Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2018 Jun 9

PMID 29883409

Citations 251

Authors

Agnieszka Strzelak

Aleksandra Ratajczak

Aleksander Adamiec

Wojciech Feleszko

Affiliations

Soon will be listed here.

Abstract

Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS. We demonstrate how the imbalance between oxidants and antioxidants resulting from exposure to tobacco smoke leads to oxidative stress, increased mucosal inflammation, and increased expression of inflammatory cytokines (such as interleukin (IL)-8, IL-6 and tumor necrosis factor α ([TNF]-α). Direct cellular effects of ETS on epithelial cells results in increased permeability, mucus overproduction, impaired mucociliary clearance, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of macrophages and neutrophils and disturbed lymphocyte balance towards Th2. The plethora of presented phenomena fully justifies a restrictive policy aiming at limiting the domestic and public exposure to ETS.

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References

Vanker A, Gie R, Zar H . The association between environmental tobacco smoke exposure and childhood respiratory disease: a review. Expert Rev Respir Med. 2017; 11(8):661-673. PMC: 6176766. DOI: 10.1080/17476348.2017.1338949. View

Chalmers G, MacLeod K, Little S, Thomson L, McSharry C, Thomson N . Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax. 2002; 57(3):226-30. PMC: 1746270. DOI: 10.1136/thorax.57.3.226. View

Wang H, Peng W, Weng Y, Ying H, Li H, Xia D . Imbalance of Th17/Treg cells in mice with chronic cigarette smoke exposure. Int Immunopharmacol. 2012; 14(4):504-12. DOI: 10.1016/j.intimp.2012.09.011. View

de Jong K, Vonk J, Imboden M, Lahousse L, Hofman A, Brusselle G . Genes and pathways underlying susceptibility to impaired lung function in the context of environmental tobacco smoke exposure. Respir Res. 2017; 18(1):142. PMC: 5525356. DOI: 10.1186/s12931-017-0625-7. View

Simpson J, Gibson P, Yang I, Upham J, James A, Reynolds P . Impaired macrophage phagocytosis in non-eosinophilic asthma. Clin Exp Allergy. 2013; 43(1):29-35. DOI: 10.1111/j.1365-2222.2012.04075.x. View

Barnawi J, Jersmann H, Haberberger R, Hodge S, Meech R . Reduced DNA methylation of sphingosine-1 phosphate receptor 5 in alveolar macrophages in COPD: A potential link to failed efferocytosis. Respirology. 2016; 22(2):315-321. DOI: 10.1111/resp.12949. View

Smith L, Paszkiewicz G, Hutson A, Pauly J . Inflammatory response of lung macrophages and epithelial cells to tobacco smoke: a literature review of ex vivo investigations. Immunol Res. 2010; 46(1-3):94-126. DOI: 10.1007/s12026-009-8133-6. View

Biselli P, Lopes F, Moriya H, Rivero D, Toledo A, Saldiva P . Short-term exposure of mice to cigarette smoke and/or residual oil fly ash produces proximal airspace enlargements and airway epithelium remodeling. Braz J Med Biol Res. 2011; 44(5):460-8. DOI: 10.1590/S0100-879X2011007500040. View

Proulx L, Castonguay A, Bissonnette E . Cytokine production by alveolar macrophages is down regulated by the alpha-methylhydroxylation pathway of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Carcinogenesis. 2004; 25(6):997-1003. DOI: 10.1093/carcin/bgh103. View

10.

Nakamura Y, Miyata M, Ohba T, Ando T, Hatsushika K, Suenaga F . Cigarette smoke extract induces thymic stromal lymphopoietin expression, leading to T(H)2-type immune responses and airway inflammation. J Allergy Clin Immunol. 2008; 122(6):1208-14. DOI: 10.1016/j.jaci.2008.09.022. View

11.

Strachan D, Cook D . Health effects of passive smoking .5. Parental smoking and allergic sensitisation in children. Thorax. 1998; 53(2):117-23. PMC: 1758719. DOI: 10.1136/thx.53.2.117. View

12.

Forsslund H, Mikko M, Karimi R, Grunewald J, Wheelock A, Wahlstrom J . Distribution of T-cell subsets in BAL fluid of patients with mild to moderate COPD depends on current smoking status and not airway obstruction. Chest. 2013; 145(4):711-722. DOI: 10.1378/chest.13-0873. View

13.

Palmer V, Kassmeier M, Willcockson J, Akhter M, Cullen D, Swanson P . N-acetylcysteine increases the frequency of bone marrow pro-B/pre-B cells, but does not reverse cigarette smoking-induced loss of this subset. PLoS One. 2011; 6(9):e24804. PMC: 3174966. DOI: 10.1371/journal.pone.0024804. View

14.

Ni I, Ji C, Vij N . Second-hand cigarette smoke impairs bacterial phagocytosis in macrophages by modulating CFTR dependent lipid-rafts. PLoS One. 2015; 10(3):e0121200. PMC: 4368805. DOI: 10.1371/journal.pone.0121200. View

15.

Hellermann G, Nagy S, Kong X, Lockey R, Mohapatra S . Mechanism of cigarette smoke condensate-induced acute inflammatory response in human bronchial epithelial cells. Respir Res. 2002; 3:22. PMC: 150508. DOI: 10.1186/rr172. View

16.

Li Y, Langholz B, Salam M, Gilliland F . Maternal and grandmaternal smoking patterns are associated with early childhood asthma. Chest. 2005; 127(4):1232-41. DOI: 10.1378/chest.127.4.1232. View

17.

Gangl K, Reininger R, Bernhard D, Campana R, Pree I, Reisinger J . Cigarette smoke facilitates allergen penetration across respiratory epithelium. Allergy. 2009; 64(3):398-405. DOI: 10.1111/j.1398-9995.2008.01861.x. View

18.

Hodge S, Upham J, Pizzutto S, Petsky H, Yerkovich S, Baines K . Is Alveolar Macrophage Phagocytic Dysfunction in Children With Protracted Bacterial Bronchitis a Forerunner to Bronchiectasis?. Chest. 2016; 149(2):508-515. DOI: 10.1016/j.chest.2015.10.066. View

19.

Poltorak A, He X, Smirnova I, Liu M, Van Huffel C, Du X . Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: mutations in Tlr4 gene. Science. 1998; 282(5396):2085-8. DOI: 10.1126/science.282.5396.2085. View

20.

Hartigan-OConnor D, Hirao L, McCune J, Dandekar S . Th17 cells and regulatory T cells in elite control over HIV and SIV. Curr Opin HIV AIDS. 2011; 6(3):221-7. PMC: 4079838. DOI: 10.1097/COH.0b013e32834577b3. View