Airborne Toxicants, Inflammation, and Immune Response in Asthma and COPD

Avatar photoVirginia A. Schad, PharmD, RPh
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Other important management strategies include avoiding triggers whenever possible, such as exposure to tobacco smoke and occupational and environmental irritants.7 Some patients may benefit from avoiding strong perfumes and other strongly scented products. Using a high-efficiency particulate air (HEPA) filter and a humidifier might be beneficial in some cases.7 Most patients require multifaceted interventions to optimize results.7 Some patients have been reported to benefit from nasal rinsing and irrigation with saline, particularly in the setting of postnasal drip.3,11 Nasal rinsing is recommended before use of any nasal medications so that the nasal lining is cleansed and topical medications are not rinsed away prematurely.3,11 If patients are found to have drug-induced NAR, they might require adjustments to their medication regimen. If relief of symptoms is not obtained after repeated interventions, surgical consultation might be warranted in some patients.3,11
Other important management strategies include avoiding triggers whenever possible, such as exposure to tobacco smoke and occupational and environmental irritants.7 Some patients may benefit from avoiding strong perfumes and other strongly scented products. Using a high-efficiency particulate air (HEPA) filter and a humidifier might be beneficial in some cases.7 Most patients require multifaceted interventions to optimize results.7 Some patients have been reported to benefit from nasal rinsing and irrigation with saline, particularly in the setting of postnasal drip.3,11 Nasal rinsing is recommended before use of any nasal medications so that the nasal lining is cleansed and topical medications are not rinsed away prematurely.3,11 If patients are found to have drug-induced NAR, they might require adjustments to their medication regimen. If relief of symptoms is not obtained after repeated interventions, surgical consultation might be warranted in some patients.3,11
Does pulmonary inflammation resulting from airborne toxicants trigger immune system activation in individuals with asthma and COPD?

The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.

Airborne toxicants, such as from cigarette smoke and exhaust gases, selectively increase inflammatory cytokine production in patients with asthma and chronic obstructive pulmonary disease (COPD), according to a study presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, February 25 to 28.

In the current study, researchers hypothesized that immune system activation may occur as a result of pulmonary inflammation in genetically predisposed patients who experience prolonged exposure to airborne toxicants. In order to test their theory, the researchers assessed levels of cytokines in supernatants after incubation of leukocytes from patients with COPD and asthma exposed to a solution of cigarette smoke, an extract of cigarette tobacco, and a solution of exhaust gases from an internal combustion engine.

The researchers found that cigarette smoke and the exhaust gases solution caused release of interleukin-1 beta (IL-1β) by leukocytes in patients with asthma and COPD, but not in healthy controls. In addition, an increased level of IL-1β occurred in patients with asthma, and the cigarette smoke solution increased tumor necrosis factor alpha (TNFα) in COPD patients. Exhaust gases increased transforming growth factor beta (TGFβ) in patients and increased levels of interferon gamma (IFNγ) in COPD patients, compared with the control group (P <.05). However, there were no statistically significant changes in the levels of IL-6, IL-2, IL-4, and IL-12, and interferon alpha (IFNα) that occurred with exposure of toxicants to leukocytes of COPD or asthma patients or healthy individuals in the control group.

The researchers concluded, “Airborne toxicants selectively increase inflammatory cytokine production in asthma and COPD patients.”

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Reference

Ishchanka A, Shchurok I, Semenova I, DuBuske L. Airborne toxicants induce pro-inflammatory cytokines in both patients with asthma and with COPD. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 039.

 

Visit Pulmonology Advisor’s conference section for complete coverage of the AAAAI 2022 Annual Meeting.

 

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