Resumen de El consumo de tabaco empeora la inflamación nasal y la calidad de vida en pacientes con rinitis alérgica
- español
Se ha descripto que la exposición al humo de tabaco genera un aumento de parámetros de atopía y de síntomas de rinitis. Pero también se reportó que los síntomas nasales y la calidad de vida en pacientes fumadores con RA no eran significativamente distintos. Ante esta dualidad, se propuso evaluar calidad de vida y parámetros inflamatorios de atopía, entre pacientes con RA fumadores activos y no fumadores.
Material y Métodos: Estudio de corte transversal en pacientes adultos voluntarios de ambos sexos, fumadores y no fumadores con RA, confirmada por Prick test, y con valoración funcional respiratoria por espirometría. Se confirmó la condición de fumador activo y no fumador con mediciones de cotinina en saliva. Se compararon los niveles de afectación de calidad de vida entre grupos con cuestionario Mini RQLQ. Se evaluaron marcadores inmunológicos en suero y en lavados nasales (IgE, IL 4, IL 5, IL 13, IL 17, IL 33). Se incorporó un tercer grupo para análisis séricos, con una muestra de fumadores pasivos. La evaluación estadística incluyó Test T de Student y Mann Whitney U (más Anova 2 vías). Para evaluación de 3 grupos, se utilizó Kruskal Wallis (Dunn´s post test). Se consideró significativo a P <0.05. Resultados: Se estudiaron 22 pacientes por grupo, edad media 37.3 años (fumadores) y 30.4 (no fumadores) sin diferencia significativa, como tampoco en sexo y sensibilidad a alérgenos. Se encontraron diferencias estadísticamente significativas en los niveles de cotinina salival (P<0.0001) y función pulmonar en VEF1 % (P=0.0447) y EF1/FVC % (P=0.0172). En las evaluaciones de interleucinas se obtuvieron resultados francamente representativos con IgE e IL 33 en suero y lavado nasal, y con IL 13 en suero e IL 17 en lavado nasal. El único parámetro estadísticamente significativo correspondió a IL 33 en suero (P<0.001), mostrando una notable tendencia en lavado nasal. No hubo diferencias significativas en los parámetros de calidad de vida.
Conclusiones: Los pacientes con RA que fuman activamente no demuestran un empeoramiento, tanto en su calidad de vida como en los parámetros inflamatorios atópicos en general, respecto de los no fumadores. Esta similitud podría explicarse por la evidencia de una señal de alarma reducida (IL 33), lo cual se traduce en consecuencias nocivas, tal como la función pulmonar disminuida demostrada en este trabajo, y su inexorable progresión en caso de mantener el consumo de tabaco
- English
It has been described that exposure to tobacco smoke causes increased parameters of atopy and rhinitis symptoms. But it was also reported that nasal symptoms and quality of life in smokers with Allergic Rhinitis (AR) were not significantly different. Given this duality, it was proposed to evaluate quality of life and inflammatory parameters of atopy among active smokers and nonsmokers having AR.
Material and methods:
Cross-sectional study in adult volunteers of both sexes, smokers and nonsmokers with AR confirmed by Prick test, and functional respiratory evaluation by spirometry. Status of active smoking and non-smoking was confirmed by salivary cotinine measurements. Levels of quality of life between groups were compared using Mini-RQLQ questionnaire. Immunological markers in serum and nasal washes (IgE, IL-4, IL 5, IL 13, IL 17, IL 33) were evaluated, and a third group was incorporated, with a sample of passive smoking for serum analysis. The statistical analysis included Student T test and Mann Whitney U (Anova 2-way). For evaluation of 3 groups, Kruskal Wallis (Dunn's post test) was used. Values of P<0.05 were considered significant. Results: Twenty two patients per group, mean age 37.3 years (smokers) and 30.4 (nonsmoking) were studied, with no significant difference, neither in age or sex, nor in sensitivity to allergens. Statistically significant differences in salivary cotinine levels (P <0.0001) and lung function FEV1% (P = 0.0447) and FEV1 / FVC% (P = 0.0172) were found. Regarding evaluations of interleukins, frankly representative results were obtained with IgE and IL 33 in serum and nasal lavage, serum IL 13 and IL 17 in nasal lavage. The only statistically significant parameter corresponded to IL 33 in serum (P <0.001), showing a notable trend in nasal lavage. There were no significant differences in the quality of life parameters. Conclusions: Active smokers AR patients do not show a worsening in both their quality of life and atopic inflammatory parameters, compared to non-smokers. This similarity could be explained by the evidence of a reduced signal alarm (IL 33), which results in harmful consequences, such as decreased lung function demonstrated in this work, and its inexorable progression if they maintain the consumption of tobacco.
Keywords: It has been described that exposure to tobacco smoke causes increased parameters of atopy and rhinitis symptoms. But it was also reported that nasal symptoms and quality of life in smokers with Allergic Rhinitis (AR) were not significantly different. Given this duality, it was proposed to evaluate quality of life and inflammatory parameters of atopy among active smokers and nonsmokers having AR.
Material and methods:
Cross-sectional study in adult volunteers of both sexes, smokers and nonsmokers with AR confirmed by Prick test, and functional respiratory evaluation by spirometry. Status of active smoking and non-smoking was confirmed by salivary cotinine measurements. Levels of quality of life between groups were compared using Mini-RQLQ questionnaire. Immunological markers in serum and nasal washes (IgE, IL-4, IL 5, IL 13, IL 17, IL 33) were evaluated, and a third group was incorporated, with a sample of passive smoking for serum analysis. The statistical analysis included Student T test and Mann Whitney U (Anova 2-way). For evaluation of 3 groups, Kruskal Wallis (Dunn's post test) was used. Values of P<0.05 were considered significant. Results: Twenty two patients per group, mean age 37.3 years (smokers) and 30.4 (nonsmoking) were studied, with no significant difference, neither in age or sex, nor in sensitivity to allergens. Statistically significant differences in salivary cotinine levels (P <0.0001) and lung function FEV1% (P = 0.0447) and FEV1 / FVC% (P= 0.0172) were found.
Regarding evaluations of interleukins, frankly representative results were obtained with IgE and IL 33 in serum and nasal lavage, serum IL 13 and IL 17 in nasal lavage. The only statistically significant parameter corresponded to IL 33 in serum (P <0.001), showing a notable trend in nasal lavage. There were no significant differences in the quality of life parameters.
Conclusions:
Active smokers AR patients do not show a worsening in both their quality of life and atopic inflammatory parameters, compared to non-smokers. This similarity could be explained by the evidence of a reduced signal alarm (IL 33), which results in harmful consequences, such as decreased lung function demonstrated in this work, and its inexorable progression if they maintain the consumption of tobacco.
