Allergen inhalation challenge in smoking compared with non-smoking asthmatic subjects

Summary Background Smoking asthmatics experience more severe symptoms, require more rescue medication and have more asthma‐related hospitalizations than non‐smoking asthmatics. However, studies in mice suggest that mainstream cigarette smoke may reduce airway inflammation and may attenuate airway hyperresponsiveness. A comparison of allergen‐induced airway inflammatory responses of smoking and non‐smoking atopic asthmatics has not been examined previously. Objectives To determine whether allergen‐induced airway responses and inflammatory profiles are attenuated in smoking when compared with non‐smoking mild allergic asthmatic subjects. Methods Allergen inhalation challenges were performed in 13 smoking and 19 non‐smoking mild allergic asthmatic subjects. The forced expired volume in 1 s (FEV1) was measured up to 7 h after allergen inhalation. Methacholine airway responsiveness was measured before and at 24 h after allergen and sputum was induced before and at 7 and 24 h after allergen. Results Both the smoking and non‐smoking groups developed similar allergen‐induced falls in FEV1 during the early and late asthmatic responses and similar increases in allergen‐induced airway eosinophils. The mean maximum fall in FEV1 during the late response was 16.3±4.3% in non‐smokers and 12.9±7.2% in smokers. The smoking asthmatics, however, did not develop allergen‐induced methacholine airway hyperresponsiveness, whereas the non‐smoking controls developed a 1.18 doubling dose shift in methacholine PC20 (P