Airway reactivity to mannitol is similarly increased in chronic cigarette and water pipe smokers

Abstract

BackgroundIn contrast to cigarette smoking, the association between water pipe smoking and airway hyperresponsiveness remains widely unexplored.MethodsA bronchoprovocation challenge with mannitol was performed in young adults recruited at the University of Basel, Switzerland. Subjects were categorized as acute water pipe smokers (single episode of water pipe smoking, no or <0.5 pack-years cigarette smoking); chronic water pipe smokers (weekly for ≥4 weeks, no or <0.5 pack-years cigarette smoking); cigarette smokers (no water pipe smokers); and never-smokers (no cigarette or water pipe smokers). Primary outcomes were airway reactivity as measured by the response-to-dose ratio (RDR) and airway responsiveness measured by the provocation dose to cause a 15% fall in forced expiratory volume in 1s (FEV1; PD15).ResultsSeventy-four subjects with a mean age of 22.5±2.5 years and FEV1 % predicted 90.1%±8.6% were included. Subgroups were matched in terms of age, gender, and spirometry results. RDR in chronic water pipe smokers and cigarette smokers was similar (0.013%/mg [0.010–0.015] vs 0.023%/mg [0.011–0.051], respectively; p=0.12) but significantly higher than in never-smokers (0.007%/mg [0.005–0.010], p<0.01). Neither a history of asthma (p=0.88) nor a positive skin prick test (p=0.69) was associated with increased airway reactivity to the mannitol challenge test. PD15 differed significantly between cigarette smokers and never-smokers (155 mg [115–395] vs 315 mg [155–475], respectively; p=0.04).ConclusionWeekly water pipe smoking may increase airway reactivity to a similar extent as cigarette smoking.

Waterpipe Smoke Exposure Triggers Lung Injury and Functional Decline in Mice: Protective Effect of Gum Arabic

“…A recent study in humans has reported that waterpipe smoking caused an increase in airway reactivity to mannitol to a similar extent as CS [4]. We have also provided experimental evidence that WPS in mice causes airway hyperresponsiveness to methacholine and that exercise training mitigates this effect [5, 6, 23].…”

“…Both short-term waterpipe smoking and long-term waterpipe smoking have been reported to cause alteration in pulmonary function [2, 3]. A recent study has demonstrated that weekly waterpipe smoking causes an increase in airway reactivity to mannitol to a similar extent as cigarette smoking (CS) [4]. Additionally, association between WPS and chronic obstructive pulmonary disease has been reported after adjusting for possible confounders such as age and CS [2, 3].…”

Comparative Study on Pulmonary Toxicity in Mice Induced by Exposure to Unflavoured and Apple- and Strawberry-Flavoured Tobacco Waterpipe Smoke

“…Clinical studies have demonstrated that WPS caused an augmentation of airway reactivity to mannitol and pulmonary inflammation [6]. It has also been reported that WPS inhalation in mice causes lung inflammation and increases airway hyperresponsiveness to methacholine [10,19].…”

“…In a recent systematic review, it has been reported that WPS was significantly associated with respiratory diseases, including chronic obstructive respiratory disease (odds ratio ðORÞ = 3:18, 95%confidence interval ðCIÞ = 1:25, 8.08), bronchitis (OR = 2:37, 95%CI = 1:49, 3.77), and passive WPS and wheeze (OR = 1:97, 95%CI = 1:28, 3.04) [5]. Moreover, clinical and experimental studies have shown that WPS inhalation increases airway reactivity, decreases lung function, and induces inflammation and oxidative stress [6][7][8]. Nevertheless, the possible impact of flavourings on the respiratory pathophysiological effects that induced WPS remains largely uninvestigated by both clinical and experimental studies.…”

Effect of smoking cessation on chronic waterpipe smoke inhalation-induced airway hyperresponsiveness, inflammation, and oxidative stress

“…It has been demonstrated that WPS induces deterioration of lung function, airway inflammation, and oxidative stress (3)(4)(5)(6)(7)(8). Recently, it has also been shown that WPS in humans increases airway reactivity similar to cigarette smoking (9). In addition, studies have reported significant correlations between WPS and chronic obstructive pulmonary disease (COPD) following the correction for potential confounders, for instance, cigarette smoking and age (8).…”