Correlation of hematologic markers of inflammation and lung function: a comparison of asymptomatic smokers and nonsmokers

Abstract

Increased inflammation of the peripheral airways has been implicated as a cause of pulmonary function impairment. However, little information is available on the correlation between subclinical decrements of pul monary function and inflammation in asymptomatic individuals. A relationship between markers of inflam mation and lung function may be useful in predicting the early onset of lung function impairment. The purpose of this study was to investigate the correlation of hematolo gic markers of inflammation and spirometry in asympto matic smokers and nonsmokers. The specific objectives of this study were twofold. The first objective was to quantify and compare the spirometric measures of lung function in smokers and nonsmokers having similar demographic and lifestyle characteristics. The second objective was to define the correlation between these spirometric measure ments and hematologic markers of inflammation (white blood cells, monocytes, basophils, PGE₁, IgG, and IgE). Systemic blood samples and spirometric measurements were obtained from 61 age-matched (33 ± 9 years) healthy, asymptomatic smokers and nonsmokers, with similar self- reported lifestyles (i.e., food, alcohol, vitamin consump tion and exercise). Both male and female smokers self- reported a higher coffee consumption (P < 0.05) compared to nonsmokers. Male smokers self-reported a trend toward current blue-collar versus white-collar occupation when compared with the nonsmokers. Body weight (77.6± 16.6 kg) did not differ between the smokers and non smokers. The male nonsmokers were taller than the male smokers (P < 0.05). All subjects were asymptomatic and had clinically normal spirometry. Compared to male nonsmokers, the male smokers had lower FEF_25-75% and FEF_75-85% values (P<0.05). No additional spirometric measurements, including FEV₁/FVC, FEV₁ and FVC were significantly different. The female smokers did not differ from the female nonsmokers (P<0.05) in any of the spirometric endpoints measured. Thirteen statistically significant (P < 0.05) correlations involving inflammatory (white blood cells, monocytes, basophils, and PGE₁) or immunologic endpoints (IgE) and spirometric measure ments were observed in female smokers, female non smokers and male nonsmokers. No statistically significant correlations involving immunologic or inflammatory endpoints were observed in the male smokers. A better mechanistic understanding of the observed relationship between elevated hematologic inflammatory endpoints and reduced lung function may provide valuable insight into the clinical significance of these correlations.

Keywords

hematologic inflammation lung function

Get full access to this article

View all access options for this article.

References

Bosse CG , Criner GJ Using spirometry in the primary care office. Spirometry 1993; 93: 122-148.

Ng'ang'a LW et al. Spirometric lung function: Distribution and determinants of test failure in a young adult population. Am Rev Respir Dis 1992; 145: 48-52.

Jaakkola MS et al. Effect of cigarette smoking on evolution of ventilatory lung function in young adults: an eight year longitudinal study. Thorax 1991; 46: 907-913.

Knudson RJ , Lebowitz MD , Holberg CJ , Burrows B. Changes in the normal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983; 127: 725-734.

Lange P. Development and prognosis of chronic obstructive pulmonary disease with special references to the role of tobacco smoking. Danish Medical Bulletin 1992; 39: 30-48.

Peat JK , Woolcock AJ , Cullen K. Decline of lung function and development of chronic airflow limitation; a longitudinal study of nonsmokers and smokers in Busselton, Western Australia . Thorax 1990; 45: 32-37.

Beaty TH , Menkes HA , Cohen BH , Newill CA Risk factors associated with longitudinal change in pulmonary function. Am Rev Resp Dis 1984; 129: 660-667.

Soyseth V. , Kongerud , Kjuus H. , Boe J. Bronchial responsiveness and decline in FEV1 in aluminium potroom workers. Eur Resp J 1994; 7: 888 -894.

Pulmonary Function Standards for Cotton Dust. 29 Code of Federal Regulations; 1910:1043, Final Rule, (h) Medical Surveillance; Dec. 1985.

10.

Lambertsen CJ The lung: physical aspects of respiration. In: Mountcastle VB , ed. Medical Physiology. St. Louis: C.V. Mosby Company, 1980; 2: 1677-1690.

11.

Strachan DP et al. Ventilatory function and winter fresh fruit consumption in a random sample of British Adults. Thorax 1991; 46: 624-629.

12.

Poysa L. et al. Diet in infancy and bronchial hyperreactivity later in childhood . Pediatric Pulmonology 1992; 13: 215-221.

13.

Sahebjami H. Nutrition and lung structure and function. Experimental Lung Research 1993; 19: 105-124.

14.

Garshick E. et al. Alcohol consumption and chronic obstructive pulmonary disease. Am Rev Resp Dis 1989; 140: 373-378.

15.

Lange P. et al. Pulmonary function is influenced by heavy alcohol consumption . Am Rev Resp Dis 1988; 137: 1119-1123.

16.

Xu X. et al. Effects of cigarette smoking on rate of loss of pulmonary function in adults: a longitudinal assessement. Am Rev Resp Dis 1992; 146: 1345-1348.

17.

Sherrill DL , Lebowitz MD , Knudson RJ , Burrows B. Smoking and symptom effects on the curves of lung function growth and decline. Am Rev Resp Dis 1991; 144: 17-22.

18.

Kilburn KH , Warshaw RH Pulmonary functional impairment from years of arc welding. The American Journal of Medicine 1989; 87: 62-69.

19.

Redline S. et al. Assessment of genetic and nongenetic influences on pulmonary function: a twin study. Am Rev Resp Dis 1987 ; 135: 217-222.

20.

Lazarus NB , Kaplan GA , Cohen RD , Leu DJ Smoking and body mass in the natural history of physical activity: Prospective evidence from the Alameda county study, 1965-1974. Am J Prev Med 1989; 5: 127-135.

21.

Margetts BM , Jackson AA Interactions between people's diet and their smoking habits: the dietary and nutritional survey of British adults. Brit Med J 1993; 307: 1381-1384.

22.

Whichelow MJ , Golding JF , Treasure FP Comparison of some dietary habits of smokers and nonsmokers. Br J Addict 1988; 83: 295 - 304.

23.

Shibata A. et al. Serum concentration of beta-carotene and intake frequency of green-yellow vegetables among healthy inhabitants of Japan. Int J Cancer 1989; 44: 48-52.

24.

Edington DW University of Michigan study confirms links between smoking and poor health habits. University of Michigan News and Information Services . 1988; p. 30.

25.

Linden et al. Airway inflammation in smokers with nonobstructive and obstructive chronic bronchitis. Am Rev Resp Dis 1993; 148: 1226-1232.

26.

Langone JJ , Cook G. , Bjercke RJ , Lifschitz MH Monoclonal antibody ELISA for cotinine in saliva and urine of active and passive smokers. J of Immunological Methods 1988; 114: 73-78.

27.

Jarvis MJ et al. Comparison of tests used to distinguish smokers from nonsmokers . Am J Public Health 1987; 77: 1435-1438.

28.

Kaplan LA , Pesce AJ , Eds. Clinical Chemistry; Theory analyses and correction , St. Louis: CV Mosby Company, 1984.

29.

American Thoracic Society. Standardization of Spirometry: 1987 Update. Am Rev Respir Dis 1987; 136: 1285-1298.

30.

Morris AH , Kanner RE , Crapo RO , Gardner RM Clinical pulmonary function testing: A manual of uniform laboratory procedures , 2nd ed. Salt Lake City: Intermountain Thoracic Society, 1984.

31.

Morris JF 'Spirometry in the Evaluation of Pulmonary Function', Medical Progress . West J Med 1976; 125: 110-118.

32.

McKarns SC , Smith CJ , Payne VM , Doolittle DJ Atherogenic and thrombogenic risk factors in smokers and nonsmokers. Modern Pathology 1995; 8: 434-440.

33.

Box Gep , Hunter WG , Hunter JS Statistics for Experimenters. New York: John Wiley and Sons 1978; pp. 81-82.

34.

Carel RS , Tockman MS , Baser M. Smoking, leukocyte count and ventilatory lung function in working men. Chest 1988; 93: 1137-1143.

35.

Sparrow D. , Glynn RJ , Cohen M. , Weiss ST The relationship of the peripheral leukoycte count and cigarette smoking to pulmonary function among adult men. Chest 1984; 86: 383-386.

36.

Walter S. Blood basophil counts in smokers and nonsmokers. Indian J Med Res 1982; 76: 317-319.

37.

Persson Cga , Svensjo E. Vascular responses and their suppression: drugs interfering with venular permeability . Chapter 4 The Pharmacology of Inflammation. (Eds.) Boneta IL , Bray MA and Parnham MJ. Elsevier, Amsterdam, 1985; pp. 61-82.

38.

Kay AB Humoral and Cellular Mechanisms of Airway Inflammation. In: Olivieri D , Bianco S , eds. Airway Obstruction and Inflammation. Paris : Karger, 1988.

39.

Hubbard RC , Brantly ML , Crystal RG Proteases. In: Crystal RG , West JB , eds. Lung Injury. New York: Raven Press, 1991; pp. 3-13.

40.

Zurier RB Role of Prostaglandins E in Inflammation and Immune Responses. In: Sameulsson B , ed. Advances in Prostaglandin Thromboxane, and Leukotriene Research. New York: Raven Press, 1990; pp. 946-953.

41.

Matthay RA Chronic Airways Diseases. In: Wyngaarden JB , Smith LH , Bennett JC , eds. Cecil Textbook of Medicine. Philadelphia: W.B. Saunders Company, 1992; 1: 386-394.

42.

Thurlbeck WM , Ryder R. , Sternly N. A comparitive study of severity of emphysema in necropsy population in three different countries. Am Rev Resp Dis 1974; 109: 239-248.

43.

Surgeon General. The health consequences of smoking for women. A report of the Surgeon General (1980), p. 90.

44.

McCord JM Is iron sufficiency a risk factor in ischemic heart disease? Circulation 1991; 83: 1112-1114.

45.

Department of Health and Human Services: The Health Conseqences of Smoking: Chronic Obstructive Lung Disease. A report of the Surgeon General. Washington, DC: Government Printing Office, DHHS (PHS) 84-50205, 1984.