The influence of smoking on the formation of airway hyperresponsiveness to cold and the course of destructive-cytological processes in the goblet cells of the bronchial epithelium in patients with asthma

Abstract

Tobacco smoking in patients with asthma can intensify the bronchi mucosa damage and significantly worsen the course of the disease.Aim. To assess the influence of tobacco smoking on the clinical manifestations of the disease, airway response to cold air exposure and destructive-cytological processes in the goblet cells of bronchial epithelium in patients with asthma.Materials and methods. In 145 patients with asthma their asthma control level was determined by the Аsthma Control Test, lung function (FEV1 , %) and airway response (∆FEV1 , %) to a 3-minute isocapnic hyperventilation (–20 °С) of cold air (IHCA) were evaluated, and induced sputum (IS) was collected. In cytograms of IS a percentage content, the index of cell destruction (ICD) and the index of cytolysis intensiveness (IC) were assessed; histochemically the activity of myeloperoxidase (MPO) and the contents of glycoproteins were identified. The 1st group included 102 non-smokers and the 2nd group included 43 smokers.Results. In IS of patients of the 2nd group in comparison with the 1st one we found intensification of the destructive (ICD = 0.47 ± 0.02 and 0.40 ± 0.02, respectively, р = 0.044) and cytolytic activity of goblet cells (IC = 0.22 ± 0.03 and 0.15 ± 0.02, respectively, р = 0.047) with the domination of the number of completely destroyed cells (21.7 ± 2.4 vs. 14.5 ± 1.6%, р = 0.043) and the decrease in the number of cells with a normal structure (52.5 ± 2.1 vs. 60.5 ± 3.1%, р = 0.047). For smokers it was typical to have high contents of neutrophils in IS (34.1 ± 3.0 vs. 23.9 ± 1.4%, respectively, р = 0.0006) and high level of myeloperoxidase in granulocytes of bronchi (94.3 ± 5.4 vs. 80.7 ± 3.6 pixels, р = 0.037). Smokers responded more actively to IHCA (∆FEV1 was –13.7 ± 2.6 vs. –7.9 ± 1.2%, respectively, р = 0.032), and the degree of the response correlated with the indices of destructive-cytological activity of IS cells.Conclusion. Tobacco smoking in patients with asthma leads to the disturbance of the structure of goblet epithelium in the bronchi with the intensification of destructive-cytological processes, which is accompanied by a decrease in the level of glycoproteins in cytoplasm, an increase in the secretory activity of the goblet cells, neutrophilia, growth of oxidative peroxidase activity of granulocytes, worsening of the bronchial conductance, and intensification of airway response to cold air.