Influence of cigarette smoking on bronchoalveolar lavage cellularity in asbestos-induced lung disease.
Schwartz DA; Galvin JR; Merchant RK; Dayton CS; Burmeister LF; Merchant JA; Hunninghake GW
Am Rev Respir Dis 1992 Feb; 145(2)(Pt 1):400-405
The influence of cigarette smoking on bronchoalveolar lavage (BAL) fluid cellularity in asbestos (1332214) induced lung disease was investigated. The study group consisted of 73 white males with extensive occupational exposure to asbestos who were participating in an ongoing research program of interstitial and pleural occupational lung diseases. Twenty subjects, mean age 57.1 years, were disease free as evidenced by normal chest X-rays and normal pulmonary function tests. Twenty eight, mean age 63.3 years, had pleural fibrosis and 25, mean age 59.4 years, had asbestosis. The proportion of subjects who were current smokers in the disease free, fibrotic, and asbestotic groups was 10, 4, and 28%, respectively. These groups had a mean number of pack years smoking of 28.1, 20.5, and 42.2, respectively. BAL was performed. The lavage fluid was assayed for alveolar macrophages, lymphocytes, neutrophils, and eosinophils. Subjects with asbestosis had significantly elevated lavage fluid macrophage, neutrophil, and eosinophil counts. Subjects with pleural fibrosis had elevated BAL fluid lymphocyte counts. Current cigarette smokers had higher concentrations of lavage fluid macrophages, neutrophils, and eosinophils compared to never smokers. Pack years of smoking were significantly correlated with BAL fluid macrophage and neutrophil counts. Multivariate analysis applied to the data for the asbestotic patients showed that cigarette smoking accounted for 17 to 18% of the variance of the lavage fluid macrophage and eosinophil counts. Asbestosis accounted for 6 to 7% of the variance in BAL fluid macrophage, neutrophil, and eosinophil counts. The authors conclude that cigarette smoking strongly influences BAL fluid cellularity in patients with asbestosis but not those with asbestos associated pleural fibrosis. This suggests that cigarette smoking influences the pathogenesis of asbestosis.
NIOSH-Grant; Pulmonary-system-disorders; Asbestos-workers; Lung-cells; Cigarette-smoking; Respiratory-system-disorders; Pulmonary-function; Humans; Occupational-exposure
David A. Schwartz, M.D., M.P.H., Pulmonary Disease Division, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA 52242
Pulmonary System Disorders
American Review of Respiratory Disease
University of Iowa, Iowa City, Iowa