A study of 1,718 Chinese children, ages 8 to 15, from a rural community, whose mothers had never smoked, showed that youngsters whose fathers smoked had small but detectable deficits in two basic lung function tests. The researchers checked 860 girls and 858 boys in a community along the Yangtze River. Of those tested, 1,374 had fathers who smoked and 344 had fathers who never smoked. No other sources of indoor or outdoor air pollution existed in the rural community. When the children were divided into two groups by fathers’ rate of cigarette consumption, those children of men with the higher level of smoking (over 30 cigarettes a day)had the largest deficits in the two lung function tests. Moreover, when the data was further examined, nonasthmatic girls showed the greatest deficits in their lung tests. (All data for the children was adjusted by age, sex, weight, height, asthma, and father’s educational level.) The investigators believe the negative impact of paternal smoking had its effect on childhood lung growth rather than on airflow obstruction. Since paternal smoking did not modify the functional relationship between age and height, they believe the observed decreases in pulmonary function represented a lung-specific effect rather than a broader problem related to overall bodily growth. The research appears in the second of two September issues of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.
Prenatal nicotine exposure in monkey newborns produces effects like those seen in human infants
Prenatal nicotine exposure in pregnant rhesus monkeys produces changes in the lung mechanics of their newborns that are strikingly similar to those reported in human offspring whose mothers smoked during pregnancy. Scientists infused 7 pregnant rhesus monkeys with nicotine and 7 control monkeys with a saline solution. They used a special infusion pump implanted in the mother to infuse the solutions from day 26 to day 160 of the timed pregnancies. Although term for the rhesus monkeys is 165 days, the infants were delivered at day 160 by Caesarian section. The researchers found that lung development in the prenatal nicotine-exposed infants was significantly impaired. They also found that their lung function test results were reduced when measured shortly after birth. The investigators note that previous clinical research suggests, for women who smoke during pregnancy, nicotine crosses the placenta to interact with nicotine receptors in the developing lungs of the fetus to cause changes in lung structure and, subsequently, to influence the offsprings’ lung function. They believe their results in monkeys are strikingly similar to changes seen in babies of smoking mothers. The research appears in the second of two September issues of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.
Combination inhaler therapy for uncontrolled moderate to severe asthma
In a “Pulmonary Perspective” article published in the second issue for September of the ATS peer-reviewed American Journal of Respiratory and Critical Care Medicine, two experts discuss how a long-acting inhaled beta2-agonist can be combined with an inhaled glucocorticosteroid to better control moderate to severe asthma. Since asthma is an inflammatory disorder of the airways, proper treatment attempts to restore airway size, which can ensure easier breathing. Over 10 million Americans are affected by asthma. Long-acting beta2-agonists are bronchodilators that act mainly on beta2-adrenergic receptors found primarily in lung cells. According to the authors, several studies have shown that monotherapy with beta2-agonists, either short- or long-acting, is clinically inferior to inhaled glucocorticosteroid (ICS) as a maintenance therapy for persistent asthma. However, a substantial proportion of patients with more severe disease are insufficiently controlled with a low to moderate dose of ICS. Rather than increasing the dose, which might induce side effects in the patient, the authors suggest adding a beta2-agonist as part of a dual formulation therapy in a single inhaler. This drug combo can offer a rapid and pronounced beneficial effect on symptoms and baseline lung function for many patients.
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Journal
American Journal of Respiratory and Critical Care Medicine