The acute effect of smoking in healthy and asthmatic smokers

Eur J Clin Invest 2010; 40 (2): 103–109 ABSTRACT Background Acute exposure to cigarette smoke is related to airway and systemic inflammation and oxidative stress. Little is known about the acute effect of cigarette smoking in smoking asthmatics. The aim of this study was to evaluate the acute effect of smoking in airway and systemic inflammation and oxidative stress in normal smokers and patients with properly treated well‐controlled persistent asthma. Materials and methods Ten normal smokers and 10 smokers with moderate persistent asthma controlled with LABA and ICS were recruited. Subjects refrained from smoking for at least 12 h prior to their inclusion. We compared the effects of smoking of two cigarettes on airway obstruction, airway inflammation and oxidative stress [by measuring fraction of exhaled nitric oxide (FeNO), plus pH and 8‐isoprostane in exhaled breath condensate (EBC)] before and 30, 90 and 180 min after smoking. Furthermore, we evaluated systemic oxidative stress, C‐reactive protein (CRP) and serum amyloid A (SAA) and urine leukotriene E4 (LTE4) before and 180 min after smoking. Results No differences were observed in EBC pH and 8‐isoprostane, FeNO and systemic oxidative stress between the groups at baseline. In asthmatics, EBC pH decreased 30 min and EBC 8‐isoprostane increased 90 min after smoking (P = 0·039 and P = 0·029 respectively), which was not evident in smoking controls. Serum oxidative stress increased only in asthmatic smokers at 180 min (P = 0·001). No differences were observed in SAA, CRP and urine LTE4 levels before and after smoking. Conclusion Acute smoking has more deleterious effects in well‐controlled properly treated asthmatic smokers compared with matched normal smokers.