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Bals, R., Boyd, J., Esposito, S., Foronjy, R., Hiemstra, P. S., Jimenez-Ruiz, C. A., . . . Blasi, F. (2019). Electronic cigarettes: a task force report from the European Respiratory Society. European Respiratory Journal, 53(2), Article ID 1801151.
Open this publication in new window or tab >>Electronic cigarettes: a task force report from the European Respiratory Society
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 53, no 2, article id 1801151Article in journal (Refereed) Published
Abstract [en]

There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives. ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.

Place, publisher, year, edition, pages
EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-157537 (URN)10.1183/13993003.01151-2018 (DOI)000460312500018 ()30464018 (PubMedID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Backman, H., Jansson, S.-A., Stridsman, C., Eriksson, B., Hedman, L., Eklund, B.-M., . . . Rönmark, E. (2019). Severe asthma: A population study perspective. Clinical and Experimental Allergy, 49(6), 819-828
Open this publication in new window or tab >>Severe asthma: A population study perspective
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2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 6, p. 819-828Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Severe asthma is a considerable challenge for patients, health care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study.

OBJECTIVE: To describe characteristics and estimate the prevalence of severe asthma in a large adult population-based asthma cohort followed for 10-28 years.

METHODS: N=1006 subjects with asthma participated in a follow-up during 2012-14, when 830 (mean age 59y, 56% women) still had current asthma. Severe asthma was defined according to three internationally well-known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Program (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care, and were also contacted by telephone to verify treatment adherence.

RESULTS: The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >40% had uncontrolled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma.

CONCLUSIONS AND CLINICAL RELEVANCE: Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4-6%, corresponding to approximately 0.5% of the general population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
IgE, asthma, eosinophils, epidemiology, lung function, neutrophils
National Category
Public Health, Global Health, Social Medicine and Epidemiology Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-157380 (URN)10.1111/cea.13378 (DOI)000475694600009 ()30817038 (PubMedID)
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-09-09Bibliographically approved
Sawalha, S., Hedman, L., Backman, H., Stenfors, N., Rönmark, E., Lundback, B. & Lindberg, A. (2019). The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study. Therapeutic Advances in Respiratory Disease, 13, Article ID 1753466619860058.
Open this publication in new window or tab >>The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study
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2019 (English)In: Therapeutic Advances in Respiratory Disease, ISSN 1753-4658, Vol. 13, article id 1753466619860058Article in journal (Refereed) Published
Abstract [en]

Background: Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of common comorbidities, cardiovascular disease (CVD), diabetes mellitus (DM), and anxiety/depression (A/D), on mortality among men and women with and without airway obstruction in a population-based study.

Methods: All subjects with airway obstruction [forced expiratory volume in 1 second (FEV1)/(forced) vital capacity ((F)VC) <0.70, n = 993] were, together with age- and sex-matched referents, identified after examinations of population-based cohorts in 2002-2004.

Spirometric groups: normal lung function (NLF) and COPD (post-bronchodilator FEV1/(F)VC <0.70) and additionally, LLN-COPD (FEV1/(F)VC <lower limit of normal). Mortality data was collected until December 2015. Results: In COPD, the prevalence of CVD and DM was higher in men, whereas the prevalence of A/D was higher in women. The cumulative mortality was significantly higher in COPD than NLF, and higher in men than women in both groups. Among women with COPD, CVD and A/D but not DM increased the risk of death independent of age, body mass index, smoking habits, and disease severity, whereas among men DM and A/D but not CVD increased the risk for death. When the LLN criterion was applied, the pattern was similar.

Conclusion: There were sex-dependent differences regarding the impact of comorbidities on prognosis in COPD. Even though the prevalence of CVD was higher in men, the impact of CVD on mortality was higher in women, and despite higher prevalence of A/D in women, the impact on mortality was similar in both sexes. The reviews of this paper are available via the supplemental material section.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
chronic airflow obstruction, co-morbidity, epidemiology, mortality, sex
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-162339 (URN)10.1177/1753466619860058 (DOI)000478856400001 ()31291820 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-10-15Bibliographically approved
Nilsson, U., Kanerud, I., Diamant, U.-B., Blomberg, A., Eriksson, B. & Lindberg, A. (2019). The prevalence of prolonged QTc increases by GOLD stage, and is associated with worse survival among subjects with COPD. Heart & Lung, 48(2), 148-154
Open this publication in new window or tab >>The prevalence of prolonged QTc increases by GOLD stage, and is associated with worse survival among subjects with COPD
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2019 (English)In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 48, no 2, p. 148-154Article in journal (Refereed) Published
Abstract [en]

Background: The role of QTc-prolongation, in relation to the increased mortality in COPD, is unclear.

Objectives: To estimate the prevalence and prognostic impact, assessed as mortality, of QTc-prolongation in COPD, restrictive spirometric pattern (RSP), and normal lung function (NLF), respectively.

Methods: All individuals (n = 993) with COPD and age- and sex-matched non-obstructive referents were identified from well-defined population-based cohorts examined in Northern Sweden in 2002–04. In 2005, the study-sample was invited to re-examination including ECG; QTc was calculated and mortality data collected until 31st December 2010.

Results: The prevalence of QTc-prolongation was higher among people with RSP than among those with NLF and, although similar in NLF and COPD, the prevalence increased by COPD-severity. Among participants with COPD, those with QTc prolongation had higher mortality than those with normal QTc, while no such differences were found among participants with NLF or RSP.

Conclusion: Among participants with COPD, the prevalence of QTc-prolongation increased by disease-severity and was associated with mortality.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Epidemiology, Comorbidity, Cardiology, Electrocardiogram, Pulmonary disease, Chronic obstructive
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-158114 (URN)10.1016/j.hrtlng.2018.09.015 (DOI)000462808300013 ()30391074 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-04-12Bibliographically approved
Hedman, L., Backman, H., Stridsman, C., Bosson, J. A., Lundbäck, M., Lindberg, A., . . . Ekerljung, L. (2018). Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms. JAMA NETWORK OPEN, 1(3), Article ID e180789.
Open this publication in new window or tab >>Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms
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2018 (English)In: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 1, no 3, article id e180789Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. OBJECTIVES To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23 753 participated (response rate, 50.1%). MAIN OUTCOMES AND MEASURES Electronic cigarette use, smoking habits, and respiratory symptoms. RESULTS Of 30 272 participants (16 325 women [53.9%]). 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%). 30 to 39 years; 5082 (16.8%). 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371(14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%). and e-cigarette use was more common among men (275 of 12 347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14 022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers. 350 of 3566 (9.8%; 95% CI, 8.8%10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15 832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P < .001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n = 525). 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P < .001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI. 1.12-1.62); age groups 20 to 29 years (OR. 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44). and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR. 2.37; 95% CI, 1.73-3.24); and current smoking (OR. 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.

Place, publisher, year, edition, pages
American Medical Association, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology Substance Abuse
Identifiers
urn:nbn:se:umu:diva-154863 (URN)10.1001/jamanetworkopen.2018.0789 (DOI)000452641400010 ()
Available from: 2019-01-03 Created: 2019-01-03 Last updated: 2019-01-03Bibliographically approved
Näsman, A., Irewall, T., Hållmarker, U., Lindberg, A. & Stenfors, N. (2018). Asthma and Asthma Medication Are Common among Recreational Athletes Participating in Endurance Sport Competitions. Canadian Respiratory Journal, 2018, Article ID 3238546.
Open this publication in new window or tab >>Asthma and Asthma Medication Are Common among Recreational Athletes Participating in Endurance Sport Competitions
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2018 (English)In: Canadian Respiratory Journal, ISSN 1198-2241, Vol. 2018, article id 3238546Article in journal (Refereed) Published
Abstract [en]

Background: Asthma prevalence is high among elite endurance athletes, but little is known about its prevalence among competitive recreational athletes. The aim of this study was to determine the prevalence of self-reported asthma and asthma medication use among competitive recreational endurance athletes and their association with training.

Methods: A web survey on asthma and medication was conducted among 38,603 adult participants of three Swedish endurance competitions (cross-country running, cross-country skiing, and swimming).

Results: The overall response rate was 29%. The prevalence of self-reported asthma (physician-diagnosed asthma and use of asthma medication in the last 12 months) was 12%. Among those reporting asthma, 23% used inhaled corticosteroids and long-acting beta-agonists daily. We found no association between training volume and daily use of asthma medication, except a trend in relation to short-acting beta-agonists. Independent predictors of self-reported asthma were female sex, allergic rhinitis, previous eczema, family history of asthma, cycling, and training for >5 h 50 min/week.

Conclusions: The prevalence of self-reported asthma among Swedish competitive recreational endurance athletes appears to be higher than that in the general Swedish population. A large proportion of recreational athletes were reported with asthma use medications, indicating an association between high physical activity and self-reported asthma among competitive recreational athletes.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-151199 (URN)10.1155/2018/3238546 (DOI)000437172400001 ()30034562 (PubMedID)
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2019-05-20Bibliographically approved
Persson, H., Lindberg, A. & Stenfors, N. (2018). Asthma Control and Asthma Medication Use among Swedish Elite Endurance Athletes. Canadian Respiratory Journal, Article ID 4646852.
Open this publication in new window or tab >>Asthma Control and Asthma Medication Use among Swedish Elite Endurance Athletes
2018 (English)In: Canadian Respiratory Journal, ISSN 1198-2241, article id 4646852Article in journal (Refereed) Published
Abstract [en]

Background. Asthma is common in elite athletes. In this study, we examined the use of asthma medication and asthma control in endurance athletes in Sweden and compared the findings with those in a reference group of patients with asthma. Methods. The Asthma Control Test (ACT) and a questionnaire on asthma, respiratory symptoms, and medication use were posted to endurance athletes (n = 711) and the reference group of patients with asthma (n = 1026). Four hundred and sixty-nine athletes (66%) responded, of whom 141 (20%) reported physician-diagnosed asthma. In the reference group, 397 (39%) responded. Results. Seventy-seven percent of the athletes with asthma reported using asthma medication during the previous year; 39% used short/long-acting β2-agonists, 31% used inhaled corticosteroids, and 31% used both daily. According to the ACT scores, 19%, 24%, and 58% of athletes with asthma had uncontrolled, partially controlled, or well-controlled asthma, respectively. After adjustment, there was no difference in ACT scores or daily use of asthma medication between the study groups. Conclusions. Many endurance athletes had uncontrolled or partially controlled asthma, and one-third used inhaled corticosteroids and long-acting β2-agonists daily. Their adjusted ACT scores and use of asthma medication were similar to the values in the reference population.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-147373 (URN)10.1155/2018/4646852 (DOI)000429429500001 ()
Available from: 2018-05-03 Created: 2018-05-03 Last updated: 2018-06-09Bibliographically approved
Schyllert, C., Andersson, M., Lindberg, A., Rönmark, E. & Hedman, L. (2018). Childhood asthma affects job and education in young adults. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Childhood asthma affects job and education in young adults
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Asthma is associated with socioeconomic status, affects daily life, and school attendance among adolescents. Rhinitis affect job choices, but it is unclear whether asthma in childhood and adolescence affects socioeconomic status (SES) with regard to occupation and education in early adulthood.

Method: In 1996, all children aged 7-8 years (y) in three municipalities in northern Sweden were invited to a parental questionnaire survey, and 97% participated. The cohort was followed up, and 2017 individuals (59% of the original cohort) participated at 7-8, 11-12, 19 and 27-28y. Current asthma was defined as physician diagnosis of asthma with wheeze or use of asthma medication during the last 12 months. Asthma groups: “early-onset, in remission” (asthma at 7-8 or 11-12 y but not at 19y), “early-onset, persistent” (asthma at 7-8 or 11-12 y and at 19 y) and “late-onset” (no asthma at 7-8 or 11-12 y but asthma at 19 y). In multinomial regression analyses adjusted for sex, BMI, smoking habits and family history of asthma, the association between asthma and SES (level of education and occupation) at age 27-28y were analyzed by using never asthma as reference.

Results: Subjects with early-onset persistent asthma had an increased risk of not reaching higher education than primary school (OR 3.54, 95%CI 1.17-10.74), or finishing university studies less than 3 years long (OR 2.05, 95%CI 1.05-4.01) compared with non-asthmatics. They also avoid occupations in the socioeconomic status group of non-manual employees, intermediate level with occupations such as clerks, assistant nurses, police officers, musicians, foremen etc, (OR 0.41 95%CI 0.17-0.99).

Conclusion: Persistent asthma since childhood affected length of education and job choice in early adulthood.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-155986 (URN)10.1183/13993003.congress-2018.OA298 (DOI)000455567100194 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: OA298

Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Backman, H., Jansson, S.-A., Stridsman, C., Muellerova, H., Wurst, K., Hedman, L., . . . Rönmark, E. (2018). Chronic airway obstruction in a population-based adult asthma cohort: Prevalence, incidence and prognostic factors. Respiratory Medicine, 138, 115-122
Open this publication in new window or tab >>Chronic airway obstruction in a population-based adult asthma cohort: Prevalence, incidence and prognostic factors
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2018 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 138, p. 115-122Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Asthma and COPD may overlap (ACO) but information about incidence and risk factors are lacking. This study aimed to estimate prevalence, incidence and risk factors of chronic airway obstruction (CAO) in a population-based adult asthma cohort.

METHODS: /FVC<0.7.

RESULTS: decline and higher levels of neutrophils than asthma only. Smoking, older age and male sex were independently associated with increased risk for both prevalent and incident CAO, while obesity had a protective effect.

CONCLUSIONS: In this prospective adult asthma cohort, the majority did not develop CAO. Smoking, older age and male sex were risk factors for prevalent and incident CAO, similar to risk factors described for COPD in the general population.

Place, publisher, year, edition, pages
W.B. Saunders Ltd, 2018
Keywords
ACO, Asthma, Epidemiology, Longitudinal study, Risk factors
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-147915 (URN)10.1016/j.rmed.2018.03.036 (DOI)000432442400017 ()29724382 (PubMedID)2-s2.0-85045212522 (Scopus ID)
Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-06-27Bibliographically approved
Eriksson Ström, J., Pourazar, J., Linder, R., Blomberg, A., Lindberg, A., Bucht, A. & Behndig, A. F. (2018). Cytotoxic lymphocytes in COPD airways: increased NK cells associated with disease, iNKT and NKT-like cells with current smoking. Respiratory Research, 19, Article ID 244.
Open this publication in new window or tab >>Cytotoxic lymphocytes in COPD airways: increased NK cells associated with disease, iNKT and NKT-like cells with current smoking
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2018 (English)In: Respiratory Research, ISSN 1465-9921, E-ISSN 1465-993X, Vol. 19, article id 244Article in journal (Refereed) Published
Abstract [en]

Background: Cytotoxic lymphocytes are increased in the airways of COPD patients. Whether this increase is driven primarily by the disease or by smoking is not clear, nor whether it correlates with the rate of decline in lung function.

Methods: Bronchoscopy with BAL was performed in 52 subjects recruited from the longitudinal OLIN COPD study according to pre-determined criteria; 12 with COPD and a rapid decline in lung function (loss of FEV1 ≥ 60 ml/year), 10 with COPD and a non-rapid decline in lung function (loss of FEV1 ≤ 30 ml/year), 15 current and ex-smokers and 15 non-smokers with normal lung function. BAL lymphocyte subsets were determined using flow cytometry.

Results: In BAL fluid, the proportions of NK, iNKT and NKT-like cells all increased with pack-years. Within the COPD group, NK cells – but not iNKT or NKT-like cells – were significantly elevated also in subjects that had quit smoking. In contrast, current smoking was associated with a marked increase in iNKT and NKT-like cells but not in NK cells. Rate of lung function decline did not significantly affect any of the results.

Conclusions: In summary, increased proportions of NK cells in BAL fluid were associated with COPD; iNKT and NKT-like cells with current smoking but not with COPD. Interestingly, NK cell percentages did not normalize in COPD subjects that had quit smoking, indicating that these cells might play a role in the continued disease progression seen in COPD even after smoking cessation.

Trial registration: Clinicaltrials.gov identifier NCT02729220.

Place, publisher, year, edition, pages
BMC, 2018
Keywords
Chronic obstructive pulmonary disease, Disease mechanisms, Lung function decline, Smoking habits, Bronchoalveolar lavage
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-154873 (URN)10.1186/s12931-018-0940-7 (DOI)000452747200001 ()30526599 (PubMedID)2-s2.0-85058092775 (Scopus ID)
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-01-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3292-7471

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