Background
Smoking influences the nature of airway inflammation in patients with bronchial
asthma though synthesis of certain cytokines. Patterns of bronchial asthma are
differentiated clinically, functionally, and regarding inflammatory biomarkers.
Aim
The research aimed to study the clinical, functional, sputum cytological differences,
and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking
status.
Patients and methods
The research was a cross-sectional study. The collection of cases began in August
2018 and ended in January 2020 at the Chest Department, Assiut University
Hospital. We studied 117 asthmatic patients who were classified regarding their
smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum
eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects
of smoking were analyzed on inflammatory cells including eosinophilic and
neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels.
Results
Smokers with asthma had worse clinical and functional outcomes. Asthmatic
smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher
in smokers compared with nonsmokers and former smokers. However, serum
periostin level was higher in nonsmokers compared with smokers and former
smokers. Serum eotaxin-2 had a positive correlation with smoking index and
eosinophilic and neutrophilic count in sputum, whereas serum periostin was
correlated negatively with smoking index and positively with eosinophilic count.
Conclusion
Asthmatic smokers had worse clinical and functional outcomes with increased
neutrophils in the sputum. The inflammatory biomarkers seen in smokers with
asthma showed low serum periostin and increased serum eotaxin-2 levels.