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Asthmatic smokers may be able to undo some of the damage to their lungs that exacerbates asthmatic symptoms just by putting down their cigarettes, according to report of the University of Groningen in the Netherlands. T

hey found that exposure to cigarette smoke appears to increase the thickness of the epithelium, or lining, of the airways in the lung.

This may be the underlying cause of the fact that smoking asthma patients experience more asthma symptoms, such as shortness of breath and phlegm production, compared to non-smoking asthma patients.

The team examined patients with asthma who were assessed each for the severity of their asthma and allergy, given questionnaires to determine the extent of their smoke-induced symptoms, and then underwent bronchial biopsies.

Of the total of 147 patients, 66 never smoked, 46 were ex-smokers and 35 were current smokers. In addition to the changes in the epithelial thickness, there was found distinct differences between the current smokers and the ex- and non-smokers. In addition to the epithelial thickening, we found that smoking negatively affects levels of exhaled nitric oxide, making it an unreliable indicator of asthma severity in smokers.

Current smokers also had more mucous-producing goblet cells in their epithelium and, the epithelial cell layer contained more mucus protein overall, when compared to never-smoking asthmatics. Smoking asthmatic patients also showed a distinct inflammatory profile in their lungs compared to never-smoking asthmatics, with a lower number of eosinophils and higher number of mast cells.

To determine the role of exposure length on asthmatic lungs, the scientists divided the ex-smokers into two groups: those with fewer than the median 3.4 pack-year exposure and those with more than 3.4 pack-years. Interestingly, while they expected to find evidence of a dose-response effect between smoking and epithelial remodeling, no such association was apparent between the number of pack-years or duration of smoking cessation and epithelial remodeling.

This study shows again how important quitting smoking is for pulmonary health, and this appears to be especially true for asthmatic patients. The good news is that quitting smoking appears to have a measurable benefit in these individuals.