytological smears of oral mucosa obtained with both a brush (endobrush) and a wooden spatula, and to compare the degree of keratinization and the nucleolar activity in smokers and non-smokers. DESIGN: We obtained cytological smears of clinically normal lateral tongues of 30 smokers and 30 non-smokers using both a wooden spatula and endobrush. The samples were dyed with Papanicolaou and the AgNORs. RESULTS: With the wooden spatula we found a greater percentage of enucleated superficial epithelial cells (P = 0.016) and deeper cells were obtained with an endobrush (intermediate cells) (P = 0.035). The smokers showed a greater percentage of enucleated superficial cells with both techniques, however this difference was significantly greater with Endobrush (P = 0.005). The average of AgNORs in the nucleated cells was greater in smokers(3.83) than in non-smokers (2.79) (P = 0.003). CONCLUSION: The Endobrush allows the clinician to obtain deeper cells of buccal mucosa. Smokers with clinically normal mucosa show a greater percentage of keratinized cells and a greater nucleolar activity, suggesting that cigarette smoking influences the cellular activity of the mucosa of the lateral tongue.

Adult↗

Phagocytosis and killing of Haemophilus influenzae by alveolar macrophages: no difference between smokers and non-smokers.

The susceptibility of smokers to pneumonia caused by Haemophilus influenzae may result from impairment of phagocytic or bactericidal function of pulmonary alveolar macrophages (PAM). We compared ingestion and killing of non-typable H. influenzae and H. influenzae type B by alveolar macrophages from asymptomatic smokers and non-smokers. Three times as many cells were recovered from bronchoalveolar lavage of smokers. Non-typable H. influenzae (NTHI) were phagocytosed and killed readily by PAM from both groups of subjects, while H. influenzae type B were resistant to phagocytosis. No difference in uptake of bacteria was detected between PAM of smokers and non-smokers. PAM from smokers had a slightly greater bactericidal activity than PAM from non-smokers. These results suggest that other host factors, such as impaired tracheobronchial clearance or the presence of conditions that favor bacterial growth rather than damage to alveolar macrophages, are responsible for the susceptibility of smokers to Haemophilus infections.

Adult↗