Review Article
Asthma and Smoking: An Unfortunate Combination
Jesús Bellido Casado
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jbellido@santpau.es
Correspondence: Dr. J. Bellido Casado. Departamento de Neumología, Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
Correspondence: Dr. J. Bellido Casado. Departamento de Neumología, Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
Departamento de Neumología, Hospital de la Santa Creu i Sant Pau, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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"Departamento de Neumología, Hospital de la Santa Creu i Sant Pau, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Bellido Casado. Departamento de Neumología, Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-08-29" "fechaAceptado" => "2006-09-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154903" "palabras" => array:6 [ 0 => "Asthma" 1 => "Smoking" 2 => "Inflammation" 3 => "Eosinophils" 4 => "Neutrophils" 5 => "Prevention" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154902" "palabras" => array:6 [ 0 => "Asma" 1 => "Tabaco" 2 => "Inflamación" 3 => "Eosinófilos" 4 => "Neutrófilos" 5 => "Prevención" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Asthma is an inflammatory disease of the airways in which a key role is played by certain cells and mediators (T-helper 2 cells, mast cells, eosinophils, interleukin 4 and 5). In certain disorders, such as irritant-induced asthma, reactive airways dysfunction syndrome, and asthma due to toluene diisocyanate, inflammation is mediated predominantly by T-helper 1 cells, macrophages and neutrophils. Smoking also produces bronchial inflammation, in this case mediated primarily by macrophages and neutrophils although eosinophil predominance has also been observed in some smokers (an allergic response to certain antigens). The remodeling of the airway wall that accompanies the chronic inflammatory cascade may alter the cell response profile making it difficult to determine which type of inflammatory infiltrate is predominant. The association of asthma and smoking is a reality in our society, and it is a combination that substantially modifies pathogenic mechanisms and gives rise to a more severe clinical picture. Resistance to some of the pharmacotherapies used routinely in the treatment of asthma (corticosteroids) has also been observed and this has favored the use of other drugs (antileukotrienes). One of the preventative measures that should be used more energetically is to encourage patients to stop smoking, paying particular attention to asthmatic smokers.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El asma es una enfermedad inflamatoria de las vías aéreas en la que desempeñan un papel primordial determinadas células y mediadores (linfocitos T <span class="elsevierStyleItalic">helper</span> -2, mastocitos, eosinófilos, interleucinas-4 y 5). En algunas situaciones la inflamación predominante está mediada por linfocitos T <span class="elsevierStyleItalic">helper</span> -1, macrófagos y neutrófilos, como en el asma por irritantes, el síndrome de disfunción reactiva de las vías aéreas, el asma por diisocianato de tolueno (TDI), etc. Por otra parte, también el tabaco produce inflamación bronquial, fundamentalmente mediada por macrófagos y neutrófilos, aunque en algunos fumadores se observa también un predominio de eosinófilos (respuesta inmunoalérgica a determinados antígenos). El remodelado bronquial que acompaña a la cascada inflamatoria crónica puede modificar la respuesta celular y confundir sobre el predominio de uno u otro tipo de infiltrado inflamatorio. La asociación de asma y tabaco constituye una realidad en nuestro medio, a la vez que modifica sustancialmente los mecanismos patogénicos, produce una clínica más florida y se observa resistencia a ciertos tratamientos habituales en el asma (corticoides), lo que ha propiciado la utilización de otros fármacos (antileucotrienos). Una de las medidas preventivas que deben utilizarse con más energía es propiciar el abandono del hábito tabáquico, prestando especial atención a los asmáticos fumadores.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:56 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "en calidad de Comité Ejecutivo de la GEMA y en representación del grupo de redactores. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 2 | 7 |
| 2024 October | 25 | 19 | 44 |
| 2024 September | 29 | 13 | 42 |
| 2024 August | 45 | 39 | 84 |
| 2024 July | 25 | 26 | 51 |
| 2024 June | 24 | 23 | 47 |
| 2024 May | 36 | 23 | 59 |
| 2024 April | 14 | 22 | 36 |
| 2024 March | 22 | 15 | 37 |
| 2024 February | 20 | 20 | 40 |
| 2023 March | 4 | 3 | 7 |
| 2023 February | 15 | 14 | 29 |
| 2023 January | 18 | 29 | 47 |
| 2022 December | 19 | 34 | 53 |
| 2022 November | 18 | 15 | 33 |
| 2022 October | 18 | 31 | 49 |
| 2022 September | 14 | 19 | 33 |
| 2022 August | 21 | 37 | 58 |
| 2022 July | 21 | 47 | 68 |
| 2022 June | 15 | 29 | 44 |
| 2022 May | 21 | 30 | 51 |
| 2022 April | 12 | 26 | 38 |
| 2022 March | 19 | 33 | 52 |
| 2022 February | 25 | 33 | 58 |
| 2022 January | 14 | 35 | 49 |
| 2021 December | 19 | 43 | 62 |
| 2021 November | 20 | 34 | 54 |
| 2021 October | 18 | 39 | 57 |
| 2021 September | 18 | 57 | 75 |
| 2021 August | 10 | 41 | 51 |
| 2021 July | 15 | 29 | 44 |
| 2021 June | 8 | 31 | 39 |
| 2021 May | 14 | 23 | 37 |
| 2021 April | 27 | 59 | 86 |
| 2021 March | 23 | 17 | 40 |
| 2021 February | 42 | 20 | 62 |
| 2021 January | 29 | 18 | 47 |
| 2020 December | 23 | 15 | 38 |
| 2020 November | 14 | 4 | 18 |
| 2020 October | 10 | 6 | 16 |
| 2020 September | 5 | 2 | 7 |
| 2020 August | 5 | 7 | 12 |
| 2020 July | 15 | 10 | 25 |
| 2020 June | 16 | 10 | 26 |
| 2020 May | 13 | 7 | 20 |
| 2020 April | 12 | 15 | 27 |
| 2020 March | 14 | 8 | 22 |
| 2020 February | 18 | 12 | 30 |
| 2020 January | 11 | 8 | 19 |
| 2019 December | 16 | 9 | 25 |
| 2019 November | 5 | 6 | 11 |
| 2019 October | 5 | 5 | 10 |
| 2019 September | 7 | 18 | 25 |
| 2019 August | 8 | 10 | 18 |
| 2019 July | 7 | 16 | 23 |
| 2019 June | 7 | 12 | 19 |
| 2019 May | 17 | 20 | 37 |
| 2019 April | 43 | 14 | 57 |
| 2019 March | 11 | 14 | 25 |
| 2019 February | 10 | 8 | 18 |
| 2019 January | 10 | 3 | 13 |
| 2018 December | 9 | 8 | 17 |
| 2018 November | 12 | 6 | 18 |
| 2018 October | 38 | 13 | 51 |
| 2018 September | 12 | 7 | 19 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 3 | 5 | 8 |
| 2018 March | 3 | 4 | 7 |
| 2018 February | 5 | 9 | 14 |
| 2018 January | 2 | 9 | 11 |
| 2017 December | 3 | 6 | 9 |
| 2017 November | 5 | 7 | 12 |
| 2017 October | 7 | 11 | 18 |
| 2017 September | 6 | 8 | 14 |
| 2017 August | 4 | 30 | 34 |
| 2017 July | 6 | 7 | 13 |
| 2017 June | 5 | 11 | 16 |
| 2017 May | 6 | 11 | 17 |
| 2017 April | 3 | 5 | 8 |
| 2017 March | 7 | 13 | 20 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 3 | 0 | 3 |
| 2016 December | 7 | 5 | 12 |
| 2016 November | 17 | 4 | 21 |
| 2016 October | 11 | 5 | 16 |
| 2016 September | 9 | 6 | 15 |
| 2016 August | 10 | 3 | 13 |
| 2016 July | 4 | 2 | 6 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 1 | 0 | 1 |
| 2015 November | 2 | 0 | 2 |
| 2015 October | 67 | 12 | 79 |
| 2015 September | 53 | 7 | 60 |
| 2015 August | 29 | 4 | 33 |
| 2015 July | 73 | 9 | 82 |
| 2015 June | 29 | 6 | 35 |
| 2015 May | 60 | 9 | 69 |
| 2015 April | 36 | 6 | 42 |
| 2015 March | 40 | 9 | 49 |
| 2015 February | 33 | 4 | 37 |
| 2015 January | 24 | 7 | 31 |
| 2014 December | 33 | 5 | 38 |
| 2014 November | 34 | 7 | 41 |
| 2014 October | 42 | 7 | 49 |
| 2014 September | 27 | 4 | 31 |
| 2014 August | 38 | 11 | 49 |
| 2014 July | 38 | 8 | 46 |
| 2014 June | 54 | 12 | 66 |
| 2014 May | 41 | 10 | 51 |
| 2014 April | 62 | 5 | 67 |
| 2014 March | 78 | 7 | 85 |
| 2014 February | 48 | 9 | 57 |
| 2014 January | 42 | 10 | 52 |
| 2013 December | 48 | 8 | 56 |
| 2013 November | 39 | 3 | 42 |
| 2013 October | 47 | 12 | 59 |
| 2013 September | 50 | 8 | 58 |
| 2013 August | 61 | 19 | 80 |
| 2013 July | 61 | 13 | 74 |
| 2013 June | 37 | 10 | 47 |
| 2013 May | 35 | 7 | 42 |
| 2013 April | 28 | 6 | 34 |
| 2013 March | 10 | 2 | 12 |
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