Published ahead of print on February 15, 2007, doi:10.1164/rccm.200607-908OC Am. J. Respir. Crit. Care Med., Volume 175, Number 9, May 2007, 919-925 A more recent version of this article appeared on May 1, 2007
Submitted on July 5, 2006 Cigarette Smoking Alters Bronchial Mucosal Immunity in AsthmaMaria Tsoumakidou1,1 Department of Gene Therapy, Imperial College London, Lung Pathology Uniit, London, United Kingdom; Thoracic Medicine, University of Crete, Crete, Greece, 2 Department of Gene Therapy, Imperial College London, Lung Pathology Uniit, London, United Kingdom; Respiratory Medicine, St Barts and the London Hospital Trust, London, United Kingdom, 3 Department of Gene Therapy, Imperial College London, Lung Pathology Uniit, London, United Kingdom, 4 Respiratory Medicine, Bristol Royal Infirmary, Bristol, Bristol, United Kingdom, 5 Thoracic Medicine, University of Crete, Crete, Greece, 6 Respiratory Medicine, St Barts and the London Hospital Trust, London, United Kingdom * To whom correspondence should be addressed. E-mail: p.jeffery{at}imperial.ac.uk.
Rationale: Cigarette smoking worsens asthma and is associated with a reduced response to corticosteroid therapy. As cigarette smoke is known to have immunomodulatory effects, we hypothesize that one mechanism by which smoking mediates its adverse effect is by reduction of the numbers of bronchial mucosal dendritic cells (DCs), which control B-cell growth and T-cell responses.
Objectives: We set out to sample the bronchial mucosa in smoking and never-smoking asthmatics and count DCs, B-cells and cells expressing genes for two key T-lymphocyte regulatory cytokines.
Methods: Twenty-one never-smoker asthmatics (6 steroid-naive), 24 smoker asthmatics (9 steroid-naive) and 10 healthy never-smokers (controls) were recruited and their endobronchial biopsies immunostained for detection of mature DCs (CD83+), Langerhan's cells (CD1a+), B lymphocytes (CD20+), Th1 (IFN Key words: asthmatic; smoker; inflammation; dendritic cells; lymphocytes
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) and Th2 (IL-4) cytokine expressing cells.
Measurements and main results: The number (per mm2) of CD83+ve mature DCs was significantly lower in smoker [median(range)] [37(0,131)] by comparison with never-smoker steroid-naive and steroid-treated asthmatics [76(24,464); p=0.006] or controls [85(40,294); p=0.004]. Moreover, B cells were fewer in smoker [26(4,234)] versus never-smoker steroid-naive and steroid-treated asthmatics [45(10,447); p=0.01] and in smoker steroid-naive asthmatics [23(4,111)] versus controls [34(10,130); p=0.05]. The number of cells expressing IFN
